1
Q
are problems that could arise during the compounding or dispensing of a prescription
A
MEDICATION INCOMPAT
2
Q
it is a result of prescribing together substances that adversely affect the appearance or elegance, safety, or therapeutic efficacy of the product
A
INCOMPAT
3
Q
INCOMPAT is generally ____
A
UNINTENTIONAL
4
Q
INCOMPAT can be determined by knowing the ____ and ____
A
physical & chemical attributes
5
Q
TWO FORMS OF INCOMPAT
A
IN VITRO
IN VIVO
6
Q
FORMS OF INCOMPAT
includes physical and chemical incompatibilities
A
IN VITRO
7
Q
FORMS OF INCOMPAT
includes therapeutic incompatibilities
A
IN VIVO
8
Q
are observed MOST EASILY and can be detected by changes in the APPEARANCE of the admixture, such as change in color, formation of precipitate, or evolution of gas
A
PHYSICAL INCOMPAT
9
Q
PHYSICAL INCOMPAT
- Insolubility
- Immiscibility
A
INCOMPLETE SOLUTION
10
Q
PHYSICAL INCOMPAT
INCOMPLETE SOLUTION:
* it is the INABILITY of a solid material to DISSOLVE in a particular solvent system
* usually happens between solids and liquids
* EX: Camphor & Water
A
INSOLUBILITY
11
Q
PHYSICAL INCOMPAT
CLASSIFY:
* Camphor and Water
A
INSOLUBILITY
12
Q
PHYSICAL INCOMPAT
INCOMPLETE SOLUTION | INSOLUBILITY:
* Camphor is more ____ and is not soluble in ____
A
more non-polar
not soluble in water
13
Q
PHYSICAL INCOMPAT
INCOMPLETE SOLUTIION | INSOLUBILITY:
* Camphor is soluble in ____, ____, ____
A
alcohol
ether
chloroform
14
Q
ALCOHOLIC SOLUTION of Camphor is known as ____
* used for temporary relief of aches
A
SPIRITS OF CAMPHOR
15
Q
PHYSICAL INCOMPAT
CLASSIFY:
* Gum and Alcohol
A
INSOLUBILITY
16
Q
PHYSICAL INCOMPAT
INCOMPLETE SOLUTION
| INSOLUBILITY:
* Gum is soluble ONLY in ____
A
water
17
Q
PHYSICAL INCOMPAT
INCOMPLETE SOLUTION:
* it is a condition wherein two or more LIQUIDS fail to dissolve or mix with one another
* usually happenes between two liquids
* EX: Oil and Water
A
IMMISCIBILITY
18
Q
PHYSICAL INCOMPAT
- it involves the SEPARATION of a solid by physical causes but NO NEW PRODUCT is being formed
- can be caused by:
- salting out
- change in solvent system
- change in pH
- change of temperature
A
PRECIPITATION
19
Q
PHYSICAL INCOMPAT
PRECIPITATION:
* concentrated solutions of ELECTROLYTES are mixed in prescription with solutions of non-electrolytes
* involves VOLATILE OILS
A
SALTING OUT
20
Q
PHYSICAL INCOMPAT
PRECIPITATION | CLASSIFY:
* Aromatic water + Salt
A
SALTING OUT
Aromatic water is a volatile oil
21
Q
PHYSICAL INCOMPAT
PRECIPITATION | CLASSIFY:
* Camphor + Alcohol + Water
A
CHANGE IN SOLVENT SYSTEM
22
Q
PHYSICAL INCOMPAT
PRECIPITATION | CLASSIFY:
* Gum + Water + Alcohol
A
CHANGE IN SOLVENT SYSTEM
23
Q
PHYSICAL INCOMPAT
PRECIPITATION | CLASSIFY:
* Phenobarbital Na + Syrup Orange
A
CHANGE IN pH
24
Q
PHYSICAL INCOMPAT
PRECIPITATION | CLASSIFY:
* Codeine sulphate + NaOH
A
CHANGE IN pH
25
# **PHYSICAL INCOMPAT**
PRECIPITATION:
* **ABSORBS heat** form the surrounding
* **increases** temperature of the solution
* **increased** solubility
CHANGE OF TEMPERATURE:
ENDOthermic reaction
26
# **PHYSICAL INCOMPAT**
PRECIPITATION | CLASSIFY:
* **Ammonium chloride** + **water**
ENDOthermic reaction
27
# **PHYSICAL INCOMPAT**
PRECIPITATION:
* **GIVES OFF heat** to the surrounding
* **decreases** temperature of the solution
* **decreased** solubility, with the **exception** of **LIME**
CHANGE IN TEMPERATURE:
EXOthermic reaction
28
# **PHYSICAL INCOMPAT**
PRECIPITATION | CLASSIFY:
* **Lime water**
Calcium oxide + water = ***Lime water*** or ***slake lime*** or ***calcium hydroxide***
EXOthermic reaction
29
# **PHYSICAL INCOMPAT**
* it is the **transformation** of a **SOLID INTO LIQUID**
* ***Efflorescent substances***
LIQUEFACTION OF SOLID INGREDIENT
30
# **PHYSICAL INCOMPAT**
LIQUEFACTION:
* powders that contain **water of hydration** that may be **released** when the powders are **triturated** or when **stored** in an environment of **low relative humidity** resulting to powders that are **damp** or **pasty**
EFFLORESCENT POWDERS
31
# **PHYSICAL INCOMPAT**
LIQEUFACTION:
* caused by ***deliquescence***, ***hygroscopicity***, ***efflorescence***, ***eutexia***
EFFLORESCENT SUBSTANCES
32
# **PHYSICAL INCOMPAT**
CLASSIFY:
* **Citric acid**
LIQUEFACTION:
Efflorescent substances
33
# **PHYSICAL INCOMPAT**
CALSSIFY:
* **Atropine sulfate**
LIQUEFACTION:
Efflorescent substances
34
# **PHYSICAL INCOMPAT**
CLASSIFY:
* **Ferrous sulfate**
LIQUEFACTION:
Efflorescent substances
35
# **PHYSICAL INCOMPAT**
LIQUEFACTION | EFFLORESCENT:
* **ABSORBS** mositure and **DISSOLVES**
DELIQUESCENCE
36
# **PHYSICAL INCOMPAT**
LIQUEFACTION | CLASSIFY:
* **NaCl**
DELIQEUSCENCE
37
# **PHYSICAL INCOMPAT**
LIQUEFACTION | EFFLORESCENT:
* **ABSORBS** mositure but **DOES NOT DISSOLVE**
HYGROSCOPICITY
38
# **PHYSICAL INCOMPAT**
LIQUEFACTION | CLASSIFY:
* **Sugar**
HYGROSCOPICITY
39
# **PHYSICAL INCOMPAT**
LIQUEFACTION | CLASSIFY:
* **Silica gel**
HYGROSCOPICITY
40
# **PHYSICAL INCOMPAT**
LIQUEFACTION:
* **RELEASES** water of crystallization
EFFLORESCENCE
41
# **PHYSICAL INCOMPAT**
LIQUEFACTION | CLASSIFY:
* **Alum**
EFFLORESCENCE
42
# **PHYSICAL INCOMPAT**
LIQUEFACTION:
* liquefaction of solids at **ROOM TEMPERATURE** due to l**owering of their melting points**
* **TWO SOLIDS** mixed together **convert** to **liquid state**
* it is **NOT ALWAYS EXPECTED**
EUTEXIA
43
# **PHYSICAL INCOMPAT**
EMLA
Eutectic Mixture of Local Anesthetic
44
# **PHYSICAL INCOMPAT**
LIQUEFACTION | CLASSIFY:
* **Prilocaine** + **Lidocaine**
EUTEXIA
45
# **PHYSICAL INCOMPAT**
LIQUEFACTION | EUTEXIA:
* what is **SALOL**
Phenyl Salicylate = salicylic acid + phenol
46
# **PHYSICAL INCOMPAT**
* **Volatilization**
* **LIBERATION** of the active ingredient
VAPORIZATION
47
# **PHYSICAL INCOMPAT**
CLASSIFY:
* **Volatile oils**
* **Ketone**
* **Esters**
* **Nitroglycerin**
* **Aldehyde**
* **Alcohol**
VAPORIZATION
48
# **PHYSICAL INCOMPAT**
* it refers to the ability of a substance to **exist** in **DIFFERENT CRYSTALLINE** or **PHYSICAL STATES**
POLYMORPHISM
49
# **PHYSICAL INCOMPAT**
CLASSIFY:
* **Cocoa butter**
* **Chlormaphenicol**
POLYMORPHISM
50
# **PHYSICAL INCOMPAT**
* **"DEHYDRATION"**
* a significant manifesstation with **liquid preparations**
WATER LOSS
51
# **PHYSICAL INCOMPAT**
CLASSIFY:
* **Phase Inversion** of O/W emulsions
* **Crumbling** of ointments
* Solutions and suspensions resulting to **increased potency**
WATER LOSS
52
* incompatibilities that have reaction in which a **visible change** is **NOT** necessarily **observed**
* it arises from **chemical reactions** that **change** the **original composition** of the substances
* this type of incompatibility is resulted due to the **formation** of **UNDESIRABLE NEW PRODUCTS** when two or more drugs are combined
CHEMICAL INCOMPAT
53
# **CHEMICAL INCOMPAT**
* "**DEHYDRATION reaction**"
* a reaction involving the **LOSS OF ELECTRONS** (H atom)
* it is triggered by the **presence** of **LIGHT** and **OXYGEN** (use amber bottle)
* it is usually manifested by a **CHANGE IN COLOR**
* **LEORA**
OXIDATION
54
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **ascorbic acid**
* **ephinephrine**
OXIDATION
55
# **CHEMICAL INCOMPAT**
* **HYDROGENATION reaction**
* it involves the **GAIN** of elect5rons
* it usually occurs with **METALLIC SALTS**
* **GEROA**
REDUCTION
56
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **Silver nitrate**
REDUCTION
57
# **CHEMICAL INCOMPAT**
* **Precipitation**
* **Evolution of Gas**
ACID-BASE REACTION
58
# **CHEMICAL INCOMPAT**
ACID-BASE:
* it involves the **separation** of ssa **solid** and accompanied by the **formation** of a **NEW substance**
PRECIPITATION
59
# **CHEMICAL INCOMPAT**
ACID-BASE | CLASSIFY:
* **Calcium hydroxide**
PRECIPITATION
60
# **CHEMICAL INCOMPAT**
ACID-BASE:
* facilitates **EFFERVESCENCE** (escape of gas)
EVOLUTION OF GAS
61
# **CHEMICAL INCOMPAT**
ACID-BASE | CLASSIFY:
* **Acetycysteine**
EVOLUTION OF GAS
62
# **CHEMICAL INCOMPAT**
desired to **mask SALTY** and **BITTER**-tasting drugs
EFFERVESCENCE
63
# **CHEMICAL INCOMPAT**
* **MOST COMMON** type of incompatibility
* involves the **DECOMPOSITION** or **BREAKDOWN** of a substance in the **presence of WATER**
HYDROLYSIS
64
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **Aspirin**
* **Lactams**
* **Esters**: -aine (with 1 i)
* **Amides**: -aine (with 2 i)
* **Imines**
HYDROLYSIS
65
# **CHEMICAL INCOMPAT**
* this involve the **degradation** of the drug or excipients through **reaction with solvents OTHER THAN WATER**
SOLVOLYSIS
66
# **CHEMICAL INCOMPAT**
* also known as **PHOTO-OXIDATION** or **PHOTOLYSIS**
* it refers to the decomposition of substance upon **EXPOSURE TO SUNLIGHT**
* have to be in **amber bottle** or **wrap aorund** with **carbon paper**
PHOTOCHEMICAL DEGRADATION
67
# **CHEMICAL INCOMPAT**
PHOTOCHEMICAL DEGRADATION is also known as
PHOTO-OXIDATION or PHOTOLYSIS
68
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **chemo drugs**: Cisplatin, Doxorubicin, Amphotericin B, Phenothiazine, Nifedipine, Nitroprusside
PHOTOCHEMICAL DEGRADATION
69
# **CHEMICAL INCOMPAT**
* it is the **conversion** of an **OPTICALLY ACTIVE** drug to an **optically INACTIVE** drug
RACEMIZATION
70
# **CHEMICAL INCOMPAT**
what is the **product** of RACEMIZATION
* contains **EQUAL AMOUNTS** of **dexta** and **levo** isomers
RACEMIC MIXTURE
71
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **Thalidomide**
* **Naproxen**
RACEMIZATION
72
# **CHEMICAL INCOMPAT**
RACEMIZATION:
* **ACTIVE** form of **THALIDOMIDE**
for MORNING SICKNESS
73
# **CHEMICAL INCOMPAT**
RACEMIZATION:
* **INACTIVE** form of **THALIDOMIDE**
teratogenic
74
# **CHEMICAL INCOMPAT**
RACEMIZATION:
* **ACTIVE** form of **NAPROXEN**
NSAID
75
# **CHEMICAL INCOMPAT**
RACEMIZATION:
* **INACTIVE** form of **NAPROXEN**
Hepatotoxic
76
# **CHEMICAL INCOMPAT**
* formation of **gels**
GELATINIZATION
77
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **Acacia** with **Ferric salts**
* **Collodion** with **phenol**
GELATINIZITION
78
# **CHEMICAL INCOMPAT**
* involves the formation of **CAKES** or **CEMENTS** at the bottom of the container
CEMENTATION
79
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **Acacia** with **Bismuth salts**
CEMENTATION
80
# **CHEMICAL INCOMPAT**
* it usually occurs when **mixing OXIDIZING** anf **REDUCING agents** with the **aid of FRICTION**
EXPLOSIVE MIXTURES
81
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **Potassium permanganate** and **SUGAR**
* **Potassium permanganate** and **GLYCERIN**
EXPLOSIVE MIXTURES
82
# **CHEMICAL INCOMPAT**
* it involves the formation of **POLYMERS** (large molecules)
POLYMERIZATION
83
# **CHEMICAL INCOMPAT**
CLASSIFY:
* **Dextrose**
* **Formaldehyde**
POLYMERIZATION
84
* this incompatibiliy is resulted due to the combination of drugs having **ANTAGONISTIC** or **OPPOSING PROPERTIES**
* it is the modification of the therapeutic effect of one drug by the **prior concomitant administration** of another; also known as **drug interactions**
THERAPEUTIC INCOMPAT
85
# **THERAPEUTIC INCOMPAT**
TWO GROUPS
Pharmacokinetics
Pharmacodynamics
86
# **THERAPEUTIC INCOMPAT**
* what the **body** does to the **drug**
* involve the effect of a drug on another from the point of view that includes absorption, distribution, metabolism, and excretion (**ADME**)
* always accompanied with **increase/decrease** in **plasma concentration** which may lead to toxicity
PHARMACOKINETICS
87
# **THERAPEUTIC INCOMPAT**
MOST SIGNIFICANT **pharmacokinetic interactions**
those that involve drug METABOLISM
88
# **THERAPEUTIC INCOMPAT**
LEAST SIGNIFICANT **pharmacokinetic interactions**
drug DISTRIBUTION
89
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
* Alteration of pH
* Complex formation
* Decreased Gastric Emptying Rate / Increased GET
* Increased Gastric Emptying Rate / Decreased GET
* Adsorption of the drug
* Inhibition of GI Microbial Flora
ALTERATION IN ABSORPTION
90
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
ALTERATION IN ABSORPTION | **pH**:
* for a drug to be **absorbed**, it requires a **gastric pH** of ____
at least 2.3 - 3
91
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
ALTERATION IN ABSORPTION | **pH**:
* drugs that **can alter the GASTRIC pH**
ANTACIDS
H2 ANTAGONIST
PPIs
92
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
CLASSIFY:
* **Anatcid** + **Bisacodyl**
* **Antacid** + **Ketoconazole**
* **Antacid** + **Salicylates**
ALTERATION IN pH
93
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
ALTERATION IN ABSORPTION:
* **insoluble** and **large compounds** that are formed when given in certain medications then become **difficult to absorb**
* common with **metals** or **metal containing durgs** are given with **tetracycline**, **fluoroquinolones** or **penicillamine**
* there could be **CHELATES**
COMPLEX FORMATION
94
any **organic compound** formed when polydentate ligand bonds to a central metal atom = reduced absorption
these are **INSOLUBLE**
CHELATES
95
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
CLASSIFY:
* **Tetracycline** + **Metals**
* **Flouroquinolones** + **Metals**
* **Penicillamine** + **Metals**
COMPLEX FORMATION
96
is the **time** for **stomach contents** to be **transported** to **intestine** thru **peristalsis**
GASTRIC EMPTYING RATE
97
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
CLASSIFY:
* **Atropine** + **Amphetamine**
DECREASED GER / INCREASED GET
98
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
drugs that can affect GER and GET are
CATHARTICS
99
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
CLASSIFY:
* **Nicotine** + **Antacid**
* **Metoclopramide** + **Antacid**
INCREASED GER / DECREASED GET
100
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
* adsorbents bind with substances that **currenetly taken with them** = reduced absorption
* common application for **toxicity** and **poisoning**
ADSORPTION OF THE DRUG
101
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
CLASSIFY:
* **Cholestyarime** + **Warfarin**
* **Colestipol** + **Vitamin K**
* **Cholestyarime** + **Digoxin**
ADSORPTION OF THE DRUG
102
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
if the patient needs combinations of those **ADSORPTION REDUCERS**, administration of medication is preferably
4 hours of interval
103
# **THERAPEUTIC INCOMPAT | PHARMACOKINETIC**
CLASSIFY:
* **Antibiotics** + **Digoxin**
INHIBITION OF GI MICROBIAL FLORA
DISPENSING 2 LAB
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