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Chap - 4


refers to type of preparation in which the drug is supplied drug form
drugs are prepared, by pharmaceutical companies, in the form(s) most suitable for its intended route of delivery and means of absorption
drug form and drug preparation are synonymous
PDR lists forms available for each drug under the heading how supplied
capsule cap
elixir elix
suppository supp
suspension susp
intramuscular IM
intravenous IV
intravenous piggyback IVPB
oral PO, po, per os
rectal R
subcutaneous subq
drug molecules are present in variety of sizes/shapes allowing for absorption through skin at various rates dermal patches
dermal patches transdermal delivery system
dermal patches provide a __, __ flow of a drug over a long period of time constant, even
consistent blood level of drug because drug is released at ___ rates, rather than all at once varying
most common use today for dermal patches is for prevention of angina
disk of compressed drug; variety of shapes/colors; coated to enhance swallowing; may be scored to enhance equal distribution if it has been broken tablet
evenly divided in halves or quarters by line scored
tablet w/special coating that resists disintegration by gastric juices; dissolves further down GI tract, in intestinal region enteric-coated tablet
drug contained w/in gelatin-type container; easier to swallow; chamber may be pulled apart to add drug powder to soft foods capsule
capsule containing drug particles that have various coatings that differ in amount of time required before coatings dissolve; designed to deliver dose of drug over period of time time-released/sustained-released capsule
advantage of time-released/sustained-released capsule form is decreased frequency of administration
time-released/sustained-released capsules contain different colored pellets which cannot be crushed or mixed with food
if the coating of the different colored pellets in time-released/sustained-released capsules is damaged it will cause the drug to be released all at once
time-released/sustained-released capsules should be swallowed whole
tablets containing palatable flavoring, indicated for a local effect on the throat or mouth lozenge (troche)
lozenges should be allowed to dissolve in the mouth
in order to prevent washing of the lozenge contents from the throat/mouth, patient is advised not to __ __ for 15 minutes after administration drink liquids
liquid form of medication that must be shaken well before administration because drug particles settle at bottom of bottle; drug not evenly dissolved in liquid suspension
common antibiotic suspension for children cephalosporin (Keflex)
liquid drug preparation that contains oils and fats in water emulsion
liquid drug forms w/alcohol base; should be tightly capped to prevent alcohol evaporation; should not be available to alcoholics elixir, fluid extract
sweetened, flavored liquid drug form syrup
liquid drug form in which drug is totally, evenly dissolved; appears clear, rather than cloudy/settled oral solution
commonly available OTC and include thousands of trade name products oral route administered drugs
drug suspended in a substance, such as cocoa butter, that melts at body temperature suppository
drug suspended in solution to be administered as an enema enema solution
often the choice of administration if patient is ordered NPO or cannot swallow rectal route of administration
sedatives, antiemetics, & antipyretics are most commonly administered rectally
drug suspended in a sterile vehicle injectable solution
injectable solutions w/sterile water base are referred to as aqueous solutions
injectable solutions w/oil base are referred to as viscous solutions
dry particles of drugs; must be mixed w/sterile diluting solution to render injectable powder
sterile water or saline solution used to dilute powder form reconstitution of a drug
powder forms are supplied undiluted because of the short period of time they remain ___ after dilution stable
various injection routes differ according to the type of tissue into which the drug is deposited and the rate of absorption
injected directly into a vein; immediate absorption & availability to major organs renders dangerous intravenous
small volume of drug injected through syringe & needle into peripheral saline lock, attached to a vein IV push
IV push can also be injected into a port on a __ __ __ primary injection line
large volume of fluids, often with drugs added, that infuse continually into a vein IV infusion/drip
when adding medication to IV solution bag through the injection port, in order to disperse the drug throughout the solution instead of concentrating at the bottom of the bag, it is necessary to invert bag a few times
drug diluted in moderate volume (50-100mL) of fluid for intermittent infusion at specified intervals, usually q6-8h IV piggyback (IVPB)
with an IVPB the diluted solution is infused into a port on the main __ __ or into a __ __ on the catheter IV tubing; rubber adapter
injected into a muscle, by positioning needle & syringe at 90-degree angle from the skin; absorption fairly rapid due to vascularity of muscle intramuscular injection
injected into fatty layer of tissue below skin by positioning needle/syringe at 45-degree angle from skin subcutaneous injection
subcutaneous injection may be route of choice for drugs that should not be absorbed as rapidly as through the IV & IM routes
injected just beneath skin, by positioning needle bevel up & syringe at 15-degree angle from skin; primarily for allergy testing intradermal injection
intradermal injection causes greatest reaction in __ tissue local
when small amount of drug injected intradermally the amount of redness can determine whether a person is sensitive to a drug
TB tests are administered intradermally
redness alone, without swelling, on a TB test does not indicate a positive result; the raised area is measured
injected into catheter placed by anesthesiologist in epidural space of spinal canal; pain medicine administered by bolus or continuous infusion through tubing attached to bag of saline solution epidural
epidural catheters have been used to administered opioid analgesics for chronic intractable pain & chemotherapy
have become popular & widely accepted vehicle for management of acute, postoperative pain epidurals
injected directly into heart; used to administer adrenaline as last resort to resuscitate patient whose heart has stopped intracardiac injection
injected into subarachnoid space that surrounds spinal cord; frequently anesthetics which render lack of sensation to those regions distal to injection intraspinal injection
intracardiac & intraspinal injections are less common parenteral routes which are limited to physician administration
injected into capsule of a joint, usually to reduce inflammation intracapsular (intra-articular)
shoulders, elbows, wrists, ankles, knees, & hips are joints often injected with anti-inflammatory drugs for arthritis / bursitis
drugs for dermal/mucosal application topical drugs forms
semisolid preparation containing a drug, for external application; dose differs for each cream/ointment
cream/ointment are topical drug forms used for dermal application
if the skin is wet use cream
if the skin is dry use ointment
liquid preparation applied externally for treatment of skin disorders medicated lotion
unlike hand lotions, medicated lotions should be __ __ __ on the affected skin patted not rubbed
preparation for external use that is rubbed on the skin as a counterirritant liniment
liniments create a different sensation that helps to __ __ in the skin or muscles mask pain
skin patch containing drug molecules that can be absorbed through skin at varying rates promoting consistent blood level between applications dermal patch
most common route of administration for nitroglycerin dermal patch & ointment
vasodilator used in treatment of angina nitroglycerin
ability to prevent angina by slow, consistent release of drug over period of time nitroglycerin external application advantages
prior to external applications, nitroglycerin was administered sublingually at the time of angina attack
1-5 inches applied q8h measured & applied on special Appli-Ruler paper nitroglycerin ointment
one patch (avail. in varied dosages) usually applied every 24 hours for angina; or applied every 24-72 hours depending on condition treated nitroglycerin dermal patch
other drug preparation considered topical are those that are applied to mucosal membranes
drugs in sterile liquids to be applied by drops; referred to as instillation of drops eye, ear, & nose drops (gtt)
sterile semisolid preparation, often antibiotic in nature, for ophthalmic use only eye ointment
medicated creams, often antibiotic/antifungal in nature, to be inserted vaginally with use of special applicator vaginal creams
drug suspended in substance that melts at body temp, for local effect rectal & vaginal suppositories
sterile solution, often an antiseptic, used to irrigate vaginal canal douche solution
tablet that is absorbed via the buccal mucosa in mouth; not to be swallowed; dissolve between cheek & gum; not commonly used today buccal tablet
tablet absorbed vie mucosa under tongue; not to be swallowed; dissolves slowly under tongue sublingual tablet
sublingual nitroglycerin most common sublingual tablet, reaching bloodstream immediately via sublingual capillaries
liquid drug forms that may be inhaled as fine droplets via use of spray bottles, nebulizers, or metered dose inhalers spray/mist
in a hospital setting __ __ install liquid into chamber of nebulizer for patient's breathing treatment respiratory therapists
bronchodilator, mucolytic agent, or sterile saline solution for moisture are common liquids instilled in nebulizers
rely on use of inhalers to keep their bronchioles open by inhaling the mist of a bronchdolator asthma patients
anesthetics that are introduced via the respiratory route for general anesthesia gas
used for dispensing tablets & capsules paper medicine cups
used for dispensing oral liquid medications; measurements marked on the sides plastic 1-oz medicine cups
crushes pills into fine powder that can be added to a beverage/food and taken, instead of having to swallow the whole pill at one time metal pillcrusher
glass cup in which tablets may be placed to be crushed mortar
club-shaped glass tool used as the crushing device to pulverize tablets pestle
ampules, vials, or prefilled syringes contain injectable medications
small glass container that holds a single dose of sterile solution for injection; must be broken at neck to obtain solution ampule
glass container sealed at top by rubber stopper to enhance sterility of contents; may be solution/powered drug that needs to be reconstituted; multiple/single dose vial
contain large quantities of solution (up to 50 mL) & may be entered repeatedly through rubber stopper to remove portions of contents multiple-dose vials
contain small quantities of solution (1-2 mL) that are removed during a single use; widely used as means of controlling abuse/removal of excess amounts of solution from a drug vial unit-dose vials
needle length varies from short, 3/8" to medium 1 to 1-1/2 for standard injections
may be used by physician for intraspinal/intracardiac routes 5" long needle
needle 2-5" long used by physician for intra-articular injections
number that represents diameter of needle lumen gauge
vary from 16 (largest) to 27 (smallest, with higher numbers representing smaller lumen needle gauges
standard hypodermic, tuberculin, & insulin are the 3 most common disposable syringes for parenteral administration
when a patient is to apply an eye ointment, the medication is administered for its local effect
all hypodermic syringes are marked with calibration of 10 calibrations per mL
all insulin dosages should be checked by __ __ prior to administration two caregivers
when administering an injection of 2-3 mL solution a __ __ syringe should be used standard hypodermic
standard hypodermic can be used for subQ or IM injections
when using a standard hypodermic syringe you must know the amount of solution needed to the nearest 0.1 mL
total capacity is only 1 mL; very narrow & finely calibrated; 100 fine calibration lines marking capacity; each line represents 0.1-mL increments; most commonly used for newborn/pediatric dosages & intradermal skin tests TB syringe
used strictly for administering insulin to diabetics; 1-mL capacity equivalent to 100 units of insulin; each calibration is counted as 2 units insulin syringe