25 Rodriguez, Jannie Belle P.

May 1, 2020
1I-PH
CHAPTER 12: SUPPOSITORIES, INSERTS, AND STICKS
1.
Vaginal Active Indication/s Contraindicatio Adverse effect/ Dosage
Insert Ingredient n/s precautions
Product
1. Estradiol Indicated for Do not use if When using IMVEXX
Imvexyy 4mcg/10m the treatment you: Imvexxy you may Y should
cg of mild to  have unusual have: be
extremely vaginal  headache administere
painful bleeding.  breast d
intercourse  currently tenderness or intravagina
after have or have pain lly:
menopause, a had certain  nausea and
symptom of cancers. vomiting 1 vaginal
changes in  currently insert daily
and around have or have for 2
the vagina had blood weeks,
due to clots. followed
menopause.  had a stroke by 1 insert
or heart twice
attack. weekly (for
 currently example,
have or have Monday
had liver and
problems. Thursday).
 have been
diagnosed
with a
bleeding
disorder.
 are allergic to
any of the
ingredients.
 think you
may be
pregnant.
2. Trimic Metronidaz Indicated for Do not use:  Abdominal Adults and
ole BP the treatment  in patients pain/cramp elderly
500mg of candidal hypersensitive  Vomiting (>65 years)
vulvovaginitis to  Diarrhea Usual
due to Metronidazole  Headache dose:
Candida , Miconazole Insert 1
 Miconazol albicans, in Nitrate or any  Dizziness vaginal
e Nitrate bacterial ingredients in  Vaginal suppository
BP 100mg vaginosis due this product. irritation at night
to anaerobic  First trimester  Rash and in the
bacteria and of pregnancy morning
Gardnerella  Patients with for 7 days
vaginalis, in severe liver or insert 1
trichomonal symptoms vaginal
vaginitis due  Patients with suppository
to nervous at night for
Trichomonas system 14 days.
vaginalis and diseases Vaginitis
in mixed  Patients with resistant
vaginal disturbances to other
infections. in treatments
hematopoiesis or
recurrent
vaginitis:
Insert 1
vaginal
suppository
at night
and in the
morning
for 14
days.
3. Ascorbic Indicated for Do not use  Vaginal itching One (1)
Prevegyn acid the treatment Prevegyne if: and burning vaginal
e (Vitamin of non-  You are  Vaginal tablet per
C) 250mg specific hypersensitiv discharge day.
vaginitis/bact e to ascorbic  Insomnia
erial acid (vitamin
vaginosis C) or to any
ingredient in
the
formulation.
 You are
pregnant or
breastfeedin
g.
4. Estradiol Treatment of Do not use in  Back pain 1 insert
Yuvafem 10mcg atrophic women with any  Diarrhea daily for 2
vaginitis due of the following  Headache weeks,
to menopause. conditions:  Abdominal followed
 Undiagnose pain by 1 insert
d abnormal twice
 genital weekly (for
bleeding example,
 Known, Tuesday
suspected, and
or history Friday).
of breast
cancer
 Active
arterial
thromboem
bolic
disease (e.g.
stroke, and
myocardial
infarction),
or a history
of these
conditions
 Known
liver
impairment
or disease
 Known or
suspected
pregnancy
5. Borax 14X, Used for the It has no known  Ask a doctor Adults and
Yeastaw Calendula treatment of interactions with before use if children
ay officinalis vaginal yeast other you have one 12 years
1X, infection. medications, and or more of and older:
Candida it is not the following: Insert one
Albicans contraindicated abdominal suppository
30X, with pre-existing pain, fever, high into
Hydrastis conditions. chills, nausea, the vagina
canadensis vomiting, every night
5X foul-smelling for 7
discharge, get consecutiv
vaginal yeast e nights.
infections Applicator
often (such as is included.
once a month
or three in 6 Children
months), may under 12
have been years of
exposed to age: Ask a
human doctor.
immunodefici
 ency virus
(HIV) that
causes AIDS,
or are under
12 years of
age.
 When using
this product,
do not use
tampons,
douches or
spermicides,
and do not
have vaginal
intercourse
(sex).
 If pregnant or
breast-
feeding, ask a
health
professional
before use.
6. Progestero ENDOMETR Do not use Common side Insert into
Endomet ne 100mg IN is for ENDOMETRIN effects include the vagina,
rin women who if you: abdominal pain, 2 or 3
need extra  Are allergic nausea, and times a
progesterone to anything in swollen ovaries. day, for up
while Endometrin Other reported to 10
undergoing  Have unusual side effects weeks, as
treatment in vaginal include abdominal your doctor
an Assisted bleeding that bloating, prescribes.
Reproductive has not been headache, urinary
Technology evaluated by infections, uterine
(ART) a doctor cramping,
program.  Currently constipation,
have or have vomiting,
had liver tiredness and
problems vaginal bleeding.
 Have or have Vaginal products
had blood with progesterone
clots in the may also cause
legs, lung, or vaginal irritation,
elsewhere in burning and
your body discharge.
2. Drugs whose physical-chemical characteristics make them a candidate for incorporation
into a suppository dosage form.
 Metoclopramide
 Chloroquine
 Aminophylline
 Aspirin
 Sodium Salicylate

3. List five clinical situations where the administration of a suppository or insert dosage
form might be preferred over oral administration.
a) The patient might have difficulty swallowing oral medicines.
b) The medicine to be administered might taste too bad when taken by mouth.
c) Enemas and suppositories might be used for the preparatory treatment of surgical
intervention and other procedures through evacuation of bowel where the patient
will have to self-administer.
d) To alleviate and treat hemorrhoids or anal pruritus (itching) – several medications
sooth the mucosa and alleviate serious anal condition symptoms.
e) To help alleviate constipation – a quick suppository medication, such as glycerin,
will soften the stools and aid in the excretion of the feces. This is mostly
recommended for infants who are constipated and are still unable to take oral
medications.

4. List five reasons a patient might be reluctant to use a suppository dosage form.
a) The patient might find it uncomfortable to use a suppository dosage form.
b) The patient does not trust his/her healthcare provider regarding the administration
of the suppository dosage form.
c) The healthcare provider might not have explained to the patient properly the
essence of administering drugs through suppository dosage form.
d) Lack of knowledge or background regarding the said dosage form.
e) The patient might feel that her privacy is being invaded in using suppository
dosage form.

5. List five counseling points for proper administration of specific rectal suppository or
vaginal insert.

How to use Imvexxy Insert, Dose pack

1) Wash and dry your hands before handling the insert.
2) Select the best position for vaginal insertion and is the most comfortable for you.
3) Hold the insert with the larger end between your fingers.
4) Place it about five inches into your vagina as directed.
5) Use this medication vaginally as prescribed by your doctor.
6. Oral administration is usually the route of choice in everyday pharmacotherapy practice.
In certain cases, however, this is impractical or even difficult (in uncooperative patients
and before surgery, during nausea and vomiting or convulsions,). In such cases, the rectal
route may provide a realistic alternative, and rectal administration is now well known to
provide, for example, anticonvulsants, non-narcotic and narcotic analgesics, theophylline,
antiemetics and antibacterial agents, and to induce anesthesia in infants. It can also be an
important alternative to intravenous or other injection routes of administration. However,
rectal route has its disadvantages which include interruption of absorption by defecation
and lack of patient acceptability. The sublingual and buccal administration routes are
useful when fast action with potent drugs is needed. Additionally, first-pass elimination is
avoided. Due to patient resistance, prolonged residence in the mouth will restrict
usefulness and this route is not convenient for long-term drug administration when using
conventional formulations.
25 Rodriguez, Jannie Belle P. May 1, 2020
1I-PH
CHAPTER 13: SOLUTIONS

1. Potassium Chloride oral solution

2. Advantages of purifying water with ion exchange method versus distillation method:
a) Ion exchange permits ease of operation over distillation method and is more
convenient to use.
b) It is less costly and would benefit those using it financially.

A. Methods used to increase the rate of solute dissolution in a solvent:

a) Stirring- this speeds up the rate of dissolution as stirring helps to distribute
the solute particles throughout the solvent. For example, when you add sugar
into a coffee, the sugar will dissolve faster when you stir it compared to when
you just let it be as it may only settle at the bottom.
b) Reducing the particle size- the smaller the particle, the greater is its surface
area which aids in the increasing contact between solute and solvent. For
example, using granulated sugar in a cup of coffee dissolves faster compared
to using sugar cubes.

3. Role of the Four Main Components of Syrup

a) Sugar – used to provide sweetness and viscosity to the syrup
b) Antimicrobial preservatives – it is used to protect the syrup against microbial
growth
c) Flavorants – renders the syrup pleasant tasting
d) Colorants – enhances the appeal or aesthetic of the syrup, a coloring agent that
correlates with the flavorant employed (i.e., brown for chocolate, red for
strawberry)

4. Methods in the Preparation of Syrups

Method Advantage/s Disadvantage/s

1. Solution with the Aid of
Heat
2. Solution by Agitation
Without the Aid of Heat
Quickest method Excessive heating will
cause inversion of sucrose
into glucose and fructose
which is sweeter and has an
increased tendency to
ferment
This is used for substance Time consuming as it is the
that are heat sensitive slowest method
 3. Addition of Sucrose to a
Medicated Liquid or to a
Flavored Liquid
4. Percolation
Simple Syrup prepared is not self-
preserving
Ease of adjusting final Needs a percolator
volume of product equipment

5. Non medicated elixirs are employed as vehicles. In selecting an appropriate vehicle, the
pharmacist should be aware and concerned of the solubility and stability of the drug
substance in water and alcohol. If a hydroalcoholic vehicle is selected, the proportion of
alcohol should only be slightly higher than the amount needed to maintain and effect the
solution of the drug. The pharmacist should also ensure that when diluting medicated
elixirs, the alcoholic concentration should be the same with his/her chosen diluent. And
lastly, all components of the medicated elixir as well as the nonmedicated elixir or diluent
should be chemically and physically compatible. This also applies with the flavor and
color characteristics of the diluent.

6. Aqueous solution utilizes water as solvent whereas non aqueous solution does not utilize
water as solvent. Both aqueous and non aqueous solutions are homogeneous mixtures of
its solute and solvent.

7. Factors that determine the appropriate method of drug extraction:

a) Nature of the crude drug
b) Adaptability of the crude drug to various extraction methods
c) Interest in obtaining complete or nearly complete extraction of the drug

8. The extent of the removal of the solvent determines the final physical character of the
extract. They can either be (a) semiliquid extracts or those of a syrupy consistency
prepared without the intention of removing all or even most of the menstruum, (b) pilular
or solid extracts of a plastic consistency with nearly all of the menstruum removed, and
(c) powdered extracts which are dry through the removal of all menstruum. The latter two
differ only slightly by the amount of remaining solvent. Each have their own advantage
due to its physical form. For instance, pilular extracts are preferred in compounding
ointments or pastes, whereas powdered form is preferred in the compounding of powders,
capsules, and tablets dosage forms.
25 Rodriguez, Jannie Belle P. May 1, 2020
1I-PH
CHAPTER 14: DISPERSE SYSTEMS
1. Features Desired in a Pharmaceutical Suspension:

a) A properly prepared pharmaceutical suspension should settle slowly and should

be readily redispersed upon gentle shaking of container. This benefit patient
administration by ensuring accurate measurement of dosage.
b) The particle size of the suspensoid should remain fairly constant throughout long
periods of undisturbed standing. This ensures the aesthetic and pleasing identity
of the suspension which encourages the patient specifically children to take their
dosage easily.
c) The suspension should pour readily and evenly from its container. This enables
convenient and efficient administration of drugs through its transfer from the
container to the spoon or medicine cup.

2. Suspending agents function by preventing the agglomeration of the finely divided

insoluble materials suspended in a liquid. It also imparts viscosity to the solution.

3. Common suspending agents include carboxymethylcellulose (CMC), methylcellulose,

xanthan gum, tragacanth, and bentonite. However, they have the same roles of producing
stable suspensions, reducing the settling of the suspended particles by increasing the
consistency of the suspended medium, and permitting easy redispersion of settled
particles.
Some drugs are not penetrated easily by the vehicle and have a tendency to clump
together or float. In this case, the powder must first be wetted to make it more penetrable
by the dispersion medium. We can also mix the wetting agents with the particles of the
powder by using a mill or a mortar and pestle. Once the powder is wetted, the dispersion
medium is added in portions and the mixture is thoroughly blended before subsequent
additions of vehicle.

4. The term “for Oral Suspension” is used for drugs that are unstable if maintained for
extended periods in the presence of aqueous vehicle which is why they are most
frequently supplied as dry powder mixtures for reconstitution at the time of dispensing,
whereas “Oral Suspension” refers to the prepared suspension not requiring reconstitution
at the same time of dispensing.
 Oral Suspension For Oral Suspension
Biogesic Cefaclor

Ibuprofen Cefixime

Livmox-clav Novamox

5. Advantages of emulsifying a liquid drug over pure liquid drug for oral administration
a) Higher stability
b) Suitability for hydrolytically susceptible drugs
c) Ease of manufacture or scale-up
6. Aggregation or flocculation is the aggregation of water droplets in an emulsion without
surface area modification. This happens when the water droplets undergo creaming or
rises to the top or bottom of the emulsion forming a concentrated layer of the internal
phase. Coalescence is the fusion of droplets with decreased total surface area to form
larger drops. This happens when there is a separation of the internal phase into a layer
which results to the breaking of the emulsion.