Pharmaceutics III Lecture 4 Parenteral Incompatabilities

alchemist04's version from 2016-04-15 21:15


Question Answer
InstabilitySlow physiological reaction involving ONE substance (drug)
IncompatibilityRapid physiological reaction involving TWO or more substances
Examples of incompatibilitymixing of narcotic, an anti-emetic and anticholinergic in the same syringe
What part of IV is drug given?Y-site
Incompatibility can occur btw .....additive and the container


Question Answer
What are the 5types of Physiological Incompatibility?(1) Precipitation (2) Adsorption (3) Absorption (4) Gas Evolution (5) Complexation
What are the causes of precipitation during admixture?(1) pH changes (2) Dilution of co-solvents (3) complexation of dissolved drug with other solute
When an acid drug is mixed with basic drug, what would you get?precipitation
What is the solution to precipitation?dilution
MIxture of poorly water soluble drugs + co-solvents will result in ?precipitation
What are the potential solutions to acid-base drug incompatibility?(1) Refer to literature for the drug products to identify specific incompatibility/cautions (2) Dilute SOLUTIONS of the two drug salts before mixing together (3) SLOW add first incompatible solution into larger volume (or flow rate) of the second incompatible solution (3) If pH adjustment is required, use HCL or NaOH


Question Answer
How does Gas Evolution occurs?Mixture of Acidic drug with a solution containing bicarbonate or carbonate which result in CO2 bubble in the solution
What are the examples of Gas Evolution?Sodium Bicarbonate injection + cephalosporins + barbiturates and buffer with carbonate
How do you prevent Gas Evolution?(1) Avoid combining acidic drugs with carbonate buffered formulation (2) Avoid mixing acidic drugs with Sodium Bicarbonate injection, use Sodium acetate injection instead.


Question Answer
Which one drug is known to absorb into polymeric matrices due to its volatility?Nitroglycerin. Other drugs adsorb.
Adsorption is driven by what kind of bond?Hydrophobic bonding interactions between lipophilic portions of the drug and the container
ADsorption is common in what kind of drug?(1) recombinant proteins (2) monoclonal antibodies (3) small molecules like valium
How do you prevent ADsorption?add Human Serum Albumin
Adsorption to IV set surface is least common for?Hydrophilic small drug molecule. For adsorption to take place, the substance must be hydrophobic.


Question Answer
What will happen when a drug mixed in co-solvent is formulated in aqueous solution?Precipitation
Slowly diluting drug solution into large amount of aqueous vehicle will result in ...?mitigation of precipitation
Drug formulated in Co-solvent should be administered as ?LVP


Question Answer
Incompatibility that results from ionic interaction which causes inactivation of the drugs is?complexation
A mixture of Heparin and Aminoglycoside will result in ?Complexation
Mixture of Calcium and Ketorolac will result in ?Ionic interaction, complexation
What is the common encounter complexation?Calcium and Phosphate Precipitation


Question Answer
All TPN's need what kind of essential elements that causes incompatibility/precipitation?Calcium and Phosphorous
Types of Calcium Phosphate precipitates(1) Ca(H2PO4) monocalcium Phosphate (2) CaHPO4 dibasic Calcium Phosphate (3) Ca3(PO4)2 Tribasic Calcium Phosphate
How does pH of a solution affects Calcium, phosphate solubility in TPN?Increase in pH = increase in precipitation
How does Calcium Chloride (salt from calcium) affects calcium phosphate solubility in TPNs?Calcium chloride injection is almost fully ionized in aqueous solution
How does Calcium gluconate (salt calcium) affects calcium phosphate solubility in TPNs?Calcium gluconate is only partially ionized in aqueous solution
How does Amino acids affect Calcium Phosphate solubility in TPNs?Amino Acids bind to calcium ions, REDUCE the amount of free ions that can form precipitates


Question Answer
Amino Acid can reduce incompatibility in TPN by binding to ------------------, reducing ........................?Calcium and phosphate, reducing complexation