Non-Sterile Compounding

Non-sterile Compounding

• This refers to the preparation of customized medications by pharmacy personnel
• These medications include oral products, creams, ointments, and suppositories

Solutions

• These are homogenous liquid systems that contains one or more chemical substance
• Solutes dissolve in a suitable solvent or mixture of solvents to produce this system
• These preparations are typically the most commonly compounded

Suspensions

• These are mixtures containing finely divided insoluble solid evenly dispersed in a liquid
• Suspensions are used when a drug is not soluble in a solvent or the stability is poor in a solution

Solvents

• Solvents dissolve a solute
• Water is the most common solvent
• Other solvents include alcohol, glycerin, and propylene glycol

Types of Solvents

• Polar solvents dissolve ionic and other polar solutes
• Non-polar solvents dissolve nonpolar solutes
• Semipolar solvents cause polarity in nonpolar molecules improving miscibility

Solute

• Solutes are chemical substances dissolved in a solvent
• Nonelectrolytes do not dissociate (ionize) and will not conduct electricity, dextrose
• Electrolytes dissociate in solution and will conduct electricity, sodium chloride, nitric acid, sulfuric acid

Pastes

• Pastes contain at least 20% solids, making them stiffer than ointments
• A paste is a thick, semi-solid preparation
• Pastes contains a high concentration of solid particles dispersed in a base
• Pastes are often used for topical application
• Pastes are thicker than creams and ointments

Suspension Instabilities

• These often lead to sedimentation or caking
• Occurs when particles in a suspension settle or clump
• Factors include gravity, particle size, and interparticle forces, affecting its stability and homogeneity
• Forms of this include sedimentation, caking, flocculation, and phase separation

Paste Instabilities

• They manifest as sedimentation, oil separation, and difficulty in re-dispersion
• Factors include particle size, temperature, and chemical reactions
• Other instabilities include drying out, separation of components, loss of spreadability, and microbial contamination

"Like Dissolves Like"

• Solvents will dissolve a similar solute
• Polar solvents dissolve polar solutes
• nonpolar solvents dissolve nonpolar solutes

Syrup

• Syrup is an aqueous solution.
• This is a saturated sucrose solution in water
• It contains less than 10% alcohol
• A syrup generally contains 60%-80% of sucrose
• Use heat or agitation when preparing

Solubility Factors

• These include Temperature, presence of multiple solutes, and co-solvent systems

Flavored Medications

• Medications can be flavored to improve patient compliance
• It can also be used with undesirable taste or texture
• Pediatric Medications like cherry-flavored amoxicillin suspension
• Veterinary Medications like tuna or beef-flavored suspensions
• Liquid Antibiotics like bubblegum-flavored amoxicillin for children

Trituration

• This refers to reducing particle size through mechanical or manual grinding in a mortar and pestle
• It ultimately reduces the surface area.

Levigation

• This refers to wetting of dry particles using a liquid to help trituration and incorporation

Pulverization

• This refers to reducing the size of a solid using a solvent that evaporates after grinding

Geometric Dilution

• A method of mixing two powders
• Small, equal portions of each are added and blending thoroughly

Levigating Ingredients

• Mineral oil, glycerin, and propylene glycol can be used as an ingredient

Compounding Equipment

• Mortar and pestle
• Electronic balance (scale)
• Ointment slab
• Spatula
• Graduated cylinder can be used

Scale Preparation

• Calibrate or tare (zero out) the scale to ensure accurate measurements

Advantages of Suppositories

• They exert a local effect on rectal mucosa
• They promote evacuation of the bowel
• Useful to unconscious patients during fitting
• Avoid first-pass metabolism
• They are used for the systemic absorption of drugs
• They can be used for patients suffering from nausea and vomiting

Batch Compound Label

• Drug name and strength
• Ingredients and quantities
• Beyond-use date (BUD)
• Storage conditions
• Lot number
• Pharmacy and compounder's name

API

• API stands for Active Pharmaceutical Ingredient
• The main component of a drug responsible for its effects

Solution Instability

• The BUD of the solution is 14 days if stored at a cold temperature
• Instability includes discoloration, turbidity, gas formation, and precipitation

CPS

• CPS stands for Compendium of Pharmaceuticals and Specialties
• It contains Drug monographs, Dosages and indications, Adverse effects and contraindications, Drug interactions, Storage information, and Manufacturer details

Compounding PPE

• Scrubs, hair net, safety goggles, mask, and gloves are necessary for PPE

Medication Compounding Forms

• Medications can be compounded into capsules, suspensions, ointments/creams/gel, suppositories, and troches/lozenges

Electrolytes

• Electrolytes dissociate and conduct electricity
• Substances dissolve in water to produce ions
• Used to help conduct electricity in the body

Topical Solvents

• A topical solvent is used in a topical mixture preparation
• Topical solvent examples include acetone, isopropanol, polyethylene glycols, collodion, various oils and polymer

Internal Solvents

• Internal solvents are used in oral compounded preparations
• Internal solvents include water, alcohol, glycerin, and propylene glycol

Osmosis

• This is the movement of particles from lower particle concentration to higher particle concentration
• It occurs by crossing a semipermeable membrane

Hypertonic Solutions

• It has a higher osmotic pressure
• It causes shrinking of tissues as water passes from the tissues to dilute the hypertonic solution
• Higher solute concentration than cells will draw water out of tissues, causing cell shrinkage

Hypotonic Solutions

• It has fewer particles and lower osmotic pressure than normal saline
• Causes painful swelling of tissues as water passes from the administration site in the tissues
• Lower solute concentration than cells will move water into tissues causing cell swelling
• Fluid will move into tissue cells leading to swelling

Solute Dissolution Factors

• Dissolution is increased with higher temperature, and lower viscosity
• Dissolution is increased with lower radius and surface area, and a lower thickness of the unstirred layer
• Salt forms of most drugs dissolve more quickly

Dissolution

• This is the act or process of dissolving
• A solute dissolves in a solvent to form a homogeneous solution
• It involves the breakdown of solid particles to disperse evenly

Chelating Agent

• Chelating Agent prevents metal ions from reacting with the phosphate, which could cause an instability

Thixotropic Solutions

• a two phase system gel
• This is semi solid when standing
• It will liquefy when shaken
• Examples include Aluminum Hydroxide Gel and Bentonite Magma