Pharmaceutical Care 4: Dispensing and Patient ❖ Vehicle - Used to increase the bulk of the

Counseling Laboratory preparation

Incompatibilities
Introduction
❖ Prescription - An order for medication, for
Rx
use by a patient that is issued by a Sulfadiazine 0.3 mg Basis
physician, veterinarian, or other licensed
practitioner who is authorized to prescribe Mineral Oil 2.0 gtts. Adjuvant
medication
Parts of a Prescription Lactose, qs ad. Vehicle
❖ Patient`s Information
❖ Refers to combination of
❖ Superscription - Rx symbol
ingredients which possess antagonistic
❖ Inscription - Body of the Rx
qualities of either therapeutic, physical or
❖ Subscription - Instruction to the Pharmacist
chemical nature
❖ Transcription - Instruction to the patient A. Possible Incompatibilities
❖ Prescriber`s Information B. Intentional Incompatibilities
Types of Incompatibilities
❖ Physical Incompatibilities
❖ Chemical Incompatibilities
❖ Therapeutic Incompatibilities
Physical Incompatibility
❖ Question of relative solubility
❖ Failure of ingredient to combine to make
satisfactory product
❖ Does not involve chemical reaction
Evidence:
❖ Incomplete solution
❖ Precipitation
❖ Separation of immiscible liquid
❖ Liquefaction of solid ingredients
❖ Eutectic mixture, Increase water
crystallization, Deliquescent
substance
❖ Wrong form of ingredient
prescribed
❖ Gelatinization
Remedy
❖ Dispensing separately
❖ Alteration of solvent
❖ Changing the order of mixing
Four Key Parts of the Inscription ❖ Use of different form
❖ Basis - Active Ingredient which ❖ Addition of ingredient that
serves as the basis for the prescription promotes solubility
❖ Adjuvant - Serves as aid to the basis ❖ Emulsification/Suspension
❖ Correction - Used to correct an undesirable Chemical Incompatibility
property of the basis
 ❖ Ingredients undergo chemical reaction ❖ Intimate mixture of any finely divided drug
whereby the original composition is and/or chemicals that may be intended for
altered internal (oral powder) or external (topical
❖ Chemical reaction are indicated as powder) use
change in physical appearance, change ❖ Packed and dispensed by pharmacist as
in color, effervescence bulk powder or divided powder depending
❖ Product of chemical reaction is usually on their intended use
insoluble ❖ Hygroscopic - Solid drugs or chemicals tha
❖ Evidence: absorb moisture from air
❖ Oxidation ❖ Deliquescent - Hydroscopic powder that
❖ Reduction may absorb sufficient moisture from air to
❖ Racemization dissolve and form a solution
❖ Formation of Precipitate Comminution Technique
❖ Trituration
❖ Evolution of gas
❖ Pulverization by Intervention
❖ Color Change
❖ Substance (eg camphor + alcohol)
❖ Production of explosion
are reduced and subdivided with
(Strong OA + Strong RA)
an additional material (eg.
❖ Cementation of Ingredient
solvent) that is easily removed
❖ Separation of Immiscible
after pulverization
liquid when organic chemicals
❖ Levigation
are decomposed
❖ Particle size of the substance is
❖ Development of heat or cold
reduced by adding a suitable non-
❖ Hydrolytic change
solvent (levigating agent) to form
❖ Remedies a paste
❖ Prevent precipitation by Mixing Procedure
adding glycerin, syrup, honey ❖ Spatulation
to incompatible ingredients
❖ Not suitable for large quantities of
❖ If precipitation is harmless, powder
suspend and provide a shake
❖ Not suitable for powders that
well label
contain potent substance because
❖ Dilute before mixing homogenous blending may noy
Therapeutic Incompatibilities occur
❖ Ingredients of antagonistic medical activity ❖ Useful for solid substance that
are prescribed together form
❖ Contraindicated ❖ EUTECTIC MIXTURE -
❖ Synergistic or Antagonist mixture of 2 or more
❖ Drug Interaction substance that liquefy
Extemporaneous Compounding when intimately mixed at
❖ Act of preparing drug formulation, dosage room temperature
form, strength and packaging that are not ❖ Example: Phenol,
available commercially but deemed Camphor,
necessary for patient care by appropriately Menthol
trained personnel standard & regulation ❖ Remedy: To add
PREPARATIONS inert diluent eg.
Powders Starch,
Magnesium
 Oxide to ❖ Have individual doses of powder
separate eutectic packaged in folded paper or
mixture plastic bag
❖ Trituration ❖ After blending (properly blended)
❖ Geometric - divided into individual dosing
Dilution units based on the amount to be
❖ Used when taken at a single time
potent substance ❖ Place each divided portion on a
must be mixed small piece of paper (folded to
with large enclose the medication)
amount of
diluents Ways of Preparing Divided
❖ Sifting Powder
❖ Tumbling
Types of Powder ❖ Weighing each portion separately
❖ Bulk Powder - for Internal or External Use before folding in a paper
❖ For External Use ❖ Approximate each portion by
❖ Dusting Powder using Block & Divided Method -
Used for non potent drug
❖ Powder Intended
for Topical ❖ Block and Divide
Application
1. Place the entire amount of prepared powder on a flat
❖ Contains one or surface (porcelain or glass plate, pill tile or large sheet of
more active paper)
ingredient
2. Form a rectangular or square shaped block of powder with
incorporated in a
a large spatula ( with uniform depth )
diluent powder
❖ Container: Sifter 3. Cut horizontally and vertically for appropriate number of
smaller, uniform blocks representing a dose or unit of
topped can or
medication
shaker canister
or wide mouth 4. With a spatula, separate each of the smaller block from the
bottle main block. Transfer to a powder paper & warp

❖ For Internal Use

❖ Types of Paper
❖ Dispensed in a wide moth ❖ Simple Bond Paper
powder square or ❖ For containing neither
container volatile component nor
❖ When the dose to be ingredient adversely
administered is a affected by air or
teaspoonful or moisture
tablespoonful, the ❖ Vegetable Parchment
container should allow ❖ Thin, semi-opaque,
having limited moisture
the patient or caregiver
resistant property
to insert the measuring
❖ Glassine Paper
spoon to withdraw the ❖ Glazed, transparent,
appropriate dose having limited moisture
❖ Divided Powder (Chartulae or resistant property
Powder Paper) ❖ Used for powders
containing volatile
component
 ❖ Waxed Paper Prescription # 1B
❖ Transparent, water
proof, used for
hygroscopic or
deliquescent material
Prescription # 1A

1. Triturate camphor & 1 gtt of

1. Triturate menthol, camphor alcohol
and phenol
2. Add calamine, starch, talc
2. Add Salicylic Acid with light
3. Pass through sieve # 40
trituration

3. Add starch in portion Prescription # 2

4. Pass powder mixture through

sieve # 40
REMARKS
❖ MOP: Spatulation
❖ Mixing: Sifting
❖ Foot Powder; Container: Sifter Top Bottle
❖ For External Use
❖ Camphor, Menthol & Phenol - Form a
Eutectic Mixture
❖ Starch
1. Mix the powders
❖ Inert diluent, to diminish
contact; geometrically, spatulating or
❖ added thru geometric triturating after each addition
dilution 2. Add peppermint oil until
❖ Camphor desired scent is obtained. Mix
❖ Available as a hard crystal
❖ If the mixture does not 3. Transfer the powder to
liquefy adequately to appropriate jar &label
dissolve the camphor, a
Remarks
few drops of alcohol may
❖ No Incompatibility in this dry
be added to complete the
dosage form
process
❖ One level teaspoon = 1.6g in
❖ Eutectic Mixture - Mixture that weight
melts at lower temperature than
any of the other ingredient
Prescription # 3 ❖ Label

Sulfadiazine 500 mg tab.

100mg/pp #2. 200mg/pp

Sodium Bicarbonate.
200mg/pp #2. 400mg/pp

Lactose, qs

No Need to write the amount of Lactose

Prescription # 4
❖ Remarks
❖ Sulfadiazine
500mg/tab = 7.7 gr/tab
x 2 = 15.4 gr
❖ Sodium bicarbonate
2 gr = 30.86gr
*46.26gr/10pptab
*4.626 grp/pp

1. Triturate individually Sodium

bicarbonate & sulfadiazine

2. Mix by spatulation, then add

ASA

❖ Lactose - Can act as diluent & 3. Block & Divide

corrective
4. Double wrap (Increase size of
❖ Diluent if < 2 grains or >
paper for double wrapping)
130mg
❖ Corrective if > 2grain or > 1 dose ＝ 1pp if capsule = 1 cap
130mg
❖ Mask the Amount / dose = amount/pp
unpleasant taste
Daily Dose = amount/pp x 6
of AI; should be
equal to the
❖ Remarks:
amount to be
❖ ASA can be easily hydrolyzed to
corrected
SA and Acetic Acid
❖ Sodium Bicarbonate - Increase
solubility of Sulfadiazine
❖ MOP: Trituration and Block and
Divide
 ❖ Sodium Bicarbonate - will form a
❖ Calculation
gummy mixture in contact with
atmospheric moisture due to ❖ Weight of child in kg
subsequent hydrolysis of SA (ASA = 25lbs/(2.2lbs/1kg) =
+ Alkali)
11.4 kg
❖ Manifestation: Gummy
preparation; formation of dump ❖ Prescribed dose in
mass mg/kg/day
❖ Type of Incompatibility: Physical
❖ Remedy: ❖ (30mg
❖ Triturate ASA and sodium Carbamazepine/dose
bicarbonate separately to )x(4doses/day)x(1/11.
avoid formation of dump 4kg)
mass
❖ Double warp to prevent = (10.53mg/kg/day) within USP doses
hydrolysis of 10-20mg/kg/day
Prescription # 5
❖ For 4 doses/day =
29.57 mg/dose
Carbamazepine
30mg/powder packet ❖ 10.53mg/kg/day x
M. Ft. Divided powders # 8 11.4kg = 120.04
mg/day
Sig. Take content of one powder
packet qid pc & hs ❖ 10 - 20 mg/kg/day = 114.228
mg/day
❖ Remarks ❖ 35mg/kg/day x 11.4 kg = 399
❖ Carbamazepine mg/day
❖ Anticonvulsant ❖ For 9 doses (8 + 1 extra)
❖ Even when in solid ❖ 30mg/dose x 9 doses = 270mg
dosage form, it has some carbamazepine
stability concern ❖ 200mg carbamazepine = 270 mg
❖ If in solid preparation carbamazepine
require special packaging 280 mg tablet powder. X.
& storage for maximum X = 378mg crushed powder - Carbamazepine is
stability available as 200mg tablet, with a
Bioavailability - When in tablet form, can be tablet weight of 280mg
reduced to 1/3 if exposed to excess moisture 300mg/packet x 9 packet = 2,700 mg powder
Decrease bioavailability caused by tablet hardening 2700mg - 378 mg = 2,322 mg lactose
due to uptake of water by the drug molecule with Capsule
the formation of the dehydrate ❖ Solid dosage forms in which the drug is
USP recommended storage in tight, preferably glass enclosed within either a hard or soft shell
container, dry place, protected from moisture ❖ The shell are usually made from a suitable
❖ If 100mg Carbamazepine/pp gelatin. Hard gelatin capsule may be filled
(100mgCarbamazepine/dose)x(4doses/day)x(1/11. for extemporaneous compounding
4kg) Capsule Size
= 35mg/kg - Exceeds the recommended dose
Prescription # 6 ❖ Separate the Ingredient
 Use 3 capsule

1. Triturate powder separately

2. Place antipyrine in a small

capsule

3. Place a thin adsorbent layer

(Mg O, Starch, Kaolin) to
separate antipyrine from
other drug

4. Add ASA in small capsule

5. Introduce Salol in the big

capsule & place the small
capsule

Pastilles
❖ Some reference make no distinction
❖ Remarks:
between lozenges and pastilles. However,
❖ ASA + Phenyl salicylate USP uses the term pastilles for a subclass
❖ Eutectic Mixture/ of lozenges; that is molded lozenges
Liquefaction ❖ Searndum artem differentiates the 2 term
❖ Formation of a dump by describing pastilles as lozenges that are
mass softer and that contain a high
❖ Type of Incompatibility: Physical concentration of sugar and gelatin
❖ Manifestation: Dump Mass Lozenges
Remedy: ❖ Solid preparation which are intended to
1. Addition of Adsorbent (MgO/Kaolin) dissolve or disintegrate slowly in the
2. Combine / Liquefy the 3 ingredient and mouth, they contain one or more
add adsorbent little by little. Triturate
medicament, usually in a flavored
after each addition to keep the
preparation dry. Add a little more sweetened base
adsorbent to ensure dry preparation ❖ They can be prepared by molding (gelatin
and/or fused sucrose or sorbitol base) or
3. Add a certain quantity of Adsorbent compression of sugar base tablet
❖ They are usually intended for the
4. Ingredient + Adsorbent → Dry +
Ingredient + Adsorbent → Dry + treatment of local irritation or infection of
Ingredient + AdsorbenT the mouth or throat but may contain
active ingredient intended for systemic
5. Advantage: No Interaction of 3 ingredient absorption after swallowing
, No Eutectic mixture Troches
6. Disadvantage: If the addition is not ❖ Subcategory of lozenges
enough, it will still liquefy
7. Superimposition ❖ Compressed lozenges
❖ Makes use of 2 capsule
❖ Putting one or more ingredient in
smaller capsule and the 3rd
ingredient in big capsule
Prescription # 7

Remarks:
❖ Gelatin
❖ Stable in air when dry,
but is subjected to
microbial decomposition
when moist or in solution
❖ Largely used in pharmacy
to contain pill & form
1. Finely powder solid capsule & as vehicle for
ingredient suppository
❖ Also recommended as
2. Mix acacia & gelatin (dry
emulsifying agent
mortar due to protein
❖ Acacia
character)
❖ Suspending agent for
3. Add glycerin suspension of insoluble
substance in water, in the
4. Add peppermint oil (2gtts) preparation of emulsion
and for making pills and
5. Add 1 - 2 gtts desired color to
troches
aromatic water
❖ Commonly used excipient -
6. Form mass on pill tile (to Glucose, Glycerin, Mucilage,
desired shape) Simple Syrup and Water
❖ Glycerin (1.249)
7. Sprinkle sugar on top of ❖ Has preservative property
pastilles ❖ Useful as humectant in
keeping substance moist
❖ Remarks:
❖ Solvent
❖ Gelatin
❖ Peppermint Oil (0.896 - 0.908)
❖ Stable in air when dry,
❖ Chief constituent is
but is subjected to
menthol
microbial decomposition
when moist or in solution ❖ Flavoring agent,
carminative, antiseptic
❖ Largely used in pharmacy
and local anesthetic
to contain pill & form
capsule & as vehicle for ❖ Aromatic Water
suppository ❖ Medicated Water
❖ Also recommended as ❖ Clear, saturated aqueous
emulsifying agent solution of volatile oil or
other aromatic or volatile
solution
❖ Peppermint Water
❖ Carminative & flavored
vehicle
Pills ❖ Readily compressible
❖ Small, round solid dosage forms containing mass
a medicinal agent & are intended for oral ❖ Use: Antimalarial drug;
administration analgesic and antipyretic
❖ Pills were formerly the most extensively ❖ Quinine Salt are usually
used oral dosage form, but they have been dispensed in capsule or
largely replaced by compressed tablet and tablet to conceal their
capsule nauseating bitter taste
❖ Substance which are bitter and unpleasant ❖ Glucose
to the taste, if not corrosive or ❖ Diluent on pillular extract
deliquescent, can be administered in this
form if the dose is not too large 1. Using geometric dilution,
continue active ingredient with
computed amount of diluent
Prescription # 8
2. Add initial amount of water (10
Preparation of Mass gtts) (Note: Test the mass by
dropping 1 ft from the pill tile. If
1. The 1st step consist of making too wet, mass will break)
the pill mass
2. The ingredients in the pill mass 3. Form into cylinder & cut in 5
include the active drug, the portion
diluent or filler and the excipient
3. The selection of diluent & 4. Roll pill on starch
excipient is important in that
they give the essential Prescription # 9
characteristic of adhesiveness,
firmness, and plasticity to the
mass
4. The mass must be sufficient
adhesive & firm to retain its
shape, yet be soft enough to be
worked with the finger, or with
suitable equipment into the
desired pillular form

❖ Remarks:
❖ Quinine Sulfate
❖ Has persistent, very bitter
taste
 1. Weigh 330mg (2M units) of Prescription # 10
Nystatin Powder
2. Measure syrup & sorbitol 60%
solution and water
3. In a mortar, place Nystatin & add
sorbitol 70% solution. Triturate
well
4. Add syrup in portion while
triturating
5. Slowly add water to the mortar
with trituration 1. Combine sugar, corn syrup and water in a
6. Measure 10mL portion of the beaker and stir until mixed well.
liquid & pour each portion into 2. Cover the mixture and heat on a hot plate
one cavity of an ice cube tray at a high setting until the mixture boils and
(just use plastic for ice candies continue boiling for two minutes.
and insert popsicle stick, tie with 3. Uncover and remove from heat at 1410C.
4. Do not stir the mixture until the
ribbon or stirring
temperature drops to 1290C.
7. Place in freezer
5. Quickly add dextromethorphan, mint
8. When the popsicle are semi extract and food color, and stir until well-
solid, insert a popsicle stick mixed.
9. Put ice cube tray into the 6. Coat the mold to be used with vegetable
freezer oil.
10. When the popsicle are 7. Pour the melt into the molds.
completely frozen, remove from 8. Cool, package and label.
the tray & package in a large
zipper close bag, label & Suppositories
dispense ❖ Solid dosage form intended for insertion
into the body orifice where they melt,
❖ Computation soften, dissolve and exert localize and
❖ 2,000,000 units/10 doses = systemic effect
200,000 units/dose Types of Suppositories
❖ Nystatin Powder (from Jetlabs) ❖ Rectal - Cyclindrical, bullet shape, 32mm (1
6050 units/mg 1/2 inch) , 2 grams (adult) or 1 gram
6050 units Nystatin/mg Nystatin = 2,000,000 unit (children)
Nystatin/ x mg Nystatin ❖ Local - 1/3 upper portion of the
rectum
❖ Systemic - 1/3 lower portion of
the rectum
❖ Urethral - Slender or pencil shape
Hard Lozenge
❖ Male - 4 gram 140 mm (length)
• Solid syrups of sugars made by heating
3 - 6 diameter
sugar with other ingredients and pouring
❖ Female - 2 gram 70 mm (length)
the mixture into a mold
• Will not disintegrate in the mouth, but will ❖ Dilatation of utherus, anti-
erode or dissolve over a 5-10 minutes infective, erectile dysfunction
period ❖ Vaginal - Globular, oviform, coreshaped ;
• Requires low moisture content (0.5-1.5%) 5g ; Anti-fungal, anti-infective,
contraceptive
Methods of Preparation ❖ 8 x 1.720 g = 13.760g
❖ Molding from a melt / fusion method → ❖ Amount of Cocoa Butter Needed
commercially 13.760g - 0.800g = 12.960g Cocoa Butter
❖ Compression ❖ (suppose that 800mg ASA
❖ Hand rolling / Shaping occupies the same volume as
800mg cocoa butter. This is NOT
Suppository Bases ACCURATE!!)
❖ Cocoa Butter ❖ ASA has a density factor 1.1 with Cocoa
❖ Theobroma oil, most widely used Butter (1.1g of ASA will displace 1g of
❖ Witepool Base Cocoa Butter)
❖ Contains natural saturated fatty ❖ Amount of base that is displaced
acid chain C₁₂ and C₁₈ by the amount of ASA used
❖ Lauric acid 1.1 g ASA/ 1 g CB = 0.8 g ASA / x
X = 0.727 g Cocoa Butter displaced by 0.8g ASA
❖ Wecobee Base
❖ Weight of Cocoa Butter needed
❖ Derived from coconut oil
for the Rx order (+ 2 extra)
13.767g - 0.727g = 13.032g Cocoa Butter
Prescription # 11A
1. Prepare the powdered active ingredient. Weigh a small
excess of the amount of active ingredient needed and
reduce this to a fine powder by trituration in a mortar.
(The excess is to allow for any loss in trituration and
transfer of the active ingredient from the mortar to the
vessel used for heating the formula)
2. Prepare the suppository base material (if the suppository
base material is in a bar or in large piece, grate or reduce
to smaller pieces)
3. Before melting the suppository base and combining the
❖ Dose: Usual pediatric 10 - 15mg/kg of body ingredient, prepare the molder (apply lubricant if
weight every 4 hours up to 60 - 80 needed)
mg/kg/day 4. 4Put a small portion of the base in a beaker and carefully
22 lbs x (1 kg/2.2lbs) = 10 kg heat on a warm water bath until the base has turned to a
100 mg ASA x 6 doses x 1 = 60 mg/kg fluid. (For cocoa butter approximately 55⁰C water bath)
Dose Day 10 kg Day 5. Add the powdered drug to the melted base and stir well
❖ Compatibility - Stability to mix
❖ Store in well closed container in 6. Add the remainder of the base in portion with stirring
7. Pour the molten mixture into the mold cavity
cool place
8. Allow the suppository to solidify at room temperature,
❖ Although ASA is subjected to
then place the mold in the refrigerator for almost 30
hydrolysis in the presence of minutes to allow the suppository to harden (Do not put
water, this preparation does not the mold in the refrigerator until the suppository have
include any water congeal or the base will not contract rapidly & thin
❖ Amount (6 + 2) cavities will form down the center of each suppository
❖ ASA 800mg 9. Trim the excess material from the top of the mold using
❖ Cocoa Butter 13.032 g spatula
❖ ASA = 8 x 100 = 800mg 10. Carefully remove the suppository from the mold cavities.
Wrap each suppositories in foil or put in individual small
❖ Final Wt of base and AI for All
plastic bags and place the suppositories in dispensing
Suppositories (Ave wt/supp =
container
1.720g)
 ❖ concentrated solution of the drug
will be present at the tip of the
❖ stick and, when applied, will exert its effect
Prescription # 11B topically

❖ if waxes and oils or plain polymers (PEGs)

alone are used – topical effect
for drugs that might not be stable
in other forms but would be stable
in a dry, hard crystalline stick
❖ Ex. styptic pencil containing alum or
aluminum sulfate

Some Ingredients Added

1. Clean and lubricate molder with mineral oil →freeze
2. Heat glycerin to 120˚C using sand bath ❖ Vitamin E and A - emollient and skin
3. Add stearic acid → mix enhancement effects
4. Add monohydrate sodium carbonate → mix ❖ Zinc Oxide, PABA, - sun block
5. Add water & allow CO2 to escape
6. Stir rapidly. Remove the scum or bubbles by scrapping it ❖ Perfume oil - perfume sticks
out or using tissue paper
7. It should become a clear and transparent solution Categories
8. Pour the hot solution into the suppository molder. Allow
the solution to overflow without hesitation
❖ Soft-Opaque (Sample Formulation
9. Allow it to cool and congeal
10. Remove the suppositories from the molder & wrap
with aluminum foil.

Medicated Stick
❖ Convenient forms for administering topical
medications
❖ Different sizes and shapes for application
to different areas of the body
❖ Soft Clear (Sample Formulation)
Desirable Characteristics
❖ Spreads easily without excessive
greasiness
❖ Does not sweat, crumble or crack
❖ Uniform, stable, and free from mottling

Bases
1. Melting bases – soften at body temperature and
spread the drug-vehicle mixture over the skin
❖ Opaque – waxes, oils, PEGs
❖ Clear - sodium stearate/glycerin
mixtures
[Link] bases - solid sticks which must be
moistened to become “activated”
 ❖ Hard (Sample Formulation) Ointment
❖ Salve / Charisma
❖ Semi-solid preparation intended for
external application to the skin and
mucous membrane
❖ Characteristic of Ointment
❖ Free from grittiness
❖ Becomes rancid with time
❖ Easily spread
Counseling ❖ Uses
❖ Apply only to the involved area and not to ❖ Emollient - Skin pliable
surrounding skin ❖ Protective barrier
❖ Apply liberally over the area ❖ Vehicle - For medication
❖ Apply as needed. ❖ Packaging
❖ Clean the surface of the stick with clean Jars
tissue after use ❖ When removing, scrape it
❖ Do not share this product with others from the surface, do not
because of the possibility of dig → It will leave
transmitting infections greater surface area
exposed
Prescription #12 ❖ Increase rancidity and
growth of bacteria
Tubes
❖ More preferred, less
exposure
Ointment Bases
❖ Oleaginous Base
❖ Non water washable, anhydrous
and insoluble in water
❖ Cannot absorb or contain water
❖ Example: Petrolatum, Synthetic
ester, Lanolin Derivative
1. Weigh/measure the ingredients.
❖ Absorption Base
2. Gently heat and melt the Sodium Stearate.
3. Mix the Purified Water with the Propylene ❖ Non- water washable, anhydrous
Glycol and add to the melted & insoluble can absorb water
Sodium Stearate. ❖ Example: Hydrophilic petrolatum,
4. Mix thoroughly, remove from heat and Woolfat (anhydrous lanolin)
allow this base to cool slightly. ❖ Emulsion Base
5. Dissolve the Menthol in the Methyl
❖ Example: Hydrophilic ointment
Salicylate, add this solution to the base
and mix thoroughly. and vanishing cream (O/W);
6. As the product begins to thicken, continue Hydrous woolfat and cold cream
to mix and pour into 5 g stick containers. ❖ Water Soluble Base
7. Allow to harden at room temperature. ❖ Example: PEG, Propylene glycol

Method of Preparation
❖ Levigation
 ❖ Use of mortar and pestle Prescription # 13B
❖ Reducing to impalpable powder to
reduce grittiness and to form a
very smooth nucleus
❖ Fusion
❖ Use of heat
❖ Heat first the substance with high
melting point like wax and
spermaceti using water bath
before adding soft, oleaginous
material

Prescription # 13A
1. Levigate hydrocortisone
powder with small
hydrophilic petrolatum
2. Geometrically incorporate
the rest of the petrolatum
3. Add urea and paraben very
gradually (6g urea dissolve in
9mL water + 3mL parabel/PG
solution)

1. Triturate 1g Betamethasone
with 4g Vaseline

❖ Remarks:
❖ Betamethasone Diproprionate
Ointment
❖ Anti-inflammatory
❖ Aquaphor + Distilled Water +
Betamethasone Oint
❖ Vaseline +
Betamethasone Oint →
Will not absorb water
 ❖ Remarks ❖ Solution by Distillation
❖ Weight of hydrocortisone 0.6g ❖ If solute is volatile
❖ Paraben or PG. 3.0g ❖ Solution by Extraction
❖ Urea. 6.0g ❖ Maceration
❖ Water. 9.0g ❖ Percolation
18.6g ❖ Digestion - With the aid of gentle
Weight of petrolatum = 60g - 18.6g =41.4 g heat
hydrophilic petrolatum ❖ Infusion - Hot or cold water
❖ Decoction - Boiling for 15 minutes
❖ Urea
❖ Hard crystalline substance that is Prescription # 14A
difficult to levigate to a fine
powder
❖ Dissolve in water before Potassium Citrate 10% (w/v) Oral
incorporation into the ointment Solution
base
Dispense 120mL
❖ White petrolatum
❖ Hydrophilic petrolatum Sig. Take 15mL tid
❖ Cannot absorb the water added
❖ + 3 g preservative (due to the addition of ❖ Remarks:
water) ❖ 10g:100mL::x:30mL
❖ Methyl paraben 0.2% of the ointment
0.12g ❖ X = 3g Potassium citrate, qs ad
❖ Propyl paraben 0.02%. water
0.012g
❖ Solubility 1g:1mL of water
❖ Propylene glycol 2-3%.
2.868g ❖ Amber bottle : White label
3.00g
❖ Use: Expectorant, systemic
Solutions alkalinizer, Diuretic
❖ Liquid preparations containing 2 or more
❖ Incompatibility:
soluble substance in a suitable solvent
❖ Aqueous solution are slightly
❖ 2 Component
alkaline and will react with acid
❖ Solute
substance
❖ Solvent
❖ Potassium citrate salt of citric acid
& potassium bicarbonate
Methods of Preparation
❖
Prescription # 14B
❖ Simple Solution
❖ Dissolving solute in solvent KMnO₄ Solution 1:20,000
❖ NaCl solution, Strong Iodine
Dispense 30mL
solution
❖ Chemical Reaction Sig. Apply on affected area tid
❖ Reacting 2 or more solutes with
each other in a suitable solvent ❖ 0.5% KMnO₄ Stock Solution
❖ Magnesium citrate solution 0.5g/ 100mL = 0.005g/x X=0.3mL
(1/20,000) x 100 = 0.005 Prescription # 15B
❖ C1V1 = C2V2 (0.005%)(30mL) = (0.5%)(x)
X=0.3mL

1. Measure 0.3mL of 0.5%

KMnO₄ stock solution

2. Qs ad water to 30mL

❖ Remarks:
❖ KMnO₄
❖ Stable in air and light but ❖ Remarks:
readily decomposed by ❖ Iodine
many reducing substance ❖ Volatilize at room
❖ Solution are unstable temperature; 1g:30 mL
❖ 1g: 15mL water water; oxidizing agent
❖ Powerful oxidizing agent ❖ KI
❖ Anti-septic/ anti-infective ❖ Added only to increase
solubility of Iodine
Prescription # 15A ❖ Solution is transparent liquid
having deep brown color with the
KI s.s. 1 fluid ounce odor or iodine
❖ Use: Treatment of Thyrotoxicosis;
Sig. Gtt 5 in aq. liq.
germicide, fungicide, antiseptic
❖ 15mL amber bottle; white label
1. Dissolve 7.5g KI crystal to
sufficient water Prescription # 16A
2. Qs ad water to 15 mL

❖ Remarks:
❖ Saturated solution - Solution that
contains the maximum amount of
solute the solvent can dissolve at
a certain temperature
❖ KI Crystal - Stable in air but slightly
hygroscopic in moist air
❖ KI aqueous solution - Gradually
becomes yellow due to oxidation 1. Mix/ Dissolve 0.66g Boric acid in
of KI to free Iodine 15mL of water
❖ Uses: Treatment of goiter; 2. Dilute with 15mL water
expectorant - Treatment of
bronchitis and asthma 4.4g: 100mL = x : 15mL. X= 0.66g
❖ Solubility 1g:0.7mL water Boric Acid
❖ 15mL amber bottle ; white label (0.66g/30mL) x100 = 2.2 % (Isotonic)
 requirements not encountered with
❖ Remarks: dosage forms intended for other route or
❖ Boric acid adminstration
❖ Weak antiseptic,
germicidal/local anti- ❖ Errors in preparing or administering
infective ❖ Dispense product with microbial
❖ 1:18 in water contamination
❖ 4.4% ❖ Error in dosage
❖ 30mL Amber Bottle, Red Label ❖ Giving the wrong drug
❖ A more complex knowledge of current
Prescription # 16B standards and procedure for handling
parenteral product is essential for any
pharmacist who is preparing or supervising
Naphazoline (E=0.27) 0.02%
the preparation, handling and use of
Zinc Sulfate 0.25% parenteral product (ASHP, USP, FDA,
Reference Books)
SWFI 30.0mL
Use of Parenteral Product
[Link] Isotonic Solution
❖ Offers one alternative when patient is
unable to take medication by mouth
❖ E (NaCl Equivalent) (unconscious, vomiting)
❖ The gram of NaCl that will ❖ Some drugs must be given parenterally
produce the same osmotic because they are not therapeutically active
pressure/effect as 1 g of the drug when taken orally because of inactivation
❖ Zinc Sulfate available as 1% in GIT or first pass metabolism by the liver
(E=0.15) ❖ A drug must be injected because it requires
1g:100mL = x:60mL X=0.6g ZnSO₄ direct delivery to an organ, a lesion,
x 0.15= 0.9g NaCl muscle or nerve
❖ Amount of NaCl in 60mL (Isotonic)
0.9g:100mL = x:60mL X=0.54g Disadvantage
NaCl ❖ More difficult and costly to produce. Must
❖ Amount of NaCl to make the conform to strict requirement for
solution isotonic microbiological purity, particulate matter
0.54g - 0.09g = 0.45g NaCl and pyrogenicity
❖ Once administered, a parenteral product
cannot be removed. Problems with dose or
adverse effect may be difficult or
impossible to reverse
Parenteral Products ❖ Any introduction of pathogens into the
❖ Those preparation intended for product during production, preparation,
administration by injection through the manipulation or handling or during.
skin administration to the patient can have
❖ Preparation manipulation, handling and serious and even deadly consequence
use are complex and extremely critical
❖ Because parenteral administration by Laminar Flow Hood
passes the natural barrier of the skin or ❖ These are workbenches that provide an
alimentary tract, these products have strict environment of specifically filtered air that
 sweeps the work are and provides and work surface for the air to
aseptic work area circulate
❖ Horizontal LFH ❖ Be careful not to let anything
❖ Vertical LFH come between a critical surface
❖ HEPA Filter and the air coming from the HEPA
❖ High Efficiency Particulate Air filter
Filter ❖ Be careful not to touch any critical
❖ 99.97% efficient surface
❖ Wipe the vials, ampules and
injection point with alcohol wipe

Prescription # 17

Penicillin 150,000 units

Dispense in syringe
Parenteral Preparation
Sig. As Directed
❖ Clean Room - Buffer room, contains the
LFH used for aseptic processing of ❖ 1,000,000 units:1mL::150,000 units: x
parenteral product X= 0.15mL
❖ Anteroom - Room adjacent to the clean ❖ Benzyl penicillin Na (Pen G Na)
room, Washing and gowning, Unpacking of Reconstitution
cleanroom supply package
❖ Introduce 0.15mL of air and
❖ Critical Surface - Surface that came in extract 0.15mL of solution
contact with sterile product, container,
❖ Benzyl penicllin Na (Pen G Na)
closure
❖ 1M (600mg) Sterile powder for
❖ Needle shaft, Plunger of syringe
aqueous injection
❖ IM/IV
Preparation of Sterile Product
❖ 1 dose/vial
❖ Wipe down the LFH using 70% Isopropyl
❖ Acceptable diluent for
alcohol and sterile gauze (4x4)
reconstitution- SWFI, D5W,
❖ Wipe the side surface of the hood first,
Dextrose injection NSS
then working surface from back to front
❖ Storage Condition
❖ The hood should be turned on atleast 30
❖ Sterile reconstituted solution are
minutes before using it
stable when refrigerated for 1
❖ Assemble the supplies needed to make the
hour
product and take them to the LFH
❖ Solution diluted for IV are stable
❖ Using aseptic technique, prepare
at room temperature for at least
the product
24 hours
❖ Horizontal LFH - be sure to work a
min of 6 inches inside front edge
of the hook
❖ Vertical LFH - be sure to work
behind the front shield and above
the area where the laminar air
stream split to enter the grills of
the front and back edge of the
 Prescription # 18A

Suspension 1. Dissolve menthol in

eucalyptus oil
❖ Liquid preparation that consist of solution
2. Triturate Magnesium
dispersed throughout a liquid phase in
carbonate into the mixture
which the particles are not soluble
(in a separate container,
add water to Magnesium
Desired Properties of a Suspension
carbonate and triturate to
❖ Fine, Uniform sized particles - gives
a smooth paste)
optimal dissolution and adsorption
3. Qs ad water to 30mL
❖ Uniform dispersion of the particles in the
liquid vehicle
❖ Ensures uniform mixture and ❖ Remarks:
uniform dose ❖ Menthol - Freely soluble in
❖ Wetting agent can be used - volatile oil
improves the ability of water to ❖ Light Magnesium Carbonate -
wet hydrophobic powder (ex. Na Absorbs volatile component;
Lauryl Sulfate) diffusable solid
❖ Slow Setting of Particles (Slow ❖ 2 Types
Sedimentation Rate) ❖ Diffusable Solid - Not
❖ Fine, Uniform size of particle soluble in solvent; readily
❖ Increase density of the liquid dispersed upon shaking
❖ Add viscosity inducing agent/ ❖ Indiffusable Solid - Not
suspending agent soluble in solvent;
❖ ex. Acacia, Tragacanth, NaCMC, Doesn`t disperse easily;
CMC requires the use of
❖ Ease of Redispersion when the product is suspending agent
shaken
❖ Solid should not form a hard
“cake” on the bottom of the
bottle when the preparation is
allowed to stand
 ❖ Coalescence - Merging of smaller droplet
Prescription # 18B with larger droplet; eventually separation
of phases CRACKING
❖ Creaming - Migration of droplet on
top/bottom of emulsion

Desired Properties of Liquid Emulsion

❖ Fine Droplet
❖ Slow aggregation of the droplet and
creaming of the product
❖ Ease of redispersion when shaken

1. Finely powder phenacetin in

a mortar
2. Add caffeine and acacia and
orange syrup
3. Add 3/4 vehicle and triturate
to form smooth paste
4. Qs ad water to final volume

Emulsion
❖ 2 phase system in which one liquid is
dispersed throughout another liquid in the
form of small droplet Method of Emulsion Preparation
❖ 2 Phases ❖ Continental or Dry Gum Method - Primary
❖ External emulsion / nucleus [Link] (O:W:EA)
Phase/Continuous/Dispersion ❖ Triturate acacia or other
Medium Emulsifying agent with oil
❖ Internal Phase / Discontinuous/ ❖ Add water (added all at once) →
Dispersed Phase triturate immediately, rapidly and
❖ Emulsion Type continuously until the primary
emulsion that form is creamy
❖ O/W
white & produces a cracking
❖ W/O
sound (3 minutes)
❖ Factors that Determine the Emulsion Type
❖ Emulsifying agent ❖ English or Wet Gum Method - Primary
❖ Phase ratio - Relative amount of emulsion [Link] (O:W:EA)
Oil and water ❖ Triturate emulsifying agent with
❖ Order of mixing - The phase that is water-mucilage
being added, usually by portions ❖ Add oil (added slowly in portions).
tend to be the internal phase Triturate
❖ Emulsifying agent - Surfactant that
concentrate at the interface of 2
immiscible phases; reduce the interfacial
tension between the immiscible phases;
provide a barrier around the droplet
 ❖ Bottle or Forbes Method - [Link] or [Link] Prescription # 20
(O:W:EA)
❖ Useful for extemporaneous preparation of
emulsion from volatile oils or oleagneous
substance of lower
❖ 1 part emulsifying agent + 2 parts oil -
throughly shaken in capped container
❖ Add water in portions - the mixture being
throughly shaken after each addition
❖ *Nascent Soap/In Situ Soap Method
Calcium Soap (W/O emulsion) Olive
Oil + Water ❖ Nascent Soap
Soap Emulsion. 1. Triturate Zinc oxide and calamine
1:1 2. Add olive oil in portion with trituration to
* The emulsifying agent is the Ca⁺⁺ salt of form slurry
the free fatty acid which is formed from 3. Add lime water in portion with trituration
the combination of 2 entities

Preparation 19

❖ Forbes/Bottle Method (O:W:EA

[Link]) - (4.65mL:3.1mL:1.6g)

1. Oil + Emulsifying agent in portion

with intermittent agitation

2. Add 2.7mL of water

3. Add syrup in portions with mixing

4. Qs ad water to final volume