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1 Paradigm Publishing Inc 1 Chapter 4 Dosage Forms and Routes of Administration Paradigm Publishing Inc 2 Solid Dosage Forms A dosage form is the physical manifestation of a drug Solid ID: 489150

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Slide1

Chapter 4

Dosage Forms and Routes of AdministrationSlide2

Solid Dosage FormsA dosage form is the physical manifestation of a drug:

SolidLiquidGasDrug delivery system affects how the drug is released in the body.Slide3

Terms to Rememberdosage form

the physical manifestation of a drug (e.g., capsule, tablet)drug delivery system a design feature of the dosage form that affects the delivery of the drug; may protect the stomach or delay the release of the active drugSlide4

Solid Dosage Forms

Although tablets and capsules may have distinctive markings and colors, the pharmacy technician should rely on the drug label and the NDC (National Drug Code) number, not the look of the medication, when confirming the identity of a drug.Slide5

Solid Dosage FormsTabletsCapsules

Lozenges, Troches, or PastillesPowders and GranulesSlide6

TabletsAvailable in a variety of sizes and shapesProduced by compression

Contain one or more active ingredients plus inactive ingredients (see Table 4.1)Slide7

TabletsSlide8

TabletsMultiple compression tablet (MCT) is either a

Tablet on top of another tablet, orTablet within a tabletCore and shells or layers each contain differentmedicineSlide9

Terms to Remembertablet

the solid dosage form produced by compression and containing one or more active and inactive ingredientsmultiple compression tablet (MCT) a tablet formulation on top of a tablet or a tablet within a tablet, produced by multiple compressions in manufacturingSlide10

Tablets

Caplet just tablet shaped like capsuleSolid interior, unlike capsuleAdvantagesEasier to swallow than large tabletLonger shelf-life than capsule

More tamper-proof thancapsuleSlide11

TabletsChewable tablets contain a flavored and/or colored base:

AntacidsAntiflatulentsVitamins Children’s tabletsOral disintegrating tablets (ODT) melt in the mouth; preferred for those who have difficulty swallowingSlide12

Terms to Remembercaplet

a hybrid solid dosage formulation sharing characteristics of both a tablet and a capsuleSlide13

Terms to Remember

chewable tablet

a solid oral dosage form meant to be chewed; readily absorbed; commonly prescribed for school-age childrenoral disintegrating tablet (ODT) a solid oral dosage form designed to dissolve quickly on the tongue for oral absorption and ease of administration without waterSlide14

TabletsCoatings can be used to improve

AppearanceFlavorEase of swallowing Slide15

TabletsCommon tablet coatings

Sugar-coated tablet (SCT): improves taste and appearance; easier to swallowFilm-coated tablet (FCT): improves appearance; can lessen side effectsEnteric-coated tablet (ECT): designed to bypass stomach and be absorbed in small intestineSlide16

Tablets

ECT or delayed-release tablets should not be split.Slide17

CapsulesConsist of a gelatin shell that encloses the drug

Contain powders, granules, or liquidsMay also containInert filler (diluent)DisintegrantsSolubilizersPreservativesSlide18

Terms to Remembercapsule the dosage form containing powder, liquid, or granules in a gelatin covering

diluent an inactive ingredient that allows for the appropriate concentration of the medication in the tablet or capsule; also used to reconstitute parenteral productsSlide19

CapsulesMost tablets and capsules are immediate-release.

Some are not immediate-release:Controlled-release: intended to regulate the rate at which a drug is releasedSustained-release (SR): dosing reduced from immediate-releaseExtended-release : dosing reduced from immediate-release and most sustained-release formsSlide20

Terms to Remembercontrolled-release dosage form

the dosage form that is formulated to release medication over a long duration of time; also called delayed releaseSlide21

Terms to Remember

sustained-release (SR) dosage form

a delayed-release dosage form that allows less frequent dosing than an immediate-release dosage formextended-release (XL) dosage form a tablet or capsule designed to reduce frequency of dosing compared with immediate-release and most sustained-release formsSlide22

Capsules

Watch drug labels very carefully! A sustained-release (SR) dosage form is not the same as an extended- release (XL) dosage form of the same drug.Slide23

Lozenges, Troches,or PastillesContain active ingredients and flavorings that are dissolved in the mouth

Usually have a local therapeutic effectExamples includeOTC lozenges for sore throatPrescription drugs such as nystatin or clotrimazoleSome narcotic medicationsSlide24

Terms to Rememberlozenge a medication in a sweet-tasting formulation that is absorbed in the mouthSlide25

Powders and GranulesPowders are milled and pulverized by machines.Examples include

Bacitracin zincAntacidsBrewer’s yeastLaxativesSlide26

Powders and GranulesGranules are larger than powders.

Granules are formed by adding small amounts of water to powders.Granules can be compressed into tablets or enclosed in capsules.Granules generally haveAn irregular shapeExcellent flow characteristics

Greater stability than powdersSlide27

Powders and GranulesEffervescent salts are coarse powders or granules containing both

Medicinal agent(s)Sodium bicarbonate with an acidWhen dissolved in water, effervescent salts release carbon dioxide gas, causing distinctive bubbling.Slide28

Terms to Rememberpowders

fine particles of medication used in tablets and capsulesSlide29

Terms to Remember

granules a dosage form larger than powders that is formed by adding very small amounts of liquid to powders

effervescent salts granular salts that release gas and dispense active ingredients into solution when placed in waterSlide30

Semisolid Dosage FormsAn emulsion is a mixture of two unblendable substances.

An oil-in-water emulsion contains a small amount of oil dispersed in water as a cream or lotion.A water-in-oil emulsion contains a small amount of water dispersed in oil as an ointment.Slide31

Semisolid Dosage FormsOintmentsCreams

GelsSuppositoriesSlide32

Ointments

Can be medicated or nonmedicatedMay contain various basesOleaginous, such as mineral oil or petroleum jellyW/O emulsions such as lanolin or cold creamO/W emulsions such as hydrophilic ointment

Water-soluble bases such as polyethylene glycolSlide33

Terms to Rememberointment a semisolid emulsion for topical use on the skinSlide34

OintmentsA paste is like an ointment but with more solids, such as zinc oxide paste.

A plaster is a preparation that adheres to the body and contains a backing material.Slide35

Terms to Rememberliniment

a medicated topical preparation for application to the skin, such as Ben GaySlide36

Terms to Remember

paste a water-in-oil (W/O) emulsion containing more solid material than an ointment

plaster a solid or semisolid, medicated or non-medicated preparation that adheres to the skinSlide37

CreamsCreams are a O/W emulsion and are usually invisible once applied.

Lotions are topical O/W emulsions that are easily absorbed:Calamine lotion (to relieve itching)Benzoyl peroxide (for acne)Slide38

Terms to Remembercream a cosmetically acceptable oil-in-water (O/W) emulsion for topical use on the skin

lotion a liquid for topical application that contains insoluble dispersed solids or immiscible liquidsSlide39

GelsA gel contains solid particles in liquid.A jelly is a type of gel that contains a higher proportion of water.

A glycerogelatin is a topical preparation made with gelatin, glycerin, water, and medicine.Slide40

SuppositoriesHave a base of cocoa butter or glycerinAre designed to melt when inserted into a body orifice, such as the rectum or vaginaSlide41

Liquid Dosage FormsConsist of one or more active ingredients in a liquid vehicle

Often less stable than solidsAllow easier dosage adjustmentsOften used for children’s medication – can be flavored to improve complianceSlide42

Liquid Dosage FormsSolutionsDispersionsSlide43

Solutions

Active ingredients are completely dissolved in liquid vehicle:Aqueous (water-based)Alcoholic (alcohol-based)Hydroalcoholic (water-and-alcohol-based)Solute is the active ingredient.Solvent is the liquid vehicle.Slide44

Terms to Remember

solution a liquid dosage form in which the active ingredients are completely dissolved in a liquid vehiclesolute an ingredient dissolved in a solution or dispersed in a suspensionsolvent the vehicle that makes up the greater part of a solutionSlide45

SolutionsAromatic water is a solution of water and oils that are easily released into the air (e.g., rose water).

An elixir is a clear, sweetened, flavored solution containing ethanol and an active ingredient (phenobarbital elixir).A syrup is an aqueous solution thickened with sugar and often used to mask taste of pediatric medications.Slide46

Liquid Dosage Forms

Syrups should be used cautiously in diabetic patients because of high sugar content.Slide47

SolutionsAn extract

is a potent dosage derived from animal or plant sources, with most of the solvent having been evaporated.A fluidextract is a liquid dosage extracted from plants and commonly used in syrups (such as vanilla).A tincture is an alcoholic or hydroalcoholic solution of plant extractions (such as iodine).Slide48

SolutionsOther solutions include

Spirits, such as camphor or peppermint spiritIrrigation solutions, used to cleanse the ear, eye, or wounds and incisionsSlide49

Terms to Rememberspirit an alcoholic or hydroalcoholic solution containing volatile, aromatic ingredients

irrigating solution any solution used for cleansing or bathing an area of the body, such as the eyes or earsSlide50

Solutions

Solutions are sometimes classified by their site or method of administration:Topical (local)Systemic (throughout the body)Epicutaneous (on the skin)Percutaneous (through the skin)

Oral (by mouth)Otic (by ear)

Ophthalmic (by eye)Parenteral (by injection)Rectal (by rectum)

Urethral (by urethra)

Vaginal (by vagina)Slide51

Terms to Rememberparenteral solution

a product that is prepared in a sterile environment for administration by injectionSlide52

DispersionsIn a dispersion

, medication is distributed throughout the vehicle but is not totally dissolved.A suspension is the dispersion of an undissolved solid in a liquid.Suspensions are useful for those who may have difficulty swallowing solid forms.Slide53

Dispersions

The drug stock bottles of liquid suspensions and emulsions for oral use should always be shaken well by pharmacy technicians before being poured into smaller medication bottles.Slide54

DispersionsColloids have properties between a solution and a fine suspension. Milk of magnesia and Aveeno (with colloidal oatmeal) are examples.

Microemulsion contains oneliquid dispersed in another, such as Haley’s M-O andCompound W.Slide55

Terms to Remember

colloid the dispersion of ultrafine particles in a liquid formulationSlide56

Terms to Remember

magma

a milklike liquid colloidal dispersion in which particles remain distinct, in a two-phase system (e.g., milk of magnesia)microemulsion a clear formulation that contains one liquid of extremely fine sized droplets dispersed in another liquid (e.g., Haley’s M-O)Slide57

Inhalation Dosage FormsInhalations are inhaled through the nose or mouth.

Dosages can be delivered via spray or aerosol.Inhalations are often used to treat allergies and asthma.Slide58

Terms to Remember

spray the dosage form that consists of a container with a valve assembly that, when activated, emits a fine dispersion of liquid, solid, or gaseous materialaerosol a pressurized container with propellant used to administer a drug through oral inhalation into the lungsSlide59

Transdermal Dosage FormsDelivers drug to the bloodstream by absorption through the skin

Transdermal patch consists ofBackingDrug reservoirControl membraneAdhesive layerProtective stripSlide60

Transdermal Dosage FormsAbsorption occurs slowly.Effects last 24 hours to 1 week.

Used to deliverNicotine (smoking cessation)Nitroglycerine (chest pain)Narcotic analgesics (chronic pain)Scopolamine (motion sickness)Slide61

Terms to Remembertransdermal dosage form

a formulation designed to deliver a continuous supply of drug into the bloodstream by absorption through the skin via a patch or diskSlide62

Routes of AdministrationRoute of administration is a way to get a drug into or onto the body.

Routes can produce a systemic effect or a local effect.Slide63

Terms to Rememberroute of administration

a way of getting a drug onto or into the body, such as orally, topically, or parenterallyoral route of administration the administration of medication through swallowing for absorption along the GI tract into systemic circulationSlide64

Routes of AdministrationSome routes produce a systemic effect:

Oral (by mouth)Sublingual (under the tongue)Buccal (between gum and cheek)Slide65

Terms to Remembersystemic effect

the distribution of a drug throughout the body by absorption into the bloodstreamSlide66

Terms to Remember

sublingual route of administration oral administration in which a drug is placed under the tongue and is rapidly absorbed into the bloodstreambuccal route of administration oral administration in which a drug is placed between the gum and the inner lining of the cheek; also called transmucosal route of administrationSlide67

Routes of Administration

Other routes produce a local effect:Topical (on the skin)Intrarespiratory (inhaled into the lungs)Ocular (to the eye)Conjunctival (to the lining of the eyelid)

Otic (to the ear canal)Nasal (to the nose)Rectal (to the rectum)

Vaginal (to the vagina)Urethral (to the urethra)Slide68

Terms to Remembertopical route of administration

the administration of a drug on the skin or any mucous membrane such as the eyes, nose, ears, lungs, vagina, urethra, or rectum; usually administered directly to the surface of the skinlocal effect the site-specific application of a drugSlide69

Terms to Rememberintrarespiratory route of administration

the administration of a drug by inhalation into the lungs; also called inhalationocular route of administration the placement of ophthalmic medications into the eyeSlide70

Terms to Rememberconjunctival route of administration

the placement of sterile ophthalmic medications in the conjunctival sac of the eye(s)otic route of administration the placement of solutions or suspensions into the earSlide71

Terms to Remember

nasal route of administration the placement of sprays or solutions into the nose

rectal route of administration the delivery of medication via the rectumSlide72

Terms to Remembervaginal route of administration

the administration of a drug by application of a cream or insertion of a tablet into the vaginaurethral route of administration the administration of a drug by insertion into the urethraSlide73

Routes of AdministrationSome medications must be administered

via the parenteral route because their molecules are too large or are broken down too quickly.Drugs are distributed systemically by injection or catheter.Slide74

Terms to Rememberparenteral route of administration

the injection or infusion of fluids and/or medications into the body, bypassing the GI tractinjection the administration of a parenteral medication into the bloodstream, muscle, or skinSlide75

Advantages and Disadvantages of the Oral Route

AdvantagesConvenientEasy to tolerateSafeSimple to administerFractional doses can be taken by splitting scored tabletsSlide76

Advantages and Disadvantages of the Oral Route

DisadvantagesDelayed onsetDestruction of the drug by GI fluidsDelayed absorption due to food and drink in the stomachFor liquids, potential unpleasant tasteFor controlled-release formulations, cannot be split or crushedSlide77

Advantages and Disadvantages

of the Oral Route

The oral route is not appropriate for patients who are experiencing nausea or vomiting.Slide78

Dispensing and Administering Oral Medications

Pharmacists should tell patientsWhat foods to take or not takeWhat behaviors to avoid (sun, driving)Methods for swallowing pillsHow to store medicationsSlide79

Dispensing and Administering Oral Medications

Measuring utensils are often dispensed with the medications:SpoonsCupsOral syringes (for pediatric meds)Droppers (for infant meds)Slide80

Terms to Rememberoral syringe a needleless device for administering medication to pediatric or older adult patients unable to swallow tablets or capsules

dropper a measuring device used to accurately dose medication for infantsSlide81

Advantages and Disadvantages of the Topical Route

Generally, the topical routeWorks quicklyProduces a therapeutic effect that is localizedProvides fast reliefHas fewer side effects than with a systemic medicationSlide82

Advantages and Disadvantages of the Topical RouteOintments

Good for extremely dry areasGreasy feelTransdermalSteady level of drug, good complianceCostly, occasional skin irritationSlide83

Advantages and Disadvantages of the Topical Route

Inhalation

Fast acting, delivers metered doseOften poor technique by patientSlide84

Terms to Remembermetered-dose inhaler (MDI)

a device used to administer a drug as compressed gas through the mouth into the lungsSlide85

Terms to Remember

diskus a nonaerosolized powder used for inhalation

nebulizer a device used to deliver medication as a mist to the lungs; often used in treating asthmaSlide86

Advantages and Disadvantages of the Topical RouteVaginal and urethral

Higher concentration of medicationInconvenient and messy to useRectalBypasses digestive system, good for nauseous patientsInconvenient to use, may cause discomfortSlide87

Dispensing and Administering Topical Medications

Ointments, creams, lotions, and gelsMight require use of gloves to avoid too much drug absorption (nitroglycerin gel) or to avoid irritation (capsaicin)Might need to be applied sparingly to avoid side effects (corticosteroids)Slide88

Dispensing and Administering Topical Medications

Transdermal patchesSite must be relatively free of hair and scar tissue.Rotate application site.Follow patch replacement schedule.Slide89

Dispensing and Administering Topical Medications

Ophthalmic medicationsShould be at or near room or body temperatureMust be stored properlyShould be applied with clean handsShould be applied with proper techniquefor dispensing dropsor ointment into eyeSlide90

Dispensing and Administering Topical Medications

Otic medicationsShould be at or near room or body temperatureShould be applied with proper technique to ensure medication reaches targetSlide91

Dispensing and Administering Topical Medications

Eardrops can never be used in the eye, but eyedrops can be used in the ear.Slide92

Dispensing and Administering Topical Medications

Nasal medicationsNasal medications are applied by drops (instillation), sprays, or aerosols.Proper technique is key to avoid sniffing medication into sinuses.Patients must not overuse OTC nasal decongestants.Slide93

Dispensing and Administering Topical Medications

Inhaled medicationsProper technique must be followed to ensure that medication reaches the lungs.With cortisone MDIs, patient should rinse mouth after application to avoid fungal infections.Spacer devices can be

used with inhalers for children.Slide94

Dispensing and Administering Topical Medications

Vaginal medicationsThe vaginal route is indicated for infections or hormone replacement.Creams and ointments are often delivered via applicator tube.For contraception, hormones can be delivered via a ring

surrounding the cervix.Intrauterine devices can deliver medication for

contraception or cancertreatment.Slide95

Dispensing and Administering Topical Medications

Rectal medicationsPatients should be instructed to remove wrappers before using.Patients should be instructed on proper orientation of suppository before insertion.Proper technique should be followed when administering enemas.Slide96

Dispensing and Administering Topical Medications

Refrigeration is necessary to store most rectal medications.Slide97

Advantages and Disadvantages of the Parenteral Route

AdvantagesCan deliver high concentrations of medi-cation at once or over long period of timeCan be administered to almost any organ or part of the bodyActs quicklySlide98

Advantages and Disadvantages of the Parenteral Route

DisadvantagesPossible injury from needle insertionPotential for introducing toxic agents into the bodyMicrobesPyrogensMust be administered carefully to avoid introduction of air bubbles or particulatesSlide99

Terms to Rememberintravenous (IV) infusion

the process of injecting fluid or medication into the veins, usually over a prolonged period of timepyrogen a fever-producing by-product of microbial metabolismSlide100

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