02-06-09001

Drug
Awareness

Noha Alaa Hamdy, Pharm D, PhD

Lecturer of Pharmacy Practice
Faculty of Pharmacy
1 Alexandria University
Semi-solid dosage
forms

NOHA ALAA, PHARMD, PHD 3

Ointments
Ointments are semisolid preparations intended for
external use.
They are easily spread.
Ointments are typically used as:
a. Emollients to make the skin more pliable,
b. Protective barriers to prevent harmful substances from
coming in contact with the skin, and
c. Vehicles in which to incorporate medication.
(dermatologic, ophthalmic, nasal, rectal, vaginal)

NOHA ALAA, PHARMD, PHD 4

 Creams
Pharmaceutical creams are semisolid preparations containing one or
more medicinal agents dissolved or dispersed in either a W/O
emulsion or an oil-in-water emulsion or in another type of water-
washable base.
The so-called vanishing creams are oil-in-water emulsions
containing large percentages of water and stearic acid or other
oleaginous components.
After application of the cream, the water evaporates, leaving behind
a thin residue film of the stearic acid or other oleaginous
component.
Creams find primary application in topical skin products and in
products used rectally and vaginally.
Many patients and physicians prefer creams to ointments because
they are easier to spread and remove.

NOHA ALAA, PHARMD, PHD 5

Gels
Gels are semisolid systems consisting of dispersions of small
or large molecules in an aqueous liquid vehicle rendered
jellylike by the addition of a gelling agent.

NOHA ALAA, PHARMD, PHD 6

Pastes
•These are semi-solids for external use.
•They differ from creams & ointments in that they
contain a high proportion of fine powder (25%),
such as starch.
•This makes them very stiff & means they do not
spread readily over the skin surface.

NOHA ALAA, PHARMD, PHD 7

Liquid dosage
forms

NOHA ALAA, PHARMD, PHD 8

Advantages of liquid dosage
forms
oMore rapid absorption
oUseful for patients having trouble swallowing solid dosage
forms
oFor some drugs (adsorbents, antacids), greater effectiveness
than solid form

NOHA ALAA, PHARMD, PHD 9

Syrups
Syrups are traditional oral solutions that contain
high concentrations of sucrose or other sugars.
•Simple syrup is a concentrated or nearly saturated
aqueous solution of sugar (65% w/w).
•The sucrose concentration of syrup plays a crucial
role in the control of microbial growth.

NOHA ALAA, PHARMD, PHD 10

Elixirs
•Elixirs are clear, sweetened hydroalcoholic solutions
intended for oral use and are usually flavoured to enhance
their palatability.
•Compared with syrups, elixirs are usually less sweet and less
viscous because they contain a lower proportion of sugar and
consequently are less effective than syrups in masking the
taste of medicinal substances.

NOHA ALAA, PHARMD, PHD 11

Suspensions
Suspensions are liquid dosage forms where the active
ingredient is insoluble.
Suspensions are available for both oral and external use
(e.g., calamine lotion)
Shake bottle before use

NOHA ALAA, PHARMD, PHD 12

 Emulsions
These are mixtures of two immiscible liquids, usually oil and water.
When the term emulsion is used, this refers to a preparation for oral use.
Shake bottle before use

Purposes of emulsions
a. Increased drug solubility. Many drugs have limited aqueous solubility
but have maximum solubility in the oil phase of an emulsion. Drug
partitioning from the oil phase to the water phase can maintain or enhance
activity.
b. Increased drug stability. Many drugs are more stable when
incorporated into an emulsion rather than an aqueous solution.

NOHA ALAA, PHARMD, PHD 13

Emulsions
c. Prolonged drug action. Incorporation of a drug into an
emulsion can prolong bioavailability, as with certain
intramuscular injection preparations.
d. Improved taste. Drugs with an unpleasant taste are more
palatable and thus more conveniently administered in
emulsion form.
e. Improved appearance. Oily materials intended for
topical application are more appealing in an emulsified form.

NOHA ALAA, PHARMD, PHD 14

Paints
Paints are solutions for application to the skin.
Those used on the skin are often formulated with a volatile
vehicle.
This evaporates on application & leaves a film of active
ingredients on the skin surface

NOHA ALAA, PHARMD, PHD 15

 Gargles & Mouthwashes
Gargles are aqueous solutions used to treat infections of the
throat.
They are often concentrated and the patient has to dilute it.
Gargles should not be swallowed but held in the throat then
spit
Mouthwashes are solutions that are used to cleanse the
mouth or treat diseases of the oral mucous membrane.
The active ingredients are usually antiseptics or bactericidal
agents.

NOHA ALAA, PHARMD, PHD 16

 Sterile dosage forms (parenterals, ophthalmic
products and irrigations )

•Sterile products are pharmaceutical dosage

forms that are sterile.
•This includes products like parenteral
preparations, irrigating solutions, and
ophthalmic preparations.
•Sterile product compounding requires cleaner
facilities, personnel training and testing, and
knowledge of sterilization and stability
principals.

NOHA ALAA, PHARMD, PHD 18

Parenteral Preparation
Enteral administration is the term used to describe
drug administration via the gastrointestinal tract.
The majority of medicines are administered orally
via this route in the form of tablets, capsules or
liquids.
Parenteral administration is commonly used to
describe drug administration by injection.

NOHA ALAA, PHARMD, PHD 19

Parenteral Preparation
The vast majority of patients would prefer to
receive their medication as an oral tablet or
liquid to swallow, or as a cream, ointment or
transdermal patch to apply to the skin rather
than receive treatment via injection, which
can be painful or stressful (indeed some
patients suffer from needle phobia).

NOHA ALAA, PHARMD, PHD 20

Parenteral Preparation
Many medicines are administered parenterally simply
because the drug molecule itself would be rapidly broken
down in the gastrointestinal tract and would thus become
inactivated before it could be absorbed into the circulatory
system.
Good examples of this are aminoglycoside antibiotics, such
as gentamicin.

NOHA ALAA, PHARMD, PHD 21

 Parenteral Preparation
Intravenous injection delivers the drug directly into the circulatory system, where
it is then rapidly distributed around the body. This is important clinically as the
drug will rapidly produce an effect, whereas peak blood levels may not be
achieved for one to two hours after a drug is administered orally.

This rapid onset of action for an intravenously administered drug may be critical
in emergency situations. Conversely, by choosing to administer a drug by
intramuscular injection, the release of the medicine from the injection site into
the circulation can be delayed and prolonged

NOHA ALAA, PHARMD, PHD 22

INFUSION SOLUTIONS
Infusion solutions are divided into two categories:
Small-Volume Parenterals (SVPs), those having a volume less than
100ml (are used to deliver medications)
Large-Volume Parenterals (LVPs), those having a volume of 100ml or
greater (are used to deliver medications depending on the stable
concentration, or to replenish fluids, to provide electrolytes, nutrients).
Infusion solutions are used for the intermittent or continuous infusion of
fluids or drugs.

NOHA ALAA, PHARMD, PHD 24

 IV fluids
DEXTROSE
SALINE (SODIUM CHLORIDE)

RINGER’S SOLUTIONS
 Lactated Ringer’s solution (Hartmann’s or, Ringer’s lactate solution)
 Ringer’s solution
WATER
 Water is used for reconstitution of powdered drugs.
 Sterile water for injection may contain a bacteriostatic agent or not.

These vehicles serve as vehicles in IV admixtures, for correcting body fluid and electrolyte disturbance and provide a caloric
source in parenteral nutrition.
NOHA ALAA, PHARMD, PHD

25
INFUSION METHODS
Continuous drip infusion is the slow primary-line infusion of an IV preparation
to maintain a therapeutic drug level or provide fluid and electrolyte replacement.
Flow rates must be carefully monitored, they are expressed as volume per unit
time (ml/hr, drops/min)
IV bolus (direct) injection rapidly delivers small volumes of an undiluted drug
to achieve an immediate effect, for drugs that cannot be diluted or to achieve a
therapeutic serum drug level quickly.
Intermittent infusion used for drugs that require further dilution and for patients
who cannot administer large amounts of IV fluids (CHF patients).

NOHA ALAA, PHARMD, PHD 26

 Ophthalmic preparations
• It is a regulatory requirement that preparations intended or
ophthalmic use, including those for cleansing the eyes, must be
sterile at the time of filling and closing in a sealed container.
• Ocular infections are extremely dangerous and can rapidly lead to
the loss of vision.
• For ophthalmic preparations, terminal sterilization of products in
their original containers should be adopted wherever possible.
• If the product cannot withstand terminal sterilization then filtration
under aseptic conditions should be considered, usually using a filter
pore size of 0.22 μm or less.
• Ophthalmic preparations must furthermore be labelled with duration
of use once opened.

NOHA ALAA, PHARMD, PHD 27

Ophthalmic administration
❑Preparation must be sterile and patient should be advised that once
opened product should be discarded within 4 weeks.
❑Good practice requires that the opening date is documented on the
pack to ensure that products that have been opened more than 4
weeks previously are not used.
❑Patients or their carers require knowledge of the proper technique
for application of the product to avoid touching the container against
the eye or anything else to avoid contamination of the containers
❑ Ophthalmic preparations include:
✓eye drops
✓eye lotions
✓eye ointments.

NOHA ALAA, PHARMD, PHD 28

 IRRIGATING SOLUTIONS.
Although these sterile products are manufactured by the same standards used to
process IV preparations, they are not intended for infusion into the venous
system.
A. Topical administration. Irrigating solutions for topical use are packaged in
pour bottles so that they can be poured directly onto the desired area. These
solutions are intended for such purposes as irrigating wounds, moistening
dressings, and cleaning surgical instruments.
B. Infusion of irrigating solutions. Surgeons performing surgical procedures often
use irrigating solutions to perfuse tissues in order to maintain the integrity of the
surgical field, remove blood, and provide a clear field of view. To decrease the risk
of infection, an antibiotic preparation, often is added to these solutions.

NOHA ALAA, PHARMD, PHD 29

 IRRIGATING SOLUTIONS.
C. Dialysis. Dialysates are irrigating solutions used in the
dialysis of patients with such disorders as renal failure,
poisoning, and electrolyte disturbances. These products remove
waste materials, serum electrolytes, and toxic products from the
body. Either in peritoneal dialysis, or hemodialysis

NOHA ALAA, PHARMD, PHD 30

Otic administration
• Patient must remain on his or her side for about 5 minutes
to allow formulation to reach inner ear canal.
• Caution when using ear drops if patency of eardrum is not
ensured

NOHA ALAA, PHARMD, PHD 31

Nasal administration
• Nasal drops: preferred in infants due to better spread as
opposed to spray.
• Nasal spray: preferred since they are less likely to be
associated with postnasal drip of the drug leading to an
aftertaste.

NOHA ALAA, PHARMD, PHD 32