pharmaceutics exam 2 Flashcards

(74 cards)

1
Q

what is a capsule?

what is the active ingredient and where is it in reference to the capsule

what comes into play and where

A

“ A solid dosage form in which medicinal agents and inert substances (like excipients) are enclosed within a small shell of gelatin”

the active ingredient in powder surrounded by a capsule

excipient comes into play

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2
Q

what is made available when a patient is unable to swallow an intact solid dosage form like a capsule what can be given

A

chewable tablet, instant dissolving tablets, oral liquids, or suppositories are made available

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3
Q

capsules

Promote better patient compliance by being:

Capsules as such may not be filled
with liquids
what may the liquids be mixed with

A
  • Solid dosage forms
  • Medication is protected
  • Easier storage and transport

Promote better patient compliance by being:
- Tasteless
- Easy to dose
- Capsules of specific designs provide
modified release

  • Capsules as such may not be filled
    with liquids

Capsules containing liquids must be sealed (requires industrial conditions)
The liquid may be mixed with an inert absorbent. The resultant solid mixture may be placed in capsules

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4
Q

Capsule forms

what is it filled with

what is its mold?

what are empty capsules often used for

what different sizes does it come in/what is the size from largest to smallest

is it usually concealed or open

A

Liquid-filled gelatin capsule

Capsule mold

Gelatin capsule- Empty capsule often used for
Extemporaneous compounding
of prescriptions

  • come in different sizes (000 large, 5 small)
  • usually concealed
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5
Q

what device do you use to ensure the correct filling of capsules?

what are the components of process?

A

use a torbial torsian balance

with this, you have an empty capsule on one side and another capsule of the same kind on the other side with the weight that you want the empty capsule to be in

let’s say that you have a 2g weight with the empty capsule on one and the empty capsule on the other side

the side with the 2g is heavier and you need to fill the empty capsule on the other side with 2g of substance in order to balance the scale

The formulation must be 2g otherwise It wouldn’t be accurate.

To compensate for the weight of the capsule being filled, the same capsule must be placed on the other side of the balance

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6
Q

How are capsules administered?

enteric coated
- what are they designed to do

extended released dosage forms
- what are they designed to do

what is the release of capsules based on

A

Enteric-coated:
– These are designed to
pass through the stomach
for drug release and
absorption in the intestine

Extended Release Dosage Forms:
These are designed to provide the release of the medication for an extended amount of time

what is the release of capsules based on - based on the coating outside of the capsule

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7
Q

Hard Gelatin Capsules

what is the empty capsule shell made of

how would you describe the capsule shell?

what description of capsules makes for higher patient compliance

A

Used to manufacture most of the
commercially available medicated capsules

Empty capsule shell made from:
–Gelatin, sugar and water
–They are clear, colorless, and essentially tasteless (want!)
–Most contain colorants & opaquants to make distinctive–for patient compliance

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8
Q

hard gelatin capsules Consist of two parts,

how is this dosage form intended to be used?

The content of capsules should be _______ in food or liquids only with the _______ of the _______

A

The base or body, which is longer and has a smaller diameter

The cap is designated to slide over the base portion and form a snug seal

This dosage form is intended to be swallowed whole.

The content of capsules should be opened and administered in food or liquids only with the concurrence of the pharmacist

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9
Q

Characteristics of Hard Gelatin Capsules

where is gelatin soluble

because gelatin is a protein, how is it digested?

what happens when gelatin is absorbed

how are most colored and made opaque, using what excipients

where does gelatin cycle through

A

Gelatin is soluble in hot water and in warm gastric fluids

Given that gelatin is a protein it is digested by proteolytic enzymes and absorbed

When gelatin dissolves it exposes its medicinal contents to the gastric (or intestinal) bodily fluids

Most are colored with FD&C and D&C dyes (colorants) and made opaque by adding titanium dioxide (opaquant).

gelatin cycles through the body

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10
Q

Where is the gelatin derived from to make capsules?

A

Gelatin is obtained by the partial hydrolysis of collagen obtained from
skin,
white connective tissue, and
bones of animals

While stable in air, gelatin is subject to microbial decomposition when moist–so needs preservative excipients

Hard capsules: contain between 13-16% moisture, but poor storage conditions can increase this level. Not good!

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11
Q

Avoid moisture in gelatin capsules, How?

what will moisture affect

what is used to protect against the absorption of atmospheric moisture

what are examples of dessicant materials

what must you leave inside

A

The moisture will affect hydroscopic agents (absorb moistrue from the air) in many capsules, therefore, small desiccant materials are used to protect against the absorption of atmospheric moisture.

Desiccant materials:
Dried silica gel, clay, and activated carbon

leave desiccant inside

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12
Q

Manufacturing hard gelatin capsule shells

capsule size

A

Capsule size: The sizes may vary but always determined by the amount of material to be incorporated

For human use: 000 (the largest) to 5 (the smallest) are commercially available.

There are 8 actual sizes [000,00,0,1,2,3,4 and 5]
Numerical designations are arbitrary and do not indicate the capsule’s capacity—000 is not the smallest but the largest
A pharmacist may compound capsules of a single medicinal agent, or combination of agents at the precise dosage prescribed for the patient

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13
Q

Developing the formulation
goal

what is the goal

what in what is important

lack in homogenity could result in what

what are ofetn used to produce the proper capsule fill volume and what are examples

A

Goal: Prepare a capsule with accurate dosage, good bioavailability, ease of filling and production, stability, and elegance.

Care in blending is important especially with low-dose drugs.

Lack of homogeneity could result in significant therapeutic consequences

Diluents or fillers are,
Often used to produce the proper capsule fill volume.
Offer bulk and cohesion
Examples:
Lactose, microcrystalline cellulose and starch

mixing only: glass mortar

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14
Q

Filling hard capsule shells

what method is used

what do you start with

what is placed on a sheet of paper

how to do the punch method

A

Pharmacists use “punch” method
Start with exact number of capsules to be filled

Powder to be encapsulated placed on sheet of paper, clean glass, or porcelain plate

Using a spatula powder is formed into a cake

Empty capsule body is held between the thumb and forefinger and “punched” vertically into the powder cake repeatedly until filled.

if making 10, make 11 to give room for error

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15
Q

Capsule sealing

what can capsules be sealed with

how can a capsule be sealed and what occurs during this

how many capsules can Industrial capsule sealing machines make

A

Capsules can be sealed with colored band of gelatin (KAPSEALS, Parker Davis)

Capsules can be sealed through a heat welding process that fuses the capsule cap to the body.

Industrial capsule sealing machines:
Can produce 60,000 to 150,000 gelatin banded, heat welded, or thermally coupled capsules per/hour

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16
Q

Cleaning and polishing capsules

A

Small amounts of powder may adhere to the outside of capsules after filling

Must remove before packaging and dispensing, wipe with clean gauze or cloth

On large scale cleaning, a vacuum can remove extraneous materials

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17
Q

Soft Gelatin Capsules

A

Pharmaceutically elegant and easily swallowed

Prepared to contain liquid, paste & dry fills

Liquids that can easily migrate through the capsule shell cannot be encapsulated into soft gelatin capsules.

When not to be used?:
When water content is > 5%
When low molecular weight water-soluble and organic compounds are employed such as,
alcohols, ketones, amines, and esters.

*Preservatives such as methylparaben and/or propylparaben used to retard microbial growth

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18
Q

Compendial requirements for capsules

A

Things added to preparations to facilitate their manufacture can only be used if,

Harmless (in the quantities used)
Do not exceed the minimum amounts required to provide their intended effect, if between 50mg or 10mg choose 10mg
Do not impair the bioavailability of the product
Do not interfere with assays to evaluate dosage form

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19
Q

Capsule within a capsule

A

The active ingredients can be separated from the other ingredients in a formulation.
In this case, you may fill a small capsule (i.e., No.5) with one powder, and then place that capsule along with the remaining ingredients inside a larger capsule.
The inside capsule should not be visible through the large capsule

used if contents will form eutectic mixtures if mixed so keep them separately so that it will not!

do not give if the internal capsule is seen if so, add powder on the walls of the cap. and put other cap inside

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20
Q

Tablet within a capsule

what can be placed in a capsule

A

Small commercially available tablets can be placed inside a capsule of a suitable size.

Small quantity of the additional powder should be deposited in the base before and after adding the tablet.

Similar to capsule inside capsule, tablet should not be visible through the filled capsule

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21
Q

Tablets

how often is it used in the commercial dosage form?

why is it liked so much

commercially available tablets can be made fast

how are tablets made

A

Most frequently prescribed commercial dosage form

Stable, elegant, and effective when made right

Commercially available tablets can be made at a rate of thousands per minute

Tablets are made primarily by compression with a limited number by molding

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22
Q

Tablets

size
grooved

A

Often vary in size,
shape, hardness, thickness
and in their ability to dissolve
In fluids.

These tablets are grooved

Are therefore intended
to be broken into two parts.

Why? Offers flexibility

Patients can swallow
them easily or use in divided
doses

they are scored so they can be broken and have some now or later

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23
Q

Definitions: types of tablets to know
Compressed tablets (C.T.):
Multiple compressed tablets (M.C.T.):
Sugar-coated tablets (S.C.T):
Film-coated tablets (F.C.T.):
Gelatin-coated tablets:
Enteric-coated tablets (E.C.T.):
Buccal or sublingual tablets:

A

Compressed tablets (C.T.):
Multiple compressed tablets (M.C.T.):
Sugar-coated tablets (S.C.T):
Film-coated tablets (F.C.T.):
Gelatin-coated tablets:
Enteric-coated tablets (E.C.T.):
Buccal or sublingual tablets:

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24
Q

Types of tablets continued

A

Instant Disintegrating/ Dissolving tablets
Extended Release Tablets (E.R.)
Vaginal Tablets:

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25
Compressed tablets (C.T.)
Diluents or Fillers: Add bulk to prepare a certain size Binder or Adhesives: Promote adhesion of the particles of the formulation Disintegrants: Promotes breakup of tablets/drug availability Antiadherents/ glidants/ or lubricating agents Miscellaneous Adjuncts: Colorants and flavorants to enhance overall appearance
26
Multiple Compressed Tablets (M.C.T) why stage at all
More than a single compression Produces multiple-layered tablets or a tablet within a tablet Each layer may contain diff. medicinal agents. Why? Separation may be required to avoid chemical and physical incompatibility Staged drug release The general appearance of the multiple-layered tablet core has an active ingredient/drug substance has a compressed layer also has an active drug why stage at all: extended released, drug bioavailable, MEC will differ if not staged
27
Sugarcoated tablets (S.C.T)
Compressed tablet can be covered with a colored or an uncolored sugar layer The coating is water-soluble The coating is quickly dissolved after swallowing The coating protects the enclosed drug from the environment The coating enhances the general appearance of tablets and permits imprinting of identifying manufacturer’s info. Disadvantages to sugarcoating tablets are, the time and expertise required in the coating process, and the increase in size, weight, and shipping costs. Maybe 50% larger and heavier than uncoated tablets (cause it's bigger) cannot be SCT and ECT, pick one!
28
Film-coated Tablets (F.C.T) what is it coated with and what is it like it is usually colored what makes it better than sugar coatings what is it designed to do
These compressed tablets are coated with a thin layer of a polymer capable of forming a skin-like film over the tablet Usually colored ( for patient compliance) More durable, less bulky, and less time-consuming to apply than sugar-coatings. Designed to rupture and expose the core tablet at the desired location within the gastrointestinal tract--absorption other than standard sites; more options all coated: what is the reason for coated
29
Gelatin-coated tablets what is its abbreviation? what does it look like what does it facilitate
GElCAP, Capsule-shaped compressed tablets Facilitates swallowing and compared to unsealed capsules, gelatin tablets are more tamper-evident
30
Enteric-coated tablets (E.C.T) Buccal and sublingual what is the shape? what is the intent/where does it need to be dissolved? what is this an alternative for what are buccal tablets designed for what are SL tablets designed for what does buccal and sublingual mean what do these two drugs protect from
ECT: Have delayed release characteristics * Designed to pass unchanged through stomach intestines where the tablets disintegrate and allow drug dissolution. * Mainly used when by-passing the stomach to improve drug absorption These are flat, oval tablets intended to be dissolved in the buccal pouch, or beneath the tongue through absorption through the oral mucosa An alternative for drugs that are poorly absorbed from the G.I. Tract Buccal tablets are designed to erode slowly Sublingual tablets designed to provide rapid-release Buccal: In the direction of the cheek Sublingual: Below or beneath the tongue protect drugs that are sensitive to gastric pH
31
Buccal drug delivery must it remain in place? what can be said about its taste? and why what should the drug not do to the teeth buccal: sublingual:
The dosage form must remain in place Total area of absorption is low compared to other routes- 100 to 170 cm2 Taste must be bland, or not acceptable for use must also be a non-irritant Drugs should not discolor or erode teeth buccal: cheek sublingual: below the tongue
32
Sublingual
Lining of the epithelium is keratinized for buccal and sublingual, but the epithelium for sublingual is thinner. What does this tell us about drug absorption?-so drugs absorb faster for SL than buccal layer that dosage form comes into contact with
33
Chewable Tablets what base does it have and what is it colored with what happens when it. is chewed or allowed to dissolve who is it ideal for when is it best used why drink water after?
Have a creamy base usually of specially flavored and colored mannitol Rapid disintegration when chewed or allowed to dissolve in mouth Ideally suited for children and adults who have difficulty swallowing solid dosage forms. use if difficulty to swallow make sure active drug not get in teeth- so drink water
34
Molded Tablets (M.T.) how may Tablet triturates (TT) be prepared what is the appearance like what is usually its diluent what is it designed for what can pharmacists insert inside to provide what what else can they add what should color match
Tablet triturates (TT) may be prepared by compression and by molding. In terms of appearance very soft and soluble Diluent: Lactose and Sucrose usually Designed for rapid dissolution Pharmacists may insert TT inside a capsule or dissolve it in liquids to provide accurate amounts of potent drugs. add color and flavorant red color should not taste like chocolate orange. should not taste be like mint
35
Vaginal Tablets
Also called vaginal inserts Uncoated and bullet or ovoid-shaped tablets Inserted in vagina for localized effects --Antibacterials for the treatment of Vaginitis caused by Hemophilus vaginalis or --Antifungal for treatment of vulvo vaginitis candidiasis caused by Candida albicans and related species not for systemic effects (like headache or neck pain)
36
the effect of density on gastric distribution what does the absence of food effect
light objects float on gastric contents (food) if there is food/food is heavy heavy objects fall to the base of greater curvature The absence of food affects the med. will be made available --based on the meal
37
physiological pharmaceutics meal makes a difference in what on an empty stomach, what happens faster to ensure, and what does it result in food has an impact on what after breakfast, snack, lunch, snack, dinner:
meal makes a difference to when the med is absorbed on an empty stomach: there is faster gastric emptying of the stomach and the drug will be absorbed faster food has an impact on disintegrating tablet after breakfast, snack, lunch, snack, dinner: gastric emptying takes a lot and the drug is not absorbed as fast
38
the effect of time of day on the route of gastric emptying 8am vs 8pm
8 am: less time it takes for gastric emptying to occur, there are fewer solids that remain in the stomach so gastric emptying is faster, and thus drug absorption is faster 8 pm: The more time it takes for gastric emptying to occur, there are more solids remain the stomach so gastric emptying is slow and thus drug absorption is slower
39
which of the following is used to improve flow properties of powder mic colloidal silica acacia bentonite A & B A, B & C
colloidal silica
40
Ointments, Creams, and Gels
“Ointments, creams and gels are semisolid dosage forms intended for topical application” Unmedicated ointments: ---Protectants (covers layer of skin, P), emollients (flexible & pliable, E), lubricants (where there is a lot friction, L) Local or systemic absorption: --Dermatologic applications treat the skin Application sites include, ---Skin, nose, surface of eye, vagina or rectum
41
Ointment Bases
As classified by USP Oleaginous bases = more fatty at top and more watery as you go down Absorption bases- mostly fatty but has a little more water than oleaginous which has no water Water-removable bases- water can remove it Water-soluble bases = more water and more fatty as you go down, water can remove it oleaginous: at the top is oleaginous, as you go down, fat decreases 100% oleaginous cannot be hydrophilic too
42
Oleaginous (hydrocarbon) bases
Application: skin use Have an emollient effect, protecting against moisture escape Effective occlusive dressings One application for an extended period without drying out It does not wash off easily --Petrolatum, USP --White Petrolatum, USP --Yellow Ointment, USP --White Ointment, USP (see textbook)
43
Petrolatum, USP
Purified mixture of semisolid hydrocarbons obtained from petrolatum. Color ranges from yellowish to amber ----Melts at 38oC to 60oC because body temp. is 37*C Used alone or in combination with other agents as an ointment base Known as yellow petrolatum and petroleum jelly ---Vaseline (Chesbrough-Ponds).
44
Petrolatum, USP
vaseline, which is yellow in color amber
45
White Petrolatum, USP
Decolorized purified mixture of semisolid hydrocarbons from petroleum Lighter color compared to yellow petrolatum- Pharmacists prefer this variety White petrolatum (White Petroleum Jelly) Commercial product ---White vaseline (Chesebrough-Ponds) --Product is all the way to the top so the cover is very close --This product implies: it looks like this and is solid from top to bottom, but there could be less in there. But you could have more because we can get rid of air pockets. All depends on the drug product
46
Yellow Ointment, USP is it prepared
Purified wax derived from the honeycomb of bee Apis mellifera. How prepared? -Melt yellow wax in a water bath (adding petrolatum until uniform mixture) -Cool and stir -The viscosity of yellow ointment is greater than plain petrolatum- viscosity is the reason why we have variety and why we want it to be a part of the product
47
Absorption Bases Why are absorption bases not easily washed from the skin’s surface???
Type I: permit the incorporation of aqueous solutions, producing water-in-oil (w/o) emulsions (e.g., hydrophilic petrolatum*) Type II: water-in-oil (w/o) that permits additional aqueous solutions (e.g., lanolin). Useful for incorporating small amounts of aqueous solutions into hydrocarbon bases. How? ---By incorporating aqueous solution into the absorption base, and then incorporating the mixture into the hydrocarbon base. Why are absorption bases not easily washed from the skin’s surface??? Because the oil absorbs onto the skin
48
Absorption bases (continued)
Lanolin, USP -Obtained from sheep wool -Cleaned, deodorized (otherwise it would smell) and decolorized -No more than 0.25% water– do not need too much water -Additional water may be added by mixing
49
Water-Removal Bases
These are oil-in-water (O/W) emulsions that closely resemble creams. May be diluted with water (aqueous phase) May absorb serous discharges -Why are they referred to as water-washable bases? -E.g., Hydrophilic Ointment, USP
50
Water-Removable Bases (continued)
Hydrophilic Ointment, USP (NOT OLEAGINOUS) Ingredient Amount (grams) Methylparaben 0.25 Propylparaben 0.15 Sodium lauryl sulfate 10.00 Propylene glycol 120.00 Stearyl alcohol 250.00 White petrolatum 250.00 Purified water 370.00
51
Water-Soluble Bases
Water-soluble bases do not contain oleaginous components (aka~ greaseless) Soften with the addition of water, will compromise dosage form, no need to add more water Large amounts of aqueous solutions are not effectively incorporated in these bases Normally used for the incorporation of solid substances Polyethylene Glycol Ointment, NF PEG 3350 400g PEG 400 600g PEG <600 Clear, colorless PEG >600 ,<1000 Semisolid PEG 1000 Wax-like
52
How is a base selected?
What should a Pharmacist consider? Desired release rate of drug from the ointment base? Desirability of topical or percutaneous drug absorption Stability of drug in the ointment base Effect (if any) the drug might have on characteristics of ointment base Desire for a base to be easily removed with water Characteristics of the surface to which the base is applied The base providing the best combination of most desired attributes should be used Good to know Creams, applied to weeping or oozing surfaces Lotions, usually applied to where friction may occur (under arm pits, thighs) Ointments, applied to dry and scaly skin surfaces
53
Preparation of ointments (Incorporation of Solids)
Mix component until uniform mixture Mortar and pestle Spatula and ointment slab or parchment paper Incorporation of solids Use stainless steel spatula except when ingredients react with the stainless steel material (i.e., iodine). A Rubber spatula can replace stainless steel in this case – 2 options: Thorough rubbing and working of the components together on solid surface until smooth and make preparation uniform. Now separate freshly prepared base from the fine powder components used in the previous mixing step. Add small amount of each together and mix until uniform. Continue until all powder and base are combined and uniformly blended. Levigation is often used to reduce powder particle size to reduce grittiness prior to incorporation of the solid material into the base. For the selection of levigating agents. Levigating agents should be physically and chemically compatible with drug and base. Mineral oil is used for when oil is the external phase, Glycerin is used when water is the external phase.
54
Preparation of ointments (Incorporation of liquids)
For incorporation of liquids…consider the capacity of ointment base Note difference between oleaginous –vs- hydrophilic ointment How to incorporate liquids into hydrophobic base? Add solution to minimum amount of hydrophilic base, and then Add this freshly prepared mixture to the hydrophobic base. Small volumes of alcoholic solutions can be added to oleaginous vehicles or emulsions with ease. For example, Natural balsams (i.e Peru balsams)
55
Preparation of ointments (Fusion method)
By this method, “all or some of the components of an ointment are combined by being melted together and cooled with constant stirring until congealed” Main methods of fusion: Heat-sensitive or volatile components are added when the temperature of mixture is low enough not to cause decomposition or volatilization. In general, components having the highest melting points are heated to the lowest required temperature to produce a melt. Think of temp. Two Alternative methods: Melt the component with the lowest melting point first, followed by the addition of the remaining components in order of their melting points. 2) Melt all components simultaneously, increasing the temperature only as needed
56
Compendial Requirements
Microbial content- Topical applications are not required to be sterile, but antimicrobial action is a must. Why? Water content is an issue. Staphylococcus aureus often found in dermatologic preparations USP chapter titled, “Microbiological Attributes of Non-sterile Pharmaceutical Products,” Deals with environmental control and application of good manufacturing practices to minimize both the type and the number of microorganisms in unsterilized pharmaceutical products. USP states certain products should be tested routinely, these are: Rectal, Urethral, or Vaginal Due to the presence of Yeast and Molds at the site of application
57
General information for packaging semisolid preparations
Topical dermatologic preparations- packaged in either jars, tubes or syringes Ophthalmic, nasal, vaginal and rectal preparations- ---packaged in tubes or syringes
58
Packaging, Storage and Labeling
Large mouth containers or metal or plastic tubes Store in cool place in sealed containers Opaque or light sensitive containers used when necessary Labels (for ointments, creams) include type of base (water soluble, water insoluble)
59
Creams
“Semisolid preparations containing one or more drug agents dissolved or dispersed in W/O or O/W emulsion or another water-washable base.” Used topically, rectally and vaginally ---Generally when creams evaporate a thin residue film consisting of stearic acid (or other oleaginous components) is left behind. Preferred over ointments by patients and pharmacists since they are easily removed --Still, both options are generally made available.
60
What makes each of the following different from the rest? ointments Creams Gels Pastes Plasters Glycerogelatins
Creams Gels Pastes Plasters Glycerogelatins
61
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Gels
“Semisolid systems consisting of dispersions of small or large molecules in an aqueous liquid, rendered jellylike by the addition of a gelling agent.” Gelling agent- Carbomers (high MW, water-soluble polymers) ---Can be prepared to be used with various routes, including skin, eye, nose, vagina and rectum The polymeric composition of Carbomers determines their viscosity. NF contains monographs of 6, they are 910, 934, 934P, 940*, 941 and 1342. Used as gelling agents at 0.5% to 2.0% in water * 940 has the highest viscosity Gels = Jellies Carbomer: of the 5 circles, that they do not come together and aggregate, if they do then there will have inconsistent dosing of the drug Should always be the same, little circles do not come together and do not aggregate Cannot make a gel without a carbomer; must have a gelling agent 940* has the highest viscosity Do not need much of it 0.5% vs 2.0% which one Is the most valuable if they both do the same job: want 0.5% is the minimum dose to do the job, ideally you do not want to add anything
63
Pastes
“Semisolid preparations intended for application to skin. They contain more solid material compared to ointments (~25%).This makes them a little stiffer.” -Used to absorb serous secretions, remaining in place after application. A portion of base is softened prior to incorporating the solids. -A portion of the base is used rather than a liquid because the liquid will soften the base.
64
Plasters
“Solid or semisolid adhesive masses spread on the backing of paper, fabric, moleskin or plastic.” -Adhesive tape- Adhesive plaster are used Provide prolonged contact at the site. --Unmedicated variety: provide protection or mechanical support at the application site --Medicated variety: Concentration of salicylic acid used in commercial plasters (range from 10-40%) for the treatment of corns of feet.
65
Examples of other plaster products
hansaplast corn removal plaster
66
Glycerogelatins
Plastic masses consisting of the following, gelatin 15% glycerin 40% water 35% medicinal substance 10% (i.e., zinc oxide) Melted and cooled to just above body temperature before being applied to affected area. Fine brush is used to apply the material, and is generally covered with bandage after hardening Applied to skin for long-term. Currently, zinc gelatin is used to treat varicose ulcers (aka~ Zing gelatin boot).
67
General Features
Features and use of, Ophthalmic Ointments and Gels Nasal Preparations Dermatologic Preparations
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Ophthalmic Ointments
Major route of drug transport in the eye is by simple diffusion via the cornea If not efficient, secondary routes are conjunctiva and sclera. Three layered structure of cornea Lipophilic epithelial layer Hydrophilic stromal layer Less Lipophilic endothelial layer on inside (inner layer) USP sterility tests Special considerations required- steam sterilization is ineffective because cannot penetrate the ointment base. Dry heat can sterilize but too harsh. So end stage sterilization is not commonly practiced. -----Instead, aseptic techniques are used when each component is added, including weighing of the ingredients. Approved antimicrobial preservatives include, Methylparaben, (0.05%) Propylparaben, (0.01%) Benzalkonium chloride, (0.008%) All very small
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Nasal Ointments
For nasal delivery ointments and gels are used. Nasal passage is lined with thin layer of mucus produced by epithelial mucus glands. -Ciliated epithelium assists with mucus movement -Local effects is the primary treatment approach (i.e., nasal decongestants). -Vascular region of the nasal passage does enable general circulation, so systemic absorption does occur. -Can be used to deliver insulin, vaccines, polypeptides & proteins. Delivered drugs to brain Can use for local and systemic
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Dermatologic preparations
Drug should both penetrate and be retained in the skin for a specified period Factors affecting drug penetration include, -Physicochemical properties of the drug -Characteristics of the vehicle -Concentration of drug in the vehicle -Oil-water partition coefficient (PC) -And general condition of the skin The skin (like in transdermal delivery systems- TDDS) acts as a natural barrier controlling the rate and extent to which drugs can penetrate it. However, unlike with TDDS, the therapeutic drug concentration delivered by a dermatologic preparation is not known. So, more qualitative measures are used. Transdermal system vs ointment: ointment can retain drug substance; skin layer, temp. PC all affects how drug passes through the skin Productt + the skin Skin acts as barrier Rate limitng: where absorption is the slowest
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how to use derm. preps
For general use, The patient must thoroughly clean the affected area with soap and water Dry the area with clean soft cloth Thin layer of medication is applied to skin area, and spread evenly. Typically 1 to 3 mg of ointment or cream is applied per square centimeter of skin – thin layer Area of application should remain uncovered unless otherwise stated Clean hands immediately following use
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What should a Pharmacist say to a patient?
Instruct patient of proper method of administration Explain the frequency and duration of use Any special warnings, ---For e.g., how should it be used during pregnancy? Therapeutic goals and outcomes Signs of an adverse response, and what to do if something goes wrong When should treatment be discontinued?
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Patient Counseling Points For all Ointments, Creams, Gels
Only a thin film should be applied Unless otherwise instructed, remove a sufficient quantity from container, apply it, and gently rub into the affected area Use a protective pad to protect area from being removed from the clothing Use of lotions and creams should be avoided Do not rub eyes or touch mouth during handling of application If patient exhibits sensitivity or intolerance contact pharmacist or physician
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