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Lecture 3 Pharmaceutics
Lecture 3 Pharmaceutics
.Pharmaceutics
1
:Drug Dosage forms .1
A. Sustained release forms :
*Definition: intended to reduce dosing frequency while maintaining relatively consistent
.blood levels of the drug
.Advantages: 1. Improved patient compliance*
.Use less total drug. 3. Fewer local or systemic S.E .2
Less fluctuation in drug level [i.e. avoid toxicity due to high conc. or .4
.].lack of efficacy due to low conc
:Characteristics of drugs intended for formulation into Sustained release drug formula *
?Have high therapeutic index → WHY .1
.Because if any failure of the system→ NO toxicity
.Drugs with t1/2 2- 8 hrs so by sustained release allow once or twice daily dosing .2
?If t1/2<2hrs→can't be made S.R →WHY*
.Because we require high drug conc. & high drug release rate which isn't applicable
.If t1/2 > 8 hrs → no need for sustained release drug formula *
Small total mgs of the drug e.g. if drug is taken 500 mg x 3 times daily so it is .3
.impossible to make S.R d.f containing 1500 mg
.For ttt of chronic conditions .4
:Classification of S.R d.fs*
Coated beads or .1 To make the granules or beads: soln of drug substance in non- aqueous solvent . 1
:granules [e.g. alcohol] → converted to beads or granules by combination with sugar &
.e.g. Spansules .starch
.N.B. If the drug dose is large→ granules may be composed of drug itself alone
. Coating: *Some of granules are left uncoated to provide immediate drug release . 2
Coats of lipid material e.g. beeswax or cellulose material e.g. ethyl cellulose are *
applied to remaining granules→ some granules receive few coats & some receive
.many→ various coat thickness→ S.R effect
Micro- .2 Definition: The process by which solids, liquids or gases are encased in → *
:encapsulation .microscopic capsules
.By two methods: a) Coacervation. b) Film-forming substance *
Encapsulated dissolution: Drug particles are microencapsulated & mixture of *
.particles is placed in D.F e.g. Micro K: microencapsulated KCl→ (adv. as slow K)
:Matrix -tablets .3 .Drug + Matrix material→ compression into tablet *
The primary dose or portion of the drug to be released immediately is placed on *
.the tablet as a layer; the rest of dose is slowly released from the matrix
.Matrix dissolution: drug compressed in tablets with slowly soluble polymer *
.N.B. Slow K tabs: KCl embedded in wax matrix
.Advantages over liquid KCl: 1) Tasteless
.Minimize high local conc. of K+ ion near GIT )2
.Lower incidence of small bowel ulceration )3
Nifedipine tablets: AI in plastic matrix→ slow diffusion of AI→ empty tab *
.appears in the stool
Osmotic system: .4 .Composed of tablet core with semi -permeable coat *
e.g. or os system .Drug release doesn't depend on pH but depends only on osmotic pressure *
Ion exchange .5 Drug +resin→ resin-Drug complex→ release due to changes in GIT pH [release is
:resin .greater in highly acidic stomach than in less acidic small intestine
Complex .6 .By chemical reaction*
:formation Release depends on GIT pH*
2
B. Suppositories:
:*Types
:Rectal .1 .weight→2g*
.e.g. 1) Aspirin & Acetaminophen→ ttt of fever
.Chloral hydrate→ ttt of insomnia )2
.Ergotamine→ for migraine )3
.Prochlorperazine→ anti-emetic )4
.Promethazine→ antihistamine )5
.Aminophylline→ ttt of asthma )6
.N.B.1) There's no suppositories in the market for epilepsy
.Phenazopyridine→ UT anesthetic available only as oral D.F )2
:Vaginal .2 Weight → 5g*
e.g. 1) Contraceptive→ contain nonoxynol-9 which is spermicidal
.Benzethonium chloride→ reduce odor producing M.Os )2
.Antifungals→ azoles )3
?N.B. Lactose is usually used as diluents in vaginal tabs→ WHY
.Water soluble 2. Inert .1
.Encounters the growth of doderlein's bacilli in vagina .3
:Urethral .3 .60mm long & 5mm diameter*
.e.g. 1.Anti-infective agents
Alprostadil or PGE1→ For ttt of erectile dysfunction [only 6mm long & 1.5mm .2
.diameter so called microsuppository]
: Preparation of suppositories *
.a) Hand rolling: for cocoa butter
.b) Compression
.c) Fusion in a mold: *For commercial production
.For all bases*
:N.B. This method should be used carefully for
.Thermolabile drugs .1
Insoluble powders→ because in the melt they may settle or float during pouring .2
.depending on their densities → Non uniform drug distribution
3
:Suppository bases *
a. Bases that . Cocoa butter [theobroma oil]:→ fat soluble mixture of TGs . 1
:melt at body temperature :Characteristics*
.Good base for rectal but not vaginal or urethral suppositories .1
.Solid up to temperature of 320C .2
.At 34-35 0C→ it melts .3
During preparation by Fusion method→ it shows polymorphism .4
.[more than one crystalline form] → disadv
N.B. Some drugs affect melting point of cocoa butter e.g. Chloral hydrate
lowers its M.P
Witepsol . 2
. Wecobee No polymorphism . 3
Fattibase . 4
:N.B. 1. For these oily bases
a) If an oil soluble drug is incorporated → it tends to remain in suppository oil
.pool
b) Water soluble drug→ passes rapidly from oily phase to aqueous phase [adv]
?but how to mix the aqueous drug with oily base
.By Emulsifiers e.g. glycerol monostearate & propylene glycol monostearate
:b. Bases that dissolve .Also called water-miscible bases *
.For vaginal & rectal suppositories*
.e.g. 1) Glycerinated gelatin
."Different molecular weight polyethylene glycol [PEG] "Carbowax )2
Glycerinated gelatin & Carbowax should be moistened with water before
.insertion
.N.B. PEG forms complex with many drugs affect release & absorption
? Q) Most commercial vaginal suppository use PEG base→ WHY
.Water miscible .1
.Easy to insert .2
.Doesn't require refrigeration .3
4
: C. Powders
Milling: is the mechanical process of reducing particle size of solids→ *
[Comminution]
:Comminution techniques*
:a. Trituration .The substance is reduced to small particles by rubbing in a mortar with pestle
b. Pulverization by Reducing particle size by using 2nd agent that can be readily removed by *
:intervention .pulverization
.Used for Gummy substances that resist grinding*
.e.g. Camphor→ is reduced by intervention of alcohol
:c. Levigation The particle size of substance is reduced by adding non-solvent [levigating *
agent] to form a paste→ the paste is then rubbed in a mortar & pestle or using
.ointment slab & spatula
.Suitable for ointment & suspension*
.e.g. of levigating agent: Mineral oil
:Mixing powders*
:a. Spatulation .By spatula on a sheet of paper*
.Useful for: 1. Mixing small amounts of powders*
Eutectic mixtures: mixtures that melt at a lower temperature than any of .2
.their ingredients→ Why? → bec. Spatulation → very little compression
e.g. of substances that form eutectic mixtures: [Phenol- Camphor- menthol-Thymol-
.phenyl Salicylate & phenacetin]
:N.B. To diminish contact between agents which tend to form eutectic mixtures
.Use inert diluents e.g. Light Mg oxide, Mg carbonate, Kaolin & starch .1
.Silicic acid prevents eutexia with aspirin & phenyl Salicylate .2
:b. Trituration .Simple mixing of two or more powders in the mortar
c. Geometric ?Used when potent substances must be mixed with large amount of diluents→ HOW *
:dilution Potent drug + equal amount of diluents in mortar → mix by Trituration → second
portion of diluents equal to volume of powder mix in mortar is added→
.Trituration…….& so on
:d. Sifting →نخلFluffy product
:e. Trumbling .Mixing powders in large container rotated by motorized process [Industry]
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: Important Definitions **
D. Tablets :
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*They are manufactured by:
1. Dry granulation
2. Wet granulation
3. Direct compression.
*Tablet Excipients:
1. Diluents: *used to make up the required bulk of the tablet.
*Common diluents: [starch- mannitol- lactose- dicalcium phosphate-Kaolin &
microcrystalline cellulose].
N.B. Calcium salts can't be used as fillers for tetracycline products→ WHY?
2. Binders & *They are added in either dry or liquid form to promote granulation & promote
Adhesives: cohesive compacts during direct compression.
e.g. 1) 10-20% aqueous solution of glucose. 2) Gelatin. 3) Povidone.
4) 25-50% solution of glucose. 5) Cellulose derivatives.
6) Natural gums e.g. Acacia→ disadvantages:
a)contaminated with bacteria. b)Variable in composition.
N.B. Acacia & Gelatin are SAAs.
3. Disintegrants. *they facilitate disintegration when tablet contacts water in GIT.
M.O.A: Draw water into tablet→ swell → tablet burst.
e.g.1. Corn starch & potato starch. 2. Cation exchange resins.
3. Cellulose derivatives. 4. Clays e.g. veegum & bentonite.
4. Lubricant, a. Lubricant: e.g. Talc, Mg stearate & Ca stearate.
Anti-adherents *Improve flow properties of granules.
& Glidants: *Reduce adhesion to dies & punches.
[overlapping *Reduce punch & die wear.
function] *Facilitate tablet ejection from the die
b. Glidants: promote the flow of tablet granulation or powder into a die for compression
by reducing friction among particles.
e.g. Potato or Corn starch.
c. Antiadherents: reduce sticking or adhesion of tablet granules or powders to the faces
of punches or die walls.
5. Sweeteners: *For chewable tabs & tabs intended to dissolve in mouth.
*May come from the diluents [Lactose-Mannitol].
e.g. 1)Saccharin: unpleasant bitter after taste [200x more sweet than sucrose].
*Tablet types:
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1. Enteric coated tabs: *They remain intact in stomach but release ingredients in intestine.
e.g. KCl→ enteric coated→ why?
a) Protect stomach from irritation.
b) Avoid drug decomposition in the stomach.
N.B. 1. Enteric coated tabs shouldn't be taken within 1 hour of ingestion of milk or
antacids→ WHY? → To avoid premature dissolution of the coat.
*Agents used to coat enteric coated tabs:
1-Shellac 2- Cellulose acetate phethalate.
2. Sugar coated: *Steps of coating: a) Seal coating [water proof].
b) Subcoating: e.g. water insoluble shellac.
c) Syrup coating: for smoothing & coloring.
d) Polishing: e.g. Carnauba wax & beeswax.
3. Film-coated tabs: *By alcohol solution of cellulosic polymers & zein.
Notes: 1) Enteric, sugar & film-coated tabs→ mask bitter taste of drugs.
2) Sugar & film coated tabs→ release contents in the stomach.
3) Advantages to manufacturer for using film coated when compared to sugar coating:
a) Less gross weight: sugar coated tabs may be 50% larger than original tabs while film coated tabs
only 2-3% larger.
b) Shorter production time [sugar coat→ many steps].
c) Lower incidence in coat shipping.
4) Wurster process: It is a technique of tablet coating in which:
1)Column of air in which granules & powders suspended.
2) Spray with coating solution.
3) Drying by rotation of solids & introduction of hot air.
*Processing problems:
A. Capping & Lamination: *Capping→ is partial or complete separation of top or bottom crown from
due to entrapment of air main body of the tablet.
during processing. *Reasons: 1. too dry granulation.
2. Excessive fine powders.
3. Excessive pressure of compression.
4. Insufficient binder.
*Lamination→ separation of the tablet into two or more layers.
B. Picking & Sticking: due *Picking→ small pinholes on the surface of tabs.
to excessive moisture or *Reasons: 1. too damp granulation.
inclusion of substances 2. Static charges on powders.
with low melting 3. Scratch punches.
temperatures in the 4. Insufficient lubricants.
formulae *Sticking→ adhesion of tablet material to die wall.
C. Mottling: *Unequal color distribution.
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2. Hardness testers.
3. Friabilators: determine friability by allowing the tablet to roll & fall within a rotating
tumbling apparatus.
a. Tablets are weighed before & after special number of rotations & weight loss is
determined.
b. Resistance to weight loss indicated the ability of the tablet to withstand abrasion
during handling, packing & shipping.
c. Compressed tabs lose 0.5-1% weight→ acceptable.
d. Some chewable tabs & most effervescent tabs are tightly friable & require unit
packaging زانتاك فوار
4. Weight.
5. Content uniformity.
6. Disintegration: evaluated to ensure that the drug is fully available for disintegration
& absorption from GIT.
*Are required for all types to tabs.
*Time for disintegration: a) Coated tabs e.g. sublingual tabs "2 min".
b) Most uncoated tabs "30 mins".
c) Sugar coat "2 hrs".
d) Enteric coated: no evidence of disintegration after 1 hr in
gastric fluid & in intestinal fluid "2 hrs".
e) Buccal tabs: "4 hrs".
7. Dissolution characteristics:
*N.B. 1. Excessive tablet compression→ difficult to disintegrate in the body→ slowing
dissolution.
2. ↑ Drug particle surface area by micronization of drugs e.g. Grisefulvin,
Chloramphenicol & sulfadiazine→ ↑ Dissolution rate so ↓ dissolution time.
3. Formulas that list spermaceti as an ingredient may now be compounded using
a substituent Cetyl ester wax [called synthetic spermaceti → MP 43-46 0C]→ why?
because spermaceti is 1)Expensive 2) Difficult to obtain.
E. Capsules :
*The best choice of diluents for stock powder special in preparing capsules is Lactose→
why? → because it is inert & H2O insoluble.
F. Ointments :
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*Important definitions:
1. Ointments: oleaginous in nature.
2. Creams: generally w/o or o/w emulsions.
3. Pastes: have high content of solids [25%].
4. Gels: semi-solid systems consisting of suspension made up of either small inorganic
particles or large organic molecules interpenetrated by a liquid.
N.B. Carbomers: they are polymers with a number of carboxy gp present → used in
topical products mainly gels as thickening agents.
*↑ pH of the solution containing carbomers→ cross linking of molecules → ↑ viscosity &
vice versa.
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*Incorporation of medical agents in Ointment bases:
a) Levigation: *Stainless steel spatula is used.
[see before] *Some substances [e.g. salicylic à- Iodine- mercuric salts] interact with metal
spatula so use rubber spatula.
*Levigation is aided using levigating agent e.g. [Mineral oil, Glycerin].
*Organic solvents e.g. ether, alcohol & chloroform aren't used as levigating
agent→ why? →Because the drug may crystallize when the solvent evaporate.
N.B. Alcohol is common in lotions.
*Incorporating powders or liquids in small amounts of ointment base is best
accomplished on pill tile [ointment tile].
b) Fusion method: N.B. Volatile materials e.g. Iodine, Camphor, Mentol→ added after melted mix
cools to 400C or less.
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7. Iodine:
a) Iodine solution *Iodine (2%) + Sodium iodide (2.4%) → using purified H2O USP as the vehicle.
USP: *I2+Na I→ NaI3 which is H2O soluble.
b) Iodine tincture *Iodine (2%) + Sodium Iodide (2.4%) → using diluted alcohol USP as a vehicle.
USP: *Iodine is soluble in alcohol so WHY Na I is included?
Not as hydrotropic agent but rather to allow the tincture to be diluted with H 2O with no
ppt.
8. Dakin's solution [Na Hypocrite solution USP]:
*The solution contains 4-6% NaOCl.
*Caution: This solution isn't suitable for application to wounds [not used as antiseptic]
→ why? → because of too strong alkalinity & oxidizing action to be applied to tissue.
*It is similar to commercial household bleach such as Clorox.
*Diluted NaOCl: diluted 10 times [Modified Dakin's solution] → used as germicide &
disinfectant.
9. Hydrogen peroxide topical solution USP (3%):
*It is known as 10- volume peroxide→ why?
because 1 ml of solution→ liberates 10 ml of oxygen.
*Use: mild antiseptic for wounds.
*M.O.A: Hydrogen peroxide tissue catalase H2O + O2 Oxidize bacteria.
*1:1 dilution with H2O: Used as mouthwash for treating Vincent's angina.
*6% Hydrogen peroxide solution [20 volume peroxide] → available as a hair & fabric
bleach→ it's too strong for medical use.
10. Chlorohexidine gluconate [4%]: Topical antiseptic # G+ve & G-ve bacteria.
*Skin cleanser. *Hand wash *Surgical scrub (4% solution).
*Oral rinse to prevent oral infection in immunosuppressed pts [M.W].
11. Petrolatum gauze شاش فازلين: It's the 1ry cover used for burns.
*Advantages: a) Exudate flow through gauze.
b) Gauze will not adhere to the wound.
N.B. The best emergency advice for minor burns is Cold H2O.
12. Benzocaine (5%) & Lidocaine: They are effective local anesthetics present in OTC
remedies.
Benzocaine (more common): Lidocaine
*Systemic toxicity is rare due to poor absorption *May cause systemic S.E.
through skin.
*Hypersensitivity reactions. *Lower incidence of hypersensitivity reactions.
N.B. Benzocaine may be present in some OTC products as Appetite suppressant → HOW?
*It is formulated as lozenges, gum or candies→ ↓ person's ability to detect sweetness →
reduces appetite.
*Put (T) or (F): Benzocaine is suitable as pharmaceutical excipient (F)
13. Phenol (Carbolic acid): possesses both antiseptic & local anesthetic effects but
never used as local anesthetic → WHY?→ It's caustic→ tissue damage.
14. Dextranomer: it is used for ttt of exudating wound only.
*The product consists of spherical beads→ sprinkled onto exudating wound→ the
hydrophilic nature of beads creates strong sucking force→ beads become grayish yellow
when they are saturated with fluids→ so wash away by irrigating with sterile H 2O or
saline.
15. Flexible Collodion: contains Camphor +Castor oil.
e.g. Salicylic acid Collodion which is prepared by dissolving salicylic acid in flexible
Collodion.→ keratolytic.
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16. Ichthammol 10% مرهم اسود: Used for ttt of inflammation & boils.
17. Permethrin: it is a topical Pediculicide & scabicide.
M.O.A: disrupting nerve cell membrane of parasites→ paralysis.
18. Wound debriding agents: "Removes necrotic material from wounds".
1. Collagenase→ [proteolytic].
2. Fibrinolysin→ [Fibrinolytic].
19. Boric acid: isn't used in topical skin preparations for infants→ because it causes
boiled blister rash→ Boron toxicity.
H. Sublingual tablets :
e.g. 1.Isosorbide dinitrate.
2. Nitroglycerin.
3. Hydrogenated ergot alkaloids (Hydergine): mood elevator for ttt of Senile
dementia.
4. Ergotamine tartarate.
N.B. dihydroergotamine is not in form of sublingual tabs.
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I. Parenterals :
1. Hypodermic needles :
a. It is composed of:
a. Hub: *Extension of the needle that fits onto the syringe.
*It's filled onto the syringe body either by a locking system such as luer lock or by
simple friction fit.
b. Bevel: *Portion of needle that is ground for sharpness.
*The back portion (heel) of the bevel is left dull→ a dull heel has been shown to
decrease the incidence of coring of rubber closure & the skin.
c. Cannula: *Shaft portion of the needle.
*Both shaft strength & flexibility are needed
d. Lumen [Bore]: *The hole in the shaft.
c. The bevel length of a hypodermic needle may vary from very short to long.
*Short bevel is preferred for injection→ I.V→ WHY?
To reduce the possibility of perforating the back wall of the vein.
N.B. For Intradermal injection: a very short bevel is preferred.
2. Other needles:
a. Winged needles: e.g. Scalp- scalp vein or butterfly: composed of 2 flexible wing like projections
for I.V injection. (plastic) + stainless steel needle.
*Action of wings: 1) Ease manipulation of the needle during insertion.
2) allow the needle to be anchored with tape to the skin.
b. Needle for insulin *Only small volumes are injected so: 1) small bore needle [25G-30G].
injection: 2) Short [3/8" to 5/8"].
c. Propylene syringes. Can withstand autoclaving.
d. Other plastic syringes. Gas sterilized.
e. Filter needle: *Used for removal of large particulate matter.
e.g. glass fragments but not suitable to remove pyrogen or bacteria→ why?
because pore size is 5 micron (too coarse).
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*Some parentral routes:
a. I.M: *The I.M injection site that is suitable for child < 3 years of age is Vastus Lateralis→why?
Because it is 1) Largest developed muscle in young children.
2) Free from major nerves & veins.
N.B. Volume limitation should be 1 ml.
b. Intradermal: *The smallest volume of injection.
*This route is usually limited to diagnostic determinations, desensitization or
immunization into forearm.
*Usually only 0.1 ml volumes are used.
c. I.V bolus *= IVP: Intravenous push [bolus].
*Even distribution of drug into the blood after IV bolus takes 4 minutes.
d. S.C: *Q) Although isotonicity is desirable for almost all Parenterals, it is critical for S.C
injection→ why?
Because S.C injection: 1) comes into contact with large number of nerve endings.
2) May remain at injection site for long period.
*If the solution isn't isotonic→ pain.
*Solution injected S.C shouldn't exceed 1 ml.
N.B: T he potential effects of hypotonic or hypertonic I.V injection are offset by their
dilutions in large volume of blood into which they are injected but the volume injected
shouldn't be large & rate of injection must be slow..
e. IV infusion: *The term Venoclysis is most closely associated with I.V infusion
*Hypodermoclysis: it is the intentional administration of IV fluids into S.C tissue→ why?
For patients whose veins are inaccessible e.g. infants or obese patients.
*Maximum volume of fluid that should be administered daily by I.V infusion is 4 L.
f. IV injection: *Suspension isn't suitable for this route→ why?
(infusion & 1. Suspension particles may block blood vessels.
bolus): 2. Insoluble suspension particles may dissolve faster than desired in blood→ immediate
therapeutic activity when S.R activity is desired.
*Only insulin (regular insulin "soluble zinc insulin crystals) may be taken I.V while
other suspensions are taken S.C.
*Other special routes for injection:
1. Intra-articular: in joint.
2. Intra-synovial: in joint fluid.
3. Intrathecal: in spinal cord fluid.
*Parentral Labels:
Include by Name:1)Antimicrobial preservatives.
2) Isotonicity adjustors.
3) pH adjustors.
4) Antioxidants.
N.B. a) Head space gases aren't written on the label→ they are inert gases that displace
oxygen to ↑ stability.
b) The quantity of pH adjustors isn't written.
**Expiration date that should be placed on the label of parentral admixture prepared in
hospital pharmacy is 24 hours.
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*Some parentral products:
1. Potassium 1. Never taken by I.V bolus→ why? → Because it may cause cardiac arrest.
injection: 2. May be taken by slow I.V infusion to allow dilution of K+ by blood.
2. Fluorouracil: 1. Routes of administration (Injection & topical).
2. I.V injection [most common].
3. No oral D.F→ Why? Because of irregular absorption from GIT.
3. Heparin Na: 1. May be taken I.V (Bolus→ loading dose/ infusion→ maintenance dose), S.C
2. Never taken I.M→ Why? To avoid local hematoma.
4. Gentamycin *Is most stable in aqueous solution.
sulfate ماء و ليست بودرة
[garamycin]:
5. KCl: 1. Parentral containers of KCl must be packaged with BLACK-FLIP OFF button→
الموت االسود why? → Because it is very dangerous if infused undiluted & reports say that it caused
many fatalities in hospitals.
N.B. There is no color code for other Parenterals that are packaged in vials.
2. Given by slow I.V infusion.
6. Iron dextran 1. Most iron salts are taken orally except iron dextran.
injection USP: 2. It is a colloidal solution of ferric hydroxide complexed with dextran.
3. Uses: ttt of iron- deficiency anemia that doesn't respond to oral therapy.
7. Diazepam: *It shouldn't be added to any infusion bottle→ why?
Because it will ppt even when added to normal saline or 5% dextrose solution.
8. Ampicillin: 1. The most stable vehicle for Ampicillin is 0.9% NaCl → 8 hrs stability.
N.B. Dextrose 5% → less than 4 hrs stability.
9. Erythromycin *If reconstituted with normal saline or other vehicles containing inorganic salts→
lactobionate: ppt→ how to overcome?
Reconstitution by sterile H2O for injection→ once reconstituted, the solution can be
diluted with normal saline or lactated Ringer's solution provided that pH remains in
the range of 6-7.5.
10. Ascorbic *Solution of ascorbic acid would be too acidic for injection→ How to overcome?
acid: Add alkali such as NaOH, NaHCO3, Na2CO3→So adjusts H between 5.5 & 7.
11. Anesthetics: *anesthetics & routes of administration: 1) Cocaine→ topical.
2) Dimethisquin→ topical. 3) Mepivacaine→ local injection.
3) Tetracaine→ topical& local injection. 4) Lidocaine→ topical ,local&IV infusion.
5) Procaine→ Intravenous & local injection (not topically due to poor absorption).
Q) Local anesthetic that isn't administered topically is: Procaine.
12. Insulin: 1. Insulin metabolism occurs both in liver & kidney.
2. Drug has a short plasma t1/2→ if injected IV→t1/2: 5-6 mins.
3. Product is available without a prescription e.g. U 100.
4. Single peak insulin is more pure than the former insulin→ Explain!
Single peak: means that it displays a single peak when assayed by chromatography
[this means nearly 99% purity]>>> older insulin products but it still has some
antigenic properties.
5. Single component insulin: refers to insulin that is obtained from single source
usually either pork or beef.
6. Onset of insulin action: a) Fast acting insulin→ 1 hour.
b) Intermediate acting insulin→2 hrs. c) Long acting insulin→ 7 hrs.
7. Characteristics of Insulin syringes: 1) 40U & 100U.
2) Color coded & calibrated. 3) Available as 1ml & o.5 ml
*100U insulin syringe: →0.5ml: it is calibrated in1unit increments to a max. of 50U.
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1ml: it is calibrated in 1 unit increments to a max of 100 U.
*So for measurement of 25U we use 100U syringe that has a maximum capacity of
50U to↑ accuracy.
*Best needle for insulin injection 25G 5/8".
*N.B. All insulin products currently available are stable at room temp.
So travelling diabetics should be advised to avoid exposure of their insulin to very
high temperature & told that it isn't necessary to refrigerate the vial in use.
*Insulin vials stored in pharmacies are required to be refrigerated because they may
be kept in stock for long period of time.
13. *Available in vials containing 50 mg of drug as powder.
Amphotercin B: *Because of Colloidal nature of the product→ only sterile water for injection without
I.V& Topical. preservative is used for reconstitution.
*It is administered by Slow I.V infusion over 2-6 hrs period.
*Never use electrolytes for reconstitution → why?
Because they will ppt [salt out] the drug.
14. Liposomal *They are reconstituted using sterile H2O for injection.
powders: *Don't reconstitute using NaCl→ why? →to avoid breakage of liposomal system.
*Dose< conventional dose→ why? → Because they are formulated as targeted drug
delivery systems→ drug will concentrate in areas of the body in which they are most
active so dose must be decreased otherwise toxicity occurs & vice versa.
(If conventional drug is required & liposomal dose is given→ the dose may be
subtherapeutic.
15. Ampicillin: *Stored in refrigerator at cold temperature 2-80C But not freezed
(syrup)
Q) A. The osmotic pressure of 0.1 molar dextrose will be approximately how many times
that of 0.1 molar NaCl?→ answer: is (1/2)→ why?
because: Osmotic pressure is one of the colligative properties (colligative properties
depend on no of particles) ∵NaCl is electrolyte that ionized to Na + & Cl- & dextrose
doesn't ionize ∴no of particles of NaCl is twice that of dextrose so osmotic pressure of
NaCl is twice that of dextrose.
B. Put (T) or (F):
1. D5W/0.9 NS is isotonic (F).
Its osmolality is 600 mosm/L so it is hypertonic.
2. D5W/0.9 NS is very harmful if infused. (F)
Because it is rapidly diluted by blood so it is safe.
3. D2.5 W/0.45 NS is isotonic. (T).
2. Ringer's solution: they are suitable for fluid & electrolyte replacement particularly for post-surgical
patients.
a. Ringer's injection: It's an electrolyte solution which consists of isotonic solution of NaCl, KCl & CaCl 2
b. Lactated Ringer: *Similar to Ringer's + Na lactate.
*It is considered to be approximately as extracellular fluid of human body.
*The injection has pH 6-7.5 BUT has an alkalinizing effect→ why?
Because lactate is metabolized to bicarbonate.
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3. Water for injection:
Water type: Comment:
A. Bacteriostatic *It is sterile H2O for injection that contains one or more suitable antimicrobial agents
water for *e.g. of antimicrobial agents is Benzyl alcohol→ C.I in premature infants due to fetal
injection USP: toxic syndrome.
(BSWfI) *The maximum volume allowed as a parentral package for bacteriostatic water for
injection is 30 ml→ why?
Because if large volume is infused→ toxicity due to presence of preservative.
*The use of BSWfI is appropriate as reconstituting agent for multi-dose vial
→ بتتاخد على كزا مره فالزمpreservative
N.B. It isn't used for single dose vial→ why?
B. Sterile water * Water sterilized & packaged in single dose containers of type I & II glass.
for injection *Containers don't exceed 1L.
USP: *The limitation of total solids depends on the size of the container → Explain!
prepared by It is 40 ppm for 30ml vials & 20 ppm for 1L vial because of relatively smaller surface
distillation then area.
autoclaving.
C. Water for *It is the form of water that is most commonly used as solvent for Parenterals during
injection USP: manufacture.
*Prepared by distillation or reverse osmosis.
*It conforms to the standards of purified H2O but it is also Pyrogen free.
N.B Pyrogens: → are bacterial byproducts which cause febrile reaction.
Test:
D. Purified *Obtained by distillation, ion exchange & reverse osmosis……….
water USP: *The method of preparation must be indicated on its label.
Not used for *Limit of dissolved solid not more than 10 ppm (i.e. it has the lowest permissible level of
injection. dissolved solids).
*It is also not suitable for ophthalmic preparations because it is hypotonic→ irritation.
N.B Purified water (hypotonic) + RBCs→ burst occurs.
N.B.: What happen if we mix NaHCO3 with 5% glucose?
Nothing will happen (but give hypertonic solution).
N.B: *Use of Edeta as chelating agent in parentral solutions & other uses:
EDETA: Ethylene diamine tetra acetic acid
*M.O.A: chelating agent or ligand e.g. edeta (electron donor)+ divalent or more metal
ion→ ring structure complex.
e.g. 1. EDETA is commonly used in parentral solutions to bind trace metals e.g. copper
& iron.
2. EDETA is taken IM to reduce blood levels & depot stores of lead in acute & chronic
lead poisoning & lead encephalopathy→ chelate form with lead is stable, H2O soluble &
readily excreted by the kidney.
*Put (T) or (F): EDETA is the best chelating agent for lithium & sodium (F).
Because they are monovalent ions.
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*Packaging of Parentral products:
1. Mini-bottles: 1) They are partially filled glass containers usually consist of 250 ml bottles
containing 50, 100 or 150 ml of either DSW or NS.
2) To these bottles one can easily add drug solutions, taking advantage of the
vacuum present in the mini-bottle.
*Notes: a) Plastic bags are also employed for preparing parentral admixture but
the plastic units don't have vacuum but are flexible enough to accommodate
additional liquids.
b) Glass bottles may be divided into 2 types:
1. Presence of airway tube: extend from rubber stopper to above fluid surface.
2. Absence of airway tube: airway is an integral part of the administration set.
c) Plastic parentral bottles & bags differ from glass units in that the plastic units
have two entry ports→ Explain!
1. One port: covered with latex cap through which pharmacist or nurse can
inject solutions into the unit.
2. 2nd port: IV set is inserted inside it.
2. Piggyback: 1. The term piggyback is most commonly associated with intermittent therapy.
*Intermittent therapy: administration of parentral drugs at space intervals→
how? Pharmacist prepare mini-bottle of drug solution (called piggyback) → this
unit is attached to the tubing of a large volume parentral bottle (LVP) already
hanging on the patient.
*Advantages of this system: 1) saves the patient from multiple injection (reduces
potential for thrombophlebitis = inflammation of vein).
2) Assures high blood levels of the additive drug because minibottle solution is
infused in a short period of time (greater conc. gradient).
3) Avoids stability or compatibility problems.
3. ADD-Vantage system: *It is a vial attached to a mini-bag of diluents.
*Health professional simply engage the vial into the bag so allowing
reconstitution of the powder.
4. Pharmacy-bulk 1) Units intended for preparation of sterile Parenterals. These units are ideal
packages: when reconstituting an antibiotic powder for transfer into several mini-bottles so
they aren't used for direct infusion of drugs.
2) They don't have antimicrobial preservative (they are pierced only once & used
in a short period of time).
5. Busher-injector: *It is an automatic device for self administrating (injecting).
*The patient fills it with filled syringe.
*Used mainly by patients using Insulin.
6. Elastomeric containers *Contain elastic balloon that is filled with sterile solution→ slowly but constantly
collapse→ provide steady volume of drug solution (zero order) → pass through
small diameter infusion line.
7. PCA units (patient a) Originally used for slow infusion of analgesics e.g. Morphine sulfate.
controlled analgesia): b) Currently used for many other infusion solutions
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very slow infusion.
2. IVPB: IV push bottle (piggyback).
2. Homogenous & Heterogeneous Systems:
1. Homogenous Systems:
some definitions:
* Solutions: homogenous system of a solute in a solvent.
*Saturated solutions: are solutions that at a given temperature & pressure, contain the
maximum amount of solute that can be accommodated by the solvent.
*Solutes can be: Gases, liquids or solids & electrolytes or non electrolytes.
**Electrolytes: → substances that form ions in solutions e.g. NaCl, HCl & atropine
SO4.
**Strong electrolytes: e.g. NaCl & HCl→ are completely ionized in H2O.
**Weak electrolytes: e.g. aspirin & atropine→ are partially ionized in H 2O.
Their aqueous solutions conduct electric current.
N.B. Conductivity: the ability to conduct current in an electric solution by movement of
ions.
**Non electrolytes: substances that don't form ions when dissolved in H2O e.g. Glycerin,
sucrose, urea…..etc.
Their aqueous solutions don't form ions when dissolved in H2O.
2. Colligative properties:
*Colligative properties of solution: are related to total number of solute particles in the
solution but independent of other chemical properties.
*Any of the colligative properties can be used to: → determine tonicity of solutions.
2. Elevation of boiling point: it is the point at which the vapor pressure of a liquid
equals atmospheric pressure 760 mmHg.
↑ Number of solute particles in solution→ ↑ B.P (elevation of B.P).
4. Osmotic pressure:
Vant Hoff equation→ defines osmotic pressure.
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**Methods of calculating isotonicity adjustment (in practice):
A. NaCl equivalents: → also called E values
*definition: it is the weight of NaCl that will produce the same osmotic effect as 1 gram
of the specified chemical.
e.g. Morphine HCl has E value of 0.15: this means that 1 gm of morphine HCl produces
the same osmotic pressure in solutions as 0.15 g of NaCl.
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&↓ pka→ ionization→ so strong acids e.g. HCl→ ionize completely into H + &Cl-so pka is
close to zero (0).
N.B. Salt & acid conc. is expressed in moles.
*Buffer: can be a combination of weak acid & its salt or combination of weak bases &
its salt.
*Buffer action: resistance to change in pH
*Buffer capacity: a) It is the ability of buffer solution to resist change in pH caused by
addition of given amount of à or base.
b) It is the number of gram equivalents of an acid or base that
changes the pH of 1 L of buffer by 1 unit.
Q) Drug has pka=6.2, what is the % of ionized to unionized form of this drug in
small intestine i.e. pH =6.2?
Answer: pH= pka→ half neutralization point.
Ionized: unionized
50% : 50%.
Q)Complete:
1) Boric acid is the weakest acid.
2) Salicylic acid is the strongest acid between weak acids.
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3) Lactic acid is the best to prepare a buffer with greatest buffer capacity at pH=4.
WHY? because pka of lactic acid nearly= required pH→ this is neutralization point
(greatest buffer capacity).
Notes:
1. All antacid preparations except Al (OH)3→ ↑ pH of urine so ↑ excretion of acidic
drugs & ↓ excretion of basic drugs.
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Stoke's law is used for:1. measuring sedimentation rate in suspension
2. measuring rate of creaming in emulsions.
A. Suspensions:
* Lotions, magmas: → they are suspension of finely divided material in small
amount of H2O.
1) Characteristics of suspensions:
a. The ideal suspension consists of: small, uniform sized particles of dispersed phase
suspended uniformly without any tendency to settle.
b. The particle size of suspended particles normally ranges from 0.5- 5.0 microns.
d. Although most drugs decompose following 1st order kinetics, Oral suspension follow
→ Zero Order Kinetics→ WHY? → Because the limiting factor is the amount of drug
actually in solution.
e. Thickening of a suspension will slow its sedimentation, but it is still necessary to get
the product out of the bottle→ How to overcome this problem?
By: 1. Thixotropy: reversible solution- gel system→ this means that it is gel that forms
flowable solution when shaken, on standing, reformation of gel will slow particle setting.
2. Pseudoplastic flow→ greater flow rate after system has been agitated.
f. The powders used in suspension are→ H2O insoluble e.g. Calamine, zinc oxide&
propoxyphene napsylate (analgesic).
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B. Emulsion:
1. Definition: it is a heterogeneous system of two immiscible phases, one of which is
water & the other is oil→ Liquid/liquid dispersion system.
*The particle size of an emulsion droplet is 0.1-100 microns.
2. Emulsions are divided into following categories:
1) O/W emulsion: *Water → continuous phase & oil→ dispersed phase
*e.g. Emulsions for oral administration →to hide taste &↑ palatability.
2) W/O emulsion: Oil→ continuous phase & water→ dispersed phase.
3) O/W/O or W/O/W Also known as multiple emulsion.
emulsions:
4) Microemulsions: *it is W/O or O/E emulsion with particle size 100 A 0-600 A0
*Unlike emulsions, they are clear & thermodynamically stable.
*Na lauryl SO4 or Potassium oleate → used as emulsifying agent.
* They are generally used to solubilize drugs in pharmaceutical industry.
5) Nanoparticle emulsions: *Similar in size & shape to the globule of microemulsion.
*It is prepared by polymerization process.
* It is used to solubilize drugs, globulins & toxoids.
3. The formulation of emulsion requires the following agents: → PAVE
1. Emulsifying agent
a. Natural: Acacia, Agar, Tragacanth, pectin, gelatin (gelatin is protein), methyl cellulose &
carboxymethyl cellulose.
b. Synthetic→ called surfactants
1. Anionic: *The large active portion of the surfactant bears a –ve charge & would migrate to
anode in an electric field.
e.g. Soaps
Na lauryl sulfate →o/w → is compatible with Icthammol & Econazole NO 3.
Dioctyl Na sulfosuccinate→ O/W
Triethanolamine stearate
Ammonium laurate
Docusate Na: stool softener.
2. Cationic: *Active portion (+ve charge) & migrates to Cathode
e.g. Benzalkonium chloride
Cetyl pyridinium chloride.
Cetrimide
*They are incompatible with anionic surfactants.
e.g. Benzalkonium chloride + Soaps→ inactivation.
3. Non-ionic: *No tendency to migrate to either pole in an electric field
e.g.
A. Sorbitan esters (spans): B. Polysorbates (tweens):
W/O emulsifying agents O/W emulsifying agents
Used as wetting agents Used as detergents & solubilizing
agents
e.g. Sorbitan monopalmitate &
Sorbitan monostearate
c. Cetomacrogel: it is incompatible with Tannic acid, ammonium salts & phenol.
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N.B 1. Cetocteryl alcohol + Na lauryl sulfate→ Anionic
Cetrimide→ Cationic O/W emulsion.
Cetomacrogel 1000→ non ionic
2. Preservatives 3. Antioxidants. 4. Viscosity enhancer
*Important Notes:
1.HLB (Hydrophilic lipophilic balance)→ for classification of Non-ionic surfactants.
*Emulsifiers are given numbers 1-20.
*↓ HLB value→ lipophilic. * ↑HLB value→ hydrophilic
*Mix 2 emulsifiers of different HLB values→ can give best HLB value for certain
emulsion formulae.
*HLB < 9→ W/O emulsion→ spans.
*9-11→ W/O or O/W
*HLB > 11→ O/W
N.B. Some anionic & cationic surfactants have HLB value
*To prepare W/O emulsion: we use W/O emulsifier e.g. spans.
*Nonoxynol: is SAA with spermicidal action.
*Rose oil + Cetrimide 20%→ stabilization by agitation.
*SAA is added to tablets→ to improve dissolution & bioavailability.
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definite time interval.
b) Globule size.
c) Flow properties.
d) The effect of stress on emulsion.
3. Chemical kinetics & Drug stability:
1. Antioxidants: react with free radicals.
A. Oil soluble: B. Water soluble:
e.g. Ascorbyl palmitate e.g. Ascorbic acid
Vitamin E Sodium sulfite
sodium bisulfate: it is a mixture of
ingredients (sodium bisulfate + sodium
metabisulfite)→ when dissolved in H2O,
sodium thisulfite is converted to sodium
bisulfate.
S.E: Sensitivity reaction causing difficulty in
breathing.
*Examples of substances liable to oxidation:
1. Epinephrine: *very sensitive to oxidation giving toxic byproducts.
*Early sign of oxidation is the presence of pink color.
*by time it darkens & forms brown ppt.
2. Aminophylline: *by exposure to air, it may change to more toxic form→ how?
*Aminophylline (Theophylline + Ethylene diamine) ↑ water solubility
of Theophylline exposure to air CO2 absorbed
3. Preservatives:
e.g. Methyl-paraben: it is ester of p-hydroxybenzoic acid.
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4. Sterilization :
A) Sterile areas:
HEPA Filters (high efficiency particulate air filters).
2. Dioctyl phthalate (DOP) Smoke test: ensures that no particle layer that 0.3mm passes through HEPA
filter.
3. When preparing most parentral admixtures, the pharmacist will work in an area at least 6 inches from the
edge of benchtop turbulence for flow.
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→Characteristics of membrane filtration:
1. Suitable for heat labile solutions.
2.. Convenient for sterilizing small volumes (for
extemporaneously prepared solution)
N.B. Important agents & their method of sterilization:
Agent: Method of sterilization:
1. Dusting powder: By dry heat 1200C for 60 min.
2. PVC (plastic): By autoclaving.
3. Lignocaine, adrenaline, By heating at 1150C
digoxin & atropine:
4. Benzyl penicillin, Thermolabile.
Nystatin & streptomycin:
*American society of health system (AsHp) has developed risk level classification:
3 levels & level 3 is the strictest.
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5. Nuclear Pharmacy :
1. Definitions:
A) Isotopes: they are atomic species that have same atomic number (number of
protons), but different number of neutrons (i.e. different mass number).
Mass number= no of protons+ no of neutrons
*Same chemical element with same chemical properties.
B) Rad: it is the amount of radiation energy that has been absorbed by living tissue
(Quantitative measurement of radioactivity).
C) Decay rate: it is the rate at which radioactive atoms undergo radioactive
disintegration.
*It follows 1st order reaction.
*Units for expressing radioisotope decay include Curie (Ci) & Becquerel.
2. Types of radiation:
Electromagnetic radiation: Particulate radiation
e.g. Gamma radiation, X-ray & UV. e.g. Alpha & Beta radiation.
*They emit photons. *Alpha: consists of 2 protons & 2 neutrons.
*High penetration power. *Beta: exists in two types negative electrons
*Gamma radiation: has greatest penetrating power (negatron) & positive electrons (positron).
→ easily penetrate a foot of tissue & several inches of *Low penetration power.
lead. - radiation: has the least penetrating power.
3. Radiopharmaceuticals may be: Diagnostic
Therapeutic
I. Diagnostic radiopharmaceuticals:
*Characteristics: 1. they should contain a radionuclide with a half life short enough to
minimize radiation exposure to the patient yet long enough to allow for collection of
imaging information.
2. The radionuclide should emit Gamma radiation (Gamma camera).
N.B. The dose rate (retrogens/h) from a point source of Gamma emitter varies inversely
with the square of distance
I1/R2 (I: Gamma intensity & R2: Distance2).
3. Examples:
a) Technetium99m TC: is ideal isotope for diagnosis→ why?
Because t1/2→ 6 hours & emits Gamma radiation.
*It is commercially available as radioisotope generator→ Explain!
→99m TC is produced by radioactive decay of Molybdenum99 (99Mo).
→This 99Mo (parent nuclide) is adsorbed on ion-exchange column made of alumina→ by
decay99Tc is formed & exchanged with Cl- available in 0.9% saline eluate solution
washed through the column.
To separate the long half life parent nuclide (99Mo) from the short half life daughter
nuclide (99Tc).
b) Sodium Iodide 123I:→ Thyroid scan.
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Nodules that don't take Iodine (cold nodules) are usually cancerous→
removed surgically.
Nodules that take Iodine (hot nodules) are usually benign.
2. Therapeutic: → in higher doses for ttt of thyrotoxicosis.
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