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RX 351 Lab - Module 10 Assignment (27pts) Name _______________________________________________________________ Complete and submit on Canvas. You must show all work to receive full credit. Do not leave off units and make sure to use leading zeros. Dropping units in your answer or failure to use a leading zero in an answer will result in no credit for that answer, even if the number itself is correct. 1. (4pts) The vial of magnesium chloride pictured here contains magnesium chloride hexahydrate (MgCl2•6H2O) MW 203. a. Calculate the osmolarity of 20% w/v magnesium chloride hexahydrate solution. b. Is the solution in the vial pictured here hypo-osmotic, iso-osmotic, or hyper-osmotic? (Use the point of reference of 300mosm/L, which is approximately the osmolarity of blood, as your point of reference.) 2. (10pts) This solution of magnesium chloride is too hypertonic/hyper-osmotic to be infused directly into a peripheral IV line – max osmolarity guideline = 900mosm/L. The pharmacist adds 20ml from this vial to a 250ml bag of D5W. Use total volume =270ml for calculations. a. Calculate the concentration of magnesium chloride hexahydrate in the prepared solution. Express as % w/v. b. Calculate the concentration of dextrose in the prepared solution. Express as % w/v. c. Calculate the osmolarity of the prepared mixture. The osmolarity of the solution is dependent on all of the solutes in the solution – in this case magnesium chloride hexahydrate AND dextrose. Osmolarity “donated” by magnesium chloride hexahydrate: Express in mosm/L. Osmolarity “donated” by dextrose. (MW=200) Express in mosm/L. The total osmolarity of the solution is ____________ mosm/L, which CAN or CANNOT be infused through a peripheral IV line. (Circle one.) 3. (3pts) The IV solution prepared in #2 is infused at a rate of 3ml/min. How many milliequivalents of magnesium will the patient receiver per hour? (atomic weight magnesium = 24.3) 4. (10pts) On a mission trip to Africa, you are asked to prepare 1L an isotonic oral solution to treat dehydration associated with diarrhea in the pediatric population of the area. The recipe is as follows: Glucose 13.5gE-value=0.16 Potassium Chloride1.5gE-value=0.78 NaCl qs to isotonic Purified Waterqs 1L a. How many grams of NaCl would you need to make this solution isotonic? b. Calculate the amount of each ingredient then fill in the rest of the information for the recipe. Storeroom Supplies: Glucose 20% Solution Potassium Chloride 20% Solution Normal Saline Solution Purified Water Completed Recipe: Glucose 20% solution _______ml (to provide 13.5g glucose) Potassium Chloride 20% solution ________ml (to provide 1.5g solution) Normal Saline solution _________ml (to provide _____g NaCl to make solution isotonic) Purified Water qs 1000ml 1 RX 351 Lab - Module 11 Assignment (27pts) Name _______________________________________________________________ Complete and submit on Canvas. You must show all work to receive full credit. Do not leave off units and make sure to use leading zeros. Dropping units in your answer or failure to use a leading zero in an answer will result in no credit for that answer, even if the number itself is correct. Part 1 - Reconstitution of Oral Products - Cefpodoxime In order to reconstitute a dry powder for oral use, you must know: · What liquid to use for reconstitution – in most cases, the liquid is purified water · How much liquid to use – information on label, monograph, and/or PI · How to add the liquid – information also on label, monograph or PI · Final concentration of API in solution or suspension – printed on container label Information from cefpodoxime monograph: Storage/Stability Suspension: Store at 20°C to 25°C (68°F to 77°F); after reconstitution, suspension may be stored in refrigerator for 14 days 1. (3pts) How would you tell a new intern to reconstitute the cefpodoxime vial pictured above? 2. (3pts) A 32kg patient is to receive 5mg/kg/dose of cefpodoxime po q12h. How many milliliters of the reconstituted liquid should she receive per dose? Show your work below. Answer: ____________ml 3. (1pt) According to the drug’s monograph, the reconstituted cefpodoxime liquid should be discarded after __________ days if stored in the refrigerator. Part 2 - Reconstitution of Parenteral Products – Cefazolin In order to reconstitute a dry powder for parenteral use, you must know: · What liquid to use for reconstitution – usually SWFI but could be other liquids · How much liquid to use – information on label, monograph, and/or PI – unlike oral products, you may have different options for the volume (which will yield different concentrations of API) · How to mix the drug – shake or swirl · Final concentration of API in solution or suspension – information on label, monograph, or PI - this information will be dependent on the volume of liquid added to the vial · Whether or not the drug needs to be further diluted prior to administration (usually in an IV bag) – information in monograph or PI Use the following Information from Cefazolin monograph and information from product label to answer the questions below. IM: Dilute 500 mg vial with 2 mL SWFI and 1 g vial with 2.5 mL SWFI resulting in a concentration of 225 mg/mL and 330 mg/mL, respectively. IV Push: Reconstitute appropriate vial size and further dilute with NS to a maximum concentration: 100 mg/mL Intermittent IV infusion: Further dilute dose with a compatible solution (eg, D5W, NS) to a final concentration of ≤20 mg/mL per the manufacturer. 1. (1pt) What liquid should be used to reconstitue the vial of cefazolin pictured above? ________________________ 2. (1pt) How much liquid should be added to the vial pictured above to reconstitute it if the patient is to receive an IM dose? ___________ml 3. (1pt) What will the final concentration of the API be after reconstitution? ______________________(Note that the answer is NOT 250mg/ml – which is what you woud get if you did the math.) 4. (1pt) Another term you may see is “withdrawable volume” – it is the total volume in the vial after reconstitution (volume of diluent + powder volume). What is the withdrawable volume of this via after reconstitution? ____________ml 5. (2pts) A patient is to receive 225mg IM. What is the patient’s dose volume? ________ml 6. (2pts) Another patient is to receive 225mg in an IVPB. Accordig to the monograph information, how would you prepare one dose? Volume of reconstituted cefazolin ________ml added to __________ml bag of D5W or NS (available sizes: 25ml, 50ml, 100ml, or 150ml-choose smallest size possible). Part 3 - Reconstitution of Parenteral Products – Acyclovir Use the information below from the acyclovir vial, PI and drug monograph to complete the missing information in this scenario. Information from Acyclovir monograph: Administration: IV For IV infusion only. Avoid rapid infusion. Infuse over 1 hour to prevent renal damage. Maintain adequate hydration of patient. Check for phlebitis and rotate infusion sites. Do not administer IM or SubQ. Acyclovir IV is an irritant (depending on concentration); avoid extravasation. Preparation for Administration: Adult For intravenous infusion, dilute reconstituted powder for injection or solution for injection in D5W or NS to a final concentration ≤7 mg/ml. Concentrations >10 mg/ml increase the risk of phlebitis. Storage & Stability Powder for injection: Store undiluted vials at 15°C to 25°C (59°F to 77°F). Following reconstitution, solution is stable for 12 hours at room temperature.Do not refrigerate reconstituted solutions or solutions diluted for infusion as they may precipitate. Once diluted for infusion with NS or D5W, use within 24 hours. Patient Dose: 900mg IV q8h 1. (2pts) The vial (pictured here) should be reconstituted with ____________ml of ______________________. 2. (1pt) Should the vial be shaken or swirled to mix the drug? _____________________ 3. (3pts) The patient’s dose volume (amount from the vial added to each bag) is _________________ml 4. (2pts) The patient’s dose should be diluted in a _________________ml bag of NS or D5W and infused over __________hour(s). Available sizes – 25ml, 50ml, 100ml, 150ml, 250ml. Choose the smallest bag size possible. 5. (2pts) If the reconstituted vial is not used, it should be stored in/at ___________________________ and is good for ________________. 6. (2pts) If the diluted drug (in NS or D5W) is not used, it should be stored in/at _______________________ and is good for _____________. 1 RX 351 Lab - Module 13 Assignment (24pts) Name _______________________________________________________________ Complete and submit on Canvas. For both formulations, use the following weighing guidelines:< 1g="" –="" use="" torsion="" balance;="" round="" to="" nearest="" 10mg=""> or = 1g – use electronic balance – round to nearest 1mg (12 pts) Topical Ointment Formulation RxCalamine 1.125g Hydrocortisone125mg Mineral Oil 1.2ml (SG=0.88) = __________g White Petrolatumqs ad 15g Complete the following directions for how to prepare 60g of this ointment. Use appropriate compounding terminology. Weigh _______________g of calamine powder on _____________________________. Weigh ______________g of hydrocortisone powder on ___________________________. Place hydrocortisone in a glass mortar and add calamine using _________________________________ technique to ensure homogenous mixture. ___________________ with a pestle until finely ground and mixture is homogenous. Transfer powder to an ointment slab. Measure __________ mineral oil in a ___________ml syringe. ____________________ the powder mixture with mineral oil on the ointment slab to form a smooth paste. Weigh _________________ g of White Petrolatum on ________________________________. Add White Petrolatum to paste by __________________________________________ to ensure even distribution of paste throughout the vehicle. _____________________________ on ointment slab until homogenous. Package. (12pts) Mouthwash Suspension Formulation Method - Watch the video “How to Make PCL Mouthwash”, taking notes on the preparatory steps for making this suspension. https://pharmlabs.unc.edu/labexercises/compounding/suspensions/videos/ Then read the section of Chapter 28 of your Contemporary Pharmacy Practice textbook on how to prepare a suspension. Then write out your own procedure to prepare 180ml of the mouthwash suspension formulation below, that is used to treat mouth sores from chemotherapy medications. RxNystatin 5000 units/mg powder4,500,000 units Hydrocortisone 10mg tablets4 tablets Diphenhydramine HCl Powder, USP0.38g Glycerin qs to wet Flavored Syrupqs ad 180ml You must use the following compounding terms in your procedure: · Triturate · Levigate · Rinse - to ensure nearly complete transfer of API from one container (like a mortar) to another container (like a dispensing container), the first container should be rinsed THREE times with a vehicle. This container is called an “oval” You have the following compounding equipment available to you. · Weigh papers, scoopula, glass mortar and pestle, 100ml graduated cylinder, and glass stirring rod Dispensing container: 6 fl oz oval – you may qs to the final volume in the oval since there is a marking at the 180ml mark. Procedure: 1