Pharmacy USP Guidelines Quiz
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Questions and Answers

Which of the following resources are relevant to understanding USP guidelines for sterile product preparation?

  • USP Chapter <800>
  • USP Chapter <661>
  • USP Chapter <797> (correct)
  • USP Chapter <795>
  • Which of the following resources provides information about compatibility of parenteral admixtures?

  • USP-NF
  • King's Guide to Parenteral Admixtures
  • Both A and B (correct)
  • Handbook on Injectable Drugs
  • When determining the beyond-use date (BUD) for a compounded sterile product, which of the following factors needs to be considered?

  • Category of the product
  • Storage conditions
  • Stability data
  • All of the above (correct)
  • Which of the following USP chapters provides guidelines for compounding hazardous drugs?

    <p>USP Chapter &lt;800&gt; (A)</p> Signup and view all the answers

    What is the primary purpose of the King Guide to Parenteral Admixtures and the Handbook on Injectable Drugs?

    <p>Assist practitioners in selecting suitable IV admixtures and ensuring compatibility. (B)</p> Signup and view all the answers

    What condition must be met for an 'immediate use product' to be compounded in poorer than ISO Class 5 air?

    <p>Aseptic processes must be followed. (B)</p> Signup and view all the answers

    Which of the following statements about single-dose containers is correct?

    <p>Unused contents must be discarded after preparation for the patient. (C)</p> Signup and view all the answers

    What is the maximum number of different sterile products allowed in the preparation of an immediate use product?

    <p>3 different sterile products (C)</p> Signup and view all the answers

    Which requirement is NOT true for immediate use compounded sterile products (CSPs)?

    <p>They may utilize diluents not included in the approved labeling. (C)</p> Signup and view all the answers

    What labeling is required for an immediate use compounded sterile product that is not administered immediately?

    <p>A label with the exact beyond-use time. (C)</p> Signup and view all the answers

    What is the primary consideration for assigning beyond use dates (BUD) according to USP guidelines?

    <p>Microbial contamination risk (D)</p> Signup and view all the answers

    For non-preserved aqueous dosage forms, what is the typical beyond use date when refrigerated?

    <p>14 days (C)</p> Signup and view all the answers

    What must occur to increase the beyond use date (BUD) of compounded drug products?

    <p>Passing sterility and endotoxin tests (D)</p> Signup and view all the answers

    In the absence of microbial and endotoxin testing for compounded sterile products (CSPs), what dictates the maximum BUD?

    <p>Potential microbial stability (A)</p> Signup and view all the answers

    What general BUD is given to non-aqueous dosage forms at controlled room temperature?

    <p>180 days (D)</p> Signup and view all the answers

    Which of the following is NOT a source of contamination to evaluate?

    <p>Food ingredients (D)</p> Signup and view all the answers

    What is the BUD for preserved aqueous dosage forms stored at controlled room temperature?

    <p>35 days (B)</p> Signup and view all the answers

    Which of the following factors does NOT affect the decision to assign a BUD?

    <p>Type of packaging used (C)</p> Signup and view all the answers

    What is a key responsibility of compounding personnel?

    <p>Identify, measure, dilute, and mix CSPs accurately (A)</p> Signup and view all the answers

    What must be ensured by the pharmacist regarding the storage of items?

    <p>Items are stored under appropriate restricted access when necessary (B)</p> Signup and view all the answers

    Which of the following accurately reflects the label strength requirements for CSPs?

    <p>CSPs must maintain labeled strength within ±10% if not specified (A)</p> Signup and view all the answers

    What should be validated to ensure effective sterilization methods?

    <p>The maintenance of CSP strength and stability (D)</p> Signup and view all the answers

    What does the designation 'C' indicate in a parenteral stability and compatibility monograph?

    <p>The item is compatible. (D)</p> Signup and view all the answers

    Which reference guide contains an alphabetical arrangement of chemical monographs?

    <p>The Merck Index (D)</p> Signup and view all the answers

    What is the maximum time non-sterile aqueous products should be sterilized?

    <p>6 hours (B)</p> Signup and view all the answers

    What is essential to follow when preparing CSPs?

    <p>Compounding protocols must conform to the correct sequence and quality (D)</p> Signup and view all the answers

    Which resource provides comprehensive information on pharmaceutical compounding and manufacturing?

    <p>Remington: The Science and Practice of Pharmacy (C)</p> Signup and view all the answers

    How often is the reference guide containing parenteral stability data updated?

    <p>Quarterly (A)</p> Signup and view all the answers

    Why is training and observing personnel crucial in compounding?

    <p>To validate proper techniques and reduce errors (D)</p> Signup and view all the answers

    What type of information does the National Formulary provide regarding pharmaceutical excipients?

    <p>Methods of validation of strength and purity (A)</p> Signup and view all the answers

    What is the purpose of assigning Beyond Use Dates (BUD)?

    <p>To ensure stability and safety of compounded products (C)</p> Signup and view all the answers

    Which database is NOT mentioned as being searchable through MWU Libraries?

    <p>Compendium of Pharmaceutical Excipients (D)</p> Signup and view all the answers

    What does the designation 'X' signify in the parenteral stability and compatibility guide?

    <p>The item is incompatible. (B)</p> Signup and view all the answers

    Which of the following is associated with the resource 'Pharmaceutical Dosage Forms and Drug Delivery Systems'?

    <p>Contains information on drug delivery methods (A)</p> Signup and view all the answers

    What conclusion can be drawn about compounded sterile products processed aseptically in a segregated compounding area?

    <p>They can be stored for a maximum of 12 hours. (C)</p> Signup and view all the answers

    For which category of compounded sterile products can terminal sterilization be utilized?

    <p>Both Category 1 and Category 2 (B)</p> Signup and view all the answers

    Which of the following statements is true regarding sterile compounded products processed under aseptic conditions?

    <p>They have shorter storage durations compared to those processed terminally. (D)</p> Signup and view all the answers

    What is required for the third category of compounded sterile products to have an extended beyond-use date?

    <p>Increased training and cleaning requirements. (D)</p> Signup and view all the answers

    When compared to aseptically processed compounded sterile products, what trend is observed in beyond-use dates for terminally sterilized products?

    <p>Longer beyond-use dates overall. (D)</p> Signup and view all the answers

    What defines the cleanroom suite based on the information provided?

    <p>It must include an ISO Class 5 PEC. (D)</p> Signup and view all the answers

    Flashcards

    USP guidelines for sterile product preparation

    Guidelines set by the United States Pharmacopeia (USP) that provide specific instructions and standards for the preparation of sterile medication.

    USP Category assignment for sterile products

    A system used to classify compounded sterile products based on their risk of microbial contamination.

    King's Guide to Parenteral Admixtures and Handbook on Injectable Drugs

    Two resources that provide detailed information on the compatibility of drugs and their safe administration in sterile solutions.

    Additional criteria for hazardous and radiopharmaceutical compounding

    Special requirements and regulations that apply to compounding sterile products that are hazardous or radioactive in nature.

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    Beyond Use Date (BUD) for compounded sterile products

    The time a compounded sterile preparation maintains its quality and purity after preparation.

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    Beyond Use Date (BUD)

    The amount of time a compounded sterile preparation maintains its quality and purity after preparation.

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    USP Category Assignment

    A system that categorizes compounded sterile products based on their risk of microbial contamination.

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    Quality Assurance Protocol

    A written protocol that ensures the accuracy, precision, identity, purity, and stability of compounded sterile products.

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    Compounded Sterile Product (CSP) Protocols

    Procedures that must be followed for preparing, storing, and dispensing compounded sterile products.

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    Evaluating Potential Harm and Bioavailability

    The evaluation of the potential harm and effect on bioavailability of combining different drugs in a sterile solution.

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    Sterility and Purity of Compounding Environment

    Ensuring that the compounding environment maintains sterility and purity.

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    Sterilization Method Validation

    The verification that sterilization methods are effective while maintaining the strength and stability of the compounded sterile product.

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    Responsibilities of Compounding Personnel

    The responsibility of compounding personnel to correctly identify, measure, dilute, and mix compounded sterile products.

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    Limitations of USP BUDs

    USP beyond use dates only consider microbial contamination, so chemical and physical stability must be assessed separately.

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    Contamination Source Evaluation

    The process of evaluating potential sources of contamination during sterile compounding.

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    Complicated Compounding Protocol

    A compounding protocol that involves multiple steps, specialized equipment, or a lengthy process.

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    Compounded Sterile Products (CSPs)

    Compounded sterile products prepared using aseptic techniques in a controlled environment.

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    Cleanroom

    A controlled environment designed to minimize microbial contamination during sterile compounding.

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    Standard (Non-Cleanroom) Compounding

    A compounding protocol that involves aseptic techniques, but not in a cleanroom.

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    Drug Information Resources

    Resources like King's Guide and Handbook on Injectable Drugs that provide compatibility and stability information about sterile products.

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    King's Guide to Parenteral Admixtures

    A resource that provides information on the compatibility of drugs in sterile solutions.

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    Handbook on Injectable Drugs

    A reference book that contains information on the stability and compatibility of medications in parenteral form.

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    Handbook of Pharmaceutical Excipients

    A comprehensive resource that provides information on pharmaceutical excipients, their properties, and their uses in drug formulations.

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    Martindale: The Complete Drug Reference

    A reference book that provides detailed information on various drugs and their uses.

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    Remington: The Science and Practice of Pharmacy

    A comprehensive resource that provides information on pharmacy practice, including pharmaceutical compounding, manufacturing, and analysis information.

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    United States Pharmacopeia - National Formulary (USP-NF)

    A resource that provides information on pharmaceutical excipients and methods of validation for strength and purity.

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    The Merck Index

    A reference book that provides detailed information on various drugs and their uses.

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    Pharmaceutical Dosage Forms and Drug Delivery Systems

    A resource that provides information on drug delivery systems and pharmaceutical dosage forms.

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    What is an 'Immediate Use' CSP?

    A compounded sterile preparation (CSP) that is made in poorer than ISO Class 5 air quality but used within 4 hours, meeting specific criteria such as aseptic technique, compatibility, and limited ingredients.

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    What is the rule about single-dose containers in CSP preparation?

    A CSP made from a single-dose container must be discarded after preparing one dose for a patient. The container cannot be used for multiple patients.

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    What is an 'Immediate Use' product?

    A CSP that is made within 4 hours and is ready to be administered to the patient.

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    What is the BUD for an 'Immediate Use' CSP?

    The beyond-use date (BUD) for CSPs prepared as 'Immediate Use' products is 4 hours from the start of preparation.

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    How is preparing a proprietary bag and vial system different from compounding?

    A proprietary bag and vial system that is prepared according to the manufacturer's instructions is not considered compounding and is not subject to USP Category requirements.

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    What is a Compounded Sterile Product (CSP)?

    A compounded sterile product (CSP) is a medication that is made by a pharmacist to meet a patient's specific needs. It is prepared in a controlled environment, typically a cleanroom, using aseptic techniques to ensure sterility.

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    What is the Beyond Use Date (BUD) for a CSP?

    The Beyond Use Date (BUD) is the time limit for which a compounded sterile product is considered safe and effective. It is based on factors such as the compounding method, storage conditions, and the ingredients used.

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    What are the USP Categories for CSPs?

    The USP Categories are a system used to classify compounded sterile products based on their risk of microbial contamination and the associated BUD limits.

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    What is USP Category 1?

    Category 1 is the safest category for CSPs, representing the lowest risk of contamination and therefore allows for the longest BUDs. Compounds in this category are made in a cleanroom.

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    What is USP Category 2?

    Category 2 CSPs are compounded in a controlled environment that may not be a cleanroom, posing a higher risk of contamination. They have shorter BUDs than Category 1 products.

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    What is USP Category 3?

    Category 3 represents a new addition to the USP guidelines, allowing for extended BUDs with greater training requirements and additional testing. This category is for complex preparations requiring more expertise and rigor.

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    In USP Category 3, what are the two compounding methods?

    This category is defined by the compounding method and storage temperature. Aseptically processed CSPs are made using aseptic techniques to minimize contamination, while terminally sterilized CSPs undergo a sterilization process after compounding.

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    What is the difference between aseptically processed and terminally sterilized CSPs in Category 3?

    Aseptically processed CSPs are made using aseptic techniques in a controlled environment, while terminally sterilized CSPs undergo a sterilization process after compounding. For example, an autoclave can be used for terminal sterilization.

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    What are source ingredients for CSPs?

    Source ingredients are the raw materials that are used to prepare a CSP. They must be of high quality and meet purity and sterility standards to ensure the safety and effectiveness of the final product.

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    What is the role of compounding personnel in CSP preparation?

    Compounding personnel must be highly trained and skilled to prepare CSPs safely and effectively, adhering to strict guidelines and protocols.

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    Study Notes

    Objectives

    • Understand and apply guidelines in USP <797> for sterile product preparation.
    • Assign appropriate categories to compounded sterile products.
    • Use King's Guide to Parenteral Admixtures and the Handbook on Injectable Drugs.
    • Understand criteria for hazardous and radiopharmaceutical compounding (USP <800> and <825>).
    • Calculate beyond use dates (BUD) for compounded sterile products using available resources.

    Reference Materials and Resources

    • United States Pharmacopeia (USP) - National Formulary (NF). Available online via the library. Chapters <797>, <800>, and <825> are relevant.
    • McEvoy's Handbook on Injectable Drugs (20th edition). Available through MWU Libraries.
    • King Guide to Parenteral Admixtures. Searchable database version through MWU Libraries.
    • Facts & Comparisons or Trissel's IV Compatibility. Accessible via MWU Libraries.

    History of USP <797>

    • Early 20th century saw expansion of pharmaceutical industry, leading to pre-manufactured drugs.
    • USP evolved into industry standards for drug products.
    • Initially developed as standards for prescribers and compounding pharmacists.
    • IV admixture services transitioned from nursing to pharmacy in the 1960s and 1970s.
    • Demand for home healthcare, total parenteral nutrition (TPN), and hospice created a need for compounded prescriptions (1980s-1990s).
    • The USP <797> was established (1992) as the standard for pre-administration manipulations.

    Responsibilities of Personnel

    • Compounding Personnel: Accurately identify, measure, mix, purify, sterilize, package, label, store, dispense, distribute compounded sterile products (CSPs). Ensure strength within monograph limits (±10% if not specified). Follow a written quality assurance protocol for accuracy, precision, identity, purity, and stability.
    • Pharmacists and Other Healthcare Providers: Train, educate, and observe personnel; document activities (handwashing, proper garb, aseptic technique, measuring/weighing, engineering controls). Validate identity, purity, and quality of ingredients. Ensure appropriate storage. Ensure sterilization methods maintain strength and stability. Maintain clean equipment for measuring, mixing, sterilizing, and purifying.

    USP <797>, Category, & BUD Assignment

    • Contamination Assessment: Evaluate potential microbial, chemical, and physical contamination, using appropriate drug information. USP <797> BUDs are primarily based on microbial contamination risk. Additional stability testing may need to be done for non-sterile products based on USP <795>.
    • Source Evaluation: Determine potential sources of contamination for the compounding protocol such as personnel, non-sterile materials, and complexity of the preparation.
    • Drug Information Resources: Assess stability data and use USP guidelines (Chapter <795>), specifically updated on 11-1-2023, to determine appropriate beyond-use dates (BUDs) for various dosage forms (aqueous, non-aqueous, oral liquids, etc.)

    Package Inserts and Additional References

    • Consult package inserts for single-dose and multi-dose containers for Beyond Use Times (BUDs) after opening.
    • Various reference materials are available online, including the Handbook on Injectable Drugs, King Guide to Parenteral Admixtures, and Trissel's IV Compatibility.

    Category Selection

    • Immediate Use Products: Products prepared for immediate use are allowed under specific criteria (aseptic process, minimized contact with non-sterile surfaces, use of sterile products, single doses, etc., within 4 hours). This does not apply to hazardous and radiopharmaceutical products.

    Hazardous Drugs Handling

    • Compounding of hazardous drugs must follow USP <800> guidelines which requires a negative pressure, containment, segregated compounding area, adherence to appropriate engineering controls such as biological safety cabinets (BSCs), and proper protective equipment such as chemo-resistant gloves and gowns throughout the preparation, handling, and administration.

    Radiopharmaceuticals (USP <825>)

    • Radiopharmaceuticals are handled according to USP <825>. For low risk, these can be in closed, sterile containers of 100 mL (single-dose) or 30 mL (multi-dose) and only trained personnel can work with them.
    • Compounding for immediate patient use is allowed outside primary or secondary containment, but only under highly specific aseptic conditions, with the appropriate BUD.

    Allergen Extracts

    • Specific considerations apply for allergen extracts, such as limited risk level requirements and stringent hand hygiene and aseptic technique compliance. Aseptic procedures occur only within a dedicated allergen-handling area. BUDs are limited.

    Compounding Environments

    • Segregated Compounding Area (SGA): Unclassifed space, defined perimeter, and positive environmental controls.
    • Cleanroom Suite: Classified area containing an ante-room (ISO Class 8 or better) and a buffer area (ISO Class 7 or better), containing a Primary Engineering Control (ISO Class 5). Various processing methods and storage temperatures are considered.

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    Description

    Test your knowledge on the USP guidelines related to sterile product preparation and compounding. This quiz covers essential concepts such as beyond-use dates, compatibility of parenteral admixtures, and regulations for hazardous drugs. Perfect for pharmacy students and professionals preparing for certification.

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