1. Chapter 5 Dosage Forms, Abbreviations, and Routes of Administration Copyright © 2004 by Elsevier Inc. All rights reserved.

2. Introduction For a technician to become proficient, it is necessary to interpret orders correctlyFor a technician to become proficient, it is necessary to interpret orders correctly Many doctors’ handwriting is referred to as “chicken scratch” and it is the responsibility of the pharmacy to interpret and clarify orders if necessaryMany doctors’ handwriting is referred to as “chicken scratch” and it is the responsibility of the pharmacy to interpret and clarify orders if necessary Many abbreviations used in prescribing medication look very much alikeMany abbreviations used in prescribing medication look very much alike

3. Copyright © 2004 by Elsevier Inc. All rights reserved. Where Do Pharmacy Abbreviations Originate? Terminology in pharmacy and medicine comes from the Latin and Greek languagesTerminology in pharmacy and medicine comes from the Latin and Greek languages Because pharmacy began in Europe, most of the abbreviations have their origins in a foreign languageBecause pharmacy began in Europe, most of the abbreviations have their origins in a foreign language Latin and Greek serve as the universal language that all medical personnel can understandLatin and Greek serve as the universal language that all medical personnel can understand

4. Copyright © 2004 by Elsevier Inc. All rights reserved. Interpreting Doctors’ Orders It is very important for the pharmacy staff to interpret doctors’ orders correctlyIt is very important for the pharmacy staff to interpret doctors’ orders correctly When writing out the various abbreviations, be sure to write as neatly as possible because other technicians and pharmacists will be reading your handwritingWhen writing out the various abbreviations, be sure to write as neatly as possible because other technicians and pharmacists will be reading your handwriting Technicians must learn all of the dosage forms and abbreviations to decipher doctors’ ordersTechnicians must learn all of the dosage forms and abbreviations to decipher doctors’ orders

5. Copyright © 2004 by Elsevier Inc. All rights reserved. Types of Dosage Forms A dosage form refers to the package or container of which the drug has taken the shapeA dosage form refers to the package or container of which the drug has taken the shape For example, it may be a tablet or a capsuleFor example, it may be a tablet or a capsule There is more than one type of tablet or capsuleThere is more than one type of tablet or capsule Tablets come in a wide variety of shapes and sizesTablets come in a wide variety of shapes and sizes

6. Copyright © 2004 by Elsevier Inc. All rights reserved. Types of Dosage Forms Tablets can be scored or unscored and coated or uncoatedTablets can be scored or unscored and coated or uncoated Much of what determines the dosage form of a medication is determined by the drug’s effectivenessMuch of what determines the dosage form of a medication is determined by the drug’s effectiveness Manufacturers prepare certain medications with the ability to release the active ingredient over an extended periodManufacturers prepare certain medications with the ability to release the active ingredient over an extended period

7. Copyright © 2004 by Elsevier Inc. All rights reserved. A. Unscored tablet B. Scored tablet

8. Copyright © 2004 by Elsevier Inc. All rights reserved. Types of Dosage Forms This allows the patient to take the medication less often, which increases complianceThis allows the patient to take the medication less often, which increases compliance Three major categories of dosage forms:Three major categories of dosage forms: –Solids –Liquids –Semisolids

9. Copyright © 2004 by Elsevier Inc. All rights reserved. Types of Dosage Forms SolidsSolids Solid agents can be contained in various packages and administered by almost all routes except parenterallySolid agents can be contained in various packages and administered by almost all routes except parenterally Most tablets contain fillers (inert substances–no active ingredient), sugar coatings, and certain additivesMost tablets contain fillers (inert substances–no active ingredient), sugar coatings, and certain additives

10. Copyright © 2004 by Elsevier Inc. All rights reserved. Types of Dosage Forms Tablets are made to be administered sublingually (sl) or vaginallyTablets are made to be administered sublingually (sl) or vaginally Tablets can be scored to allow for dosage to be cut in halfTablets can be scored to allow for dosage to be cut in half Chewable tablets are convenient for persons who have difficulty swallowing and for childrenChewable tablets are convenient for persons who have difficulty swallowing and for children

11. Copyright © 2004 by Elsevier Inc. All rights reserved. Types of Dosage Forms Tablets can be enteric coated (EC) to protect the drug through the acidic environment of the stomach or to delay release of the drugTablets can be enteric coated (EC) to protect the drug through the acidic environment of the stomach or to delay release of the drug Extended-release–types are made to control the amount of drug distributed over a set timeExtended-release–types are made to control the amount of drug distributed over a set time

12. Copyright © 2004 by Elsevier Inc. All rights reserved. Plain tablets Scored tablets Enteric-coated tablets

13. Copyright © 2004 by Elsevier Inc. All rights reserved. Capsules and Caplets Capsule and caplet dosage forms are closely related to tabletsCapsule and caplet dosage forms are closely related to tablets Capsules can have either a hard or soft outer shellCapsules can have either a hard or soft outer shell Hard capsules are composed of sugar, gelatin, and waterHard capsules are composed of sugar, gelatin, and water Pulvule–type of capsule that is shaped differently for identification purposesPulvule–type of capsule that is shaped differently for identification purposes

14. Copyright © 2004 by Elsevier Inc. All rights reserved. Capsules and Caplets Spansules–can be pulled apart to sprinkle the medication onto food for childrenSpansules–can be pulled apart to sprinkle the medication onto food for children The main difference between capsules and caplets is that capsules can be pulled apartThe main difference between capsules and caplets is that capsules can be pulled apart

15. Copyright © 2004 by Elsevier Inc. All rights reserved. Types of Capsules Capsules Extended-release capsules

16. Copyright © 2004 by Elsevier Inc. All rights reserved. Lozenges/Troches These are other forms of tablets that are not meant to be swallowed but to dissolve in the mouth, which releases the medication more slowly; similar to hard candyThese are other forms of tablets that are not meant to be swallowed but to dissolve in the mouth, which releases the medication more slowly; similar to hard candy Cough dropsCough drops Troches are larger than normal-sized tablets and are flat; chalky consistencyTroches are larger than normal-sized tablets and are flat; chalky consistency

17. Copyright © 2004 by Elsevier Inc. All rights reserved. Implants A special type of capsule can be implanted under the skin and left in place for up to 5 yearsA special type of capsule can be implanted under the skin and left in place for up to 5 years Contraceptives containing progestinContraceptives containing progestin Medication is released in a stair-step methodMedication is released in a stair-step method

18. Copyright © 2004 by Elsevier Inc. All rights reserved. Patches Solid pieces of material that hold a specific amount of medication to be released into the skin over timeSolid pieces of material that hold a specific amount of medication to be released into the skin over time Easily administered and eliminate a possible upset stomachEasily administered and eliminate a possible upset stomach Uses: Angina-Nitroglycerin; chronic pain- DuragesicUses: Angina-Nitroglycerin; chronic pain- Duragesic Motion sickness-ScopolamineMotion sickness-Scopolamine

19. Copyright © 2004 by Elsevier Inc. All rights reserved. Liquids Composed of various solutionsComposed of various solutions Can be administered by all routesCan be administered by all routes Syrups–sugar-based solutions that have medications dissolved in them, which improves the taste of the drug. They tend to be thicker than waterSyrups–sugar-based solutions that have medications dissolved in them, which improves the taste of the drug. They tend to be thicker than water

20. Copyright © 2004 by Elsevier Inc. All rights reserved. Liquids Elixirs–agents that contain dissolved medication in either an alcohol base or water and alcohol (hydroalcoholic) baseElixirs–agents that contain dissolved medication in either an alcohol base or water and alcohol (hydroalcoholic) base Alcohol usually covers up the bad taste of the drugAlcohol usually covers up the bad taste of the drug Elixirs have the same consistency as waterElixirs have the same consistency as water

21. Copyright © 2004 by Elsevier Inc. All rights reserved. Sprays Sprays are composed of various bases as alcohol or water in a pump-type dispenserSprays are composed of various bases as alcohol or water in a pump-type dispenser Nasal decongestants or sunscreensNasal decongestants or sunscreens Nitroglycerin translingual spray that is used under the tongue for relief of anginal painNitroglycerin translingual spray that is used under the tongue for relief of anginal pain

22. Copyright © 2004 by Elsevier Inc. All rights reserved. Inhalants and Aerosols Inhaler agents come in a variety of forms but all must be easily inhaled into the lungsInhaler agents come in a variety of forms but all must be easily inhaled into the lungs Common devices available OTC are vaporizers and humidifiersCommon devices available OTC are vaporizers and humidifiers Respiratory therapists use nebulizers to give breathing treatments to hospital patientsRespiratory therapists use nebulizers to give breathing treatments to hospital patients Patients can also be trained to use nebulizers at homePatients can also be trained to use nebulizers at home

23. Copyright © 2004 by Elsevier Inc. All rights reserved. Inhalants and Aerosols Anesthetics come in solutions that are inhaled and administered during surgery by an anesthesiologistAnesthetics come in solutions that are inhaled and administered during surgery by an anesthesiologist Prescribed inhalants contain drugs that treat asthma and allergiesPrescribed inhalants contain drugs that treat asthma and allergies Metered dose inhalers (MDIs) dispense a specific amount of drug with each puff or inhalationMetered dose inhalers (MDIs) dispense a specific amount of drug with each puff or inhalation

24. Copyright © 2004 by Elsevier Inc. All rights reserved. Emulsions The mixture of water and oil when used with an emulsifier binds the two togetherThe mixture of water and oil when used with an emulsifier binds the two together Oil can have water as a baseOil can have water as a base Water is contained in an oil baseWater is contained in an oil base Most emulsions are used topically. Some are used parenterally, such as lipids (fats) in nutritional parenteral feedingsMost emulsions are used topically. Some are used parenterally, such as lipids (fats) in nutritional parenteral feedings

25. Copyright © 2004 by Elsevier Inc. All rights reserved. Suspensions These are liquids that have very small, solid particles suspended in the base solutionThese are liquids that have very small, solid particles suspended in the base solution They can be used orally by children and seniorsThey can be used orally by children and seniors Suspensions have a “shake well” sticker and a date of expirationSuspensions have a “shake well” sticker and a date of expiration

26. Copyright © 2004 by Elsevier Inc. All rights reserved. Enemas Enemas may be administered for two different reasons–retention or evacuationEnemas may be administered for two different reasons–retention or evacuation They can be used to deliver medication to the body, bypassing the stomach while being absorbedThey can be used to deliver medication to the body, bypassing the stomach while being absorbed Most common use is to evacuate the lower intestine to prepare for surgeries or for women in laborMost common use is to evacuate the lower intestine to prepare for surgeries or for women in labor

27. Copyright © 2004 by Elsevier Inc. All rights reserved. Semisolids Semisolids contain both liquids and solidsSemisolids contain both liquids and solids They are meant for topical applicationThey are meant for topical application Creams–have medications in a base that is part oil and part water and for topical useCreams–have medications in a base that is part oil and part water and for topical use Lotions are thinner than creams because their base contains more waterLotions are thinner than creams because their base contains more water

28. Copyright © 2004 by Elsevier Inc. All rights reserved. Semisolids Ointments contain medication in a glycol or oil base; they cover the skin surface and keep out moistureOintments contain medication in a glycol or oil base; they cover the skin surface and keep out moisture Gels contain medication in a very viscous (thick) liquid that easily penetrates the skinGels contain medication in a very viscous (thick) liquid that easily penetrates the skin Pastes contain a lesser amount of liquid base than solids. They are able to absorb skin secretions unlike other topical agentsPastes contain a lesser amount of liquid base than solids. They are able to absorb skin secretions unlike other topical agents

29. Copyright © 2004 by Elsevier Inc. All rights reserved. Suppositories Can be used both rectally and vaginallyCan be used both rectally and vaginally Rectal suppositories bypass the stomach, which is important if the patient has nausea and vomitingRectal suppositories bypass the stomach, which is important if the patient has nausea and vomiting Vaginal suppositories are used mainly to treat vaginal infectionsVaginal suppositories are used mainly to treat vaginal infections

30. Copyright © 2004 by Elsevier Inc. All rights reserved. Powders Powders are solids, yet they can be packaged in some forms that allow them to be sprayed similar to liquid dosage formsPowders are solids, yet they can be packaged in some forms that allow them to be sprayed similar to liquid dosage forms One of the main uses is to decrease the amount of wetness of an areaOne of the main uses is to decrease the amount of wetness of an area Antifungal foot agentsAntifungal foot agents They can also be spread over a wide areaThey can also be spread over a wide area

31. Copyright © 2004 by Elsevier Inc. All rights reserved. Routes of Administration By mouth or oral medications are very convenient, do not need to be measured, less expensive, systemic, and safeBy mouth or oral medications are very convenient, do not need to be measured, less expensive, systemic, and safe The downside is that they do not work as quickly as parenteralsThe downside is that they do not work as quickly as parenterals Some drugs cannot be taken orally because they are not as effectiveSome drugs cannot be taken orally because they are not as effective

32. Copyright © 2004 by Elsevier Inc. All rights reserved. Sublingual and Buccal Agents Nitroglycerin is the most commonly used sublingual tablet that treats anginal attacksNitroglycerin is the most commonly used sublingual tablet that treats anginal attacks Buccal agents are placed between the gum and cheek where the medication penetrates the mouth lining and then enters the bloodstreamBuccal agents are placed between the gum and cheek where the medication penetrates the mouth lining and then enters the bloodstream

33. Copyright © 2004 by Elsevier Inc. All rights reserved. Rectal Rectal (R) agents are used in a person who is vomiting and cannot take oral medicationsRectal (R) agents are used in a person who is vomiting and cannot take oral medications To reduce inflammation, either ointments or creams can be used in addition to suppositoriesTo reduce inflammation, either ointments or creams can be used in addition to suppositories They work on a specific site and not systemicallyThey work on a specific site and not systemically Downside–they are uncomfortable and the actual amount of drug absorbed is unpredictableDownside–they are uncomfortable and the actual amount of drug absorbed is unpredictable

34. Copyright © 2004 by Elsevier Inc. All rights reserved. Capsule Sizes Capsules vary in size, color, transparency, and identifying marksCapsules vary in size, color, transparency, and identifying marks The larger half of the capsule is known as the body and the smaller half is known as the capThe larger half of the capsule is known as the body and the smaller half is known as the cap Not all capsules are meant to be swallowed; specific dosages of medications can be sprinkled onto food or into liquidsNot all capsules are meant to be swallowed; specific dosages of medications can be sprinkled onto food or into liquids

35. Copyright © 2004 by Elsevier Inc. All rights reserved. Topical Topical (TOP) preparations effects range from systemic to localized for rashesTopical (TOP) preparations effects range from systemic to localized for rashes There are agents to fight skin infections, inflammation, and UV rays of the sunThere are agents to fight skin infections, inflammation, and UV rays of the sun They work at the site of action and systemicallyThey work at the site of action and systemically An advantage is easy applicationAn advantage is easy application A downside is that they may cause a reactionA downside is that they may cause a reaction

36. Copyright © 2004 by Elsevier Inc. All rights reserved. Parenteral: Intravenous, Intravenous Piggyback, Intramuscular, Subcutaneous Parenteral comes from the Greek and means “side of intestine” or “outside of intestine”Parenteral comes from the Greek and means “side of intestine” or “outside of intestine” The most common parenteral medications are given IV, IM, or SCThe most common parenteral medications are given IV, IM, or SC Very small gauge needles are used, and the length depend on the site being injectedVery small gauge needles are used, and the length depend on the site being injected Benefits–speed of actionBenefits–speed of action

37. Copyright © 2004 by Elsevier Inc. All rights reserved. Parenteral: Intravenous, Intravenous Piggyback, Intramuscular, Subcutaneous Parenteral drugs work within a few minutesParenteral drugs work within a few minutes Important for emergency situations, for those who are combative, or for those who are unable to swallowImportant for emergency situations, for those who are combative, or for those who are unable to swallow A disadvantage is the increased risk of infectionA disadvantage is the increased risk of infection

38. Copyright © 2004 by Elsevier Inc. All rights reserved. Parenteral: Intravenous, Intravenous Piggyback, Intramuscular, Subcutaneous Injections are more expensive and require preparation and administration by trained personnelInjections are more expensive and require preparation and administration by trained personnel Another downside is that once a drug is injected there is little time to alter its course if an allergic reaction takes place or too much drug is givenAnother downside is that once a drug is injected there is little time to alter its course if an allergic reaction takes place or too much drug is given

39. Copyright © 2004 by Elsevier Inc. All rights reserved. Eye, Ear, Nose Doctors often use eye solutions to treat ear conditions, but ear solutions cannot be used to treat eye conditions because the eye is sterileDoctors often use eye solutions to treat ear conditions, but ear solutions cannot be used to treat eye conditions because the eye is sterile All eye agents are sterileAll eye agents are sterile Otic preparations are not necessarily sterile because they treat the ear canal and do not penetrate a sterile environmentOtic preparations are not necessarily sterile because they treat the ear canal and do not penetrate a sterile environment

40. Copyright © 2004 by Elsevier Inc. All rights reserved. Eye, Ear, Nose All ophthalmics need to be kept sterileAll ophthalmics need to be kept sterile For the eye, ear, and nose there are different types of agents, including ointments, solutions, and suspensionsFor the eye, ear, and nose there are different types of agents, including ointments, solutions, and suspensions Most ear treatments are for clearing up infections or cleaning out ear wax buildupMost ear treatments are for clearing up infections or cleaning out ear wax buildup

41. Copyright © 2004 by Elsevier Inc. All rights reserved. Eye, Ear, Nose Most nasal sprays are used to treat colds and allergiesMost nasal sprays are used to treat colds and allergies Eye treatments are for infections, inflammation, and glaucomaEye treatments are for infections, inflammation, and glaucoma These dosage forms work on the specific site rather than the whole bodyThese dosage forms work on the specific site rather than the whole body

42. Copyright © 2004 by Elsevier Inc. All rights reserved. Eye, Ear, Nose A main disadvantage of solutions for the eye, if not kept sterile, is that they can introduce bacteria into the area being treatedA main disadvantage of solutions for the eye, if not kept sterile, is that they can introduce bacteria into the area being treated Ophthalmics do not last as long as other treatments because of the blinking of the eye and tearingOphthalmics do not last as long as other treatments because of the blinking of the eye and tearing Ointments make it hard to see clearlyOintments make it hard to see clearly

43. Copyright © 2004 by Elsevier Inc. All rights reserved. Inhalants Inhalants (INH) are used to treat lung diseasesInhalants (INH) are used to treat lung diseases Dosage forms are limited but very effective if used properlyDosage forms are limited but very effective if used properly MDIs are used for asthma, bronchitis, or emphysemaMDIs are used for asthma, bronchitis, or emphysema Corticosteroids are also available in MDIs for more chronic conditionsCorticosteroids are also available in MDIs for more chronic conditions

44. Copyright © 2004 by Elsevier Inc. All rights reserved. Inhalants Onset of action is very quickOnset of action is very quick Most aerosols come in handheld units and are very convenientMost aerosols come in handheld units and are very convenient The downside is that, if not used properly, little if any of the drug is able to get into the lungsThe downside is that, if not used properly, little if any of the drug is able to get into the lungs

45. Copyright © 2004 by Elsevier Inc. All rights reserved. Miscellaneous Routes Vaginal or uretheral dosage forms– suppositories, ointments, foams, and gelsVaginal or uretheral dosage forms– suppositories, ointments, foams, and gels They are used for treatments of infections and inflammation; vaginal foams are used as a contraceptiveThey are used for treatments of infections and inflammation; vaginal foams are used as a contraceptive Advantages are they bypass a systemic effect and affect a specific site but are not easily applied and are uncomfortableAdvantages are they bypass a systemic effect and affect a specific site but are not easily applied and are uncomfortable

46. Copyright © 2004 by Elsevier Inc. All rights reserved. Other Considerations: Form and Function Dosage forms are created based on the results from many clinical trials that delve into the pharmacokinetics of the medication or the function of the drug in experimentsDosage forms are created based on the results from many clinical trials that delve into the pharmacokinetics of the medication or the function of the drug in experiments

47. Copyright © 2004 by Elsevier Inc. All rights reserved. Pharmacokinetics Represent many different components concerning the actions of a drugRepresent many different components concerning the actions of a drug Considerations such as:Considerations such as: –Levels of the drug throughout the blood and tissues –Absorption or movement of the drug throughout the body –Overall distribution

48. Copyright © 2004 by Elsevier Inc. All rights reserved. Pharmacokinetics MetabolismMetabolism Excretion of the drugExcretion of the drug Reaction of the drugs with other drugsReaction of the drugs with other drugs Patient compliancePatient compliance Life of the drug that includes bioavailability, half-life, bioequivalence, and excretionLife of the drug that includes bioavailability, half-life, bioequivalence, and excretion

49. Copyright © 2004 by Elsevier Inc. All rights reserved. Absorption Medications are made to get through natural body barriers, such as the skin, stomach, intestines, blood-brain barrier, and other membranous tissuesMedications are made to get through natural body barriers, such as the skin, stomach, intestines, blood-brain barrier, and other membranous tissues How well the drug passes through these barriers is the one factor that determines its ultimate effectivenessHow well the drug passes through these barriers is the one factor that determines its ultimate effectiveness

50. Copyright © 2004 by Elsevier Inc. All rights reserved. Absorption Important chemicals and drugs are able to pass a lock and key mechanism by latching onto receptor sites that allow the chemical or drug to pass into the organ to reach the final site of action intended for the drugImportant chemicals and drugs are able to pass a lock and key mechanism by latching onto receptor sites that allow the chemical or drug to pass into the organ to reach the final site of action intended for the drug

51. Copyright © 2004 by Elsevier Inc. All rights reserved. Distribution After the absorption of a medication, it is distributed throughout the body from the bloodstream into tissues, membranes, and ultimately organs of the bodyAfter the absorption of a medication, it is distributed throughout the body from the bloodstream into tissues, membranes, and ultimately organs of the body The distribution of a drug throughout the body is not necessarily equal throughout the whole bodyThe distribution of a drug throughout the body is not necessarily equal throughout the whole body

52. Copyright © 2004 by Elsevier Inc. All rights reserved. Metabolism Most metabolism takes place in the liverMost metabolism takes place in the liver Metabolism changes the chemical structure of the original drugMetabolism changes the chemical structure of the original drug There are different influences that can alter metabolism such as age, gender, genetics, diet, and other chemicals digestedThere are different influences that can alter metabolism such as age, gender, genetics, diet, and other chemicals digested

53. Copyright © 2004 by Elsevier Inc. All rights reserved. Excretion Excretion is the last phase of a drug’s life in the bodyExcretion is the last phase of a drug’s life in the body There are many ways a drug can be excreted from the body: via the kidneys, feces, exhalation, sweat glands, breast milkThere are many ways a drug can be excreted from the body: via the kidneys, feces, exhalation, sweat glands, breast milk Urination and bowel movements are the most common methods of excretionUrination and bowel movements are the most common methods of excretion

54. Copyright © 2004 by Elsevier Inc. All rights reserved. Bioavailability This is the rate at which the drug makes it to its destination and is available to the site of action for which it was intendedThis is the rate at which the drug makes it to its destination and is available to the site of action for which it was intended Many drugs travel into the liver before they have a chance to be absorbed into the whole system.Many drugs travel into the liver before they have a chance to be absorbed into the whole system. Known as the “first pass effect”Known as the “first pass effect”

55. Copyright © 2004 by Elsevier Inc. All rights reserved. Half-Life Refers to the measurement of the time it takes the body to break down and excrete one half of the drugRefers to the measurement of the time it takes the body to break down and excrete one half of the drug This is an important factor in the creation of drugs for it tells the manufacturer how long it takes the body to rid itself of the drugThis is an important factor in the creation of drugs for it tells the manufacturer how long it takes the body to rid itself of the drug

56. Copyright © 2004 by Elsevier Inc. All rights reserved. Bioequivalence This is the comparison between drugs either from different manufacturers or in the same company but from different batches of a drugThis is the comparison between drugs either from different manufacturers or in the same company but from different batches of a drug Generic drug manufacturers strive to achieve the same equivalence as brand name manufacturers for competitionGeneric drug manufacturers strive to achieve the same equivalence as brand name manufacturers for competition

57. Copyright © 2004 by Elsevier Inc. All rights reserved. The Use of Additives All medications are prepared with some sort of additiveAll medications are prepared with some sort of additive These include coloring, flavorings, fillers, and preservativesThese include coloring, flavorings, fillers, and preservatives Other types include those that increase the dispersing of the drug once it reaches the intestines and others that release the medication over a longer period of timeOther types include those that increase the dispersing of the drug once it reaches the intestines and others that release the medication over a longer period of time

58. Copyright © 2004 by Elsevier Inc. All rights reserved. Manufactured Products All types of dosage forms must be made and approved by the Food and Drug Administration (FDA)All types of dosage forms must be made and approved by the Food and Drug Administration (FDA)

59. Copyright © 2004 by Elsevier Inc. All rights reserved. Large-volume IV IVPB

60. Copyright © 2004 by Elsevier Inc. All rights reserved. Miscellaneous Agents and Devices Ocular inserts–lenses inserted into the eye that release a continuous amount of drug over timeOcular inserts–lenses inserted into the eye that release a continuous amount of drug over time Injectable Forms–long-acting for birth control, antipsychotic episodes, and steroidsInjectable Forms–long-acting for birth control, antipsychotic episodes, and steroids

61. Copyright © 2004 by Elsevier Inc. All rights reserved. Packaging and Storage Requirements Medications are packaged according to manufacturers’ specifications to ensure effectiveness and shelf life of the drugMedications are packaged according to manufacturers’ specifications to ensure effectiveness and shelf life of the drug All medications have a package insert that describes the storage and stability of the drugAll medications have a package insert that describes the storage and stability of the drug