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TYPES OF DOSAGE

FORMS

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Types of dosage forms:Types of dosage forms:

Definition:Definition: Dosage forms are the meansDosage forms are the means

by which drug molecules are deliveredby which drug molecules are delivered

to sites of action within the body.to sites of action within the body.

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They are classified according to:They are classified according to:

Route of administrationRoute of administration Physical formPhysical form

OralOral SolidSolidTopicalTopical SemisolidSemisolid

RectalRectal LLiquidiquid

ParenteralParenteralVaginalVaginal

InhaledInhaled

OphthalmicOphthalmic

OticOtic

Types of dosage forms

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DRUGS FOR INTERNALDRUGS FOR INTERNALROUTE OFROUTE OF

ADMINISTRATION ADMINISTRATION

LIQUID DOSAGE FORMSLIQUID DOSAGE FORMS

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Oral solution POTIONEOral solution POTIONE

clear liquid preparation for oral use containing oneclear liquid preparation for oral use containing one

or more activeor more active substancessubstances dissolved indissolved in distilleddistilled

water water ==excipientexcipientTo correct flavor it is addedTo correct flavor it is added 20% syrup20% syrup (except for (except for

potions given to relieve nausea and vomiting or topotions given to relieve nausea and vomiting or to

stimulate appetite).stimulate appetite).

If the potion contains irritants of theIf the potion contains irritants of the

gastrointestinal tract, it is addedgastrointestinal tract, it is added mucilage 20%.mucilage 20%.It is added preservativeIt is added preservative nipaginnipagin 0.05%.0.05%.

It is administered byIt is administered by teaspoonful or tablespoonfulteaspoonful or tablespoonful..

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SYRUPSYRUP

is obtained by dissolvingis obtained by dissolving one or moreone or more activeactiveingredients iningredients in excipient syrup(excipient syrup(== content 2/3content 2/3

sugar and 1/3 water sugar and 1/3 water ))..

It is addedIt is added preservativepreservative nipaginnipagin 0.1%.0.1%.

This form drug is contraindicated in patientsThis form drug is contraindicated in patientswith diabetes and those who are vomiting.with diabetes and those who are vomiting.

It is administered byIt is administered by teaspoonful or teaspoonful or

tablespoonfultablespoonful..

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MACERATE PRODUCTMACERATE PRODUCTSS result fromresult from

mixing plant,mixing plant, ((dried and choppeddried and chopped)), with the, with thenecessary amount of solvent (water or necessary amount of solvent (water or

water water --alcohol mixture)alcohol mixture)

kept at room temperature for a certainkept at room temperature for a certain

period of time.period of time.

It is an advantageous methodIt is an advantageous method to useto use

active principles thatactive principles that areare sensitive to heatsensitive to heat

is a preliminary operation in theis a preliminary operation in the

preparation of other drug types (infusion,preparation of other drug types (infusion,

decoction).decoction).

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INFUSIONINFUSION (TEA)(TEA)

containscontains activeactive thermolabilethermolabile ingredientsingredients,,

poorly soluble in coldpoorly soluble in cold solventssolvents,, obtained fromobtained from

softsoft fragments of plantsfragments of plants (leaves,(leaves,flowers),flowers), which arewhich are boilboiled ined in water for 5water for 5

minutesminutesThe infusion is leftThe infusion is left 30 minutes at room30 minutes at room

temperature, thentemperature, then it isit is filter filter eded..

It is addedIt is added 20%20% syrupsyrup (*with the exceptions(*with the exceptions

from the oral solutions)from the oral solutions)

It is pIt is preparereparedd for 1for 1--2 days.2 days.

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DECOCTIONDECOCTION

is prepared as infusion with the difference thatis prepared as infusion with the difference thathard parts of plants (roots, stems)hard parts of plants (roots, stems) are used.are used.

ContainsContains thermostablethermostable active principlesactive principlesHHardard parts of plantsparts of plants are boiledare boiled in water bath isin water bath is

made for 30 minutesmade for 30 minutesThe filtrationThe filtration is performed when the solution isis performed when the solution is

hot.hot.

It is addedIt is added 20%20% syrupsyrup

the volume of evaporated water is addedthe volume of evaporated water is added

It is pIt is preparereparedd for 1for 1--2 days.2 days.

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Is aIs a dispersion systemdispersion system consisting of two or consisting of two or more nonmore non--miscible liquidsmiscible liquids (o/w or w/o)(o/w or w/o) whichwhich

are mixed under certain conditions together are mixed under certain conditions together with emulsifiers (gums, mucilage, starch)with emulsifiers (gums, mucilage, starch)

MMilkyilky,, cloudycloudy//homogeneous appearancehomogeneous appearanceNNipaginipagin 0.05% is added as a preservative0.05% is added as a preservative

Taste and smell correctives are addedTaste and smell correctives are addedThe label will mention "shake well beforeThe label will mention "shake well before

use"use"

EMULSIONSEMULSIONS

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ORAL SUSPENSION:ORAL SUSPENSION:

--

Oral suspensions areOral suspensions are

aa

dispersion systemdispersion system

where solidwhere solid, insoluble, fine, insoluble, fine particles (dispersedparticles (dispersed

phase) are dispersed in liquid phasephase) are dispersed in liquid phase= excipient= excipient

water water (dispersion medium)(dispersion medium)-- may show a sediment which is readilymay show a sediment which is readily

dispersed on shaking to give a uniformdispersed on shaking to give a uniformsuspension which remains sufficiently stable tosuspension which remains sufficiently stable to

enable the correct dose to be deliveredenable the correct dose to be delivered

-- Not intended for systemic administration of Not intended for systemic administration of

drugs with high potencydrugs with high potency

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Intermediate products used inIntermediate products used in

compoundingcompounding

Spirits:Spirits: They are alcoholic or aqueousThey are alcoholic or aqueousalcoholic solutions of volatilealcoholic solutions of volatilesubstances used assubstances used as flavouringflavouring agents.agents.

Aromatic waters: Aromatic waters: These are aqueousThese are aqueoussolutions, usually saturated of volatilesolutions, usually saturated of volatile

oils or other volatile substances. Usedoils or other volatile substances. Usedas flavoring agents.as flavoring agents.

TINCTURESTINCTURES

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Intermediate products used in compoundingIntermediate products used in compounding TINCTURESTINCTURES

are alcoholic preparationsare alcoholic preparationscontaincontainss the active principals of vegetablethe active principals of vegetable

drugs obtained by macerating or dissolvingdrugs obtained by macerating or dissolving

the plant fragments with alcohol 70the plant fragments with alcohol 7000..

tthey are relatively weak compared to extracts.hey are relatively weak compared to extracts.

tthe proportion of active substance and solventhe proportion of active substance and solvent

isis either 2:8 or 3:7 depending of drugseither 2:8 or 3:7 depending of drugs

can be stored for can be stored for 11--3 years3 years

iit it is given as dropss given as drops

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Intermediate products used in compounding:Intermediate products used in compounding: EXTRACTSEXTRACTSThese are concentrated preparations containing theThese are concentrated preparations containing theactive principals of vegetable or animal drugs which haveactive principals of vegetable or animal drugs which havebeen extracted with suitable solventsbeen extracted with suitable solvents ((alcohol, water,alcohol, water,ether or various mixturesether or various mixtures)) and concentrated to formand concentrated to form

liquid, soft or dry extract.liquid, soft or dry extract.

Extraction process involves two times:Extraction process involves two times:

* Time I* Time I -- drug dissolution in the solvent;drug dissolution in the solvent;* Time II* Time II -- evaporation and concentration untilevaporation and concentration until it gets ait gets acertain consistancycertain consistancy..

Store in dark bottles, sealed and protected from heat.Store in dark bottles, sealed and protected from heat. InInthese conditions can be kept from one year to severalthese conditions can be kept from one year to severalyears (eg China fluid extract, dry extractyears (eg China fluid extract, dry extract beladonabeladona).).

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DRUGS FOR INTERNALDRUGS FOR INTERNALROUTE OFROUTE OF


SOLID DOSAGE FORMSSOLID DOSAGE FORMS

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TABLETTABLET

SOLID DOSAGE FORM OBTAINEDSOLID DOSAGE FORM OBTAINED

THROUGH COMPRESSING ACTIVETHROUGH COMPRESSING ACTIVE

SUBSTANCES TOGETHER WITHSUBSTANCES TOGETHER WITHCOLORANTS, FLAVORANTS,COLORANTS, FLAVORANTS,

ANTIOXIDANTS, PRESERVATIVES AND ANTIOXIDANTS, PRESERVATIVES ANDEXCIPIENTSEXCIPIENTS

CAN BE PRODUCED IN A VARIETY OFCAN BE PRODUCED IN A VARIETY OF

SIZES, SHAPES, SURFACE MARKINGSSIZES, SHAPES, SURFACE MARKINGS

VERY POPULAR DOSAGE FORMVERY POPULAR DOSAGE FORM

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TABLETTABLET

A coating may be applied to: A coating may be applied to:

11-- hide the taste of the tablet's components.hide the taste of the tablet's components.22-- make the tablet smoother and easier tomake the tablet smoother and easier to

swallow .swallow .33-- make it more resistant to themake it more resistant to the

environment.environment.

44-- extending its shelf life.extending its shelf life.

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Film coated tablets

latin - Film tabulettae (film tab.)

The tablet is coated with a

membrane of polymeric substancesthat improves physicochemical stability

of the drug and delays the rate of drugabsorption.

e.g. Augmentin

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Enteric coated tablets

latin - Tabulettae enterosolventes(tab. enterosolv.)

The tablet is coated with an acid-

resistant substance that will dissolveonly in the less acidic portions of the

intestinese.g. Voltaren, Ospen

EFFERVESCENTEFFERVESCENT

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EFFERVESCENTEFFERVESCENT

TABLET:TABLET:

EffervescentEffervescent tabletstablets are uncoated tablets thatare uncoated tablets that

generally contain acid substances (citric andgenerally contain acid substances (citric and

tartaric acids) and carbonates or bicarbonatestartaric acids) and carbonates or bicarbonates

and which react rapidly in the presence of water and which react rapidly in the presence of water by releasing carbon dioxide.by releasing carbon dioxide.

--They are intended to be dissolved or dispersed inThey are intended to be dissolved or dispersed in

water before use providing:water before use providing: A A-- Very rapid tablet dispersion and dissolution.Very rapid tablet dispersion and dissolution.

BB-- pleasant tasting carbonated drink.pleasant tasting carbonated drink.

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Sugar coated tablets

latin – dragee (drag.)

The tablet that contains activeingradient(s) of unpleasant taste may

be covered with colored sugar to makeit more palatable.

This type of tablet should beadministered in whole form.

Example: Vitaferro, Quinine.

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THERE ARE MULTI-LAYERS

DRAGEES

• contain active ingredients, each one with its own excipient, separatedby layers of sugar in order to avoid the interaction between ingredients

• (eg Mexase, layered dregees containing digestive enzymes, is indicated

as replacement therapy in various types of digestive disorders).

CACHETSCACHETS

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CACHETSCACHETS

consists of two covers of wafer which areconsists of two covers of wafer which arecoupled to form a box that contains activecoupled to form a box that contains active

ingredients.ingredients.

ExcipientExcipient = lactose= lactose is added if the sum of activeis added if the sum of active

substances is less than 0.25gsubstances is less than 0.25g

this dosage form is used to administratethis dosage form is used to administratesubstances with unpleasant taste or odor.substances with unpleasant taste or odor.

since cachets disintegrate in the stomach,since cachets disintegrate in the stomach,hygroscopic drugs or irritating substanceshygroscopic drugs or irritating substances

should not be given in this dosage form.should not be given in this dosage form.

Soft gelatin capsuleHard gelatin capsule

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CAPSULECAPSULE

A capsule A capsule is a medication in a gelatin container is a medication in a gelatin container andand

methylcellulose, calcium alginate.methylcellulose, calcium alginate.

-- Advantage: mask the unpleasant taste of its contents Advantage: mask the unpleasant taste of its contents andand

are easier to swallow.are easier to swallow. Hygroscopic drugs or irritatingHygroscopic drugs or irritatingsubstances can be administrated like this.substances can be administrated like this.

-- The two main types of capsules are:The two main types of capsules are:

11-- hardhard--shelled capsulesshelled capsules, which are normally used for dry,, which are normally used for dry,powdered ingredients,powdered ingredients,

22-- softsoft--shelled capsulesshelled capsules, primarily used for oils and for active, primarily used for oils and for activeingredients that are dissolved or suspended in oil.ingredients that are dissolved or suspended in oil.

Soft gelatin capsuleHard gelatin capsule

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SPANSULESSPANSULES

areare hardhard--shelled capsulesshelled capsules that includethat include

microdrageesmicrodragees, some soluble in the stomach,, some soluble in the stomach,others in the gut.others in the gut.

May contain a single active ingredient which isMay contain a single active ingredient which isreleased at different times/at different levels, or released at different times/at different levels, or

more substances that are released at the samemore substances that are released at the same

level or different levels of the gastrointestinallevel or different levels of the gastrointestinal

tract.tract.

POWDERPOWDER

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POWDERPOWDER

11--Bulk PowdersBulk Powders areare multidosemultidose preparationspreparationsconsisting of solid, loose, dry particles of consisting of solid, loose, dry particles of

varying degrees of fineness. They contain onevarying degrees of fineness. They contain oneor more active ingredients, with or withoutor more active ingredients, with or withoutexcipientsexcipients and, if necessary, coloring matter and, if necessary, coloring matter

and flavoring substances.and flavoring substances.

-- usually contain nonusually contain non--potent medicaments suchpotent medicaments such

as antacids since the patient measures aas antacids since the patient measures adose by volume using a 5ml medicine spoon.dose by volume using a 5ml medicine spoon.The powder is then usually dispersed in water The powder is then usually dispersed in water

or, in the case of effervescent powders,or, in the case of effervescent powders,dissolved before taking.dissolved before taking.

22--Divided PowdersDivided Powders are singleare single--dosedose

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gg

presentations of powder (for example, apresentations of powder (for example, a

small sachet) that are intended to besmall sachet) that are intended to beissued to the patient as such, to be takenissued to the patient as such, to be taken

in or with water.in or with water.

EXCIPIENT=LACTOSE AD 0.5G IF THEEXCIPIENT=LACTOSE AD 0.5G IF THE

SUM OF ACTIVE INGREDIENTS ISSUM OF ACTIVE INGREDIENTS IS

BELOW 0.5GBELOW 0.5G

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GRANULESGRANULES

--

They are consisting of solid, dry, vermicular,They are consisting of solid, dry, vermicular,cylindrical or spherical aggregates of powder cylindrical or spherical aggregates of powder particles often supplied in singleparticles often supplied in single--dose sachets.dose sachets.

-- Some granules are swallowed with water, others areSome granules are swallowed with water, others areintended to be dissolved in water before taking.intended to be dissolved in water before taking.

-- Effervescent granules evolve carbon dioxide whenEffervescent granules evolve carbon dioxide whenadded to water.added to water.

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PILLSPILLS

-- Pills are oralPills are oral small spherical or ovoid dosage formsdosage formswhich consist of spherical masses prepared fromwhich consist of spherical masses prepared from

one or more medicaments incorporated with inertone or more medicaments incorporated with inert

excipientsexcipients (PILULAR EXCIPIENT)(PILULAR EXCIPIENT) ..

-- Pills are now rarely used.Pills are now rarely used.

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DRUGS FOR EXTERNALDRUGS FOR EXTERNALROUTE OFROUTE OF


ORAL MUCOSAORAL MUCOSA

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LIQUIDLIQUID

DOSAGEDOSAGE

FORMSFORMS

GARGLES:GARGLES:

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-- They are aqueous solutions used in theThey are aqueous solutions used in the

prevention or treatment of throat infections.prevention or treatment of throat infections.-- Usually they are prepared in a concentratedUsually they are prepared in a concentrated

solution with directions for the patient tosolution with directions for the patient todilute with warm water before use.dilute with warm water before use.

MOUTHWASHESMOUTHWASHES::

These are similar to gargles but are used for These are similar to gargles but are used for oral hygiene and to treat infections of theoral hygiene and to treat infections of themouth.mouth.

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BUCOBUCO--PHARYNGEAL SHOWERS arePHARYNGEAL SHOWERS are

aqueous solution administered under pressureaqueous solution administered under pressure

using a suitable device (big syringe or rubber using a suitable device (big syringe or rubber

device).device).

Solutions can be administrated to the mouthSolutions can be administrated to the mouthmucosa using a SPRAYmucosa using a SPRAY

– – The solution covers quickly, easily and uniformlyThe solution covers quickly, easily and uniformly

the entire surface of the mouththe entire surface of the mouth

Solutions with glycerin asSolutions with glycerin as excipientexcipient

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g yg y pp

which are administrated at oral mucosawhich are administrated at oral mucosa

((fr.fr.COLLUTOIRECOLLUTOIRE))

are consistent viscous solutions used for theare consistent viscous solutions used for theanointing (anointing ( frenchfrench== badigeonner badigeonner )) the mouththe mouthmucosamucosa with awith a cotton padcotton pad soaked insoaked in thethe

solutionsolutionto treat mouth, gums, throatto treat mouth, gums, throat

the solution forms a protective coating thatthe solution forms a protective coating thatfavors the prolonged contact of drugfavors the prolonged contact of drugsubstances with mucosa (eg Glycerin 10%substances with mucosa (eg Glycerin 10%

borax preparation).borax preparation).

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SEMISEMI--SOLIDSOLID

DOSAGEDOSAGE

FORMSFORMS

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GelGel

A gel which can be injected directly into the A gel which can be injected directly into the

pocket.pocket.The gel hardens quickly and then slowlyThe gel hardens quickly and then slowlydissolves over the next 7 days releasingdissolves over the next 7 days releasing

doxycyclinedoxycycline..This gel fills the entire pocket which may not beThis gel fills the entire pocket which may not be

the case with fibers or chips.the case with fibers or chips.

2 syringes (1 with polymer + 1with antibiotic)2 syringes (1 with polymer + 1with antibiotic) – –interlocked together so the content is mixedinterlocked together so the content is mixed

TOOTHPASTETOOTHPASTE

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TOOTHPASTE

Used for maintenance of oral hygiene and teethUsed for maintenance of oral hygiene and teethContainsContains

– – Abrasive substances Abrasive substances (calcium carbonate,(calcium carbonate,

magnesium, aluminum hydroxide)magnesium, aluminum hydroxide)

– – Anti Anti-- caries agent:caries agent: sodium fluoride is the mostsodium fluoride is the mostcommonly used fluoride.commonly used fluoride.

– – Whitening ingredient:Whitening ingredient: sodiumsodium perborateperborate..

– – Agglutinative ingredients Agglutinative ingredients (starch)(starch)

– – Flavoring substancesFlavoring substances (menthol,(menthol, spearmintspearmint,,peppermint,peppermint, cinnamoncinnamon,, cloveclove, caraway,, caraway, coriander coriander ,,eucalyptus)eucalyptus)

– – PreservativesPreservatives ((pp--hydrozybenzoatehydrozybenzoate)) – – Antiseptics Antiseptics

Foaming agentsFoaming agents lower the surface tension oflower the surface tension of

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Foaming agentsFoaming agents lower the surface tension of lower the surface tension of

water so that bubbles are formed.water so that bubbles are formed.

Foaming agents help in removing particles fromFoaming agents help in removing particles from

teeth.teeth.

Common foaming agents are sodiumCommon foaming agents are sodium

lauryllauryl sulfatesulfate, sodium, sodium lauryllauryl

sulfoacetatesulfoacetate,, sulfolauratesulfolaurate, sodium, sodium lauryllaurylsarcosinatesarcosinate, sodium, sodium stearylstearyl fumaratefumarate, and, and

sodiumsodium stearylstearyl lactatelactate..

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SOLIDSOLID

DOSAGE FORMSDOSAGE FORMS

Sublingual tablet:Sublingual tablet:

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Sublingual tablet:Sublingual tablet:

-- Sublingual tablets are administered by placingSublingual tablets are administered by placingthem in the mouth, under the tonguethem in the mouth, under the tongue

-- The medications dissolve rapidly, are absorbedThe medications dissolve rapidly, are absorbedand enter into the bloodstream.and enter into the bloodstream.

-- Avoid the acid and enzymatic environment of Avoid the acid and enzymatic environment of the stomach and the drug metabolizingthe stomach and the drug metabolizing

enzymes of the liver.enzymes of the liver.

-- Examples :Examples : nitroglicerinanitroglicerina,, buprenorfinabuprenorfina,,

isoprenalinaisoprenalina..

LOZENGELOZENGE OR TROCHEOR TROCHE

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-- is a solid preparation consisting of is a solid preparation consisting of activeactivesubstances included in an excipient of substances included in an excipient of

sugar and gum, the latter giving strengthsugar and gum, the latter giving strengthand cohesiveness to the lozenge andand cohesiveness to the lozenge and

facilitating slow release of thefacilitating slow release of the

medicament.medicament.

-- It has topical effect and it is used toIt has topical effect and it is used to

medicate diseases of mouth and throat.medicate diseases of mouth and throat.

-- Not toNot to be swallowed !!!be swallowed !!!

DENTAL FIBRESDENTAL FIBRES

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DENTAL FIBRESDENTAL FIBRES

PolyvinylacetatePolyvinylacetate fibresfibres impregnated withimpregnated with

tetraciclinetetracicline

FibresFibres are packed in layer into the pocket andare packed in layer into the pocket andkept in place by means of kept in place by means of cyanoacrylatecyanoacrylate

adhesive and removed after 10 days of adhesive and removed after 10 days of

sustained release of tetracyclinesustained release of tetracycline

Treatment of adultTreatment of adult

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Treatment of adultTreatment of adult

periodontitisperiodontitis; as an adjunct to; as an adjunct toscaling and rootscaling and root planingplaning for thefor the

reduction of pocket depth andreduction of pocket depth and

bleeding on probing in selectedbleeding on probing in selectedpatients with adultpatients with adult periodontitisperiodontitis

Eg.Eg. Actisite Actisite®®

ContainContain especially antibacterial andespecially antibacterial and

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antifungalantifungal drugs.drugs.

Advantage: Advantage: cancan achieveachieve high concentrations of high concentrations of

antibiotics at infection siteantibiotics at infection site which is of which is of particular particular importance because bacteriaimportance because bacteria

areare protectedprotected by theby the biofilmbiofilm..

MICMIC (minimum inhibitory concentration) of (minimum inhibitory concentration) of antibioticantibiotic is sometimesis sometimes a hundreda hundred timestimes higher higher

for for biofilmbiofilm bacteriabacteria than for than for thethe

samesame bacteriabacteria outside theoutside the biofilmbiofilm..

DENTAL CONESDENTAL CONES

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-- A dosage form intended to be placed in the A dosage form intended to be placed in theempty socketempty socket following a tooth extraction, for following a tooth extraction, for

preventing the local multiplication of preventing the local multiplication of

pathogenic bacteria associated with toothpathogenic bacteria associated with tooth

extractions.extractions.

HH i l l t di l l t d hh ithith

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Have aHave a conical, elongatedconical, elongated shapeshape with awith a

lengthlength of 0.8of 0.8 cmcm and aand a basebase diameter of diameter of 22--4mm.4mm.

May contain antiseptic,May contain antiseptic,antiinflammatoryantiinflammatory,, anestheticsanesthetics andand

substancessubstances that stimulatethat stimulate tissuetissue recovery.recovery.

Depending onDepending on their their composition, somecomposition, some dentaldental

conescones are solubleare soluble inin tooth sockets.tooth sockets.

egeg Apernil Apernil,, NeoconesNeocones..

PERIODONTAL CHIPS

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PerioChipPerioChip is indicated as an adjunct to scalingis indicated as an adjunct to scalingand root planning procedures for reduction of and root planning procedures for reduction of

pocket depth in patients with adultpocket depth in patients with adult periodontitisperiodontitis..

OneOne PerioChipPerioChip is inserted into a periodontalis inserted into a periodontal

pocket with probing pocket depth (PD)pocket with probing pocket depth (PD) ≥≥ 5 mm.5 mm.

Up to 8Up to 8 PerioChipsPerioChips may be inserted in a singlemay be inserted in a singlevisit. Treatment is recommended to bevisit. Treatment is recommended to be

administered once every three months inadministered once every three months inpockets with PD remainingpockets with PD remaining ≥≥ 5 mm.5 mm.

http://http://www.youtube.com/watch?vwww.youtube.com/watch?v=Ew2ePfc2_F=Ew2ePfc2_F

ss

PERIODONTAL CHIPSPERIODONTAL CHIPS

http://www.youtube.com/watch?v=Ew2ePfc2_Fs










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PERIOCHIPPERIOCHIP®®

biodegradable chipbiodegradable chip

containscontains chlorhexidinechlorhexidine which is active againstwhich is active against

a broad spectrum of microbes.a broad spectrum of microbes.slow release of active drug which has beenslow release of active drug which has beenshown, in vitro, to fights bacteria for a periodshown, in vitro, to fights bacteria for a periodof 7 to 10 days.of 7 to 10 days.

it maintains clinical effectiveness and has notit maintains clinical effectiveness and has not

been associated with changes in bacterialbeen associated with changes in bacterialresistance in the oral cavity.resistance in the oral cavity.

indications: gum disease (a chronic disease),indications: gum disease (a chronic disease),requiring longrequiring long--term therapyterm therapy

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TheThe PerioChipPerioChip should be grasped usingshould be grasped using

forceps (such that the rounded end pointsforceps (such that the rounded end points

away from the forceps) and inserted into theaway from the forceps) and inserted into the

periodontal pocket to its maximum depth. If periodontal pocket to its maximum depth. If necessary, thenecessary, the PerioChipPerioChip can be further can be further

maneuvered into position using the tips of themaneuvered into position using the tips of theforceps or a flat instrument.forceps or a flat instrument.

TheThe PerioChipPerioChip does not need to be removeddoes not need to be removed

since it biodegrades completely.since it biodegrades completely.

Nasal Solution (Drops) and Sprays:Nasal Solution (Drops) and Sprays:

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Drugs in solution may be instilled into the nose from aDrugs in solution may be instilled into the nose from a

dropper or from a plastic squeeze bottle.dropper or from a plastic squeeze bottle.

The drug may have a local effect, e.g. antihistamine,The drug may have a local effect, e.g. antihistamine,

decongestant.decongestant.

Alternatively the drug may be absorbed through theAlternatively the drug may be absorbed through the

nasal mucosa to exert a systemic effect.nasal mucosa to exert a systemic effect.

The use of oily nasal drops should be avoided becauseThe use of oily nasal drops should be avoided because

of possible damage to the cilia of the nasal mucosa.of possible damage to the cilia of the nasal mucosa.

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RESPIRATORY MUCOSARESPIRATORY MUCOSA

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InhalationsInhalations

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InhalationsInhalations

areare medicinalmedicinal solutions usedsolutions used toto

treattreat upper upper airway diseases, whichairway diseases, which areareobtained byobtained by dissolvingdissolving active substancesactive substances in hotin hot

water water (70(7000C)C) volatilizationvolatilization of of

activeactive principlesprinciples intointo water vapors thatwater vapors that areareinhaledinhaled

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Nebulizer or (atomizer):Nebulizer or (atomizer):

A nebulizer is a device used to administer medication to people in forms of a liquid mist to the airways.

- It is commonly used in treating asthma, and other respiratory diseases.

- It pumps air or oxygen through a liquid medicine to turn it into a vapor,

which is then inhaled by the patient.Nebulizers, for that reason, are usually reserved only for serious cases of

respiratory disease, or severe attacks.

Aerosols Inhaler: Aerosols Inhaler:

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-- Inhalers are solutions of drugs in a mixture of inert propellantInhalers are solutions of drugs in a mixture of inert propellantssheld under pressure in an aerosol dispenser.held under pressure in an aerosol dispenser.

-- Release of a dose of the medicament in the form of Release of a dose of the medicament in the form of dropletsdropletsof 5 micrometer of 5 micrometer diameter from the container through adiameter from the container through aspringspring--loaded valve incorporating a metering device.loaded valve incorporating a metering device.

-- The patient then inhales the released drug through aThe patient then inhales the released drug through a

mouthpiece.mouthpiece.-- It is commonly used to treat asthma and other respiratoryIt is commonly used to treat asthma and other respiratory

problems.problems.

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In the lastIn the last twotwo decadesdecades it is also used ait is also used a

dosage form containingdosage form containing

micronizedmicronized powderspowders withwith very small sizevery small size of of

11--55 micronsmicrons administratedadministrated withwithaa turboturbo inhaler.inhaler.

TheThe drugdrug formform itself itself does not falldoes not fall into theinto thecategory of category of aerosolsaerosols butbut somesome

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CONJUNCTIVAL MUCOSACONJUNCTIVAL MUCOSA

Ophthalmic dosage forms:Ophthalmic dosage forms:

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p gp g

Eye drops:Eye drops:

•• ophtalmicophtalmic sollutionsollution (eye drops) are liquid(eye drops) are liquid

dosage forms used to administer medicationdosage forms used to administer medicationin the eye.in the eye.

•• Depending on the condition being treated,Depending on the condition being treated,

they may contain steroids, antihistamines orthey may contain steroids, antihistamines or topical anesthetics.topical anesthetics.

•• Eye drops sometimes do not haveEye drops sometimes do not havemedications in them and are only lubricatingmedications in them and are only lubricating

and tear and tear --replacing solutions.replacing solutions.

ExcipientExcipient -- distilled water distilled water

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– –pHpH close to that of tear close to that of tear secretionsecretion

– –notnot irritantirritant

– –do notdo not contain impuritiescontain impurities

– –sterile!!!!sterile!!!!Typically,Typically, ophtalmic solutionophtalmic solution isis

preparedprepared in small quantities (5in small quantities (5--20g)20g)for afor a maximum period of maximum period of 30 days30 days

OPHTHALMIC OINTMENT & GEL:OPHTHALMIC OINTMENT & GEL:

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These are sterile semiThese are sterile semi--solidsolid

Preparations intended for application toPreparations intended for application to

the conjunctiva or eyelid margin.the conjunctiva or eyelid margin.

It meltsIt melts

quickly andquickly and

diffuses easily on thediffuses easily on the

surfacesurface of of the eyethe eye byby blinking.blinking.

Must adhereMust adhere

to the lining of to the lining of

the eye,the eye,

Must notMust not bebe irritant.irritant.

THERAPEUTIC CONTACT LENSTHERAPEUTIC CONTACT LENS

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is ais a pharmaceutical formpharmaceutical form containing activecontaining activesubstances embedded insubstances embedded in gelatin andgelatin and whichwhich isis

appliedapplied likelike contactcontact lens.lens.

OCULAR MINI TABLETSOCULAR MINI TABLETS

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small (diameter of small (diameter of 3 mm3 mm and weightand weight of of aa

fewfew centigrams)centigrams)appliedapplied eyeeye on liningon lining andand is quicklyis quickly solublesoluble inin

ocular secretion.ocular secretion. jelly, transparent, slightly jelly, transparent, slightly colored,colored, sterile.sterile. It IIt I

may be administeredmay be administered to treatto treatconjunctivitisconjunctivitis and other eye pathology.and other eye pathology.

DRUGS FOR EXTERNAL

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DRUGS FOR EXTERNALDRUGS FOR EXTERNAL

ROUTE OFROUTE OF


NASAL MUCOSANASAL MUCOSA

DRUGS FOR EXTERNAL

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ROUTE OFROUTE OF


OTIC MUCOSAOTIC MUCOSA

EAR DROPS:EAR DROPS:

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-- Ear drops are solutions, suspensions or Ear drops are solutions, suspensions or

emulsions of drugs that are instilled into the ear emulsions of drugs that are instilled into the ear

with a dropper.with a dropper.

-- It is used to treat or prevent ear infections,It is used to treat or prevent ear infections,

especially infections of the outer ear and ear especially infections of the outer ear and ear canal.canal.


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(TOPICAL) ROUTE OF(TOPICAL) ROUTE OF


SKINSKIN -- CUTANEOUSCUTANEOUS

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LIQUIDLIQUID

DOSAGEDOSAGE

FORMSFORMS

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Lotions:Lotions:

-- These are fluid preparations (aqueous) for These are fluid preparations (aqueous) for

external application without friction.external application without friction.

-- They are either dabbed on the skin or applied onThey are either dabbed on the skin or applied on

a suitable dressing and covered with aa suitable dressing and covered with awaterproof dressing to reduce evaporation.waterproof dressing to reduce evaporation.

Liniments:Liniments:

-- Liniments are fluid semiLiniments are fluid semi--fluid or occasionallyfluid or occasionally

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- Liniments are fluid, semiLiniments are fluid, semi-fluid or, occasionally,fluid or, occasionally,

semisemi--solid preparations intended for applicationsolid preparations intended for application

to the skin.to the skin.

-- They may be alcoholic or oily solutions or They may be alcoholic or oily solutions or emulsions.emulsions.

-- Most are massaged into the skin (e.g. counter Most are massaged into the skin (e.g. counter --

irritant).irritant).

-- Liniments should not be applied to broken skin.Liniments should not be applied to broken skin.

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SEMISEMI--SOLIDSOLID

DOSAGEDOSAGE

FORMSFORMS

OINTMENTSOINTMENTS

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Ointments are semi-solid preparations for

application to the skin that contain 20% active

ingredients included in a excipient (lanolin or vaseline)

CREAMS:CREAMS:-- Semisolid preparations containing one or more medicinalSemisolid preparations containing one or more medicinal

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agents dissolved in either anagents dissolved in either an o/wo/w or w/o emulsionor w/o emulsion ContaisContais atatleast 20% water least 20% water -- They are divided into two types:They are divided into two types:

A A

--

oiloil

--inin

--water (O/W) creams:water (O/W) creams:

which are composed of smallwhich are composed of small

droplets of oil dispersed in a continuous aqueous phase.droplets of oil dispersed in a continuous aqueous phase.OilOil--inin--water creams are more comfortable and cosmeticallywater creams are more comfortable and cosmetically

acceptable as they are less greasy and more easily washedacceptable as they are less greasy and more easily washedoff using water.off using water.

BB-- water water --inin--oil (W/O) creams:oil (W/O) creams: which are composed of smallwhich are composed of smalldroplets of water dispersed in a continuous oily phase.droplets of water dispersed in a continuous oily phase.

Water Water --inin--oil creams are more difficult to handle but many drugsoil creams are more difficult to handle but many drugswhich are incorporated into creams are hydrophobic and willwhich are incorporated into creams are hydrophobic and willbe released more readily from a water be released more readily from a water --inin--oil cream than anoil cream than anoiloil--inin--water cream.water cream.

GELS:

semisolids consisting of dispersions of small or large

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molecules in an aqueous liquid vehicle rendered jelly-likethrough the addition of a gelling agent.

Contain water soluble bases prepared from natural gumssuch as tragcanth, pectin, alginates, or from synthetic

derivatives of natural substances such as methylcellulose.

POULTICE:It is soft, viscous, pasty preparation for external use. They are applied to skin

while they are hot. Poultice must retain heat for a considerable time becausethey are intended to supply warmth to inflamed parts of body.

E.g. Kaolin poultice (B.P.C.)

PASTAPASTA

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is ais a variety of variety of ointmentointment that hasthat has

aa harder harder consistency,consistency, because it containsbecause it contains aa

large amount of large amount of insolubleinsoluble drugdrug particles.particles.TheThe excipientexcipient maymay bebe water, water water, water --alcohol,alcohol,

possiblypossibly a small amounta small amount of fat.of fat.Does not meltDoes not melt at body temperatureat body temperature

Forms aForms a protective layer protective layer (eg(eg water water pastepastecontainingcontaining large amountslarge amounts of zinc oxide).of zinc oxide).

55-- Pastes :Pastes :-- Pastes are basically ointments into which a highPastes are basically ointments into which a high

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percentage of insoluble solid has been addedpercentage of insoluble solid has been added--The extraordinary amount of particulate matter stiffens theThe extraordinary amount of particulate matter stiffens the

system.system.

--Pastes are less penetrating and less macerating and lessPastes are less penetrating and less macerating and lessheating than ointment.heating than ointment.

--Pastes make particularly good protective barrier whenPastes make particularly good protective barrier whenplaced on the skin, the solid they contain can absorb andplaced on the skin, the solid they contain can absorb and

thereby neutralize certain noxious chemicals before theythereby neutralize certain noxious chemicals before theyever reach the skin.ever reach the skin.

-- Like ointments, paste forms an unbroken relatively water Like ointments, paste forms an unbroken relatively water

– – impermeable film unlike ointments the film is opaqueimpermeable film unlike ointments the film is opaqueand therefore can be used as an effective sun blockand therefore can be used as an effective sun blockaccordingly.accordingly.

-- Pastes are less greasy because of the absorption of thePastes are less greasy because of the absorption of thefluid hydrocarbon fraction to the particulates.fluid hydrocarbon fraction to the particulates.

Semisolid contains a larger proportion of solid materials than ointments.

Stiffer than ointment

Good protective barriers

Opague, water impermeable, prevent dehydration

Good absorbent

PomadePomade

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variant of variant of ointmentointment used especiallyused especially to anointto anoint

thethe hair hair it contains activeit contains active substancessubstances embeddedembedded

inin excipientsexcipients asas lanolinlanolin (eg(eg fluocinolonefluocinolone N,N,

pomade).pomade).

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SoapsSoaps are madeare made of of softsoft or or

hardhard consistencyconsistency obtainedobtained

fromfrom alkalinealkaline saltssalts of fattyof fatty acidsacids mixedmixed

withwith active substancesactive substances (eg(eg sulfur sulfur soap).soap).

MEDICINAL VINEGARMEDICINAL VINEGAR

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excipientexcipient isis an aqueous solutionan aqueous solutionof of aceticacetic acidacid 6%6%

If theIf the activeactive substancesubstance isisthethe essential oilessential oil it isit is

calledcalled aromaticaromatic vinegar.vinegar.It is administered throughIt is administered through

rubbingrubbing

RUBBING ALCOHOLRUBBING ALCOHOL

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SOLIDSOLID

DOSAGE FORMSDOSAGE FORMS

Dusting powders:Dusting powders:

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-- These are free flowing very fine powders for These are free flowing very fine powders for external use.external use.

- Are sprinkled onto the intact skin (Not for useNot for useon open wounds unless the powders areon open wounds unless the powders are

sterilized).sterilized).

- Consist of talc, magnesium stearate, silicon

dioxide (silica), or starch. They adhere to the

skin, forming a low-friction film that attenuatesmechanical irritation. Powders exert a drying

(evaporative) effect.

- May contain antiseptic agents or antibiotics

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CAUSTICCAUSTIC PENCILSPENCILS

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•• solidsolid preparationspreparations containingcontaining causticcaustic

substancessubstances

••

Cylindrical shape, 5cm lengthCylindrical shape, 5cm length andand 33--5 mm5 mm diameter diameter

••

Eg.Eg. silver silver nitratenitrate pencilspencils toto cauterizecauterizewoundswounds or to treat warts andor to treat warts and verrucaverruca).).

Plasters:Plasters:

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Plasters are solid dosage forms that adhere toPlasters are solid dosage forms that adhere tothe skin when spread upon cotton felt line or the skin when spread upon cotton felt line or

muslin as a backing materialmuslin as a backing material

Afford protection and mechanical support. Afford protection and mechanical support.

Bring medication into close contact with theBring medication into close contact with the

surface of the skin.surface of the skin.

TransdermalTransdermal patch:patch:

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-A transdermal patch or skin patch is a medicated

adhesive patch that is placed on the skin to deliver a

specific dose of medication through the skin and into thebloodstream.

-An advantage of a transdermal drug delivery route over other types such as oral, topical, etc is that it provides a

controlled release of the medicament into the patient.

- The first commercially available patch was scopolamine

for motion sickness.

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Other examples TTS :Other examples TTS :

ClonidineClonidine

LidocaineLidocaine HClHCl and epinephrineand epinephrine

Lidocaine/TetracaineLidocaine/Tetracaine

NicotineNicotineTestosteroneTestosterone

FentanylFentanylMeth lMeth l Salic lateSalic late/Menthol/Menthol


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ROUTE OFROUTE OF


RECTAL MUCOSARECTAL MUCOSA

SUPPOSITORY:SUPPOSITORY:

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It is a solid medicated mass, usuallyIt is a solid medicated mass, usually

conecone--shaped ,that is inserted into theshaped ,that is inserted into therectum (rectal suppository), where itrectum (rectal suppository), where it

melts at body temperature .melts at body temperature .

areare solid,solid, brittle,brittle, fusiblefusible at bodyat bodytemperaturetemperature

i li l hh li d i lli d i l hh

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conicalconical shape or shape or cylindricalcylindrical shapeshape

finishedfinished with awith a cone like shapecone like shape

Weight:Weight: for for adultadult 3g,3g, for childrenfor children

2g2g andand for babies 1gfor babies 1gExcipentExcipent: cocoa butter : cocoa butter or or glyceroglycero--

gelatingelatin or or syntheticsynthetic derivatives.derivatives.EgEg glycerineglycerine suppository,suppository,

phenylbutazonephenylbutazone suppositories).suppositories).

ENEMA:ENEMA:

AnAn enemaenema is the proced re of introd cingis the proced re of introd cing

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An An enemaenema is the procedure of introducingis the procedure of introducingliquids into the rectum and colon via theliquids into the rectum and colon via theanus.anus.

Types of enema:Types of enema:

EVACUATOR ENEMA:EVACUATOR ENEMA: usedused as a bowelas a bowel

stimulant to treat constipation. E.g. softstimulant to treat constipation. E.g. softsoap enema & Mgsosoap enema & Mgso44 enemaenema

--The volume of The volume of evacuantevacuant enemas may reachenemas may reach

up to 1.5 liters.up to 1.5 liters.

-- They should be warmed to bodyThey should be warmed to body

temperature before administration.temperature before administration.

DRUG MEDICINAL ENEMADRUG MEDICINAL ENEMA

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has a volume of has a volume of 100100--150ml150ml andandtoto bebe retainedretained containscontains 5 drops5 drops of of

opiumopium tincturetincture or or benzylbenzyl alcohol in order toalcohol in order todecrease intestinal movementsdecrease intestinal movements andandfavorsfavors retention)retention) ..

If If it containsit contains irritants 20% mucilage it is addedirritants 20% mucilage it is added

EnemasEnemas are administrated usingare administrated using anan irrigator.irrigator.

TheThe medicinalmedicinal enemasenemas are alwaysare alwaysadministeredadministered after after evacuator evacuator enema.enema.

Retention (drug medicinal) enema:Retention (drug medicinal) enema:

-- No warming needed.No warming needed.

May exert:May exert:

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-- May exert:May exert:

AA-- Local effect:Local effect: e.g. a barium enema is usede.g. a barium enema is used

as a contrast substance in the radiologicalas a contrast substance in the radiologicalimaging of the bowel.imaging of the bowel.

BB-- Systemic effect:Systemic effect:e.g. the administration of substances intoe.g. the administration of substances into

the bloodstream. This may be done inthe bloodstream. This may be done insituations where it is impossible to deliver situations where it is impossible to deliver a medication by moutha medication by mouth


ROUTE OFROUTE OF

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ROUTE OFROUTE OF


VAGINAL MUCOSAVAGINAL MUCOSA

Vaginal Douche:Vaginal Douche:

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a device is used to introduce a stream of

solution into the vagina for medical or hygienic reasons.

Vaginal gelVaginal gel

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Vaginal creamVaginal cream

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Vaginal FoamVaginal Foam

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VAGINAL SUPPOSITORYVAGINAL SUPPOSITORY(PESSARIES)(PESSARIES)

AreAre solidsolid dosagedosage formsforms ovaloval shaped weightshaped weight

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Are Are solidsolid dosagedosage forms,forms, ovaloval shaped, weightshaped, weightof of 22--4g4g

Excipient:Excipient: cocoa butter or glycerococoa butter or glycero--gelatingelatinUnder the action of Under the action of bodybodytemperaturetemperature andand vaginal secretions, thevaginal secretions, the

pessaries meltpessaries melt releasingreleasingthethe activeactive substancessubstances (eg(eg estrogenestrogen ).).

Are administrated profoundly into vagina, Are administrated profoundly into vagina,preferablypreferably after aafter a vaginal lavagevaginal lavage with antisepticwith antisepticsolutionsolution (or (or an infusion of an infusion of chamomile flowers).chamomile flowers).

VaginalVaginal

tabletstablets

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Vaginal tablets

areare ovoidovoid or or cylindricalcylindrical solid formssolid formssometimessometimes slightlyslightly effervescenteffervescent

whichwhich disintegratedisintegrate rapidlyrapidly releasingreleasing

the active ingredientthe active ingredient inin vaginalvaginal

environmentenvironment

(eg(eg metronidazole vaginalmetronidazole vaginal tablets).tablets).

Vaginal ringsVaginal rings are 'doughnutare 'doughnut--shaped' polymeric drugshaped' polymeric drugdelivery devices designed to provide controlleddelivery devices designed to provide controlled

VAGINAL RING:VAGINAL RING:

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delivery devices designed to provide controlleddelivery devices designed to provide controlledrelease of drugs to the vagina over extended periodsrelease of drugs to the vagina over extended periodsof time.of time.

Several vaginal ring products are currently available,Several vaginal ring products are currently available,including:including:

FemringFemring ::

a lowa low--dosedose estradiolestradiol--acetate releasing ring,acetate releasing ring,manufactured from siliconemanufactured from silicone elastomer elastomer , for the relief of , for the relief of hot flashes and vaginal atrophy associated withhot flashes and vaginal atrophy associated with

menopause.menopause.NuvaRingNuvaRing::

a lowa low--dose contraceptive vaginal ring, releasingdose contraceptive vaginal ring, releasing

progesterone and estrogen.progesterone and estrogen.

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DRUGS FOR PARENTERALDRUGS FOR PARENTERALROUTE OF ADMINISTRATIONROUTE OF ADMINISTRATION

PARENTERALPARENTERAL

Th tTh t t lt l

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The termThe term parenteralparenteral

derived from the Greek words:derived from the Greek words:

parapara (outside) and(outside) and

enteronenteron,, (intestine)(intestine)

denotes routes of administration other than oraldenotes routes of administration other than oral

route.route.

refers to therefers to the injectableinjectable routes administration.routes administration.

Pure,sterilePure,sterile andand pyrogenpyrogen free preparationsfree preparations

intended to be administeredintended to be administered parenterallyparenterally..

ParenteralParenteral Routes of Routes of

Administration Administration

1 Intra1 Intra articulararticular 66 IntrasynovialIntrasynovial

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Administration1. Intra1. Intra--articular articular

– – joints joints

2.2. IntraspinalIntraspinal – –spinal columnspinal column

3. Intra3. Intra

--arterialarterial

– –arteriesarteries

4. Intravenous4. Intravenous

– –veinsveins5.5. IntradermalIntradermal

– –skinskin

6.6. IntrasynovialIntrasynovial

– – joint fluid joint fluid

7.7. IntrathecalIntrathecal – –spinal fluidspinal fluid

8.8.

IntracardiacIntracardiac

– –heartheart

9. Intramuscular 9. Intramuscular

– –musclesmuscles10. Subcutaneous10. Subcutaneous

– –under the skinunder the skin

ROUTESROUTES

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ParenteralParenteral dosage forms:dosage forms:

AnAn injectioninjection is an infusion method ofis an infusion method of

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An An injectioninjection is an infusion method of is an infusion method of putting liquid into the body, usuallyputting liquid into the body, usuallywith a hollow needle and a syringewith a hollow needle and a syringewhich is pierced through the skin to awhich is pierced through the skin to a

sufficient depth for the material to besufficient depth for the material to beforced into the body.forced into the body.

AN INTRAVENOUS INJECTION: AN INTRAVENOUS INJECTION:

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It is a liquid administeredIt is a liquid administereddirectly into the bloodstreamdirectly into the bloodstream

via a vein.via a vein.

Intravenous RouteIntravenous RouteAdvantage:Advantage:

May be a lifeMay be a life--saving procedure because of saving procedure because of

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yy g pg pthe placement of the drug directly into thethe placement of the drug directly into the

circulation and the prompt actions whichcirculation and the prompt actions whichensues.ensues.

Disadvantage:Disadvantage:Once the drug administered, it cannot beOnce the drug administered, it cannot be

retrieved.retrieved.

In the case of adverse reaction to the drug,In the case of adverse reaction to the drug,

for instance, the drug cannot be easilyfor instance, the drug cannot be easily

removed from the circulation.removed from the circulation.

Intravenous RouteIntravenous RoutePrecautions:Precautions:

Strict aseptic precautions must be taken atStrict aseptic precautions must be taken at

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Strict aseptic precautions must be taken atStrict aseptic precautions must be taken at

all times to avoid risk of infection.all times to avoid risk of infection.

The syringes and needles used must beThe syringes and needles used must be

sterilized and to the point of entrance muststerilized and to the point of entrance must

be disinfected to reduce chance of be disinfected to reduce chance of

carrying bacteria from the skin into thecarrying bacteria from the skin into the

blood via the needleblood via the needle

Intravenous Route (IV)Intravenous Route (IV)

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INTRAMUSCULAR INJECTION:INTRAMUSCULAR INJECTION:

It is the injection of a substance directly into a

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- It is the injection of a substance directly into a

muscle.

- Many vaccines are administeredintramuscularly.

- Depending on the chemical properties of thedrug, the medication may either be absorbed

fairly quickly or more gradually.

- Injection fibrosis is a complication that may

occur if the injections are delivered with great

frequency or with improper technique.

Volume of Administration:Volume of Administration:li it d

Intramuscular (IM)Intramuscular (IM)

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limited :limited :

– –55 mLmL in thein the glutealgluteal regionregion – –22 mLmL in the deltoid of the arm.in the deltoid of the arm.

Injection is 2 to 3 inches deepInjection is 2 to 3 inches deep20 to 22 gauge needle.20 to 22 gauge needle.

Such injuries include:Such injuries include:

1. Paralysis resulting from neural1. Paralysis resulting from neural

Intramuscular Intramuscular

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1. Paralysis resulting from neuraly gdamagedamage

2. Abscesses2. Abscesses3. Cysts3. Cysts

4. Embolism4. Embolism5. Hematoma5. Hematoma

6. Scar formation6. Scar formation

Subcutaneous injection:Subcutaneous injection:

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Subcutaneous injections are given by injecting a fluid into the subcutis, the

layer of skin directly below the dermis and epidermis.

Subcutaneous injections are highly effective in administering vaccines and

such medications as insulin.

PARENTERAL PREPARATIONSPARENTERAL PREPARATIONS

•• are sterile preparations intended for are sterile preparations intended for d i i i b i j i i f id i i t ti b i j ti i f i

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administration by injections, infusion or administration by injections, infusion or

implantation into the bodyimplantation into the body

•• Supplied in glass ampoules, vials, plasticSupplied in glass ampoules, vials, plasticcontainers or prefilled syringes.containers or prefilled syringes.

INJECTIONINJECTION

a solutiona solution which must be pure,which must be pure, sterilesterile and nonand non--ii

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pyrogenicpyrogenic..

– – FilteringFiltering -- impurities removalimpurities removal

– – SterilizingSterilizing-- microorganisms removalmicroorganisms removal – – DepyrogenationDepyrogenation --fever fever --producingproducing


removalremoval

usingusing

variousvarious

physicophysico

--

chemicalchemical methodsmethods

OilyOily solutionssolutions can be injectedcan be injected onlyonlyintramuscularlyintramuscularly ..

SolutionsSolutions for intramuscular or subcutaneousfor intramuscular or subcutaneousadministrationadministration should beshould be isotonicisotonic asas

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administrationadministration should beshould be isotonicisotonic asaspossiblepossible and at pHand at pH 7.3.7.3.

IntravenouslyIntravenously can becan beadministeredadministered slightlyslightly alkalinealkaline andand hypertonichypertonic

solutionssolutions (hypertonic(hypertonicsolutionssolutions givengiven imim or or scsc produceproduce inflammatoryinflammatory

reactions,reactions, necrosis).necrosis).NoNo oilyoily solution can besolution can beadministratedadministrated intravenously.intravenously.

AMPOULESAMPOULES

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AMPOULES AMPOULES

PREFILLED SYRINGESPREFILLED SYRINGES

VIALSVIALS

PELLETPELLET

Ampoules Ampoules

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Containers for infusion solutionsContainers for infusion solutions

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Prefilled syringePrefilled syringe

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Vials may be designated for Vials may be designated for singlesingle--

dosedose or or multimulti--dosedose use.use.

SingleSingle--dose vialsdose vials do not contain preservativesdo not contain preservatives

and should be discarded after one use.and should be discarded after one use.MultidoseMultidose vialsvials contain a preservative to inhibitcontain a preservative to inhibit

bacterial contamination once the vial has beenbacterial contamination once the vial has beenused.used.

ReadyReady--toto--mixmix

systemssystems

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Consist of a specially designedConsist of a specially designedminibagminibag with an adapter for attachingwith an adapter for attaching

a drug vial.a drug vial.

The admixingThe admixing takes place just prior totakes place just prior to

administration.administration.

•• PARENTERAL PREPARATIONSPARENTERAL PREPARATIONS

•• Injections (suspension, emulsions)Injections (suspension, emulsions)•• InfusionsInfusions

liquid

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•• InfusionsInfusions

•• Concentrates for injections or infusionsConcentrates for injections or infusions

•• Powders for injectionsPowders for injections•• LyophilisatedLyophilisated powderspowders

•• ImplantsImplants

solid

InjectableInjectable emulsionsemulsions

Must meet the sameMust meet the same conditionsconditions

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asas injectableinjectable solutionssolutions (purity,(purity,

sterility,sterility, nonnon--pyrogenicitypyrogenicity))

By stirringBy stirring must exhibit amust exhibit a

aa homogeneoushomogeneous appearance.appearance.

May be administeredMay be administered nutritionalnutritional purposes.purposes.

Intravenous fat emulsionsIntravenous fat emulsions – –IntralipidIntralipid, 10,20,30%, 10,20,30%

– –ClintecClintec – –LiposynLiposyn 11,10, 20%11,10, 20%

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posyp y , 0, 0%, ,

– – Abott Abott LiposynLiposyn 111, 10,20,30%111, 10,20,30%

as a source of calories and essentialas a source of calories and essentialfatty acids for patients requiringfatty acids for patients requiringparenteralparenteral nutrition for extended period,nutrition for extended period,

usually more than 5 days.usually more than 5 days.

INJECTABLEINJECTABLE SUSPENSIONSSUSPENSIONSareare aqueous or aqueous or oilyoily solutionsolution for for

injectioninjection whichwhich must bemust be preparedprepared inin asepticasepticconditions.conditions.

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Active Active

substancesubstance

must bemust be

veryvery finelyfinely pulverizedpulverized (about 10(about 10 microns)microns) toto

pass throughpass through the syringethe syringe needleneedle No.16.No.16.

Must be shakenMust be shaken 11--2 minutes before2 minutes before

injectioninjection toto get aget a homogeneoushomogeneous appearanceappearance

and withoutand without residueresidue at the bottom of at the bottom of thethevialvial or or container container (eg(eg EfitardEfitard).).

DrugDrug InjectableInjectable SuspensionSuspension-- Liquid preparations of solids suspended in aLiquid preparations of solids suspended in asuitable liquid mediumsuitable liquid medium

Example:Example: MethylprednisoloneMethylprednisolone Acetate AcetateSuspensionSuspension

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p

-- Dry solids that, upon the preparationsDry solids that, upon the preparationsconformingconforming in all respects to the requirementsin all respects to the requirementsfor for InjectableInjectable SuspensionsSuspensions

Example:Example: ImipenemImipenem;;

CilastatinCilastatin for Injection Suspensionfor Injection Suspension

LyophilisationLyophilisation

also known asalso known as freezefreeze--dryingdrying isis

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aa dehydrationdehydration process typically usedprocess typically used

toto preservepreserve a perishable material.a perishable material.

FreezeFreeze--drying works bydrying works by freezingfreezing the materialthe material

(at minus 75 degrees) and then reducing the(at minus 75 degrees) and then reducing thesurroundingsurrounding pressurepressure to allow the frozen water to allow the frozen water

in the material toin the material to sublimatesublimate directly from thedirectly from the

solid phase to the gas phase.solid phase to the gas phase.

LyophilizationLyophilization

is the mostis the most beneficialbeneficial conditioningconditioning

andand management of management of unstable productsunstable products ininsolutionsolution

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solution

– – organorgan extracts,extracts, – – serums,serums,

– – vaccines,vaccines,

– – antibiotics,antibiotics,

– – bloodblood preparations,preparations,

– – some anesthetics.some anesthetics.

LYOPHILIZATIONLYOPHILIZATION allows:allows:

– – LyophilizationLyophilization inin layerslayers of of incompatibleincompatiblesubstancessubstances

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– – LyophilizationLyophilization thethe drydry emulsionsemulsions which,which, mmixing withixing with distilled water distilled water toto givegive thethe

correspondingcorresponding emulsion.emulsion.

– – DehydrationDehydration of of thermolabilethermolabile productsproducts thatthatordinaryordinary dryingdrying byby heatingheating wouldwould degradedegrade;;

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LyophilisingLyophilising biopharmaceuticals maintains itsbiopharmaceuticals maintains itspotency over time, extending its shelf potency over time, extending its shelf --life for life for

prolonged storage.prolonged storage.

LyophilisedLyophilised products require an additionalproducts require an additional

preparation step prior to administration. Thispreparation step prior to administration. This

process, known as reconstitution, entailsprocess, known as reconstitution, entailsmixing the dry drug with a liquid to create anmixing the dry drug with a liquid to create an

injectableinjectable solution.solution.

Implants (pellets)

A small tablet that is prepared for insertion under theskin by giving a small surgical cut into the skin which is

stitched after the insertion of tablets The tablet must be

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stitched after the insertion of tablets. The tablet must be

sterile one.

Contraceptive tablets are formulated as implant.

Specialized AccessSpecialized Access

Devices that provide continued accessDevices that provide continued accessand reduce pain associated withand reduce pain associated withadministration (Repeated injections overadministration (Repeated injections over

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administration (Repeated injections over administration (Repeated injections over

time)time)SeveralSeveral catheters of central venouscatheters of central venous

are used for a variety of are used for a variety of parenteralparenteralmedications.medications.

ExampleExample:: cancer chemotherapy,cancer chemotherapy,

long term antibiotic therapylong term antibiotic therapy

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