Oral solids adapting

This case is typical of requests for pharmacy preparations in order to give tailor-made care, the doctor has prescribed an individual preparation instead of a licensed pharmaceutical preparation. When the oral route would have been an option, licensed oral solid medicines had to be adapted anyway because of the low dose required. 

In nursing homes psychoactive medicines are commonly administered as drops. If there is no oral liquid form available, the pharmacist may receive a doctor s prescription for the adaptation of an oral solid into an oral liquid. Tablets may be pulverised or capsules can be emptied and administered with semisolid food. However, there may be other solutions such as improving swallowing technique or a different administration route. Even for patients with an enteral feeding tube there may be alternatives or at least points of attention. 

If the active substance is not available as raw material it may be processed from oral solid dosage forms by adapting those. Not all solid dosage forms however are tit for such an operation. Tablets with a gastro-resistant coating or modified-release tablets should not be crushed unless the product information confirms its suitability, see further Sect. 4.10.7. 

If there is no problem in adapting the oral solid, several methods of processing present themselves crushing or pulverising in a mortar, (half-)mechanically pulverising, dispersing in water. 

FIGURE 11.8 Plasma Vitamin E concentration after oral administration of a Vitamin E solid dispersion. Key ( ) PEG-32 glyceryl laureate (Gelucffe44/14) solid dispersion and commercial product. (Adapted from Barker, S.A., Yap, S.P., Yuen, K.H., McCoy, C.P., Murphy, J.R., and Craig, D.Q.M. (2DGQ>ntrol. Rel., 91 477-488.)... 

FIGURE 14.12 Semilog plot of plasma warfarin concentrations (geometric mean, SE) normalized to lmg dose vs. time after oral administration of 100 rg (open square) and 5mg (solid square). (Adapted from Lappin, G. et al., Clin. Pharmcol. Ther., 80, 203, 2006. With permission.)... 

Figure 17 Plasma concentration of flurbiprofen (FP) enantiomers after oral administration of rac-FP and rac-FP-PPA (equivalent to 3 mg/kg of rac-FP) to rats. Data represent the mean (w=6). ( ) S(-l-)-FP. (o) R(—)-FP. Solid and broken lines are the simulation curves calculated for S(+)- and R(—)-FP, respectively. (Adapted from Ref. 48.)...

FIGURE 49.7 Embedded engineered particles in solid dispersions prepared by melt extrusion. (Adapted from Miller, D.A., Improved oral absorption of poorly water-soluble drugs by advanced solid dispersion systems, in Division of Pharmaceutics, The University of Texas at Austin, Austin, TX, 2007, p. 312.)... 

Cachet Capsule Herbal tea Powder Formulation Preparation Solid dosage form Tablet Content uniformity Excipients Adapting oral dosage forms... 

This chapter discusses the formulation and methods of preparation of the most used solid dosage forms that can be prepared in hospital or community pharmacies. The formulation of licensed medicines, particularly tablets and capsules, is discussed to such an extent as it is necessary to understand how they are made in case they may have to be adapted for the preparation of other oral preparations in pharmacies. 

Acrylic resins, because of their desirable esthetics, ease of processing, optical clarity that can duplicate in appearance the oral tissues it replaces, satisfactory mechanical properties and excellent biocompatibility, are the materials of choice wherever plastics have found applications in dental practice. The ready acceptability of these materials is the result of the ease with which they can be converted into their final state even under clinical conditions. In practically all dental applications a liquid monomer-solid mixture is cured by a free radical initiated polymerization that is generated by heat, light, an initiator, or a redox initiator-accelerator system adapted to the constraints imposed by the oral environment. 

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