PHARMACEUTICAL DOSAGE FORMS ----------------------------------------------------------------- I. INTRODUCTION Dosage Forms – drug products/preparations containing: o Active Pharmaceutical Ingredient (API)/ Drug o Exipients/Additives/Adjuncts Drug – any article intended for use in diagnosis, cure, treatment, mitigation or prophylaxis in man and other animals – affects the structure or any function of the body Excipients – inactive ingredients o Role: drugs more appealing and efficacious o Use: solubilize, suspend, emulsify, dilute, stabilize, preservatives, color, flavor, etc. Placebo – dosage form that does not contain an API Drug Delivery System – products that allow for uniform release and targeting of drugs into body Cosmetics – any substance/preparation intended to be placed in contact with external parts of human body or with teeth and mucous membranes of oral cavity with a view exclusively or mainly to cleaning them, perfuming them, correcting body odors, changing their appearance, protecting them and/or keeping them in good condition Compounding – preparation, mixing, packaging or labeling of a drug to prepare an individualized drug treatment for a patient REASONS FOR FORMULATING DOSAGE FORMS: appearance, palatability, ease of administration, solubility, stability II. SOLID DOSAGE FORMS A. POWDERS intimate mixtures of finely divided drugs or chemicals in dry form which may be used internally or externally size: sieve no. o very coarse – no. 8 o coarse – no. 20 o moderately coarse – no. 40 o fine – no. 60 o very fine – no. 80 Advantages: rapid dispersion of ingredients; flexibility in compounding; good stability Disadvantages: inaccuracy of dose; not suitable for dispersing deliquescent and hygroscopic drugs COMPOUNDING: o Trituration – mortar and pestle o Levigation – forming a paste by addition of levigating agent (ex. mineral oil, glycerin) o Pulverization by Intervention – addition of volatile substance to gummy materials (ex. camphor + alcohol; I2 crystals + ether) Mixing/Blending o Trituration – mortar and pestle Types of mortar and pestle Glass – smooth non-porous surface; for simple admixture; for chemicals that stain Porcelain – rough inner surface; for comminction Wedgewood – rougher surface; for crystalline substances o Spatulation – use of spatula; not for potent substances o Sifting – use of sifter; not for potent substances o Geometric Dilution – addition of an equal volume of diluent to a potent substance placed in a mortar o Tumbling – large containers rotated by a motorized process TYPES OF POWDER o Bulk Powders – dispensed in large quantities Oral Powders – dissolved/dispersed in a liquid or mixed with food before use Dentrifices – contain a soap, mild abrasive and anticariogenic agent Dusting Powders – locally applied non-toxic powders that have no systemic action Douche Powders – dissolve in warm water prior to use as cleansing agent/antiseptic for a body cavity Insufflators – blown into body cavities using an insufflator Triturations – dilutions of potent powdered drugs (10% API) o Divided Powders/Chartulae – dispersed in individual doses usually in folded papers TYPES OF POWDER PAPER o White Bond Paper – opaque paper with no moisture resistance o Glassine Paper – glazed transparent moisture-resistant paper o Vegetable Parchment – thin, semi-opaque, moistureresistant paper o Waxed Paper – transparent waterproof paper; suitable for deliquescent and hygroscopic drugs PAGE 1 OF 7 © MANOR REVIEW CENTER NOTES (K.L) Sublingual Tablets – dissolve rapidly under tongue for systemic absorption (ex. Nitroglycerin, ISDN) Lozenges – candies that dissolve slowly in mouth for local effect (ex. Strepsils® - dicholorobenzyl alcohol + amylmetacresol) TYPES: Troches – compressed lozenges Pastilles – molded lozenges Lollipops – lozenges on sticks o Tablets Used to Prepare Solutions Effervescent Tablets – ex. Alka-Setlzer® - antacid + pain reliever Compounding/Dispensing Tablets – contain a large amount of API used by pharmacists in compounding multiple dosage units Hypodermic Tablets – used by physicians to prepare parenteral solutions Molded Tablets/Tablet Triturates B. GRANULES prepared agglomerates of powders; size: sieve no. 4 to 12; for tablet formulation: sieve no. 12 to 20 Advantages: flow well compared to powders; less tendency to cake or harden; more stable to humidity; more easily wetted by liquids PREPARATIONS: o Wet Granulation – most common; addition of liquid binder o Dry Granulation – for moisture-sensitive and heat labile materials; use compaction/compression forces o Effervescent Granules – dissolved in water before use in which CO2 gas is released to mask the unpleasant taste of drug COMPONENTS: o NaHCO3 o Citric acid sticky o Tartaric acid crumble PREPARATION: o Dry/Fusion Method – binder is 1 molecule of water in citric acid o Wet Method – binder is water + alcohol C. TABLETS solid dosage forms which are prepared mainly by compression or molding Advantages: precision and low content variability; low manufacturing cost; easy to package and ship; simple to identify; most stable of all oral dosage form; tamper proof Disadvantages: some drugs resist compression; some drugs that require encapsulation prior to compression TYPES OF TABLETS: o Tablets for Oral Ingestion Compressed Tablets – formed by compression; some are scored Multiple Compressed Tablets – ex. layered tablets, compression coated tablets Coated Tablets Sugar Coated Tablets – coated with a water soluble sucrose-based solution Film Coated Tablets – coated with a thin layer of polymer material Enteric-Coated Tablets – remain intact in stomach and disintegrate in small intestine o Tablets Used in the Oral Cavity Chewable Tablets – chewed in mouth before swallowing; does not contain disintegrant; diluent: mannitol and xylitol Rapidly/Orally Disintegrating Tablets – liquefy on tongue before swallowing (ex. Resperidone, Ondasetron) Buccal Tablets – dissolve slowly in cheeks/buccal pouch for systemic absorption (ex. Progesterone) D. CAPSULES solid dosage forms in which drug is endosed within either a hard or soft soluble shell usually made of gelatin o Gelatin – partial hydrolysis of collagen from the skin/bones of animals Types: Type A – acid hydrolysis Type B – base hydrolysis Alternative: hydroxypropyl methylcellulose (HPMC) or stach Types of Capsules: Hard Gelatin Capsules – dry-filled or two-piece capsules (cap and body) o made of gelatin, sugar and water + colorant + opacifying agent (TiO2) + SO2 [0.15%] (to prevent decomposition of gel) o contains 12-16% moisture o stored at 21-25oC/30-35% RH o capsule sizes: (increase capsule size = decrease capacity) Human – No. 5 (smallest) – No. 000 (largest) Veterinary – No 10. – No. 12 Soft Gelatin Capsules – one-piece capsules; contains nonaqueous liquids (vitamin e, cod liver oil, digoxin), suspensions, pastes, and dry solids o made of gelatin, plasticizer (glycerin, sorbitol) and preservatives against fungi o contains 6-10% moisture o no specific sizes PAGE 2 OF 7 © MANOR REVIEW CENTER NOTES (K.L) E. ORAL MODIFIED-RELEASE SOLID DOSAGE FORMS drug release features are based on time, course and locations Reasons: o to prolong therapeutic effect to reduce dosing frequency o to delay the effect MTC Cp MEC immediate controlled sustained delayed Time onset onset Types: o Extended-Release – provides a prompt-desired effect followed by a gradual release of remaining amount Problem: dose dumping Types: Controlled Release – zero order Sustained Release – first order o Delayed-Release – drug release is other than the time of prompt administration o Repeat Actions – contains 2 single doses of a medication (1st dose immediate; 2nd dose delayed) o Targeted Release – drug release is isolated in a specific body region/tissue absorption and action D. PHARMACEUTICAL INSERTS Suppositories – solid masses inserted into body cavities in which they will melt at body temperature or dissolve into aqueous secretions of body orfice o Types: Rectal; Vaginal (Pessaries); Urethral (Bougies) – ex. Alprostadil (for erectile dysfunction) FEATURES SHAPE WEIGHT SIZE INTENDED USE RECTAL Bullet Torpedo Adult: 2g Pedia: 1g Adult: 32mm Pedia: 16mm Both VAGINAL Globular Ovoid Cone 5g Varies Local URETHRAL Pencil-like Male: 4g Female: 2g Male: 140mm Female: 70mm Local o SUPPOSITORY BASES Oleaginous Base Cocoa Butter – most common base for rectal suppository; solid at 32oC, melts at 34-35oC; exhibits polymorphism (ȣ - least stable [18oC]; α; β’; β – most stable [34.5oC] Wecobee ® - from coconut Witepsol ® - saturated PAs (C12-C18); major: lauric acid Glyceryl Monopalmitate Water-Soluble/Miscible Base Glycerinated Gelatin – most common base for pessaries Polyethylene Glycol (PEG) o PREPARATIONS: Hand Molding/Rolling/Shaping – oldest and simplest; base is rolled into desired shape by hand Compression Molding – base is forced into molds; problem: air entrapment Pour/Melt Molding – most common; base melted and poured into molds Vaginal Tablets/Inserts – ovoid tablets inserted into the vagina using a plastic inserter; contains antimicrobial agents Implants/Pellets – small, sterile cylinders or devices inserted under the skin for prolonged and continuous absorption o Norplant ® - levonorgestel (5 years) o Leuprolide – prostate cancer (1 year) III. SEMI-SOLID DOSAGE FORMS3 A. OINTMENTS semi-solid dosage forms applied externally on the skin or the mucous membranes Types: o Medicated – contains activated pharmaceutical ingredients (API) o Non-Medicated – used as base Ointment Bases: o Oleaginous/Hydrocarbon Base – greasy, anhydrous, emollient, occlusive, non-water washable Petrolatum/Yellow Petrolatum/Petroleum Jelly (Vaseline®) – purified mixture of semisolid hydrocarbon from petroleum White Petrolatum – decolorized Yellow Wax/Beeswax – wax obtained from the honeycomb of Apis mellifera White Wax – bleached Yellow/Simple Ointment – yellow petrolatum + yellow wax White Ointment – white petrolatum + white wax o Absorption Base – greasy, emollient, occlusive, non-water washable; can absorb small amounts of water w/o Hydrophilic Petrolatum (Aquaphor®) – petrolatum + cholesterol (emulsifying agent) + beeswax + stearyl alcohol Anhydrous Lanolin/Woolfat – wax-like substance from the wool of Ovis aries (sheep) containing 0.25% moisture *Hydrous Lanolin – 25% moisture; Modified Lanolin – without free lanolin alcohols and excess detergents PAGE 3 OF 7 © MANOR REVIEW CENTER NOTES (K.L) o Water-Removable Base – o/w; water-washable; nonocclusive; non-greasy; can be diluted with large amounts of water Hydrophilic Ointment o Water-Soluble Base – lipid-free; greaseless; waterwashable; non-occlusive; for incorporation of solid materials Polyethylene Glycol (PEG) Ointment – MW < 600 liquids; MW > 100 wax-like solids; MW 600-1000 semisolids B. CREAMS semi-solid preparations containing APIs dissolved or dispersed in w/o or o/w emulsion or water-washable base; preferred: ease of spreadability o Vanishing Creams – o/w base; large % water – ex. glycerin, propylene glycol – + stearic acid o Cold Cream/Petrolatum Rose Water Ointment – w/o base; mineral oil less rancid; white wax; spermaceti (cetyl esters wax) + Na borate C. GELS dispersion systems consisting of small inorganic particles or large organic molecules dispersed throughout a liquid vehicle, rendered jelly-like by addition of a gelling agent; thixotropy – reversible gel-sol formation IV. TRANSDERMAL DRUG DELIVERY SYSTEM controlled release DDS or patches which allow the passage of drugs from the skin to the systemic circulation PARTS OF TDDS: o Occlusive Backing Layer – prevents water loss and drug loss o Drug Matrix System – stores API o Adhesive Layer – ensures continuous drug absorption o Release Liner – removed before use to enable drug release EXAMPLES: o Scopolamine (Transderm Sccp®) – 1st TDDS developed; for motion sickness o Nitroglycerin – angina o Clonidine – 1st TDDS for hypertension o Fentanyl – opioid analgesic o Estradiol and Testosterone – hormone replacement therapy V. LIQUID DOSAGE FORMS SINGLE PHASE Solutions – liquid preparations containing one or more substances dissolved in a suitable solvent Advantages: completely homogenous dose; immediate availability for absorption; flexible Disadvantages: degrade more rapidly; interact with other component; bulky DESCRIPTIVE TERMS Very Soluble Freely Soluble Soluble Sparingly Soluble Slightly Soluble Very Slightly Soluble Insoluble D. PASTES semi-solid preparations applied on skin and contain a large proportion of solid material (≥25%) and therefore stiffer than ointments Use: to prolong contact of drug Zinc Oxide Paste (ZnO) – treatment of diaper rash E. PLASTERS solid or semisolid adhesive masses spread on a backing of paper, fabric, moleskin or plastic Use: to prolong the contact of drug and affords protection Salicylic Acid Plaster – keratolytic (10-40% salicylic acid) F. GLYCEROGELATIN plastic masses applied on skin with a fine brush contains: 40% glycerin, 35% water, 15% gelatin, 10% AI Zinc Gelatin Boot – treatment of varicose ulcers PARTS OF SOLVENT REQUIRED FOR 1 PART OF SOLUTE <1 1-10 10-30 30-100 100-1,000 1,000-10,000 >10,000 Water Official Types: o Purified Water – distillation; reverse osmosis; ion exchange o Water for Injection – purified water that is pyrogen-free o Sterile Water for Injection – water for injection that is sterilized o Bacteriostatic Water for Injection – sterile water for injection with antimicrobial agent (benzyl alcohol); not for neonates o Sterile Water for Inhalation o Sterile Water for Irrigation A. AQUEOUS SOLUTIONS G. POULTICES/CATAPLASM soft, moist masses of meal, herbs, seeds, etc.; applied hot in a cloth Use: to localize infectious materials and counterirritant Kaolin Poultice – treatment for boils and anti-inflammatory Aromatic Water/Medicated Waters – clear, saturated aqueous solutions of volatile oils or other aromatic substances; o Use: flavored/perfumed vehicles o Preparations: Distillation – not economical; only method for: Strong Rose Water, Orange Flower Water Simple Solution – with or without dispersant (ex. talc) o Problem: Salting out – insoluble layer at top PAGE 4 OF 7 © MANOR REVIEW CENTER NOTES (K.L) Diluted Acids – aqueous solutions prepared by dissolving concentrated acids in water; strength: 10% w/v; (ex. Diluted HCl – treatment for achlorhydria; taken with straw) Astringent – locally applied solutions that precipitate proteins and cause constriction of the skin o Aluminum Acetate Topical Solution – wet dressing in contact dermatitis o Calcium Hydroxide Topical Solution – more soluble in cold water o Coal Tar Topical Solution – for eczema Antibacterial Topical Solutions o Hydrogen Peroxide Topical Solution 2H2O2 –(catalase)--> O2^ + 2H2O (3% = 10 volumes – antiseptic); (6% = 20 volumes – bleaching agent) o Povidone-Iodine Topical Solution (Betadine®) – complex of 10% I2 and polyvinyl pynolidone (PVP) o Thiomersal Topical Solution (Merthiolate®) – contains 0.1% thimerosal – organic, mercurial antibacterial Douche – aqueous solutions used as cleansing agent or antiseptic for a body cavity o Eye Douche – removes foreign particles and discharges o Pharyngeal Douche – throat o Vaginal Douche – maintain the acidic pH of the vagina (ex. pH Care® - chlorhexidine gluconate) Enemas – rectal solutions employed mainly to evacuate the bowel (evacuation enema) or to affect a local or systemic disease by absorption (retention enema) o Fleet® Enema – sodium phosphates enema; evacuation enema o Sulfasalazine Enema – ulcerative colitis; retention enema Gargles – used for treating pharynx and nasopharynx by forcing from lungs through solution held in throat Mouthwashes – used by swishing the liquid in oral cavity to cleanse mouth or treat diseases of oral cavity B. SWEET AND OTHER VISCID AQUEOUS SOLUTIONS Syrups – concentrated solutions of sucrose or other sugars in water o Types: Simple Syrup/Syrup NF – 85% w/v or 65% w/w; sp. gr. = 1.313; self-preserving at ≥65% sugar; poor solvent for drugs Flavored Syrups Orange and Cherry – acidic medium Cocoa – bitter Raspberry – sour and salty Ora-Sweet® - for compounding Medicated Syrup – simple/flavored syrups + APIs o PREPARATIONS: Solution w/ Heat – fastest methods; problem: overheating sucrose inversion/caramelization Solution without Heat – prevents sucrose inversion Percolation – slow rate (1mL/min); to prevent bubbles (oxidation) Reconstitution – addition of sugar to a medicated liquid; addition of medicated liquid to syrup Honeys – somewhat allied to syrups but using honey as base Mucilages – thick, viscid, adhesive liquids o PREPARATIONS: Dispersion of gums in water Extraction of mucilaginous principles o Use: suspending agent o ex.: Acacia Mucilage, Tragacanth Mucilage Jellies – class of gels in which structural coherent matrix contains a high portion of water; use: lubricant, contraceptive, topical anesthetic (Lidocaine Jelly) C. HYDROALCOHOLIC SOLUTIONS Elixirs – clear; sweetened hydroalcoholic solutions intended for oral use; alcohol: 5-40%; self-preserving at ≥10% alcohol o PREPARATIONS: Simple Solution Admixture of 2 Medicated Liquids o Types: Medicated Elixir – digoxin, phenobarbital, diphenhydramine, dexamethasone Non-Medicate Elixir – aromatic elixirs, iso-alcoholic elixir – better solvent; higher content Tinctures – hydroalcoholic solutions prepared from vegetable drugs or chemical substances; alcohol content varies; strength: 10% w/v o PREPARATIONS: Process P – percolation (ex. Belladonna Tincture) Process M – maceration (ex. Sweet Orange Peel Tincture) Simple Solution – Iodine Tincture (2% in 50% alcohol); Green Soap Tincture; Compound Benzoin Tincture o Opium Tincture – Laudanum o Camphorated Opium Tincture – Paregoric Spirits/Essences – hydroalcoholic solutions of volatile oil; alcohol content: 50-90% o PREPARATIONS: Simple Solution – aromatic ammonia spirit Solution with Maceration – peppermint spirit Chemical Reaction – ethyl nitrite spirit Distillation – brandy (spiritus vini vitis); whisky (spiritus frumenti) Fluidextracts – “100% Tinctures” too potent and too bitter; hydroalcoholic solutions from vegetable drugs (ONLY) prepared by percolation o PREPARATIONS: Process A – must be assayed; percolation Process E – alternative to process E; percolation (shorter diameter and longer in length) Process D – boiling water PAGE 5 OF 7 © MANOR REVIEW CENTER NOTES (K.L) o Cascara Sagrada Fluidextract – cathartic D. NON-AQUEOUS SOLUTIONS Liniments/Embrocations – alcoholic or oleaginous solutions containing more than one API and are usually rubbed on the skin Types: o Alcoholic – penetrating action; rubefacient and counterirritant o Oleaginous – massage; less irritating Collodions – clear liquids prepared by dissolving 4% pyroxylin (cotton [cellulose tetranitrate; soluble guncotton, collodion cotton, nitrocellulose] +HNO3 + H2SO4) in 3:1 ether and alcohol; use: water repellent protective Types: o Flexible Collodion – +3% castor oil flexible; +2% camphor waterproof o Salicylic Acid Collodion – keratolytic Extracts o METHODS OF EXTRACTION: Maceration – soaking Digestion – maceration with gentle heat Infusion – maceration in hot or cold water Decoction – boiling in water Percolation – column/percolator o TYPES: Semi-Liquid Extract – liquid/syrupy; no solvent is removed Pilular/Solid Extract – plastic; nearly all solvent is removed Powdered Extract – dry powders; all solvent is removed VI. LIQUID PHASE DOSAGE FORMS: DISPERSED A. SUSPENSIONS liquid preparations consisting of solid particles (suspensoids) dispersed throughout a liquid vehicle Types: o Gels PHENOMENA IN GELS: Imbibition – no increase in size Swelling – increase in size Syneresis – gel shrinks Xerogel – formed when only framework remains o Al(OH)3 Gel – antacid; Betamethasone Gel; Tretinoin Gel Magmas/Milk – two-phased gels in which gel mass consist of small distinct particles and therefore whitish in color o PREPARATIONS: Hydration – MgO + H2O Chemical Reaction – MgSO4 + NaOH o Milk of Magnesia – antacid; Bentonite Magma – suspending agent Lotions – liquid suspensions applied externally on body o Calamine Lotion – antipruritic; ZnO + ferric oxide; trituration o White Lotion – chemical reaction; ZnSO4 + sulfurated potash Mixtures – liquid preparations containing more than one active ingredient dissolved or dispersed in al liquid vehicle o Bordeaux Mixture – CuSO4 + CaO; algaecide in pools o Kaopectate – Kaolin + Pectin; antidiarrheal B. EMULSIONS two-phase systems prepared by combining 2 immiscible liquids; internal/discontinuous/dispersed phase; external/continuous/dispersion medium Types: o Oil in water (o/w) o Water in oil (w/o) o Multiple Emulsion – w/o/w or o/w/o o Microemulsion – transparent; most stable Emulsifying Agent – reduce the interfacial tension by forming a film at interface HLB System – increase in HLB value = increase in hypophillic ACTIVITY Antifoaming W/O Emulsifier Wetting Agent O/W Emulsifier Detergents Solubilizer HLB VALUE 1-3 3-6 7-9 8-18 13-16 15-20 PREPARATIONS: o Dry Gum/Continental Method – 4(oil): 2(water): 1(gum); oil + gum, then add water all at once; w/o o Wet Gum/English Method – 4(water): 2(oil): 1(gum); water + gum, then add oil gradually in small portions; o/w o Forbes Bottle Method – for volatile oils and less viscous oils; 3:2:1 or 2:2:1 o Nascent Soap/In Situ Soap Method – fats/fixed oils + aqueous solution of alkali; emulsifier: salt of free fatty acid VII. STERILE DOSAGE FORMS A. STERILE PRODUCTS PAGE 6 OF 7 Parenterals – injectable Ophthalmic – eyes Otic – not always Inhalationals Irrigation Dialysis Implants © MANOR REVIEW CENTER NOTES (K.L) B. PARENTERAL ROUTES VIII. AEROSOLS Intravenous (IV) – veins; most common and important; 100% bioavailability; bolus or infusion Intramuscular (IM) – mild-deltoid muscle 2mL; gluteus medius – children, gluteus maximus – adults 5mL; ex. vaccines Subcutaneous (SC/SQ) – under skin (lower abdomen, upper arm, thigh); maximum volume: 1.3mL; ex. insulin Intradermal (ID) – most superficial skin layer (anterior forearm) 0.1mL; ex. skin test Intraarterial Intracardiac Intraspinal Intrathecal Intraarticular Intrasynovial Epidural pressurized dosage forms upon actuation will deliver a fire mist of the product (liquid/solid drug in a gaseous medium) Types: o Space Spray – airborne mist o Surface Spray – surface Components: o Product Concentrate – APIs, surfactant, antioxidant, perfume o Propellant – expels product Liquefied Gas – propane, butane, isobutene, hydrofluorocarbons, dimethyl ether Compressed Gases – CO2, N2, N2O AEROSOL CONTAINER ASSEMBLY o Pressurizable Container Tin-Plated Steel – most widely used Aluminum – seamless and more inert Glass o Valve – regulates flow o Actuator – pressed to activate valve assembly o Stern – supports actuator and delivers product in proper form o Gasket – prevents leakage of contents o Spring – retraction of actuator o Mounting Cup – exposed to formulation and supports valve o Housing – supports actuator, stern, and dip tube o Dip Tube – conveys product from bottom to valve at top C. OFFICIAL INJECTIONS Injection – solution For Injection – for reconstitution Injectable Emulsion Injectable Suspension For Injectable Suspension – for reconstitution D. COMPONENTS Active Pharmaceutical Ingredient (API) Solvent/Vehicle o Water: WFI, SWFI, BWFI o NaCl Injection o Ringer’s Injection – NaCl, KCl, CaCl2 (electrolyte replenisher) o Lactated Ringer’s Injection – NaCl, KCl, CaCl2, Na lactate – systemical alkalizer o Fixed Vegetable Oils – cottonseed, corn, peanut, sesame o Alcohol, glycerin, Ethyl Oleate, Isopropyl Myristate Buffers – maintain the required pH Tonicity Adjusters – reduce the pain Preservatives Nitrogen Gas – headspace PAGE 7 OF 7 © MANOR REVIEW CENTER NOTES (K.L)