1. 6
Dosage Formulations and Routes of Administration

2. Sources of Drugs Natural drug sources
Occur in nature and are naturally occuring
Derived or extracted from plants, animals, and minerals

3. Sources of Drugs Natural drug sources Plant sources include:
Acetylsalicyclic acid (aspirin) derived from white willow bark
Cocaine derived from the coca plant
Codeine and morphine derived from the opium poppy plant

4. Sources of Drugs Natural drug sources Animal sources include:
Bovine insulin derived from cow pancreas
Porcine insulin derived from pig pancreas
Pepsin derived from cow stomach
Thyroid hormones derived from pig thyroid gland

5. Sources of Drugs Natural drug sources Mineral sources include:
Ferrous sulfate (iron) to treat iron deficiencies
Gold used to treat arthritis
Magnesium for milk of magnesia (laxative and antacid)

6. Sources of Drugs Natural drug sources Mineral sources include:
Potassium to supplement low potassium levels
Sodium chloride is common base solution for IV therapies
Zinc for skin protectants and sunscreen

7. Sources of Drugs Synthetic drug sources
Produced in a laboratory, not naturally occuring
Semisynthetic: naturally occuring substance that has been chemically altered
Synthesized: made in laboratory to imitate a naturally occurring drug

8. Sources of Drugs Synthetic drug sources Examples of synthetic drugs
Adrenalin
Synthesized epinephrine for treating hypersensitivity and asthma attacks
Amoxicillin, ampicillin, and piperacillin
Semi-synthetic pencillins to treat various infections

9. Sources of Drugs Synthetic drug sources Examples of synthetic drugs
Barbiturates
Synthetic CNS depressants
OxyContin
Synthetic opiate for pain management

10. Sources of Drugs Genetically engineered drug sources Recombinant DNA
Combining two different DNA strands to produce a new strand of DNA or rDNA
Human insulin created to treat diabetes
Recombinant hepatitis B vaccine

11. Sources of Drugs Genetically engineered drug sources
Monoclonal antibodies (MAbs)
Hybrid cells created in laboratory from animals; used to treat tumors and diagnose various conditions
Rituxan, Zevalin, Erbitux, Avastin: used in the treatment of various cancers

12. Drug Nomenclature Chemical name
Reflects the chemical structure of the compound
Often long and hard to remember and pronounce
Named according to guidelines from the International Union of Pure and Applied Chemistry (IUPAC)
Used primarily in research settings

13. Drug Nomenclature Generic name Convenient and concise
Assigned by manufacturer in collaboration with the FDA
Not capitalized
May be used by anyone—not restricted by copyright or tradmark
Used in the USP and the USP-NF

14. Drug Nomenclature Trade or brand name
Registered or trademarked by a specific producer or manufacturer to identify its particular drug
This name cannot be used by other manufacturers but a generic may be sold under more than one trade name.
Usually capitalized
Also called the "proprietary name"

15. Classification of Drugs
Classifications based on:
Chemical ingredients
Method by which the drug is used
Area of the body that is treated
Two usual classification methods
Therapeutic use
Mechanism of action

16. Dosage Formulations Dosage forms
How medication is prepared for administration to the patient
Solid or liquid
Single medication may be available in multiple dosage forms for use at various disease states, patient ages, and desired results.

17. Dosage Formulations Solid dosage forms Most widely available form
Can be administered orally, rectally, vaginally, or topically
Advantages and disadvantages

18. Dosage Formulations Solid dosage forms Tablets
Small formed shapes usually taken by mouth
Active and inert ingredients work together to ensure tablet is easy to swallow, taste, digestible, and releases drug at proper time.

19. Dosage Formulations Solid dosage forms Tablets
Molded tablets made with mold and wet materials
Compressed tablets formed by die-punching compressed, powdered, crystalline, or granular substances into a uniform shape, usually has a film, sugar coating, or enteric coating

20. Dosage Formulations Solid dosage forms Tablets
Caplets are film-coated tablets in the shape of a capsule.
Chewable tablets should be chewed for desired results.
Effervescent tablets dissolve in liquid before administration.
Fast dissolving tablets can be taken orally without water.

21. Dosage Formulations Solid dosage forms Tablets
Sublingual tablets disintegrate and are absorbed under the tongue.
Buccal tablets disintegrate in the buccal pouch, between the gums and the cheek.
Vaginal tablets are dissolved and absorbed through the mucous lining of vagina.

22. Dosage Formulations Solid dosage forms
Capsules have drug contained in a shell
Soft gelatin shells are soft and elastic, flexible during administration, and can't be broken apart.
Hard gelatin shells have two oblong halves joined together, which can be separated if necessary.

23. Dosage Formulations Solid dosage forms
Lozenges (also called pastilles or troches)
Hard, disk-shaped solid form in a sugar base
Remains in the patient's mouth until has been completely dissolved and all medication releases

24. Dosage Formulations Solid dosage forms Powders
Usually produced in large supplies for bulk compounding
Can be used internally or externally
Individual doses packaged in a powder paper

25. Dosage Formulations Solid dosage forms Granules
Made from wetted then dried powders ground into course, nonuniform particles
Commonly used in pediatric antibiotic suspensions
Dissolved in distilled water

26. Dosage Formulations Solid dosage forms Medicated sticks
For topical application of local anesthetics, sunscreens, antivirals, antibiotics, and cosmetics

27. Dosage Formulations Semisolid dosage forms Suppositories
Administer medication via rectum, vagina, or urethral tract
Melt or dissolve at body temperature
Used for babies and other instances where oral dosing may not be practical
Creams may or may not contain medication; oil-in-water or water-in-oil bases.

28. Dosage Formulations Semisolid dosage forms
Ointments are applied externally to the skin or mucous membranes.
Oleaginous ointments: emollients to soothe and cool. Hydrophobic, meaning not easy to wash off.

29. Dosage Formulations Semisolid dosage forms
Ointments are applied externally to the skin or mucous membranes.
Water-soluble ointments: contain no fat or water, easily wash off. Can be mixed with nonaqueous or solid medication
Anydrous ointments: absorb water, turning into a water-in-oil emulsion

30. Dosage Formulations Semisolid dosage forms
Ointments are applied externally to the skin or mucous membranes.
Emulsions
Emollient bases made of water-in-oil (occlusive) or oil-in-water (nonocclusive)
Pastes
Stiff or very viscous ointments that do not melt or soften at body temperature; usually contain at least 20% solids

31. Dosage Formulations Liquid dosage forms Solutions
Medication is completely dissolved and evenly distributed (homogeneous) and quickly absorbed
Aqueous solutions use purified/sterile water as vehicle for douches, irrigating solutions, enemas, washes, and sprays.

32. Dosage Formulations Liquid dosage forms Solutions
Viscous aqueous solutions use purified/sterile water; thick, sticky—either liquid or semisolid; syrups, jellies, and mucilages.

33. Dosage Formulations Liquid dosage forms Solutions
Nonaqueous solutions don't use water, usually alcohol, glycerin, or propylene glycol.

34. Dosage Formulations Liquid dosage forms Solutions
Hydro-alcoholic solutions use alcohol and water as vehicle or dissolving agent. Example:
Elixirs: liquid preparations with flavored water and alcohol mixtures for oral administration. Many drugs dissolve more easily this way. Range of alcohol contents varies from 2–30%.

35. Dosage Formulations Liquid dosage forms Solutions
Hydro-alcoholic solutions use alcohol and water as vehicle or dissolving agent. Example:
Aromatic elixirs are nonmedical, used to mask unpleasant medicine taste.

36. Dosage Formulations Liquid dosage forms Solutions
Alcoholic solutions use no water, usually ethyl or ethanol alcohols.
Collodions contain pyroxylin, applied to skin, can carry an added medication
Spirits contain volatile and aromatic substances, administered internally or inhaled.

37. Dosage Formulations Liquid dosage forms Solutions
Alcoholic solutions use no water, usually ethyl or ethanol alcohols.
Glycerite contains medication dissolved in glycerin, then is mixed into a water or alcohol vehicle, often has viscous, jelly-like consistency, rarely used today.

38. Dosage Formulations Suspensions
Contain very fine solid particles mixed with gas, liquid, or solid
Break down faster than tablets or capsules
Must be shaken well before use

39. Dosage Formulations Suspensions
Usually intended for oral ingestion where large amount of medication is needed.
Other routes
Ophthalmic, parenteral, otic, and rectal

40. Dosage Formulations Suspensions Magmas and milks Lotions
Suspensions of undissolved medications in water
Lotions
For external use only

41. Dosage Formulations Suspensions Gels Extractives
Similar to magmas and milks but particles are smaller, used for oral or topical administration
Extractives
Drug extracted by soaking dried plant or animal tissue in solvent

42. Dosage Formulations Suspensions Tinctures Fluidextracts
Extractive alcoholic and hydro-alcoholic solutions; each mL of tincture = 100 mg of crude ingredient
Fluidextracts
More potent than tinctures; each mL = 1,000 mg of crude drug

43. Dosage Formulations Suspensions Extracts
Similar to tinctures and fluidextracts but potency of crude drug is 2–6 times stronger

44. Dosage Formulations Emulsions
Mixtures of water and oil (which normally do not mix)
Internal phase: one liquid broken into small elements
External (or continuous) phase: the other liquid remains liquid
Emulsifying agent added to keep two liquids from seperating

45. Dosage Formulations Liniments
Applied to skin with friction and rubbing
Can be solutions, suspensions, or emulsions
Contain medication that mildly irritates skin, producing counterirritation or inflammation to relieve inflammation of deeper tissues or muscles
Ben-Gay most common OTC liniment today

46. Dosage Formulations Transdermal patches Sprays
Medicated adhesives that deliver medication directly into bloodstream through the skin
Prescription and OTC applications
Sprays
Pump-type dispenser delivers medication nasally or translingually for quick absorption and onset

47. Dosage Formulations Inhalants
Fine powder or solution delivered as mist into nose or mouth, immediately entering respiratory tract
Asthma inhalers and allergy nasal sprays

48. Dosage Formulations Aerosols
Very fine liquid or solid particles mixed in vehicle, packed with gas and pressure, administered via respiratory tract or topically

49. Delayed and Extended Releases
Medications released over a period of time
Extended release (ER)
Long acting (LA)
Sustained release (SR)
Time release (TR)
Controlled release (CR)

50. Routes of Administration
Method by which medication is introduced into the body for absorption and distribution
Varies from patient to patient
Factors include patient's age, consciousness, medical condition, time to achieve results, and side effects.

51. Routes of Administration
Oral
Abbreviation: PO (per os, Latin for "by mouth")
Advantages
Safe, convenient, easy to store; readily available; lower cost, immediate release or extended release; easy to self-administer

52. Routes of Administration
Oral
Disadvantages
Hard to swallow for those who are children, elderly, unconscious, ventilated, or having digestion problems
Take longer to absorb and distribute

53. Routes of Administration
Oral
Sublingual
Tablets administered under the tongue, bypassing the digestive system and diffusing directly into the blood supply
Buccal
Tablets and lozenges/troches administered between the gum and cheek, absorbed into bloodstream through mucous membranes

54. Routes of Administration
Transdermal (percutaneous)
Generally uses patch applied to skin
Delivers medication to bloodstream
Two kinds of patches
One controls rate of delivery to skin and bloodstream
One lets skin control rate of delivery

55. Routes of Administration
Inhalation
Medication inhaled through mouth directly into lungs
Effective for lung conditions when immediate relief is needed
Nasal
Inhaled through nose and absorbed into the bloodstream
Sprayed into nose for local effects

56. Routes of Administration
Parenteral
Medication does not pass through the gastrointestinal system.
Quicker absorption and distribution
Convenient for those who cannot take medicine orally
Varied rate of delivery
Dosage must be correct because action is immediate and unreversable.

57. Routes of Administration
Parenteral
Intradermal (ID)
Injection into top layers of skin
Subcutaneous (SC)
Injection into tissue under the skin

58. Routes of Administration
Parenteral
Intramuscular (IM)
Injection into large muscle masses, such as upper arm, thigh, buttock
Intravenous (IV)
Medication administered directly into vein

59. Routes of Administration
Parenteral
Other parenteral routes include:
Implant
Device inserted into the body to slowly release medication
Intra-arterial
Injection into artery
Intra-articular
Injection within joint

60. Routes of Administration
Parenteral
Other parenteral routes include:
Intracardiac
Injection into heart
Intraperitoneal
Injection into abdominal or peritoneal cavity
Intrapleural
Injection into sac (pleura) surrounding lungs

61. Routes of Administration
Parenteral
Other parenteral routes include:
Intrathecal
Injection into cerebrospinal fluid around spinal cord
Intraventricular
Injecting antibiotics or chemotherapy agents into brain cavities (ventricles)

62. Routes of Administration
Parenteral
Other parenteral routes include:
Intravesicular
Injection into urinary bladder
Intravitreal
Injection into vitreous body of the eye

63. Routes of Administration
Topical
Administered externally to the skin
Absorbed into the mucous membrane, preventing particles from being absorbed into the bloodstream
Rectal
Administered through the rectum for local or systemic effects

64. Routes of Administration
Vaginal
Medications inserted into vagina for absorption and distribution for local or systemic conditions
Ophthalmic
Solutions, ointments, suspensions, or gels administered through the eye
Treats conditions of the eye directly

65. Routes of Administration
Otic
Medications administered in the ear to treat infections, inflammation, and severe wax buildup
Solutions and suspensions absorbed in the ear canal for immediate relief

66. Summary
Drug sources, nomenclature, common dosage forms, routes of administration

67. Summary
Important to:
Dispense proper dosage form of medication
Dispense proper dosage amount, especially for parenteral ROAs
Pharmacy technician must understand drug names, the meaning and use of each dosage form and ROA.