PST Level 5 Semester 2

NTA Level 5 • Semester 2 • PST05208 Preservation of Pharmaceutical Product ………………………………………………………… 157 Pharmaceutics Theory and Compounding • Source Session/Topic 23 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 23: Preservation of Pharmaceutical Product ………………………………………………………… 157 PST 05208 Pharmaceutics Theory & Compounding NTA Level 5 Semester 2 Facilitator Guide iii Background There is currently an ever-increasing demand for pharmaceutical personnel in Tanzania. This is due to expanding investment in public and private pharmaceutical sector. Shortage of trained pharmaceutical human resource contributes to poor quality of pharmaceutical services and low access to medicines in the country (GIZ, 2012). Through Public-Private-Partnership (PPP) the Pharmacy Council (PC) together with Development Partners (DPs) in Germany and Pharmaceutical Training Institutions (PTIs) worked together to address the shortage of human resource for pharmacy by designing a project named “Supporting Training Institutions for Improved Pharmaceutical Services in Tanzania” in order to improve quality and capacity of PTIs in training. CSSC prepared a Multi-actor Partnership (MAP) project proposal on how to sustain and strengthen health care in Tanzania through improvement of pharmaceutical training and an inter-institutional coordination of actors. This will harmonize and improve access to quality pharmaceutical service in Tanzania. The project has a various key stakeholders like; CSSC, NACTE, PC, TCU, CEDHA and Pharmaceutical Training Institutions (PTIs). Through this project, few PTIs will receive infrastructural improvements to increase the quantitative and qualitative capacities (CUHAS, RUCU and KSP). Furthermore this project will train Pharmaceutical tutors from different PTIs on teaching and assessment methods in Tanzania and thus improved health delivery through increased qualified human resource. It was also observed that in the previous stakeholder‟s meetings there was a need for the development of training manuals and assessment plans for NTA Level 5 & 6, in order to support the establishment and implementation of the curriculum in PTIs. During MAP kick- off workshop done in February 2018, Stakeholders agreed that there was a need for development of the said manuals and it was among the highest priority in Pharmacy education in Tanzania. Therefore this project aims at developing facilitator‟s guide and assessment plans for NTA Level 5 & 6. Pharmacy Council, CSSC and action medeor developed the Terms of Reference and selected a qualified service provider with experience in material development to develop the mentioned training manuals and assessment plan. Centre for Educational Development in Health Arusha (CEDHA) was selected and offered a contract to develop Facilitators guide for NTA level 5 & 6 and assessment plan. Centre for Educational Development in Health Arusha (CEDHA) was offered a leading role with the instructions to include experts who have developed teaching materials for NTA Level 4. These experts are primarily experienced pharmaceutical and non-pharmaceutical tutors. The mode of operation used by CEDHA to develop facilitators guide and assessment plan was participatory approach which included a number of activities through various workshops PST 05208 Pharmaceutics Theory & Compounding NTA Level 5 Semester 2 Facilitator Guide iv such as planning, and orientation of material development. After these preliminary workshops, experts developed materials individually and in-groups. Thereafter, developed draft materials were reviewed, edited and formatted and draft one was finalized and shared to stakeholders for inputs. Finally, CEDHA submitted the finalized Facilitator‟s guides and assessment plans for NTA level 5 and 6 to CSSC for endorsement, printing, dissemination and sharing with relevant authorities. There are 11 modules for NTA level 5 making 11 facilitator guides including one practicum guide. PST 05208 Pharmaceutics Theory & Compounding NTA Level 5 Semester 2 Facilitator Guide v PST 05208 Pharmaceutics Theory & Compounding NTA Level 5 Semester 2 Facilitator Guide vi Acknowledgment The development of standardized training materials of a competence-based curriculum for pharmaceutical sciences has been accomplished through involvement of different stakeholders. Special thanks go to the Pharmacy Council for spearheading the harmonization of training materials in the pharmacy after noticing that training institutions in Tanzania were using different curricula and train their students differently. I would also like to extend my gratitude to Christian Social Service Commission (CSSC) for their tireless efforts to mobilize funds from development partners (German Ministry of Industry and action medeor). It is through the implementation of the Multi-Actors Partnership (MAP) project, CSSC has been able to provide the financial and technical support needed during the development of this training material. Many thanks go to the Centre for Educational Development in Health Arusha (CEDHA) experts on health material development and training who coordinated the development of these module sessions particularly Ms. Diana H. Gamuya for her commitment in coordinating and facilitating the planning and development to its completion. Particular acknowledgements are sent to Mr. Dickson Mtalitinya and Members from the secretariat of National Council for Technical Education (NACTE) for facilitating and providing their expertise to the success of this work. It will be unfair if I will not recognize the efforts and contributions of all CEDHA supportive staff that made this process a success; accountant, secretary, drivers and printers Finally, I very much appreciate the contributions of the tutors and content experts representing PTIs, hospitals, and other health training institutions. Their participation in meetings and workshops, and their input in the development of this training manual/facilitators guide have been invaluable. These participants are listed with our gratitude below: Ms. Elizabeth Shekalaghe Registrar, Pharmacy Council of Tanzania Dr. Fadhili Lyimo Assistant Director Allied Health,MoHCDGEC Dr. Catherine Jincen Acting Principal, CEDHA Dr. Sungwa N. Kabissi Project Manager – MAP, CSSC Ms. Diana H. Gamuya CEDHA Ms. Grace Mallange PC Ms. Emily Mwakibolwa Pharmacy Council PST 05208 Pharmaceutics Theory & Compounding NTA Level 5 Semester 2 Facilitator Guide vii Ms. Tumaini H. Lyombe MUHAS Ms. Dilisi J. Makawia KSP Director of Human Resources Development Ministry of Health, Community Development, Gender, Elderly and Children PST 05208 Pharmaceutics Theory & Compounding NTA Level 5 Semester 2 Facilitator Guide viii Introduction Module Overview This module content is a guide for tutors of Pharmaceutical schools

NTA Level 5 • Semester 2 • PST05208 Calculations Involving Buffer Solutions Pharmaceutics Theory and Compounding • Source Session/Topic 22 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 22: Calculations Involving Buffer Solutions Total Session Time: 60minutes + 6 hours of Practices Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Give overview of calculations involving buffer solutions • Perform calculations involving buffer solution Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks 45minutes Introduction to Calculations Involving Buffer 2 Presentation Solutions 60 minutes Presentation Performing Calculations Involving Buffer 3 Solutions Demonstration 4 05 minutes Presentation Key Points 5 05 minutes Presentation Evaluation 150 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Buffer Solution (45 minutes) • When a minute trace of hydrochloric acid is added to pure water, a significant increase in hydrogen – ion concentration occurs immediately • In similar manner, when a minute trace of sodium chloride is added to pure water, it causes a correspondingly large increase in in the hydroxyl – ion concentration • These changes takes place because water alone cannot neutralize even traces of acid or base, that is, it has no ability to resist changes in hydrogen – ion concentration or pH. A solution of a neutral salt, such as sodium chloride, also lacks this ability. Therefore it is said to be unbuffered • The presence of certainly substances or combination of substances in aqueous solution imparts to the system the ability to maintain a desired pH at a relatively constant level, even with the addition of materials that may be expected to change the hydrogen – ion concentration. • These substances or combinations of substances are called buffers, their ability to resist changes in PH is referred to as buffer action; their efficiency is measured by the function known as buffer capacity; solutions of them are called buffer solutions • By definition, then, a buffer solution is a system, usually an aqueous solution, that possesses the property of resisting changes in PH with the addition of small amounts of a strong acid or base • Buffers are used to establish and maintain an ion activity within rather narrow limits • In pharmacy, the most common buffer systems are used in o The preparation of such dosage forms as injections and ophthalmic solutions, which are placed directly into pH sensitive body fluids; o The manufacture of formulations in which the pH must be maintained at a relatively constant level to ensure maximum product stability: and o Pharmaceutical tests and assays requiring adjustment to or maintenance of a specific pH for analytic purposes • A buffer solution is usually composed of a weak acid and a salt of the acid, such as acetic acid and sodium acetate, or weak base and a salt of the base, such as ammonium hydroxide and ammonium chloride • Typical buffer systems that may be used in pharmaceutical formulations include the following pairs; acetic acid and sodium acetate, boric acid and sodium borate, and disodium phosphate and sodium acid phosphate 151 • Formulas for standard buffer solutions for pharmaceutical analysis are given in the united States Pharmacopeia • In the selection of a buffer system, due consideration must be given to the dissociation constant of the weak acid or base to ensure maximum buffer capacity. This dissociation constant, in the case of an acid, is a measure of the strength of acid; the more readily the acid dissociates, the higher its dissociation constant and the stronger the acid • Selected dissociation constants, or ka value, the dissociation constant, or Ka value, of a weak acid is given by the equation: Ka = (H+) (A-) Where A- == salt (HA) HA == acid • Because the numerical values of most dissociation constants are small numbers and may vary over many powers of 10, it is more convenient to express them as negative logarithms pKa = – log Ka When equation Ka = (H+) (A-) is expressed in logarithmic form, it is written: (HA) pKa = – log (H+) – log salt acid + Since pH = – log (H ): then pKa = pH – log salt acid and pH = pKa + log salt acid 152 Buffer Equation: • The equation just derived is the Henderson –Hasselbalch equation for weak acids, commonly known as the buffer equation • Similarly, the dissociation constant, or Kb value, of a weak base is given by the equation: Kb = (B+) (OH -) in which B+ = salt (BOH) and BOH = Base And the buffer equation for weak bases, which is derived from this relationship, may be expressed as: pH = pKw – pKb + log base salt • The buffer equation is useful for calculating o The pH of a buffer system if its composition is known o The molar ratio of the components of a buffer system required to give a solution of a desired pH. The equation can also be used to calculate the change in pH of a buffered solution with the addition of a given amount of acid or base STEP 3: Performing Calculations Involving Buffer Solutions (60 Minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students in small manageable groups ASK students to discuss in groups on the following questions • pKa Value of a Weak Acid with known Dissociation Constant • Calculate the pKa value of a weak acid, given its dissociation constant, Ka. REFER • Students to Pharmaceutical Calculation. 13th Edition by HOWARD C. ANSEL: Chapter 11, for

NTA Level 5 • Semester 2 • PST05208 Calculations Involving Rate of Flow of Intravenous Pharmaceutics Theory and Compounding • Source Session/Topic 21 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 21: Calculations Involving Rate of Flow of Intravenous Fluid Total Session Time: 120minutes + 6 hours of Practices Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Give overview of calculations involving rate flow of Intravenous Fluid • Perform calculations Involving rate of flow of Intravenous Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks 45minutes Introduction to Calculations Involving Rate Flow 2 Presentation of Intravenous Fluid 60 minutes Presentation Performing Calculations Involving Rate of flow 3 of Intravenous Fluids Demonstration 4 05 minutes Presentation Key Points 5 05 minutes Presentation Evaluation 145 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Rate of Flow of Intravenous Fluid (45 minutes) • On medication orders, the physician specifies the rate of flow of intravenous fluids in milliliters per minute, drops per minute, amount of drug(as milligrams per hour), or, more frequently, as the approximate duration time of administration of the total volume of the infusion. • Pharmacist may be called on to perform or check rate of flow calculations as those described in the following example problems in this session • Oftentimes, the following equation finds use in rate – of flow calculations Rate of flow (drops/minute) == Volume infusion (mL) x Drip set Drops/m Time (minutes) • In common usage are macro sets that deriver 10, 15, or 20 drops per milliliter and micro drip or mini drip sets that deriver 60 drops per milliliter STEP 3: Performing Calculations Involving Rate of Flow of Intravenous Fluid (60minutes) Activity: Small Group Discussion (30 minutes) DIVIDE students in small manageable groups ASK students to discuss in groups on the following questions • A medication order calls for 100mL of D5W to be administered over an 8-hour period. Using an IV administration set that drivers 10 drops/mL, how many drops per minute should be delivered to the patient? REFER Students to Pharmaceutical Calculation. 13th Edition by HOWARD C. ANSEL: Chapter 11, for reference ALLOW students to discuss for 20 minutes 146 ALLOW each groups to present for 5 minutes CLARIFY and SUMMARIZE by using the contents below Volume of fluid = 1000mL 8hours = 480minutes 1000(mL) = 2.08 per minute 480(minutes) 2.08mL/min x 10 (drops/mL) = 20.8 or 21 drops per minutes OR, Solving by the equation: Rate of flow (drop/min) = Volume infused (mL) x Drip set (drops/mL) Time (min) 1000mL x 10drops/mL ==20.8 or 21drops per minutes 480minutes STEP 4: Key Points (5 minutes) • On medication orders, the physician specifies the rate of flow of intravenous fluids in milliliters per minute, drops per minute, amount of drug(as milligrams per hour), or, more frequently, as the approximate duration time of administration of the total volume of the infusion. • Pharmacist may be called on to perform or check rate of flow calculations as those described in the following example problems in this session STEP 5: Evaluation (5 minutes) • What is formula used to calculate rate of flow of intravenous fluids? 147 STEP 6: Take Home Assignment (15 minutes) Activity: Take home Assignment (15 minutes) ASK each individual student to do the following assignment • Ten (10) milliliters of 10% calcium gluconate injection and 10 mL of multivitamin infusion are mixed with 500mL of a 5% dextrose injection. The infusion is to be administered over 5 hours. If the dropper in the venoclysis set calibrates 15drops/mL, at what rate, in drops per minutes, should the flow be adjusted to administer the infusion over the desired time interval? ALLOCATE time for students to do the assignment and submit REFER students to recommended references 148 References Ansel, H. C &Stocklosa, M. J. (2001). Pharmaceutical Calculations (11th ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Ansel, H. C (2010) Pharmaceutical Calculations (13rd ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Senya, S. S, Mwasha, C.Y, Muyinga, A. M, Amiri,R. I. and Mauga E.A.S.K. (2011) Tanzania Pharmaceutical Handbook (2nd ed.). Dar eS Salaam, Tanzania: School of Pharmaceutical Sciences. Zatz, J.L and Teixeira, M.G. (2005). Pharmaceutical Calculation (4th ed.). New Jersey: John Wiley & Sons, Inc 149 ← Previous TopicNext Topic →View all Pharmaceutics Theory and Compounding topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 5 • Semester 2 • PST05208 Calculations Involving Intravenous Admixture Pharmaceutics Theory and Compounding • Source Session/Topic 20 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 20: Calculations Involving Intravenous Admixture Total Session Time: 120minutes + 6 hours of Practices Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Give overview of calculations involving intravenous admixture • Perform calculations Involving of intravenous admixture Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks 45minutes Introduction to calculations involving intravenous 2 Presentation admixture 60 minutes Presentation Performing Calculations Involving Intravenous 3 Admixture Demonstration 4 05 minutes Presentation Key Points 5 05 minutes Presentation Evaluation 140 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Introduction to Calculations Involving Intravenous Admixture (45 Minutes) • The preparation of intravenous admixtures involves the addition of one or more drugs to large volume sterile fluid such as sodium chloride injection, dextrose injection, lactated ringer‟s injection and others. • The additives are generally in the form of small volume sterile solutions packed in ampules, vials, small – volume minibags for use as piggybacks, or sterile solids, some requiring constitution with a sterile solvent before transfer • Although a wide variety of drugs and drug combinations are used in preparing dilute infusions for intravenous therapy, some of the more common additives include electrolytes, antibiotics, vitamins, trace minerals, heparin, and, in some instances, insulin • In any properly administered intravenous admixture programme, all basic fluids(large volume solutions), additives (already in solution or extemporaneous constituted), and calculations must be carefully checked against the medication • Patient care facilities often adopt standard concentrations of intravenous solutions of commonly used drugs to provide uniformity within the institution • Common examples are dopamine 400mg in 250mL of D5W, insulin 25 units in250mL of NS, and nitroglycerin 50mg in 250mL D5W. • In preparing these standard concentrations, the pharmacist withdraws the determined volume From an ampule or vial containing the concentrated drug solution and transfers it to the specified volume of D5W, NS, or other intravenous fluid. 141 STEP 3: Performing Calculations Involving Intravenous Admixture (60minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students in small manageable groups ASK students to discuss in groups on the following questions • A medication order for a patient weighing 154lb. calls for 0.25mg of amphotericin B per kilogram of body weight to be added to 500mL of 5% dextrose injection. If amphotericin B is to be obtained from a constituted injection that contains 50mg/10mL, how many milliliters should be added to the dextrose injection? REFER Students to Pharmaceutical Calculation. 13th Edition by HOWARD C. ANSEL: Chapter 11, for reference ALLOW students to discuss for 20 minutes ALLOW each groups to present for 5 minutes CLARIFY and SUMMARIZE by using the contents below 1kg == 2.2 lb. 154(lb.) = 70 2.2(lb.) 0.25mg x 70 = 17.5mg Constituted solution contains 50 mg/ 10mL 50 (mg) == 10 (mL) x = 3.5mL 17.5(mg) x (mL) OR, solving by dimensional analysis: 154 lb. x1kg x 0.25mg x 10mL = 3.5mL 2.2lb 1kg 50mg 142 STEP 4: Key Points (5 minutes) • The preparation of intravenous admixtures involves the addition of one or more drugs to large volume sterile fluid such as sodium chloride injection, dextrose injection, lactated ringer‟s injection and others. • The additives are generally in the form of small volume sterile solutions packed in ampules, vials, small – volume minibags for use as piggybacks, or sterile solids, some requiring constitution with a sterile solvent before transfer STEP 5: Evaluation (5 minutes) • What are the procedures for preparation of intravenous admixtures? STEP 6: Take Home Assignment (15 minutes) Activity: Take home Assignment (15 minutes) ASK each individual student to do the following assignment • An intravenous infusion is to contain 15mEq of potassium ion and 20mEq of sodium ion in 500mL of 5%. Using potassium chloride injection containing 6g/30mL and 0.9% sodium chloride injection, how many milliliters of each should be used to supply the required ions? ALLOCATE time for students to do the assignment and submit REFER students to recommended references 143 References Ansel, H. C &Stocklosa, M. J. (2001). Pharmaceutical Calculations (11th ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Ansel, H. C (2010) Pharmaceutical Calculations (13rd ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Senya, S. S, Mwasha, C.Y, Muyinga, A. M, Amiri,R. I. and Mauga E.A.S.K. (2011) Tanzania Pharmaceutical Handbook (2nd ed.). Dar eS Salaam, Tanzania: School of Pharmaceutical Sciences. Zatz, J.L and Teixeira, M.G. (2005). Pharmaceutical Calculation (4th ed.). New Jersey: John Wiley & Sons, Inc 144 ← Previous TopicNext Topic →View all Pharmaceutics Theory and Compounding topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 5 • Semester 2 • PST05208 Calculations Involving Constituted Solutions Pharmaceutics Theory and Compounding • Source Session/Topic 19 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 19: Calculations Involving Constituted Solutions Total Session Time: 120minutes + 6 hours of Practices Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Give overview of calculations involving constituted solutions • Perform calculations involving constituted solutions Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks 45minutes Introduction to Calculations Involving Constituted 2 Presentation Solutions 60 minutes Presentation Performing Calculations Involving Constituted 3 Solutions Demonstration 4 05 minutes Presentation Key Points 5 05 minutes Presentation Evaluation 131 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Introduction to Calculations Involving Constituted Solutions (45 Minutes) • Process of mixing and diluting solutions • Parts of Solutions Terms • Solute o Substance to be dissolved or diluted o Can be either solid or liquid • Solvent o Substance (liquid) that dissolves another substance to prepare solution o Often referred to as diluent • Solution o Resulting mixture of solute plus solvent Caution o Before reconstituting injectable drugs, read and follow label or package insert directions carefully o Check drug o Check diluent dates • When reconstituting injectable medications, must determine both type and amount of diluent to be used o Sterile water and 0.9 percent NaCl commonly used o Some drugs supplied with special diluent o Determine volume in mL of diluent to be used 132 o Check that route noted on drug label matches route ordered o Reconstitute drug and note resulting supply dosage on vial o Note if single-dose or multiple-dose vial Example Drug Label 133 STEP 3; Performing Calculations Involving Constituted Solutions (60 Minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students in small manageable groups ASK students to discuss in groups on the following questions • Reconstituting Parenteral Solutions: Single Strength o Order: Zithromax 400 mg IV daily for 2 days o Available: Zithromax 500 mg vial for IV infusion o Drug is in powder form with directions on label that state, “Constitute to 100 mg/mL with 4.8 mL of Sterile Water for Injection REFER Students to Pharmaceutical Calculation. 13th Edition by HOWARD C. ANSEL: Chapter 11, for reference ALLOW students to discuss for 20 minutes ALLOW each groups to present for 5 minutes CLARIFY and SUMMARIZE by using the contents below Procedure: 1. How much and what type of diluent is needed? • 4.8 mL of sterile water 2. What is the dosage concentration after reconstitution? • 100 mg per mL 3. What is the total volume after reconstitution? • 5 mL 4. Given the ordered dose, how many doses are available in the vial? • One To reconstitute Zithromax: • Choose 5 mL syringe • Withdraw 4.8 mL of sterile water • Add 4.8 mL of sterile water to Zithromax powder and shake well Determine amount needed for dose ordered 1. Convert • No conversion needed 2. Think • Need 400 mg 134 Have 100 mg per mL • Need four times that amount 3. Calculate Dosage on hand = Amount on hand Dosage desired X Amount desired 100 mg = 400 mg 1 mL X 100 X = 400 100 X= 400 X = 4 mL 100 100 Withdraw 4 mL of reconstituted Zithromax using 5 mL syringe • Further dilute and give IV • Since single-dose vial, discard any remaining drug Reconstituting Parenteral Solutions: Multiple Strength • Some parenteral powdered medications have directions for preparing several different solution strengths • Penicillin G potassium 1,000,000 units vial Reconstitution instructions note four different solution concentrations as determined by amount of diluent added Units per mL mL Diluent 20 mL 50,000 10 mL 100,000 4 mL 250,000 1.8 mL 500,000 • Order: Penicillin G potassium 300,000 units IM every 6 h for adult patient o Available: Penicillin G potassium 1,000,000 unit vial o Given the reconstitution concentrations on the previous slide, which should you use when preparing to administer the ordered dose? • Consider: o Dose ordered o Patient receiving dose o Consider: o Volume and concentration that results with each noted diluent volume o Smaller the amount of diluent added, stronger the resulting solution concentration 135 o Consider maximum recommended volumes for injection by patient and parenteral route • Considering previously mentioned factors, adding 4 mL of diluent results in reasonable volume and medication concentration o Results in concentration of 250,000 units per mL o How many mL are needed to deliver ordered dose of 300,000 units? 1. Convert o No conversion necessary 2. Think o 250,000 units in 1 mL need 300,000 units o Slightly more than what is available in 1 mL 250,000 units = 300,000unit 1mL x mL 250, 000x = 300,000 250,000 = 300,000 x = 1.2 mL 250,000 250,000 o Rule o When reconstituting multiple-dose injectable medications: o Label reconstituted drug noting resulting supply dosage o In previous example, 250,000 units per mL o Verify length of drug potency and storage directions o Label on penicillin G potassium notes that solution “may be kept in refrigerator for one (1) week” o Complete label of reconstituted multiple-dose vial, noting:  Date and time of preparation  Supply dosage  Length of potency o Expiration date o Complete label of reconstituted multiple-dose vial, noting:  Storage directions  Own initials o Different IM and IV Reconstitution Instructions  Reconstitution instructions can differ in amount and/or type of diluent based on administration route  Must carefully check route ordered and related reconstitution directions

NTA Level 5 • Semester 2 • PST05208 Calculations Involving Osmolarity Pharmaceutics Theory and Compounding • Source Session/Topic 18 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 18: Calculations Involving Osmolarity Total Session Time: 120 minutes + 6 hours of Practices Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Give introduction to calculation involving Osmolarity • Concept on osmolarity vs. osmolality • Perform calculations Involving Osmolarity Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and compute SESSION OVERVIEW Activity/ Step Time Content Method 1 05 Minutes Presentation Introduction, Learning Tasks 2 40 Minutes Presentation Introduction to Calculation Involving Osmolarity 25 Minutes Presentation Concept on Osmolarity vs. Osmolality 40 Minutes Presentation Performing Calculation Involving Osmolarity 3 Demonstration 4 05 Minutes Presentation Key Points 5 05 Minutes Presentation Evaluation 125 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Introduction to Calculation Involving Osmolarity (40 Minutes) Osmolarity Osmolarity is defined as the number of osmoles of solute per liter (L) of solution. It is expressed in terms of osmol/L or Osm/L. Osmolarity depends on the number of particles in a chemical solution, but not on the identity of those molecules or ions. Sample Osmolarity Calculations A 1 mol/L NaCl solution has an osmolarity of 2 osmol/L. A mole of NaCl dissociates fully in water to yield two moles of particles: Na+ ions and Cl- ions. Each mole of NaCl becomes two osmoles in solution. A 1 M solution of sodium sulfate, Na2SO4, dissociates into 2 sodium ions and 1 sulfate anion, so each mole of sodium sulfate becomes 3 osmoles in solution (3 Osm). To find the osmolarity of a 0.3% NaCl solution, you first calculate the molarity of the salt solution and then convert the molarity to osmolarity. Convert percent to molarity: 0.03 % = 3 grams 100 ml = 3 grams / 0.1 L = 30 g/L molarity NaCl = moles / liter = (30 g/L) x (1 mol / molecular weight of NaCl) Look up the atomic weights of Na and Cl on the periodic table and add the together to get the molecular weight. Na is 22.99 g and Cl is 35.45 g, so the molecular weight of NaCl is 22.99 + 35.45, which is 58.44 grams per mole. Plugging this in: Molarity of the 3% salt solution = (30 g/L) / (58.44 g/mol) molarity = 0.51 M You know there are 2 osmoles of NaCl per mole, so: Osmolarity of 3% NaCl = molarity x 2 Osmolarity = 0.51 x 2 Osmolarity = 1.03 Osm 126 STEP 3: Concept on Osmolarity vs. Osmolality (25 Minutes) • Osmolality and osmolarity are units of measurement. Osmolality is the number of osmoles of solute in a kilogram of solvent, while osmolarity is the number of osmoles of solute in a litre of solution. Osmolarity is the concentration of an osmotic solution. • Osmolality is convenient to use because the amount of solvent remains constant, regardless of changes in temperature and pressure. • While osmolarity is easy to calculate, it's less difficult to determine because the volume of solution changes according to temperature and pressure. Osmolarity is most commonly used when all measurements are made at a constant temperature and pressure. • If osmolality is the number of osmoles of solute in a kilogram of solvent, then osmolarity is the number of osmoles of solute in a litre of solution. • Osmolarity deals with the concentration of an osmotic solution, while osmolality deals with the concentration of particles in a fluid. • It is easier to determine the osmolality than the osmolarity. Osmolarity is expressed as Osm/L, and osmolality is expressed as Osm/Kg. • Osmolality is used to determine medical conditions like diabetes, shock and dehydration, while osmolarity is used for the detection of the concentration of dissolved particles in urine.Osmolality is the commonly used method of measurement in Osmometry. • When the concentration of solutes is very low, the osmolality and osmolarity are similar. 127 STEP 3: Performing Calculations Involving Osmolarity (40 Minutes) Activity: Small Group Discussion ( 20 minutes) DIVIDE students in small manageable groups ASK students to discuss in groups on the following questions • How many mOsmol are represented in a liter of a 0.9% sodium chloride solution REFER Students to Pharmaceutical Calculation. 13th Edition by HOWARD C. ANSEL: Chapter 11, for reference ALLOW students to discuss for 20 minutes ALLOW each groups to present for 5 minutes CLARIFY and SUMMARIZE by using the contents below Formula weight of NaCl = 58.5 1 mmol of NaCl (= 58.5mg) = 2 mOsmol 900mg of NaCl per 100mL = 9000mg NaCl per liter Then by using proportion: 58.5mg = 2mOsmol x = 9000 x 2 9000mg x mOsmol 58.5 X = 307.7 = 308mOsmol/L STEP 4: Key Points (5 Minutes) • Milliosmoles (mOsmol) is an expression of the osmotic activity of 1 Millimole • A distinction also should be made between the terms osmolarity and osmolality. Whereas Osmolarity is the milliosmoles of solute per liter of solution while osmolality is the milliosmoles of solute per kilogram of solvent. For dilute aqueous solutions, osmolarity and osmolality are nearly identical. • For more concentrated solutions, however, the two values may be quite dissimilar. The Pharmaceutical personnel should pay particular attention to a product‟s label statement regarding molarity versus molality. 128 STEP 5: Evaluation (5 Minutes) • What is Milliosmoles? • What are the difference between osmolarity and osmolality? STEP 6: Take Home Assignment (15 minutes) Activity: Take home Assignment (15 minutes) ASK each individual student to do the following assignment • A solution contains 156mg of k+ ions per 100 mL. How

NTA Level 5 • Semester 2 • PST05208 Calculations Involving Milliosmoles (mOsmol) Pharmaceutics Theory and Compounding • Source Session/Topic 17 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 17: Calculations Involving Milliosmoles (mOsmol) Total Session Time: 120 minutes + 6 hours of Practices Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Give introduction to calculations involving milliosmoles • Perform calculations Involving Milliosmoles Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and compute SESSION OVERVIEW Activity/ Step Time Content Method 1 05 Minutes Presentation Introduction, Learning Tasks 45 Minutes Introduction to Calculations Involving 2 Presentation Milliosmoles 60 Minutes Presentation Performing Calculation Involving Milliosmoles 3 Demonstration 4 05 Minutes Presentation Key Points 5 05 Minutes Presentation Evaluation 120 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Introduction to Milliosmoles (45 minutes) • The osmotic activity of a solution may be stated in terms of Milliosmoles which is an expression of the osmotic activity of 1 Millimole • The term Osmolarity is used to express the strength in mOsmol per liter and indicates the total ionic concentration of the solution • Labels of some pharmacopoeia solutions that provide intravenous replenishment of fluids, nutrients, electrolytes and the osmotic diuretic mannitol are required to state osmolar concentration. • This information indicates to the practitioner whether the solution is hypotonic, isotonic or hypertonic with regard to biologic fluids and membranes • Since the unit that is used to measure osmotic concentration is Milliosmoles then; o For non – electrolytes e.g. dextrose 1 mmol (formulary weight in mg) represents 1 mOsmol o For electrolytes, the total number of particles in solution depends on the degree of dissociation of the substance in question, assuming complete dissociation • 1 mmol of NaCl represents 2 mOsmol ( Na+ and Cl-) of the total particles • 1 mmol of CaCl2 represents 3 mOsmol ( Ca2+ and 2Cl-) of the total particles • 1 mmol of Sodium citrate (Na3C6H5O7) represents 4 mOsmol ( 3Na+ -C6H5O7) of the total particles • The milliosmolar value of separate ion of an electrolyte may be obtained by dividing the concentration in mg per liter of an ion by its atomic weight • The milliosmolar value of the whole electrolyte in solution is equal to the sum of the milliosmolar value of separate ions • According to USP, the ideal osmolar concentration may be calculated using the following equation: • mOsmol/L = Weight of the substance(in g/L) x Number of specie x 1000 Molecular weight (in g) 121 • Examples o A solution contains 5% anhydrous dextrose in water for injection. How many mOsmol per liter are represented by this concentration? o Formula weight of anhydrous dextrose = 180 o 1mmol of anhydrous dextrose (= 180 mg) = 1 mosmol o 5% solution contains 50g or 50,000mg/L o Therefore:  mOsmol/L = 50,000 = 278mOsmol/ 180  OR Using USP equation:  mOsmol/L = 50 x 1000 = 278 mOsmol/ L o 180 STEP 3: Performing Calculations Involving Milliosmoles (60 Minutes) Activity: Small Group Discussion ( 40 minutes) DIVIDE students in small manageable groups ASK students to discuss in groups on the following questions • How many mOsmol are represented in a liter of a 0.9% sodium chloride solution REFER Students to Pharmaceutical Calculation. 13th Edition by HOWARD C. ANSEL: Chapter 11, for reference ALLOW students to discuss for 20 minutes ALLOW each groups to present for 5 minutes CLARIFY and SUMMARIZE by using the contents below Formula weight of NaCl = 58.5 1 mmol of NaCl (= 58.5mg) = 2 mOsmol 900mg of NaCl per 100mL = 9000mg NaCl per liter Then by using proportion: 58.5mg = 2mOsmol x = 9000 x 2 9000mg x mOsmol 58.5 X = 307.7 = 308mOsmol/ 122 STEP 4: Key Points (5 minutes) • Milliosmoles (mOsmol) is an expression of the osmotic activity of 1 Millimole • The osmotic activity of a solution may be stated in terms of Milliosmoles which is an expression of the osmotic activity of 1 Millimole • The term Osmolarity is used to express the strength in mOsmol per liter and indicates the total ionic concentration of the solution • This information indicates to the practitioner whether the solution is hypotonic, isotonic or hypertonic with regard to biologic fluids and membranes STEP 5: Evaluation (5 minutes) • What is Milliosmoles? • What are the uses of Osmolarity? STEP 6: Take Home Assignment (15 Minutes) Activity: Take home Assignment (15 minutes) ASK each individual student to do the following assignment • A solution contains 156mg of k+ ions per 100 mL. How many mOsmol are represented in a liter of the solution? ALLOCATE time for students to do the assignment and submit REFER students to recommended references 123 References Ansel, H. C &Stocklosa, M. J. (2001). Pharmaceutical Calculations (11th ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Ansel, H. C (2010) Pharmaceutical Calculations (13rd ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Senya, S. S, Mwasha, C.Y, Muyinga, A. M, Amiri,R. I. and Mauga E.A.S.K. (2011) Tanzania Pharmaceutical Handbook (2nd ed.). Dar eS Salaam, Tanzania: School of Pharmaceutical Sciences. Zatz, J.L and Teixeira, M.G. (2005). Pharmaceutical Calculation (4th ed.). New Jersey: John Wiley & Sons, Inc 124 ← Previous TopicNext Topic →View all Pharmaceutics Theory and Compounding topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260

NTA Level 5 • Semester 2 • PST05208 Calculations Involving Millimoles Pharmaceutics Theory and Compounding • Source Session/Topic 16 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 16: Calculations Involving Millimoles Total Session Time: 120 minutes + 6 hours of Practices Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Give overview of calculations involving Millimoles • Perform calculations involving Millimoles Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer • Handout 11.1 Powders and granules for oral administration SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks 2 45minutes Presentation Introduction to Calculations Involving Millimoles 60 minutes Presentation Performing Calculations Involving Millimoles 3 Demonstration 4 05 minutes Presentation Key Points 5 05 minutes Presentation Evaluation 115 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Millimoles (45 minutes) • A Millimole (mmol) of an element, a compound, or an ion is its atomic, molecular, or ionic weight respectively e.g. the ionic weight of Ca2+ is 40, therefore, 1 mmol Ca2+ = 40mg calcium • The number of mmol of each ion obtained from a salt in solution depends on the number of each ion in the molecule of the salt. e.g. Sodium chloride (NaCl, mol wt.: 58.5) has 1 Na and 1 Cl in each molecule. Hence 1 mmol NaCl ( 58.5mg) provides 1 mmol Na (23mg) and 1 mmol Cl (35.5mg) • Calcium chloride (CaCl2.2H2O, mol wt.: 147) has 1 Ca2+ and 2Cl in each molecule. Hence 1mmolCaCl2.2H2O (147mg) provides 1 mmol Ca2+ ( 40mg) and 2mmol Cl(71mg) • Therefore the amount of mg salt containing 1 mmol of a specified ion is calculated by the following equation: mg salt containing 1 mmol of specified ion = molecular weight of the salt Number of specified ions in the molecule Example: • How many mg calcium chloride are needed to provide 1 mmol of Ca2+ and 1 mmol of Cl- • mgCaCl2.2H2O containing 1 mmol of Ca2+= 147 = 147 mg 1 • 147mg CaCl2. 2H2O will provide 1 mmol Ca2+ • mgCaCl2.2H2O containing 1 mmol of Cl- = 147 = 73.5mg 2 • 73.5 mg CaCl2. 2H2O will provide 1 mmol Cl- • When g or mg salt are stated the number of mmol can be calculated by simple proportion 116 Example: • How many mmol Cl are obtained from234mg sodium chloride? • 58.5mg NaCl provide 1 mmol Cl-, therefore; 1 == x x = 1 x 234 = 4mmol 58.5 234 58.5 234mg NaCl provide 4 mmol Cl- STEP 3: Calculating Millimoles (60 minutes) Activity: Small Group Discussion ( 40 minutes) DIVIDE students in small manageable groups ASK students to discuss in groups on the following questions • 367mg calcium chloride provide how many mmol Ca2+ and how many mmol Cl-? REFER Students to Pharmaceutical Calculation. 13th Edition by HOWARD C. ANSEL: Chapter 11, for reference ALLOW students to discuss for 20 minutes ALLOW each groups to present for 5 minutes CLARIFY and SUMMARIZE by using the contents below 1mmol Ca2+ = 147 == 147mg 1 Therefore: 1 = x x = 1 x 367 = 2.49 = 2.5 mmol Ca2+ 147 367 147 – 1mmol Cl = 147mg = 73.5mg 2 117 Therefore: 1 = x x = 1 x 367 = 4.99 = 5mmol Cl-73.5 367 73.5 367mg calcium chloride provide 2.5mmol Ca2+ and 5 mmol Cl- STEP 4: Key Points (5 minutes) • A Millimole (mmol) of an element, a compound, or an ion is its atomic, molecular, or ionic weight respectively e.g. the ionic weight of Ca2+ is 40, therefore, 1 mmol Ca2+ = 40mg calcium • The number of mmol of each ion obtained from a salt in solution depends on the number of each ion in the molecule of the salt. e.g. Sodium chloride (NaCl, mol wt.: 58.5) has 1 Na and 1 Cl in each molecule. Hence 1 mmol NaCl ( 58.5mg) provides 1 mmol Na (23mg) and 1 mmol Cl (35.5mg) STEP 5: Evaluation (5 minutes) • What is Millimole (mmol) of an element? STEP 6: Take Home Assignment (15 minutes) Activity: Take home Assignment (15 minutes) ASK each individual student to do the following assignment • Calculate the strength of sodium chloride solution which is iso – osmotic with blood serum and tears ALLOCATE time for students to do the assignment and submit REFER students to recommended references 118 References Ansel, H. C &Stocklosa, M. J. (2001). Pharmaceutical Calculations (11th ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Ansel, H. C (2010) Pharmaceutical Calculations (13rd ed.). Philadelphia, United States: LIPPINCOTT WILLIAMS & WILKINS Senya, S. S, Mwasha, C.Y, Muyinga, A. M, Amiri,R. I. and Mauga E.A.S.K. (2011) Tanzania Pharmaceutical Handbook (2nd ed.). Dar eS Salaam, Tanzania: School of Pharmaceutical Sciences. Zatz, J.L and Teixeira, M.G. (2005). Pharmaceutical Calculation (4th ed.). New Jersey: John Wiley & Sons, Inc 119 ← Previous TopicNext Topic →View all Pharmaceutics Theory and Compounding topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260