Suspension medical

Typical examples of liquid samples include those drawn from containers of commercial solvents beverages, such as milk or fruit juice natural waters, including from lakes, streams, seawater, and rain bodily fluids, such as blood and urine and, suspensions, such as those found in many oral medications. 

Sahcyhc acid USP, EP, and other pharmacopeia grades are used medically as antiseptic, disinfectant, antifungal, and keratolytic agents. Sahcyhc acid is formulated in lotion or ointment formulations for the treatment of dandmff, eczema, psoriasis, and various parasitic skin diseases. Because the keratolytic property of this aromatic acid has use in the safe removal of dead skin cells from the surface of healthy skin, the acid is used in concentrated sahcyhc acid solutions or suspensions to remove warts and corns. In more dilute form, sahcyhc acid preparations have found use in dandmff and eczema treatment. Sahcyhc acid has been considered and found effective by the Advisory Committees to the FDA in various over-the-counter (OTC) dmg regulated uses. Among these are acne products, dermatitis, dry skin, dandmff and psoriasis products, and foot care products (24). 

In 1937 Krebs found that citrate could be formed in muscle suspensions if oxaloacetate and either pyruvate or acetate were added. He saw that he now had a cycle, not a simple pathway, and that addition of any of the intermediates could generate all of the others. The existence of a cycle, together with the entry of pyruvate into the cycle in the synthesis of citrate, provided a clear explanation for the accelerating properties of succinate, fumarate, and malate. If all these intermediates led to oxaloacetate, which combined with pyruvate from glycolysis, they could stimulate the oxidation of many substances besides themselves. (Kreb s conceptual leap to a cycle was not his first. Together with medical student Kurt Henseleit, he had already elucidated the details of the urea cycle in 1932.) The complete tricarboxylic acid (Krebs) cycle, as it is now understood, is shown in Figure 20.4. 

Calf kidneys, dog kidneys and rhesus monkey kidneys were treated with trypsin to give suspensions of cells. The suspensions were centrifuged and the packed cells diluted with 400 volumes (calf cells) or 200 volumes (dog cells and rhesus monkey cells) of a growth medium consisting of 5% horse serum and 0.5% lactalbumen hydrolysate in Earle s saline, with 100 units/ml each of penicillin and streptomycin. These media were used separately to produce Semliki Forest/calf interferon, Semliki Forest/dog interferon and Semliki Forest/rhesus monkey interferon. The cell-containing growth medium was dispensed into 500 ml medical flat bottles (70 ml in each). The cultures were incubated at 36°C. Confluent sheets of cells (monolayers) were formed in 5 to 6 days. The growth medium was then removed and the monolayers were washed with isotonic phosphate-buffered saline, pH 7.5. 

Where there is a dosing device provided with the product, the dose reproducibility and accuracy should be demonstrated. Examples include dropper devices, dose-measuring devices, and pen injectors. The instructions for use should also be discussed for such devices and may be particularly important for devices such as two-chamber cartridges and the like containing suspension products. It might be necessary to discuss how dosing devices meet the relevant Essential Requirements of the Medical Device Directives with reference to appropriate and relevant harmonized and other European (EN) and International Standards Organization (ISO) standards. 

Liquids and Suspensions. Most liquid formulations are not packaged in unit-dosage form. Therefore, before administration, the proper amount of medication to be taken for each dose must be measured. This additional requirement may compound any difficulties a patient may have in following a prescribed schedule. Patients suffering from visual impairment, arthritis, or tremors associated with neurological disorders are particularly likely to become frustrated with this type of formulation. Visual impairments make it difficult, if not impossible, for many elderly patients to measure the prescribed amounts of medication accurately. Impaired dexterity, owing to tremors or arthritis, may have effects on a patient s ability to hold both a spoon and a bottle at the same time while pouring out the desired amount of liquid. 

Additional difficulties are encountered by elderly patients if a medication is in the form of a suspension. Problems may occur because a patient cannot see, or disregards, the words Shake Well on the label or is not able to exert the amount of agitation necessary to provide a uniform suspension. Certainly, unevenly distributed amounts of active ingredients throughout a suspension may result in serious consequences for a patient in terms of either under- or overdosing. 

Suspension of licensing authority for medical personnel from outside jurisdictions Authorization of other doctors to perform functions of medical examiner Access to Communications and Parking Relations Identification of public health officers, e.g., badges Dissemination of accurate information, rumor control, 1-800 numbers Establishment of command center Access to elected officials... 

A similar technique has been applied to the generation of monodisperse suspensions in water. This type of method was first used in medical field and then widely used to spray monodisperse solid particles such as polystyrene latex particles. Aerosols of solutes have also been produced by atomizing solutions of salt, sugar or methylene blue dye dissolved in water. In practical operations, a low concentration of solid particles in a solvent is recommended in order to avoid possible agglomeration of suspensions in the solvent. 

Pediaprofen pediatric suspension contains 80 mg of ibuprofen in 5 mL of the suspension. While taking 2.5 mL of this medication, the patient spilled 0.5 mL of the suspension. How many grams of ibuprofen did the patient receive ... 

A pharmacist dispensed 4 fluidounces of an antacid suspension with instructions that the patient take two tablespoonfuls of the medication four times a day. How long will the medication last ... 

Children s Advil is available in a suspension form containing ibuprofen in a strength of 100 mg/5 mL of the suspension. If the patient receives one teaspoonful of the medication three times daily, how many grams of the drug will be consumed by the patient in two days ... 

A medication order for theophylline oral suspension for a patient to be taken in doses of one teaspoonful three times a day for five days, and then one teaspoonful two times a day for two days. How many milliliters of the suspension should be dispensed to provide the quantity for the prescribed dosage regimen ... 

A physician prescribes an ophthalmic suspension to contain 100 mg of cortisone acetate in 8 mL of normal saline solution (NSS). The pharmacist has a 2.5% suspension of cortisone acetate in NSS. How many milliliters of this and how many milliliters of NSS should be used in preparing the medication order ... 

A medication order in the hospital setting calls for isophane insulin suspension to be administered to a 152-lb patient on the basis of 1 unit per kg per 24 hours. How many units of isophane insulin suspension should be administered daily ... 

Pepcid liquid suspension is available in a strength of 40 mg/mL. The normal maintenance dose in an adult patient is 20 mg qhs. How many milliliters of this medication would you administer to an eight-year-old patient at bedtime ... 

For a patient born on March 12, 1992, what is the quantity of Vantin liquid suspension (100 mg/5 mL) needed if the medication is required for 14 days The adult dose for Vantin is 200 mg bid, and the prescription is written on August 30, 1996. 

Many drugs are administered as parenterals for speed of action because the patient is unable to take oral medication or because the drug is a macromolecule such as a protein that is unable to be orally absorbed intact due to stability and permeability issues. The U.S. Pharmacopoeia defines parenteral articles as preparations intended for injection through the skin or other external boundary tissue, rather than through the alimentary canal. They include intravenous, intramuscular, or subcutaneous injections. Intravenous injections are classified as small volume (<100 mL per container) or large volume (>100 mL per container) injections. The majority of parenteral dosage forms are supplied as ready-to-use solutions or reconstituted into solutions prior to administration. Suspension formulations may also be used,101 although their use is more limited to a subcutaneous (i.e., Novolin Penfill NOVO Nordisk) or intramuscular (i.e., Sandostatin LAR Depot Novartis) injection. Intravenous use of disperse systems is possible but limited (i.e., Doxil Injection Ortho Biotec). 

Figure 4 Electron micrographs of unchlorinated poly(vinyl acetate-co-oxazolidinone) (top) and chlorinated poly(vinyl acetate-co-oxazolidinone) (bottom) coated medical catheters exposed for 72 h to a flowing aqueous suspension of Pseudomonas aeruginosa (10 CFU/mL). 

Suspension Do not administer carbamazepine suspension with other liquid medications or diluents. 

Soiutions and suspensions - Most topical ocular preparations are commercially available as solutions or suspensions that are applied directly to the eye from the bottle, which serves as the eye dropper. Avoid touching the dropper tip to the eye because this can lead to contamination of the medication and also may cause ocular injury. Resuspend suspensions (notably, many ocular steroids) by shaking to provide an accurate dosage of drug. 

Many of the more prominent vaccine preparations in current medical use consist of attenuated viral particles (Table 10.11). Mumps vaccine consists of live attenuated strains of Paramyxovirus parotitidis. In many world regions, it is used to routinely vaccinate children, often a part of a combined measles, mumps and rubella (MMR) vaccine. Several attenuated strains have been developed for use in vaccine preparations. The most commonly used is the Jeryl Linn strain of the mumps vaccine, which is propagated in chick embryo cell culture. This vaccine has been administered to well over 50 million people worldwide and, typically, results in seroconversion rates of over 97%. The Sabin (oral poliomyelitis) vaccine consists of an aqueous suspension of poliomyelitis virus, usually grown in cultures of monkey kidney tissue. It contains approximately 1 million particles of poliomyelitis strains 1, 2 or 3 or a combination of all three strains. 

We have established that codeine is most commonly taken as an oral medication. So, once a pill or liquid suspension containing codeine is swallowed, what happens Figure 3.4 gives a simplified answer. 

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