1. PHARMACY TECHNICIAN
CHAPTER TEN

2. Rationale for Compounding
Certain valuable drugs have been discontinued by their manufacturers
The FDA has removed some drugs from the market
Drugs may not be available in a strength or dosage form appropriate for a specific patient
Patients may have sensitivities or allergies to preservatives or other substances
A combination therapy may not be commercially available

3. Basic Procedures in Compounding
Obtaining the recipe or formula
Writing a worksheet based on the formula
Collecting all ingredients and equipment necessary to prepare the compound
Weighing each ingredient and having measurements verified by the pharmacist
Following the directions of the formula to prepare the compounded medication
Packaging and labeling the compounded medication in an appropriate container
Having the pharmacist provide a final check of the compound
Cleaning the workstation and equipment used

4. A technician prepares tablets using a mold.

5. Solid Dosage Forms
Capsule—a solid dosage form in which the active ingredient and any excipients are enclosed in a soluble gelatin shell that will dissolve in the stomach
Tablet—a solid dosage form that may be administered orally, sublingually, vaginally, or as a pellet under the skin
Powder—a solid dosage form made from blended active ingredients and excipients
Lozenge—a solid dosage form administered orally to be dissolved in the mouth
Troche—interchangeable term for lozenge, but sometimes prepared in soft form
Suppository—a solid dosage form used to administer medication by way of the rectum, vagina, or urethral tract

6. Figure 10.4
Capsule size chart.

7. Liquid Dosage Forms
Solution—a water-soluble chemical dissolved in water
Suspension—liquids containing ingredients that are not soluble in the vehicle
Emulsion—a suspension consisting of two immiscible liquids and an emulsifying agent to hold them together

8. Semisolid or Soft Solid Dosage Forms
Ointment—a semisolid topical preparation that is applied to the skin or mucous membranes
Cream—soft solid that is opaque and usually applied externally
Paste—stiff, or very viscous, ointment that does not melt or soften at body temperature
Gel—semisolid system consisting of suspension made up of small inorganic particles or of large organic molecules interpenetrated by a liquid

9. Other Dosage Forms Ophthalmic—preparations for the eye
Otic—preparations for the ear
Nasal—preparations for the nose or sinuses

10. Psychological Impact of Medication Flavoring
Medication with an appealing color/taste is perceived as more effective by patients
Successful flavoring helps ensure medication compliance
Sight and sound play an important role in flavor experience

11. Sensory Roles in Flavoring
Influenced by taste, smell, sight, touch, and sound
Smell makes a stronger impression on a person than actual taste
Females are more sensitive to smell than males
Elderly patients may require extra flavoring
Certain diseases alter a patient’s ability to taste and smell

12. Flavoring Considerations
Focus on the individual patient
Be aware of allergies or sensitivities—chocolate, peanuts, particular preservative or dye
What does this patient like?
Pediatric flavoring
Children have more taste buds and are more sensitive to taste
Prefer sweet tastes; dislike bitter flavors
Newborns/babies with less taste “experience” require less flavor
Some appropriate flavor choices include raspberry, bubblegum, marshmallow, berry, citrus, vanilla

13. Flavoring’s Impact on Stability, Solubility, and Ph
Some flavors may raise or lower pH of compounded medication and cause instability
Aqueous solutions should be flavored with water-miscible flavors
Oil preparations require an oil-based flavor
Some flavoring agents/preservatives in the flavor may affect the active ingredient in the compound and cause degradation of the drug
Use a flavoring agent that will not affect pH for compounded medications that are stable only at a certain pH
Obtain exact pH from the company that produces the flavoring agent; most provide a list of flavors and relative pH values

14. Four Taste Types Sour, sweet, bitter, and salty
“Fifth” sense is called umami—tastes glutamates and cannot be duplicated by the combination of any of the other four tastes
Taste buds contain taste receptors for all tastes

15. Five Basic Flavoring Techniques
I. Blending uses a flavor that will blend with the drug taste
Example: Citrus flavors blend with sour tastes; bitter tastes can be blended with salty, sweet, and sour tastes; salt reduces bitterness and sourness and increases sweetness
II. Overshadowing or overpowering uses a flavor with a stronger intensity than the original product
Examples: Wintergreen, methyl salicylate, glycyrrhiza (licorice), and oleoresins
III. Physical methods include formation of insoluble ingredients into a suspension and emulsification of oils

16. Five Basic Flavoring Techniques (cont.)
IV. Chemical methods include absorption of the drug with an ingredient that eliminates the taste of the offensive drug
V. Physiological methods include use of an additive, such as peppermint, to anesthetize taste buds and thus reduce their sensitivity

17. Coloring Should be appealing and appropriate for dosage form
Not always necessary
Use minimal amount to keep color “light”
Coloring agent should match flavor of the product
Example: Cherry should be red, grape should be purple, and so on
Be aware of patient sensitivities or allergies to certain dyes
Dye-free flavoring agents available