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S Pharmacy Preparations CHAPTER 5
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INTRODUCTION

To give an idea to students about how drugs are prepared in pharmacy, a few pharmacy preparations practicals can be
demonstrated in two sessions.
 

EXERCISE 1: TO PREPARE AND DISPENSE 50 ML OF CALAMINE LOTION

Formula: For 100 mL

Calamine 15 g

 Zinc oxide 5g

Bentonite 63 g

Lique ed phenol

Sodium citrate 5g

Glycerine 5 mL

Puri ed water ad 100 mL.

PROCEDURE

Weigh out the calculated quantities of calamine, zinc oxide and bentonite. Mix them thoroughly in a mortar
Take 20 mL of puri ed water in graduated ask and add the required quantity of sodium citrate.
Pour a little of water from ask into mortar containing calamine, bentonite and zinc oxide. Triturate to make
homogenous paste. Add required amount of glycerin and phenol to this mortar and triturate.
Transfer the mixture to the ask. Rinse the mortar with a little quantity of puri ed water and transfer this rinsing into
the ask. Add su cient quantity of water to make up the nal volume 50 mL. Transfer it to an Amber-colored bottle,
label and dispense.
 

HOW TO APPLY

Wash and completely dry the affected area before applying the lotion. Shake lotion well before use.
Apply this medication to the affected area of skin, generally three to four times daily or as directed by your physician.
Do not dilute or mix with other lotions. 22

LABELING

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PHARMACOLOGICAL ACTIONS

Calamine: Calamine is a mixture of zinc oxide (ZnO) with about 0.5% iron (III) oxide (Fe2O3). It is the main ingredient in
calamine lotion and is used as an antipruritic to treat sunburn, eczema, rashes, poison ivy, chickenpox, insect bites and
stings. It is used as a mild antiseptic to prevent infections that can be caused by scratching the affected area. It is also
used to dry weeping or oozing blisters and acne abscesses. It is also used as coloring agent in various cosmetics.

Zinc oxide: It is insoluble in water, used as dusting powder, ointment, lotion and paste. It has soothing and protective
action in eczema. It is also used as mild astringent for skin.

Bentonite: It is colloidal aluminum silicate insoluble in water but swells into a homogenous mass. It is used as
suspending agent because it increases the viscosity of the vehicle. It is also used as a bulk laxative. It should be
 sterilized before using on open wounds.

Sodium citrate: It helps in the dispersion of solids in this preparation and reduces the viscosity of this preparation.

Lique ed phenol: It has an antiseptic and mild local anesthetic effect. However, in the amount used, it acts as a
preservative in this preparation. It is particularly required as glycerin promotes the growth of microorganisms.

Glycerine: When applied locally, it acts as an emollient and helps in penetration of ingredients by making the skin moist
and soft. Due to its viscous nature, the lotion stays for a longer time at the site of application. It is hygroscopic in nature,
so prevents drying up and cracking of skin and the lesions.
 

THERAPEUTIC USES

In pruritis: used as soothing and protective lotion

To allay pain and swelling of sun burns
For prickly heat
Any other irritating skin condition
It is also used in herpes zoster and chickenpox. 23

PRECAUTIONS

Avoid contact with the eyes, on the inside of your nose, mouth or genital area.
Contraindicated if known sensitivity or allergy to any ingredient.
Ask a doctor before using calamine lotion on children younger than 6 months of age.
Stains the clothes, hence be careful.
 

EXERCISE 2: TO PREPARE AND DISPENSE 25 ML OF MANDLE'S THROAT PAINT

Formula for 100 mL:

For 100 mL

Iodine 1.24 g

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Potassium iodide 2.48 g

Mentha oil 0.40 mL

Water 2.48 mL
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M Alcohol 90% 3.76 mL
o Glycerine up to 100 mL
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S PROCEDURE
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Weigh out the required amount of iodine and potassium iodide and transfer to a glass jar. 10 drops of water and 5 mL
of glycerin. Stir the contents. When contents are completely dissolved, add required amount of Mentha oil and
dissolve it.
Transfer the contents into a measuring cylinder and add glycerin to make volume up to 25 mL. Transfer contents into
Amber-colored bottle, label and dispense.
 

LABELING

PHARMACOLOGICAL ACTIONS

Iodine: It is nonmetallic component. It acts locally and has antiseptic properties. It is an oxidising agent and acts as
bactericidal. 24

Potassium iodide: it is used to dissolve iodine as iodine is highly soluble in aqueous solution.

Water acts as solvent for potassium iodide. Mentha oil acts as avoring agent and is volatile. Alcohol is used to
dissolve Mentha oil and glycerin. It also acts as preservative, antiseptic and astringent. Glycerine helps iodine to stick to
affected area for longer period. It also has antiseptic action and reduces edema.
 

THERAPEUTIC USES

Tonsillitis
Pharyngitis.
 

PRECAUTIONS

Do not take food/water half an hour before and after the application of the paint.
 

EXERCISE 3: TO PREPARE AND DISPENSE 1:5000 SOLUTION OF POTASSIUM PERMANGANATE WITH

DIRECTIONS TO DILUTE IT TO 1:15000 BEFORE USE.

Calculations:
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Prepare 1% stock solution

1% stock solution is
1 g in 100 mL
or 1000 mg in 100 mL
P or 100 mg in 10 mL
M or 10 mg in 1 mL
o For 1:5000 solution of KMnO4 we need:
1 g in 5000 thousand mL
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or 1000 mg in 5000 mL
f or 10 mg in 50 mL
M So now we take 1 mL of stock solution (10 mg) and add 49 mL of distilled water
S What we get is 10 mg in 50 mL of water, i.e. 1:5000 solution of KMnO4
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PROCEDURE

Measure accurately 100 mg of KMnO4 crystals. Dissolve it in 10 mL of distilled water (1% stock solution). Stir with a
glass rod to mix potassium permanganate solution.
Take 1 mL of solution and add 49 mL of water to make volume 50 mL. This is 1:5000 solution.
Label and dispense it in an amber-colored bottle to prevent oxidation.

LABELING

25
 

STORAGE CONDITIONS

It should be stored in a tightly corked container in a cool dark place away from the sun light.
 

PHARMACOLOGICAL ACTIONS

Potassium permanganate has bactericidal and fungicidal activity. Potassium permanganate, on contact with organic
matter, liberates nascent oxygen that oxidizes enzymes essential for living microorganisms and their metabolism, thus
producing antiseptic effects. It also acts as astringent. It is readily soluble in water.

Therapeutic uses: The KMnO4 is available in pharmacy stores as crystals. Dissolve 2–3 crystal for 1 Liter water, add
water till you get light pink color.

The major uses of this preparation are:

As disinfectant for water and utensils—1 in 100 solution

As a cleansing application to ulcers and abscesses—1 in 1,000 solution
As mouthwash (in gingivitis and steatites), gargles (Condyls gargles), for washing wounds and for vaginal irrigation—1
in 4,000 solution
Sitz's baths given in hemorrhoids, piles and ssures
As gastric lavage in the treatment of morphine, opium, strychnine, aconitine and other alkaloid poisonings (but not for
cocaine and atropine because they are not easily oxidized by potassium permanganate)—1 in 5,000 solution is
employed as applications for weeping skin lesions and for urethral irrigation—1 in 5,000 and 1 in 10,000 solutions
Treatment of snake bite (effective only if the venom is on the skin). It oxidize venom (within 1-2 minutes of bite).
 

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ADVERSE EFFECTS

P The crystals and concentrated solutions of KMnO4 are caustic and can cause corrosive burns.
M
Higher concentration can cause skin irritation, edema and mucous membrane turns brown.
o
P There can be staining of clothes
f Do not disinfect surgical instruments, rusting can happen.
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OF ORAL REHYDRATION SOLUTION

ORS is a simple, cheap and effective treatment for diarrhea-related dehydration, e.g. cholera or rotavirus. It consists of a
solution of salts and other substances such as glucose, sucrose, citrates or molasses, which is administered orally. It is
used around the world, but is most important in the Third World, where it saves millions of children from diarrhea, still
their leading cause of death.
 

WHO FORMULA (FOR 1 LITER SOLUTION)

Sodium chloride 3.5 g

Sodium citrate 2.9 g

Potassium chloride 1.5 g

Glucose anhydrous 20.0 g


 

OBJECTIVE OF ORS

To prevent dehydration
To reduce mortality.
 

PROCEDURE

Weigh the required quantities of sodium chloride, sodium citrate, potassium chloride and glucose. 26

Figure 5.1: Method to fold paper to make packet for powder.

Mix them on a paper placed over pill tile by using powder spatula.
Put the powder in a packet. Make a packet by folding a paper (Fig 5.1).
Label the packet and dispense.

ORAL REHYDRATION SALTS (ORS) IP

Sodium chloride 3.5 g

Sodium citrate 2.9 g

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Potassium chloride 1.5 g

Glucose anhydrous 20.0 g

P Directions: Dissolve the contents of powder in 1000 mL of freshly boiled and cooled water and take
M frequent sips
o Pharmacist's Sign Regd No.
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f Pharmacy, ABC Delhi
M Batch no. AB577
Mfg. date 26.02.2016
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Expiry date 25.02.2018
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The frequency of sips will depend on level of dehydration.

 

PHARMACOLOGICAL ACTIONS

In diarrhea loss of water and electrolytes leads to dehydration. Hence, both water and electrolytes are given for treatment
of dehydration. If water alone is given it will dilute the salts present in body and aggravates the condition.

WHO ORS (for 1 liter) provides following salts as mEq/L:

Na+ 90.0
K+ 20.0
HCO–3 30.0
Glucose 111.0
 Cl- 80.0
Osmolarity of 311 mOsm/L 27

215 calories.
 

PHARMACOLOGICAL ACTION OF SALTS

SODIUM CHLORIDE

As you know, sodium is the main ion involved in various processes in the body, e.g. action potential generation. It helps to
maintain muscle tone. Symptoms associated with hyponatremia are fatigue, muscle weakness, abdominal cramps,
confusion, hypotension, weak pulse, cyanosis, oliguria, tachycardia, loss of skin elasticity and dryness of mucous
membranes.
 

GLUCOSE

Glucose is the source of energy. Apart from that it helps in absorption of sodium. Molar ratio of glucose is more than
sodium in ORS. Sodium is absorbed through facilitated diffusion or cotransport with the help of glucose.

Other contents provide su cient amount of potassium, chloride and bicarbonate lost in diarrhea. Sodium citrate is
the source of HCO-3 and also provides stability to the solution. Potassium chloride in uences the muscle action and
ameliorates the cramps. Chloride helps to maintain the uid balance and production of gastric acid.
 

THERAPEUTIC USES

1. Diarrhea

Oral rehydration therapy is widely considered to be the best method for combating the dehydration caused by diarrhea
and/or vomiting. Rehydration does not stop diarrhea, but keeps the body hydrated and healthy until the diarrhea passes.
ORS is recommended in mild-to-moderate cases of diarrhea. Intravenous uids are required in severe cases of
dehydration.

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The amount of rehydration that is needed depends on the size of the individual and the degree of dehydration.
Rehydration is generally adequate when the person no longer feels thirsty and has a normal urine output. A rough guide
to the amount of ORS solution needed in the rst 4–6 hours of treatment for a mildly dehydrated person is:
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Up to 5 kg (11 lb): 200–400 mL
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o 5–10 kg (11–22 lb): 400–600 mL
P 10–15 kg (22–33 lb): 600–800 mL
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M 15–20 kg (33–44 lb): 800–1000 mL
S 20–30 kg (44–66 lb: 1000–1500 mL
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30–40 kg (66–88 lb): 1500–2000 mL
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40 plus kg (88 lb): 2000–4000 mL.
The degree of dehydration can be assessed by following parameters:
Pulse in dehydration has low volume and is thready.
No tears, dry mouth in case of moderate-to-severe dehydration.
Urine output is decreased in dehydration.

2. Heat stroke

3. In patients of burns/surgery to maintain hydration

4. Change from parenetral to enteral therapy

5. High-grade fever 28

Homemade ORS:

 In a glassful of water, add I teaspoonful of sugar and a pinch of salt. You can also add half a lemon.

Rice water and dal water can also be used.

or

An inexpensive home-made solution consists of 8 level teaspoons of sugar and 1 level teaspoon of table salt mixed
in 1 liter of water. A half cup of orange juice or half of a mashed banana can be added to each liter both to add
potassium and to improve taste.

Super-ORS

In this amino acids are added, e.g. alanine and glycine.

New WHO ORS

Because of the improved effectiveness of reduced osmolarity ORS solution, especially for children with acute, non-
cholera diarrhea, WHO and UNICEF now recommend that countries use and manufacture the following formulation in
place of the previously recommended ORS solution. Osmolality is reduced to 245 mmol/L.

Reduced osmolarity ORS:

Ingredient (grams/liter), ion (mmol/liter)

Sodium chloride (2.6), Sodium (75)
Glucose, anhydrous (13.5), Glucose, anhydrous (75)
Potassium chloride (1.5), Chloride (65)/Potassium (20)
Trisodium citrate, dihydrate (2.9), Citrate (10)
Total Osmolarity = 245. In the human body, the plasma osmolality is about 285 mOsm/L.
 

PRECAUTIONS

Hot water should not be used as it may lead to breakdown of bicarbonate and alteration in avor
Do not use if the solution is colored.
Always use freshly prepared solution.
The solution made should not be used 24 hours after its preparation as glucose in uid will lead to development of
infection.

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Use clean utensils to make solution.

Today, the total production is around 500 million ORS sachets per year, with the children's rights agency UNICEF
P distributing them to children in around 60 developing countries. ORS represents a cheap and effective way of reducing
M the millions of deaths caused each year by diarrhea.
o  
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f EXERCISE 5: TO PREPARE AND DISPENSE MOUTHWASH SOLUTION
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S Mouthwash/rinse is a liquid which is held in the mouth passively or swilled around the mouth by contraction of the
D perioral muscles and/or movement of the head.
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Formula for 100 mL:

For 100 mL

Sodium chloride 0.5 g

Sodium bicarbonate 2.5 g

Peppermint water 50 mL

PROCEDURE

Weigh out the required amount of sodium chloride and sodium bicarbonate. Put salt into a beaker. Add peppermint
water to the beaker.
Stir the contents so that contents are completely dissolved.
 Transfer contents into dispensing bottle, label and dispense. 29

LABELING

PHARMACOLOGICAL ACTIONS

Sodium chloride: It removes debris, kills bacteria, decreases plaque formation, prevents gingivitis, makes solution
isotonic and masks the unpleasant taste of sodium bicarbonate.

Sodium bicarbonate: It removes debris, dissolves proteins and also removes mucus crusts.

Mouthwash freshens the breath and prevents plaque formation and gingivitis. Commercial available mouthwashes are
chlorhexidine based or non-chlorhexidine based. Chlorhexidine mouthwashes stain the teeth, hence chlorhexidiene
washes can be used. Mouthwash can be analgesic, anti-in ammatory or antifungal.
 

THERAPEUTIC USES

Tonsillitis
Pharyngitis

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Aphthous ulceration
Gingivitis.

 
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o PRECAUTIONS
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f Do not take food/water for 15 minutes after the mouthwash rinse. Chlorhexidine containing mouthwashes usually stain
M the teeth. No-chlorhexidine mouthwashes are available now.
S  
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Thymol 0.06 g

Hard soap 0.72 g

Sodium bicarbonate 0.72 g

Saccharin 0.24 g

CaCo3 3.26 g
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PROCEDURE

Weigh required amount of each salt and mix these in mortar.

Transfer 5 g of tooth powder in the given sachet.
 Seal and label the sachet.

LABELING

PHARMACOLOGICAL ACTIONS

Thymol—It has antiseptic and antimicrobial properties.

Hard soap—It is abrasive in nature hence it has better cleaning effect.
Sodium Bicarbonate—It is alkaline in nature and hence prevents chances of caries.
Saccharin—It is a sweetening agent.
Calcium carbonate—It removes debris and satins.
 

USES

The major use of this preparation is to clean the teeth.

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