Compounding II

Question 1

Equipment used for HDs

Answer 1

Should be dedicated for HD preparation and sanitized after use

Question 2

What should be done for equipment that cannot be thoroughly sanitized?

Answer 2

Should not be used for HDs (any residue could contaminate other drugs)

Question 3

What must be done regularly to confirm accuracy?

Answer 3

Calibrated

Question 4

When measuring, which device should be selected to get the most accurate measurement?

Answer 4

One that has a measuring capacity equal or slightly larger than the amount being measured

Question 5

Measurements should always be made in which system?

Answer 5

Metric

Question 6

Graduates

Answer 6

Measuring equipment with lines on the glass that are used to measure the volume

Question 7

Graduated Cylinder

Answer 7

Has the same diameter from the top to the bottom of the container.

Provider more accurate measurements than conical versions or beakers.

Question 8

The wider the mouth

Answer 8

The lower the accuracy (of measurement)

Question 9

A graduate should not be used to measure…

Answer 9

Volumes less than 20% of the graduates capacity

Question 10

The bottom of “this” is at the center where the measurement is read.

Answer 10

Meniscus

Question 11

The most accurate device for measuring small volumes.

Especially useful for measuring viscous (thick) liquids, such as glycerin and mineral oil.

Answer 11

Syringes

Question 12

Patients receiving a liquid who require a very accurate dose should use…

Answer 12

An oral syringe for measurement

Question 13

Oral syringes are useful for squirting the medication into…which can be useful for children and animals.

Answer 13

Side of the mouth

Question 14

Which types of syringes are commonly used for sterile compounding (to transfer drugs and additives into IV bags)

Answer 14

Hypodermic (parenteral) Syringes

Question 15

All syringe packages

Answer 15

Should be wiped off with isopropyl alcohol 70% prior to being brought into the SEC

Question 16

Sterile syringes (that are individually wrapped) should be opened… in order to avoid shedding (release of particles) into the sterile space?

Answer 16

Along the seal

Question 17

Make secure, leak-free connections between syringes, catheters and IV lines.

Have male and female ends that screw together forming a tight seal.

Answer 17

Luer lock

Question 18

How to choose the correct size syringe?

Answer 18

• Do NOT use the EXACT size syringe needed
• Select the closest syringe size above the size needed
• Do not add two different syringe sizes for a dose

Question 19

Uses “For Oral Use Only” stickers over the syringe cap

Uses a syringe design that prevents connection to an IV port

Brightly colored plungers/caps that differentiate oral syringes vs IV syringes

Clear communication of the correct route of administration to the nurse

Answer 19

Safety measures used to avoid fatal medication errors

Question 20

Thin plastic or glass tubes used to measure small volumes.

Referred to as droppers

Can be used by patients to take medication

Answer 20

Pipettes

Question 21

Type of pipette that draws up a set volume only, which is the volume the pipette can hold.

Answer 21

Volumetric pipette

Question 22

Type of pipette that is graduated and is used to measure different volumes. Commonly used in compounding.

Answer 22

Mohr pipette

Question 23

Graduated droppers that meet USP Criteria

Answer 23

Release drops of water that weigh 45 - 55 mg when held vertically

Question 24

Sometimes called a Class A Balance. Requires calculation for the minimum weighable quantity (MWQ).

Answer 24

Class III Torsion Balance

Question 25

Sensitivity Requirement / Acceptable Error Rate (0.05 or 5%) = ?

Answer 25

MWQ

Question 26

Sensitivity Requirement

Answer 26

Most often 6 mg. Means 6 mg can be added or removed before the dial moves 1 division.

Question 27

Called an analytical balance or a scale. This balance is used most commonly. Has a higher sensitivity. Compounder must "tare" or "zero out" the balance after placing the weigh boat or glassine paper on the scale.

Answer 27

Electronic Balance

Question 28

With either balance, what must always be done?

Answer 28

Never place material to be weighted directly on the balance

Question 29

A compounding pharmacy needs at least (how many & which types)...mortar and pestle.

Answer 29

* One Glass * One Wedgewood OR Porcelain

Question 30

Type of mortar used for liquids, such as suspensions and solutions, and for mixing compounds that are oily or can stain.

Answer 30

Glass

Question 31

Type of mortars have a rough surface, and are preferred for grinding dry crystals and hard powders.

Answer 31

Wedgewood

Question 32

Type of mortars have a smooth surface, and are preferred for blending powders and pulverizing gummy consistencies.

Answer 32

Porcelain

Question 33

Used to mix and transfer (move) ingredients from one place (such as an oinment slab) to another place

Answer 33

Spatulas

Question 34

The flat part of the spatula blade can be used to:

Answer 34

* Flatten and Grind ingredients to pack preparations such as ointments into containers

Question 35

Which type of spatula would not be used if making a mixture that contains metallic ions?

Answer 35

Steel

Question 36

Which type of spatula is used to handle corrosive material?

Answer 36

Rubber

Question 37

A flat board made of porcelain or glass. Used as a work surface since the material is hard and non-reactive.

Answer 37

Ointment Slabs

Question 38

Can be used as a work surface if the water content of the mixture will not cause the paper to tear

Answer 38

Disposable parchment ointment pad

Question 39

Ointment Mills & Grinders reduce the particle size, which:

Answer 39

Increases the surface area & rate of drug absorption

Question 40

Draws the ointment (or another semi-solid preparation) between rollers that grind and homogenize the ingredients.

Answer 40

Ointment Mills

Question 41

Also called an electric mortar and pestle. Can be used to mix ointments, creams, or other semi-solid preparations. Similar to a smoothie blender. Can be small and hand-held.

Answer 41

Homogenizer

Question 42

Can save time by continuously stirring the mixture to dissolve and mix the ingredients.

Answer 42

A hot plate with a magnetic stirrer

Question 43

Helpful when the temperature needs to be carefully controlled. Protects the ingredients from overheating and burning. Water in the outer container separates the inner container from the direct heat source, to prevent burning.

Answer 43

Water bath

Question 44

Heating with Microwave Ovens

Answer 44

Heat quickly; Provides uneven heat.

Question 45

Used to prepare tablets, lozenges/troches (orally-dissolving tablets) and suppositories. Refrigeration helps soft products retain shape.

Answer 45

Reusable or Disposable Molds

Question 46

Two plastic or metal plates used to compress damp powder into tablets.

Answer 46

Tablet Press

Question 47

Ingredients that are recommended for use will be listed in either:

Answer 47

* The USP National Formulary (USP-NF) * The Food Chemicals Codex (FCC)

Question 48

Pork-derived and will not be suitable for some patients

Answer 48

Gelatin capsules

Question 49

Plant-derived capsule material

Answer 49

Hypromellose

Question 50

Size 000

Answer 50

Largest Capsule Size

Question 51

Size 5

Answer 51

Smallest Capsule Size

Question 52

Do not produce therapeutic effects, but are needed to make the dosage form stable, functional and, with some oral dosage forms, palatable.

Answer 52

Excipients

Question 53

What should be obtained the confirms the specifications and quality if any substance comes from a non-FDA registered facility?

Answer 53

Certificate of Analysis (CoA)

Question 54

If there in an ingredient without an expiration date...

Answer 54

The pharmacist will assign a cautious date that is no more than 3 years from the date of receipt (the day the pharmacy received the item) Label should include: * Date of Receipt * Assigned Expiration Date

Question 55

Lowers the surface tension between two ingredients (or phases) in a preparation to make them more miscible.

Answer 55

Surfactant

Question 56

In surfactants, the side of the phase that is close tot he other phase is...

Answer 56

The "face"

Question 57

Common mechanism of action of a surfactant involves...

Answer 57

Forming a micelle structure

Question 58

Surfactants are amphiphillic, meaning:

Answer 58

They are both hydrophyllic (on one side) and hydrophobic (on the other side)

Question 59

Type of surfactant that reduce the surface tension between a liquid and a solid. Can also be referred to as Levigating Agents.

Answer 59

Wetting Agent

Question 60

Type of surfactant that is added to an emulsion to keep the liquid droplets dispersed throughout the liquid vehicle. Helps prevent the two liquids from separating into distinct phases. Can be called emulgents.

Answer 60

Emulsifiers

Question 61

Type of surfactant added to suspensions to help keep the solid particles from settling. Must be shaken to redisperse the solid prior to use.

Answer 61

Suspending Agent

Question 62

A type of Suspending Agent that will make a preparation easier to shape or mold.

Answer 62

Plasticizer

Question 63

Type of surfactant used to grind down particles. Mineral oil is a commonly used example for lipophilic compounds. Glycerin or Propylene Glycol are used for aqueous (water-soluble) compounds.

Answer 63

Levigating Agent

Question 64

Help foam to form by lowering the surface tension of water.

Answer 64

Foaming Agent

Question 65

Higher HLB #

Answer 65

More H2O Soluble (O/W)

Question 66

Lower HLB #

Answer 66

More Lipid Soluble (W/O)

Question 67

The HLB Scale Range

Answer 67

0 - 20

Question 68

Taste is not palatable. They are primarily used topically.

Answer 68

W/O Formulations

Question 69

Compound is Oxidized

Answer 69

Loses electrons

Question 70

Compound is Reduced

Answer 70

Gains electrons

Question 71

Type of Degradation that is visible with a color change.

Answer 71

Oxidation

Question 72

Becomes amber-colored. Begins with change in the alcohol functional group in the sugar.

Answer 72

Epinephrine oxidation

Question 73

Presence of which functional group on a benzene ring makes oxidation more likely?

Answer 73

Hydroxyl (-OH)

Question 74

How can oxidation be prevented?

Answer 74

Carefully control changes in temperature and pH * Light Protection * Adequate Storage (Refrigeration) * Chelating Agents (have the letters ED) * Antioxidants (inhibit free radicals) * Buffers (pH maintenance)

Question 75

Type of Degradation occurs when water cleaves a bond in a molecule.

Answer 75

Hydrolysis

Question 76

Which types of functional groups are susceptible to hydrolysis?

Answer 76

* Esters (O=C-OR) * Amide (O=C-N) * Lactam, a cyclic Amide (N-H)

Question 77

How can hydrolysis be prevented?

Answer 77

Compounds should be protected from moisture * Light Protection * Dessicants * Lyophillized (freeze-dried) Powder * Hydroscopic (water-absorbing) Salt * Prodrugs * Control Temperature (hydrolysis occurs more rapidly at higher temps) * Buffer (pH maintenance)

Question 78

Includes compounds that are sensitive to light such as ascorbic acid, folic acid, nitroprusside, and phytonadione injections. Sensitivity to UV light exposure causes breakage of covalent bonds.

Answer 78

Photolysis

Question 79

Compound changes into a form with the same atoms but an inactive structure

Answer 79

Isomerization

Question 80

Compound changes into an isomer that differs only in the configuration of the atoms

Answer 80

Epimerization

Question 81

Methods that limit drug degradation

Answer 81

* Excipients * Light Protection * Packages * Proper Storage