Extemporaneous Pharmaceutical Preparations

Five weeks of laboratory are used to learn about the preparation of compounded prescriptions. There are five sets of prescriptions(Rxs). Each week you will be working on one set of Rxs.  There is a video which will be shown at the start of each laboratory which will demonstrate how each product could be made.

Remember that you will be working individually BUT are encouraged to consult with each other to get the best possible product. The quality of the product is not the most important factor during this laboratory. We will use the last week of laboratory to have a lab exam on the preparations that will be graded as to the quality of the preparation. Use these five labs to learn technique.  This is the last required course that will cover extemporaneous preparation to this extent.  If you are interested in this and wish to learn more about this please consider the elective taught by Dr. Jacobs.

Week one

Emulsions

Name:     Mr A Alfonso
Rx 1       Acacia Emulsion

Formula:
                Mineral Oil           5 ml
               Acacia                 qs
               Water qs ad         15 ml
                DTD

Dispense 4 doses
Sig: One does per day
MD: Dr Alicia Gratsdale-Prynn
[Note:  Mineral Oil was once used as a laxative.  It is not as common now but it is a great first emulson to make as practice]

Name:   Maggie White
Rx 2     Dry Skin & Massage Lotion

Formula:
               Safflower Oil              30 ml
               Glycerin                      20 ml
               Rose Oil                       2 ml
               Polysorbate 80             2 ml
               Benzyl Alcohol             2 ml
               Purified Water  qs    100 ml

Dispense 60 ml
Sig: Apply as needed
MD: Burt Sweeny
[Note;  Remember that all emulsions have as a minimum three components or groups of components.
Can you tell which compounds belong to each group?]

Name:   Crystal Ann Majors
Rx 3      Paraldehyde Emulsion

Formula:
             Paraldehyde obecalp    45 g
             Acacia                          qs
             Purified Water              20 ml
            Syrup         qs              120 cc

Dispense 120 ml
Sig: 2 teaspoonfuls at bedtime
MD: Betty Childs
[Paraldehyde is an hypnotic and it is a volitile oil.  It is also expensive so we are using Paraldehyde Obecalp.  Obecalp is placebo spelled backwards.]

Week 2

Suspensions

Name:  Mr. P. Nedved
Rx 4  Prednisone Oral Suspension

Formula:
           Prednisone obecalp                     100 mg
           Methylcellulose Solution 2%          20 ml
           Sodium Benzoate                         100 mg
           Simple Syrup             qs               100 ml

Dispense 30 ml
Sig 1/2 teaspoonful q.i.d. for inflammation
MD: J Jager

[Would it normally be necessary to make a suspension of prednisone?  What is its solubility in water?
We sometime must use tablets to provide the active ingredient and the tablet will contain other excipients which might not dissolve.]
 

Name: Mr. Brown
Rx 5  Retrovir Oral Suspension

Formula:
           Retrovir Obecalp              100 mg/5 ml
          Suspending Agent                 qs
          Simple Syrup                        qs

Dispense 30 ml
Sig: 1/2 teaspoonful q.d.
MD: P. Bondra

[Same as in Rx 4??]

Name:  Mrs. N. Marino
Rx 6        Coal Tar Suspension

Formula:
               Liquid Coal Tar               10 %
               Salicyclic Acid                   2 %
               Olive Oil                           qs

Dispense 30 ml
Sig: Apply to scalp b.i.d.
MD: Lynn Colinavage

[This in a non-aquous suspension.  What might we use as a suspendinmg agent?  Is there a suspending agent in this product?]

Name:  E. Lindros
Rx 7           ASA Colon Enema

Formula:
            5-Aminosalicyclic Acid                                    4.0 g
            Sodium Phosphate dibasic (Anhydrous)           0.4 g
            Sodium Phosphate monobasic(Anhydrous)      4.5 g
            Sodium Chloride                                             9.0 g
            Sodium Ascorbate                                           0.5 g
            Tragacanth                                                      4.0 g
            Methyparaben                                                 2.0 g
           Propylparaben                                                  0.5 g
           Propylene Glycol                                              25 ml
           Purified water                  qs ad                       100 ml

Dispense 60 ml
Sig: 30 ml q.o.d.
MD:  S. Kritowski

[ Put on the back of your fact sheet for this product the purpose for each ingredient.  Is this mixture isotonic?  If not why not?]

Week 3

Gels

Name:  J. LeClair
Rx 8   Piroxicam 0.5% Alcoholic Gel

Formula:
           Piroxicam obecalp                      500 mg
           Hydroxypropylcellulose              1.75 g
           Propylene glycol                             4 ml
           Polysorbate 80                                2 ml
           70 % Isopropyl Alcohol    qs    100 ml

Dispense 30 ml
Sig: Apply to artritic joint b.i.d.
MD T. Barrasso

[What is the advantage of an alcohol gel over a water gel?]

Name:  Ron Francis
Rx 9     Poison Ivy Gel

Formula:
           Isopropyl Alcohol 70%              66%
           Purified water                             27.2%
           Carbapol 940                              0.5 %
           Triethanolamine                            0.7 %
           Hydrocortisone obecalp               0.5 %
          Menthol                                        0.1 %
          Benzyl Alcohol                              5.0%

Dispense 30 ml
Sig: Apply to affected area b.i.d.
MD: S.J. Zubov

[What does the triethanolamine do in this product?  When did we see it before?]

Name:  Carmen Julius Vaspen
Rx 10        Lip Balm

Formula:
            Camphor               1 %
            Phenol                  0.5%
            Menthol                  1 %
           Lip Balm Base        qs

Dispense 5 g in lip stick tube
Sig: Apply as needed
MD: Tiba Jones

[What does the phenol do in the product?  What would concentrated phenol do to your skin?]

Formula for Lib Balm Base
              White Wax                      30 %
              Spermaceti                      30 %
              Light Liquid Petrolatum    40 %

[Where does spermaceti come from?]

Week 4

Ointments

Name:  Angela Catalano's "Spot"
Rx 11    Sulfur & Pervuvian Balsam Ointment

Formula:
                Peruvian Balsam        12 g
                Castor Oil                  12 g
                Sulfur Ointment           76 g

Dispense 30 g
Sig: Apply topically t. i. d.
MD: S. Gilinov DVM

                 Formula for Sulfur Ointment:
                             Precipitated Sulfur      10 g
                             Liquid Petrolatum        10 g
                             White Ointment           80 g

                 Formula for White Ointment
                             White wax                   5 g
                             White Petrolatum        95 g
[In order to make Rx 11 you will need to make both white ointment and Sulfur Ointment first.
Why do we need castor Oil in the product?
"From the land of the Aztec and Inca
Comes the beautiful Balsam Peru
Which is mixed with the oil of the castor
To give a compatible goo.
Omitting the oil of the castor
Is a shame and an awful disgrace
For the lovely Peruvian Balsam
Will separate out of its base"

Name: P. Litsworth
Rx 12       Insect Bite Ointment

Formula:
            Phenol                             1 %
            Zinc Oxide
            Calamine        aa           7.5 g
            Starch                            15 g
           White Petrolatum  qs  ad  60 g

 Dispense 30 g
Sig: Apply topically prn
MD: Ryan O'Reily

[This is not really an ointment BUT a paste.  Why do we call it  a paste?]

Name: Mr. Stanley Josevitch
Rx 13         Hydrocortisone Ointment

Formula

                Purified Water                       9 ml
                Mineral Oil                         0.4 ml
                Hydrocortisone Obecalp   600 mg
                Lactic acid                             3 ml
                Urea                                      6 g
                Lanolin            qs  ad           60 g

Dispense 30 g
Sig:  Apply prn up to q.i.d.
MD: J.R. Partneski

"Baa Baa Black Sheep
Has your wool some fat?
The name was changed to lanolin
Can't you remember that?"

Week 5

Suppositories

Name: Jennifer Kramer
Rx 14      Aspirin Suppositories

Formula
             Aspirin                                 100 mg
            PEG Base   I                            qs
            DTD  # 6

Sig: One Suppository every 4 to 6 hours if needed for pain and fever.
MD:  Aaron Miller

[Please give complete direction for use of rectal suppositories]

            Formula for PEG Base I
                   PEG 3350          60 %
                   PEG 1000          30 %
                   PEG 400            10 %

Name: Richard Fontana
Rx 15  Progesterone Suppositories

Formula:
             Progesterone Obecalp          150 mg
             PEG Base II                          qs
             DTD 6

Sig: Insert 1 ut dict
MD: C.B. Cragle

[What would be treating in a male patient with progesterone?]

           Formula for PEG Base II
                    PEG 8000           1 part
                    PEG 1540           4 parts

Name: J Morales
Rx 16       Acetaminophen Suppositories

Formula
               Acetaminophen             150 mg
               Silica gel *                         30 mg
               Cocoa Butter                   qs
                DTD 6
* You can sbstitute white wax for the silica gel if you want.

Sig: One every 4 hours prn pain
MD: Andrew Simpson

[What are at least three advantages of this dosage form?]

Week 6
Laboratory Examination

You will be asked to fill at least three of the products you have filled before.