Pharmacy Foundations: Drug formulations & patient counseling Flashcards

1
Q

Reasons to use Long-acting oral tablets/capsules

A
  1. reduce nausea or provide longer duration action
  2. reduces peaks conc, leading to reduced side effects
  3. some can be opened and sprinkled onto food
  4. should not be crushed/chewed, can lead to OD
  5. Some can be cut on score line
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2
Q

Osmotic Controlled-Release Oral Delivery system

A

OROS

Water is absorbed via osmosis, increasing pressure in capsule forcing it out through a small opening.

Tablet/Capsule may be visible in patients stool

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3
Q

When are suspensions or solutions a good option

A
  1. useful in patients with difficulty swallowing or who are unable to follow directions.
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4
Q

Prior to admission, suspensions must be….

A

shaken to redisperse medication

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5
Q

Do solutions need to be shaken prior to administration….

A

No

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6
Q

When are chewable tablets a good option?

A

For children who cant swallow

or for calcium tablets for adults due to being too big

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7
Q

When are ODT a good option?

A

when patient cant swallow due to dysphagia or has nausea and unable to tolerate

also if adherence issues, dissolve quickly

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8
Q

Benefits of sublingual or buccal tablets

A

same benefits as ODT medications

faster onset of action than tablet or capsules that is swallowed.

Less drug lost to gut degradation and 1st pass metabolism

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9
Q

Benefits of granules, powders, or capsules that can be opened or sprinkled onto soft food…

A

Mostly used for pediatric and geriatric patients

can be given via NG tube rather than IV for certain patients

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10
Q

Which sweetener is dangerous for those with phenylketonuria (PKU)

A

Phenylalanine which is found in sweetener aspartame

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11
Q

ODT counseling

A

don’t push through foil backing as they’re easily broken/crumbled.

peel back foil of one blister and remove tablet

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12
Q

Oral film counseling

A

place on tongue and it will dissolve in seconds, ok to swallow with saliva and then wash hands after

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13
Q

Benefits of Subcutaneous (injections)

A

used for rapid effect or drugs that would degrade/not absorb if given orally

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14
Q

Benefits of long-acting intramuscular injections

A

Improve adherence and decrease need for more frequent injections

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15
Q

Benefits of Intravenous injections

A

Bypass oral route

fast response

avoids drug loss caused by Nausea/vomiting

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16
Q

5 Steps for injectable medication

A

1: wash hands
2: prepare injection
3: select and clean injection site
4. inject
5. discard appropriate stuff into sharps container

17
Q

Which injections should you not rub skin near injection site?

A

Anticoagulant medications as they can cause bruising

18
Q

Safe handling of Monoclonal Antibodies

A

should not be shaken and should be stored at normal temperatures and not extreme hot or cold.

19
Q

Patch administration sites

A

Upper chest
Upper or lower back
Upper arm, facing out
Flanks, sides of body abdomen level

20
Q

Patches with unusual application sites

A

Xulane: abdomen, back, arm or butt
Daytrana: Hip
Oxytrol: abdomen, hip or butt
Vivelle-Dot: lower abdomen or butt
Transderm-Scop: behind the ear

21
Q

Which patches can you cut?

A

Lidoderm and Qutenza

22
Q

Which patches need to be removed prior to having an MRI?

A

Clonidine (Catapres-TTS)
Rotigotine (Neupro)
Scopolamine (Transderm Scop)
Testosterone (Androderm)

23
Q

Can you cover patches with tape?

A

Most cannot be covered, some can be covered around the edges

Fentanyl & Buprenorphine (Butrans) require special film = Bioclusive & Tegaderm

24
Q

How to dispose of patches properly?

A

Press adhesive sides together and then dispose of it

More potent narcotic can be flushed

25
Q

Nasal sprays benefits

A

faster route of onset than oral and used for acute conditions that should be treated quickly

Bypass gut absorption and 1st-pass metabolism, proteins that would get destroyed in the gut can be given nasally

26
Q

Nasal Spray counseling

A

Before use:
1.Shake bottle gently, and remove cap
2.Prime pump before first use or when you have not used recently
3.Blow nose to clear nostrils

Using:
1.Close one nostril and insert into other nostril
2.Breathe in through nose, press firmly on applicator to release spray
3.Breathe out through mouth
4.Wipe applicator with tissues and replace cap.
5. Don’t blow nose right after using spray

27
Q

Can ear drops be used in the eyes?

A

No

Eye drops can be used as ear drops but ear drops cannot be used as eye drops

28
Q

Eye drop counseling

A
  1. Wash before and after use
  2. Shake few times, gels should be inverted and shaken once prior to use
  3. Bend neck back, pull down lower eye lid and release drop without letting tip touch eyes
  4. Close eye, place finger between eye/top of nose to keep medication in that area for at least 1 minute
  5. If doing second medication, need to wait at least 5-10min. Wait 10 min for gel
29
Q

Which preservative requires removal of contact lenses prior to administration and waiting atleast 15 minutes to put back lenses

A

Benzalkonium chloride (BAK)

30
Q

Ear Drop counseling

A
  1. If cold, gently shake and roll in hands to warm up
  2. Lie down or tilt affected ear up
  3. Pul earlobe up n back for adults, down and back for kids < 3
  4. Administer drops, keep ear facing up for about 5 minutes
31
Q

Rectal medication enema counseling

A

Best results, empty bowels immediately before use

1.Shake well before use
2. Best results, lying on the left side with left leg extended and right leg flexed forward for balance
3. Gently insert, pointed slightly towards navel.
4. Grasp firmly, tilt so nozzle faces back, squeeze slowly
5. Remain in position for at least 30 minutes or all night for max benefit

32
Q

Rectal suppositories counseling

A
  1. Do not handle too much so that it doesn’t melt
  2. Insert with pointed end first
  3. Best results, keep inserted for 1-3 hours
33
Q

General rule for missed medication dose counseling

A

if missed, take as soon as remember.
if close to next dose, skip missed dose and take next dose as scheduled
do not double up on two doses at same time unless discussed with healthcare provider

34
Q

Medication storage counseling

A

stored in a cool, dry place (not bathroom, avoid humidity)

35
Q

Adherence counseling and monitoring

A
  1. use motivational interviewing techniques
  2. perform refill history to look at adherence
  3. lack of adherence could be due to poor understanding or experiencing side effects
36
Q

What is motivational interviewing

A

technique that focuses on patients priorities to help facilitate change

ask open ended questions, use empathy and reserve judgements to build patient relationships

37
Q
A