By V. Larson. Butler University. 2019.

Bad prescribing or a dispensing error may also create a problem generic prilosec 10mg on line, and regarding which patents may have neither the insight nor the courage to queston prilosec 40 mg overnight delivery. Factors may be related to the patent buy cheap prilosec 40 mg on-line, the disease, the doctor, the prescripton, the pharmacist or the health system and can ofen be avoided. Low-cost strategies for improving adherence increase efectveness of health interventons and reduce costs. Health care providers should be familiar with techniques for improving adherence and they should employ systems to assess adherence and to determine what infuences it. Patent Reasons In general, women tend to be more adherent than men, younger patents and the very elderly are less adherent, and people living alone are less adherent than those with partners or spouses. Patent disadvantages such as illiteracy, poor eyesight or cultural attudes (for example preference for traditonal or alternatve drugs and suspicion of modern medicine) may be very important in some individuals or societes, as may economic factors. Doctors should be aware that in most setngs less than half of patents initated on anthypertensive medicine treatment are stll taking it a year later. Similarly, in epilepsy, where events may occur at long intervals, adherence is notoriously unsatsfactory. The Doctor-Patent Interacton There is considerable evidence that this is crucial to concordance. If they are in doubt or dissatsfed they may turn to alternatve optons, including ‘complementary medicine’. There is no doubt that the medicine ‘doctor’ has a powerful efect to encourage confdence and perhaps contribute directly to the healing process. Prescripton Reasons Many aspects of the prescripton may lead to non-adherence (noncompliance). It may be illegible or inaccurate; it may get lost; it may not be reflled as intended or instructed for a chronic disease. Also, the prescripton may be too complex; it has been shown that the greater the number of medica- tons the poorer the adherence, while multple doses also decrease adherence if more than two doses per day are given. Not surprisingly adverse efects like drowsiness, impotence or nausea reduce adherence and patents may not admit to the problem. Pharmacist Reasons The pharmacist’s behaviour and professionalism, like the doctor’s, may have a positve impact, supportng adherence, or a negatve one, raising suspicions or concerns. This has been reported in relaton to generic drugs when substtuted for brand-name drugs. Pharmacist informaton and advice can be a valuable reinforcement, as long as it agrees with the doctor’s advice. The Healthcare System The healthcare system may be the biggest hindrance to adherence. Long waitng tmes, uncaring staf, uncomfortable environment, exhausted medicine supplies and so on, are all common problems in developing countries, and have a major impact on adherence. An important problem is the distance and accessibility of the clinic from the patent. Some studies have confrmed the obvious, that patents farthest from the clinic are least likely to adhere to treatment in the long term. They difer from accidental to deliberate excessive dosage or medicine maladministraton. Thalidomide marked the frst recognized public health disaster related to the introducton of a new medicine. It is now recognized that clinical trials, however thorough, cannot be guaranteed to detect all adverse efects likely to be caused by a medicine and hence necessitatng post-marketng surveillance. Health workers are thus encour- aged to record and report to the Natonal Pharmacovigilance Centre for any unexpected adverse efects with any medicine to achieve faster recogniton of serious related problems. Major Factors Predisposing to Adverse Efects It is well known that diferent patents ofen respond difer- ently to a given treatment regimen. For example, in a sample of 2422 patents who had been taking combinatons of drugs known to interact, only 7 (0. Drugs which commonly cause problems in the elderly include hypnotcs, diuretcs, non-steroidal ant-infamma- tory drugs, anthypertensives, psychotropics, digoxin etc. All children, and partcularly neonates, difer from adult in their response to drugs. Some drugs are likely to cause problems in neonates (for example morphine ), but are generally toler- ated in children. Other drugs associated with problems in children include chloramphenicol (grey baby syndrome), antarrhythmics (worsening of arrhythmias), acetylsalicylic acid (Reye’s syndrome etc). Drug Interactons Interactons (see Appendix 6) may occur between drugs which compete for the same receptor or act on the same physiolog- ical system. They may also occur indirectly when a medicine- induced disease or a change in fuid or electrolyte balance alters the response to another medicine. Interactons may occur when one medicine alters the absorpton, distributon, metabolism or eliminaton of another medicine, such that the amount which reaches the site of acton is increased or decreased. When two drugs are administered to a patent, they may either act independent of each other, or interact with each other. Interactons may increase or decrease the efects of the drugs concerned and may cause unexpected toxicity. As newer and more potent drugs become available, the number of serious medicine inter- actons is likely to increase. Remember that interactons which modify the efects of a medicine may involve non-prescripton drugs, non-medicinal chemical agents, and social drugs such as alcohol, marijuana, tobacco and traditonal remedies, as well as certain types of food. Pharmaceutcal Interactons Certain drugs, when added to intravenous fuids, may be inactvated by pH changes, by precipitaton or by chemical reacton. Benzylpenicillin and ampicillin lose potency afer 6-8 hours if added to dextrose solutons, due to the acidity of these solutons. Some drugs bind to plastc containers and tubing, for example diazepam and insulin. The Efect of Food on Medicine Absorpton Food delays gastric emptying and reduces the rate of absorp- ton of many drugs; the total amount of medicine absorbed may or may not be reduced. However, some drugs are pref- erably taken with food, either to increase absorpton or to decrease the irritant efect on the stomach. Pharmacist plays and important role as a connectng link between the physician and patent.

Thus discount 20 mg prilosec with mastercard, the weight of the component present in the unknown sample may be calculated with the help of the following expression : Wt purchase genuine prilosec. It may be accomplished by performing a separate parallel estimation generic 40mg prilosec free shipping, without using the sample at all, and under identical experimental parmeters as employed in the actual analysis of the given sample. Note : Always avoid using an appreciably large blank correction which gives rise to a vague and uncertain ‘exact value’ thereby minimising the precision of the analysis. In short, the results thus obtained by the two fundamen- tally different techniques must be concordant thereby justifying and ascertaining the fact that the values obtained are fairly small limits of error. The actual differ- ence in the quantity of components present in samples with or without the added component ultimately gives the recovery of the quantum added component. A good satisfactory recovery builds up the confidence in the accuracy of the method of analysis. Note : The method of ‘standard addition’ is particularly useful to physicochemical techniques of analysis, for instance : spectrophotometry, turbidimetry. A graph is plotted between the concentration values and the ratios obtained from the physical value (i. Any unknown concentration may be determined effec- tively by adding the same amount of ‘internal standard’ and locating exactly where the ratio obtained falls on the concentration scale. The powerful and effective technique of statistics may render such results, which scatter in a random manner, into a better form that may be employed intelligently. Besides, the specific statistical treatment of the calibration data, aided by pre- programmable calculators and micro-computers, very often yields a fairly accurate and more presentable determination of the graphs between absorbance and concentration than those produced manually. It may be calculated by taking the average of individual results as shown below : i= n ∑ x1 x1 x2 x3 x4...... Therefore, there exists a diminishing return from accumulating more and more replicate meaurements. In other words, the mean of 9 results is 3 times as reliable as 1 result in measuring central tendency (i. Median The median of an even number of results is nothing but the average of the ‘two middle values’ pro- vided the results are listed in order ; whereas for an odd number of results the median is the ‘middle value’ itself. However, the ‘mean’ and the ‘median’ are exactly identical in the case of a truly symmetrical distribu- tion. In short, median is an useful measure specifically when dealing with very small samples. Average Deviation (or Mean Deviation) It is the average of the differences between the individual results and the mean. In the case of a small number of observations the average deviation is found to be not quite significant statistically. The average or mean distribution may be calculated by adopting the following steps, namely : (i) To find the differences between individual results and the mean, without considering the +ve or –ve sign, (ii) To add these individual deviations, and (iii) To divide by the number of results (i. Hence, an ‘average deviation’ may be expressed as : i= n ∑[x1 − x] i =1 Average Deviation = d = n 3B. Standard Deviation It is the distance from the mean to the point of inflexion of the normal distribution curve. In compari- son to the average deviation the ‘standard deviation’ is usually considered to be much more useful and meaningful statistically. For a finite number of values it is normally symbolised as ‘S’, and may be expressed as follows : i= n 2 ∑[i− x] i =1 S = n − 1 In a situation, where ‘n’ is fairly large, say to the extent of 50 or more, it hardly matters whether the denominator in the above expression is either n – 1 or n; however, the former (i. Coefficient of Variation (ν) The coefficient of variation (ν) is simply the standard deviation(s) expressed as a percentage of the mean ( x ) as stated below : s ν = × 100 x 3B. However, the former is fundamentally more important in statistics than the latter, whereas the latter is employed more frequently in the treatment of chemical data. Calculate the mean, median, average deviation, standard deviation and coefficient of variation. In a situation whereby a large number of replicate readings, not less than 50, are observed of a titrimetric equivalence point (continuous variable), the results thus generated shall normally be distributed around the mean in a more or less symmetrical fashion. Thus, the mathematical model which not only fits into but also satisfies such a distribution of random errors is termed as the Normal or Gaussian distribution curve. It is a bell-shaped curve which is noted to be symmetrical about the mean as depicted in Figure 3. The equation of the normal curve may be expressed as given below : 1 (x )2 /2 2 y = e σ 2 where, y = Relative frequency with which random sampling of the infinite population shall bring forth a specific value x, σ = Standard deviation, and µ = Mean. Examples : (a) Burette Reading : Burettes are mostly graduated with the smallest graduation as 0. However, the second place of the decimal is normally estimated by arbitrarily sub-dividing the smallest division into 10 equal parts. Thus, in the latter instance the zeros only serve to locate the decimal point and, therefore, may be eliminated completely by proper choice of units, e. Computation Rules The following computation rules are advocated to make sure that a calculated result, arrived at either by addition and subtraction or multiplication and division essentially contains only the number of ‘digits’ duly justified by the experimental data. Following three steps are to be carried out sequentially : (i) All numbers are required to be rounded up preliminarily to two decimal places, (ii) Add the rounded numbers, and * ‘Digit’—denotes any one of the ten numerals, including the zero. However, the percentage precision of product cannot be greater than the percentage precision of the least precise term entering the calculation. In case, the digit to be dropped is 5, always round up the preceding digit to the nearest even number i. Evidently, this method avoids a tendency to round up numbers in one direction only. In rounding off quantities to the nearest correct number of significant figures, add one to the last figure retained provided the following figure is either 5 or over. In fact there are two frequently employed methods that may be used to compare the results, namely : (a) Student’s t-Test, and (b) Variance-Ratio Test (or F-Test). In order to perform these two tests one should have a clear understanding of the statistical term ‘the number of degrees of freedom’. Thus, a sample having n values have n degrees of freedom, whereas the sum Σ(x – x )2 is considered to have n – 1 degrees of freedom, because for any defined value of the mean, x , only n – 1 value can be assigned freely, as the nth is being defined from the other values automatically. It serves two main objectives, namely : (i) It is employed to test the difference between the means of two sets of data x1 and x2, and (ii) It is used to compare the mean obtained from a sample having certain standard value and to express certain degree of confidence in the significance of the comparison. Besides, the t-table also gives the information that the probability of obtaining the difference of 0. Variance-Ratio Test (or F-Test) A test that makes use of the ratio of the variances of two sets of results to determine if the standard deviations (s) are significantly different.

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The possibility of allergic sensitivity cheap prilosec 10mg online, including an anaphylactoid reaction buy prilosec with paypal, should be kept in mind buy prilosec online. It decreases the influx of ionic calcium across the cell membrane of arterial smooth muscle as well as conductile & contractile myocardial cells. It has no effect on the normal atrial action potential or intraventricular conduction time. Sick sinus syndrome (except in patients with a functioning external ventricular pacemaker) 4. Atrial flutter or atrial fibrillation and an accessory bypass tract (Wolff-Parkinson- White, Lown-Ganong-Levine syndromes) 6. Serious adverse effects (including death) have been recorded in a series of patients with hypertrophic cardiomyopathy receiving verapamil. Digoxin: chronic verapamil usage can increase serum digoxin levels by 50-75% during first week of therapy. Disopyramide: should not be given within 48 hours before or 24 hours after verapamil Lithium: increased sensitivity to the effects of lithium (neurotoxicity) reported Carbamazepine: levels may be increased by verapamil Rifampicin: markedly reduces oral verapamil bioavailability Cyclosporin: levels may be increased by verapamil Theophylline: levels may be increased by verapamil Neuromuscular blocking agents: verapamil may prolong the duration of action Verapamil! Anticoagulation for prophylaxis and/or treatment of venous thrombosis, pulmonary embolism, thromboembolism associated with atrial fibrillation or prosthetic valve insertion. Duration of therapy is individualised and in general should be continued until the danger of thrombosis & embolism has passed. An anticoagulant effect generally occurs within 24 hours after drug administration, however peak anticoagulant effect may be delayed by 72-96 hours. Warfarin may potentiate a more hypercoagulable state in the first 24-48 hours due to the more rapid depletion of the anticoagulant proteins C & S when compared to the clotting factors with longer half-lives. This initial pro-coagulant effect is increased with the use of higher loading doses. Anticoagulants have no direct effect on established thrombus but prevent further extension of the formed clot. Bleeding tendencies associated with active ulceration or overt bleeding of gastrointestinal/genitourinary or respiratory tracts, cerebrovascular haemorrhage, cerebral aneurysms, dissecting aorta, pericarditis and pericardial effusions, bacterial endocarditis 6. Haemorrhagic complications may present as headache, paralysis, paraesthesia or altered consciousness & need to be excluded. Cardiovascular: None described Digestive: Nausea, vomiting, diarrhoea, flatulence, bloating Skin: Necrosis, bullous eruptions, urticaria, pruritus, alopecia Warfarin! It has hypnotic, sedative, anxiolytic, anti-convulsant & muscle- relaxant properties. It has negligible residual effects the following morning without rebound insomnia on cessation of treatment. It is rapidly & well absorbed after oral administration with an elimination half-life of 5 hours, prolonged to 7 hours in the elderly. It is not removed effectively by haemodialysis due to a large volume of distribution. Risk of rebound & withdrawal after abrupt discontinuation after prolonged treatment. Gradual dose decrement is recommended, especially so in patients with a history of seizures Anterograde amnesia may occur especially in the elderly or with disruption of sleep. The risk of confusion is also higher in the elderly & in patients with cerebral impairment. Discuss with your clinical pharmacist • Consider withholding non-essential treatment if enteral tube administration is necessary • Do not crush long acting/slow or controlled release tablets • Do not crush enteric coated tablets • Preferentially use liquid formulations where available • If in doubt, check with your clinical pharmacist before administering medicines via enteral feeding tubes • There may be differences in enteral tube administration between brands available. Random levels that do not conform to the timings indicated below are not clinically useful. Levels close to steady state may be reached earlier if a loading dose has been administered. Drugs with long half-lives may be monitored before steady-state has been achieved to ensure patients with impaired metabolism or renal excretion are not at risk of developing toxicity at the initial dosage regimen - Drug concentrations may be requested for any of the following reasons: - Suspected toxicity - Lack of response - To assess patient compliance - To assess therapy following a change in dosage regimen - A change in clinical state of the patient - Potential drug interaction due to a change in other medications - Where manifestations of toxicity and disease are similar - To interpret a result, the details of the dosage regime (dose and duration) must be known - For patients suspected of symptoms of drug toxicity, the best time to take the blood specimen is when the symptoms are occurring - If there is a question as to whether an adequate dose of the drug is being achieved, it is usually best to obtain trough levels (rather than peak) as these are less influenced by absorption and distribution problems. However, for some drugs where toxicity is a concern (such as gentamicin), peak levels may be requested - A range of drug concentrations is usually targeted rather than a specific value as the effect of a drug at a known concentration may vary greatly between individuals - Trough levels are usually obtained at the end of the dosage interval i. Hum an and veterinary m edicines have not been dealt with in separate chapters, because the technologies and exci- pients are the sam e. Calcium Effervescent Tablets + 10 m g/g) Vitam in B Com plex + Vitam in C + Vitam in A + Vitam in D3 Concentrate, Ferrous Sulfate Tablets W ater-m iscible (100,000 i. Tablets (100 m g + 10 m g + 100 µg) + 25 m g/m l) Vitam in B1 + Vitam in B6 + Vitam in B12 Vitam in A + Vitam in E Tablets Tablets (33,000 i. For this The excipients m ostly used in the for- reason, scale-up for production m ust m ulations and their suppliers are list- therefore be checked and revised, as ed in Table 1. It is only in very exceptional cases that the form ulations have been opti- m ized by a system atic study involving a com parison between different exci- pients or by varying the am ounts of excipients. Thus, the form ulations are m erely suggestions that require fur- ther optim ization. They were m ostly supplied free of charge as sam ples by pharm aceutical com panies. Since the m anufacturer’s nam e was m ostly not m entioned, it unfortunately cannot be listed here. Significant differences in the proper- ties of the preparations m ay occur if the sam e active substance is used, but has a different grain size or origi- nates from another m anufacturer. The reason for this is that the difference in physical properties m ay exert a strong effect particularly on solid drugs (cf. The form ulations are practically always m odified by the custom er when they are scaled up to m eet the dem ands of industry. Arom as or colorants are added to the form ulations in am ounts depending on the particular taste of the target group. In view of the very num ber of for- m ulations presented here and for capacity reasons, the long-term stability of all of them cannot be checked. They m ostly concern either storage at room tem perature (20 – 25 °C) over a period of one year or a stress test that lasts at least just as long. By virtue of 200 –1,000 g of the m ixtures to be its versatility form ulations containing it tabletted were used.

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It has been found to increase the skin penetration of both hydrophilic and lipophilic drug molecules (70–73) cheap prilosec online mastercard. The possible mechanisms include increased drug solubil- ity prilosec 10 mg, increased skin partitioning buy discount prilosec on-line, and the penetration-enhancing effect through their interaction with the skin lipids (70–73). However, further studies are required to clarify their mechanism of skin penetration. In particular, liposomes and lipid nanopar- ticles are widely used in cosmetic products for their moisturizing and smoothen- ing effect on the skin (37,74). Furthermore, they can be used to deliver skin pro- tectants, antioxidants, and skin-whitening agents. Vesicular systems can be used to deliver hydrophilic and hydrophobic cosmetic agents and improve their skin retention and sustain the release of these agents. Table 4 provides a representative list of cosmetic agents delivered using various nanosystems. Inorganic sunscreens, such as titanium dioxide and zinc oxide, derive their sunscreen functionality from their particulate nature. The functionality of organic sunscreens can be improved by encap- sulating them in various nanosystems (79) in which the nano-encapsulated sun- screen can function as both particulate and organic sunscreens. Furthermore, the encapsulation improves skin retention and reduces systemic absorption of sun- screens. In addition, the nanosystem can protect the organic sunscreen from pho- toxidation and enhance sun protection factor by sustaining the release from the nanosystem (79). Polymeric nanoparticles, made of poly(vinyl alcohol) substituted with various satu- rated fatty acids, including myristic, palmitic, stearic, and behenic acids, were used to limit the skin penetration of benzophenone-3 (61). In a similar manner, nanocapsules made of poly(E-caprolactone) were used to protect octyl methoxycinnamate (82). In such cases, the active agent has to penetrate to a depth of 20 to 200 m in the skin (83). Therefore, deformable liposomes, ethosomes, and niosomes have been widely explored for topical and transdermal applications. The concentration of estradiol was significantly increased in the epidermis by using transfersomes compared with an aqueous solution (85). Transfersomes pro- duced a threefold increase in methotrexate penetration across excised pig skin com- pared with an aqueous solution and conventional liposomes (86). Similarly, ethosomes resulted in 30-fold higher testosterone levels in 24 hours compared with commercial testosterone patch (29). Acyclovir delivered from etho- somes was significantly higher than commercial cream formulation (87). The estradiol flux was in the following order: Tween 20 > Span 60 > Span 85 > Span 40. Of the various systems, transfersomes are promis- ing for topical/transdermal delivery of small molecules, with several of them in early or advanced clinical trials. As a result, ketoprofen transfersomes was found to have much lower systemic exposure (90). Protein Delivery Among the various nanosystems, transfersomes and ethosomes appear to be promising for systemic delivery of proteins (Table 6). Several preclinical and clin- ical studies have shown the feasibility of transdermal delivery of insulin by using transfersomes (Transferulin r ) (91). Insulin in transfersomes produced a compar- ative pharmacokinetic profile to subcutaneously injected insulin (91). The normo- glycemia lasted for 16 hours, with a single application of Transferulin. However, transfersomes may not be suitable for producing peak insulin concentrations (due to their relatively long lag time of 6 hours) but can be used as a sustained insulin delivery system. Alternatively, biphasic vesicles have been developed for the systemic delivery of proteins through the skin (92). The protein is entrapped in a w/o microemulsion, which is, in turn, encapsulated in a lipid vesicle. Biphasic vesicles of insulin have been shown to reach steady state glucose levels within 6 to 8 hours and the effect of insulin lasted for 75 hours in diabetic rats (92). The biphasic vesicles dissociate in the skin and release the insulin, which is then taken up into the systemic circulation through lymph. One of the advantages of the biphasic vesicles is that drugs can be loaded in both the microemulsion and the vesicle (92). Although the Langerhans cells form only 1% of keratinocytes, they cover 25% of the total skin area (93). When these cells are activated, they migrate to the draining lymph nodes and induce strong antigen-specific responses by B and T lymphocytes (94). Gap junction protein loaded in transfer- somes elicited antigen-specific antibody titers that were equivalent to subcutaneous injection (96). In a similar manner, ethosomes were used to immunize the mice with hepatitis B surface antigen (97). Results showed that the ethosomal system produced more robust immune response compared to intramuscular injection of hepatitis B surface antigen suspension or topically applied hydroalcohilic solution. Gene Delivery An attractive alternative to protein is to deliver the gene of interest to the epider- mal cells, which can then express the protein. Cutaneous gene therapy is particularly attractive owing to the multitude of potential disease states in the skin, such as infectious (herpes), proliferative (psoriasis), and invasive (carcinoma) diseases (99). Topical gene therapy can be easily confined to the affected area, thus reducing the likelihood of systemic toxicity. Moreover, the assessment of efficacy by visual inspection or biopsy is immeasurably more practical for the skin than any other organ. However, there are several key physical and enzymatic barriers that gene-based medicines have to overcome before producing a therapeutic effect (99). The physiochemical properties of the lipoplexes such as particle size, charge density, and stability of the complex influence the skin transport and subsequent cell uptake. Lipoplexes have been found to mainly localize to the follicular regions in the skin and hence can be used to treat perifollicular diseases such as alopecia (100). A new class of cationic Gemini surfactants has been explored for topical gene delivery (103). These surfactants are composed of two ionic head groups which are attached to their hydrocarbon tails [e. No skin irritation was observed, unlike the conventional cationic liposomes (104).

By virtue of 200 –1 purchase prilosec amex,000 g of the m ixtures to be its versatility form ulations containing it tabletted were used order prilosec 40 mg with mastercard. It can also be am ounts weighed out in the form ula- com bined with alm ost all active sub- tions correspond to the am ount in the stances with the exception of those tablets m ultiplied by a factor of 1 purchase cheapest prilosec and prilosec,000. Acetylsalicylic acid and m etam izole can be pressed when lit- The technology involved in direct tle Ludipress has been added; ibu- com pression assum es great im por- profen requires a larger am ount; and tance in the tablet form ulations, be- the fraction of Ludipress required in cause it is often the cheapest m eans, the tablets is too large for paraceta- particularly in the production of ge- m ol (= acetam inophen). This lim it m ay be shifted upwards by special direct com pres- No other dry binder has a binding sion auxiliaries, e. Even if the active sub- quired for granulation is restricted and stance is sensitive to hydrolysis, m od- therefore the viscosity of the solution ern equipm ent, e. Other alternatives consist of using dif- The granules for tabletting of the pre- ferent grades of Kollidon. Substituting sented form ulations were m ostly pro- Kollidon 25 or Kollidon 30 by Kollidon duced by traditional m eans, i. The exam ple was resorted to only in exceptional of a placebo tablet illustrated in Fig. All the form ulations were devised on rotary tabletting presses that were fit- Conversely, there would be som e ted with 10 – 20 punches. In practice, however, the sam e hardness is usually achieved In the m anufacture of tablets it is im - by increasing the am ount of Kollidon. If it at the sam e pressure, but when the is not stated to the contrary, the active substance consists of crystals disintegration tim e is m easured in of two different sizes (crystalline = artificial gastric juice. Tablets of greater hardness or laid down that the in-vitro release are obtained if fine instead of coarse of active substance be checked. To a certain Unfortunately, these data cannot be extent, the disintegration and the given for all form ulations. Conse- lyophilisates quently, the properties of the suspen- sion thus form ed were assessed. Fluidized-bed granulation was resorted to only in exceptional cases in view of the am ounts needed. Details are m aceutical Excipients offer several given in the book “Kollidon – possibilities and m echanism s. It is laid down in m any active solubilizers in water and countries that the K-value m ust not form the structures of m icelles. The exceed 18, and there is also a re- m icelle that envelops the active striction on the am ount to be used substance is so sm all that it is in- for each dose adm inistered in visible or perhaps visible in the intram uscular application. C Hydrophilization Typical fields of application are oil- soluble vitam ins, antim ycotics of Active substances can also be the m iconazole type, m outh disin- solubilized by Lutrol F 68 in addi- fectants, e. Soluble Kollidon products tion of 5 – 9% has practically no ef- fect in changing the viscosity, but Low concentrations, i. In this book, a num ber of form ulations for m ade-up suspensions or extem - poraneous suspensions produced from instant granules or dry syrups 100 50 0 without Povidone with 5% Kollidon 90 F Fig. They also do not Arom as and dyes are quoted in only increase the viscosity when used in exceptional cases, because they these am ounts and can be com - depend strongly on the taste of the bined with all other conventional target group concerned and are often suspension stabilizers. It been already integrated in the form u- reduces the sedim entation rate and lations. They allow 6 Sem i-solid the production of physically stable drugs (gels, form ulations when they are used in low concentrations in the vicinity of cream s, 1– 4%. This is often coupled The Crem ophor types, Crem ophor A with a guarantee of superior absorp- 6 and Crem ophor A 25 are the m ost tion. Consequently, this have been arranged in alphabetical point m ust be worked out in the final order of their active substances. Properties of the granules Free flowing, water dispersible granules having alm ost no bitter taste. M anufacturing (Direct com pression) M ix all com ponents, pass through a sieve and press with low com pres- sion force. Rem arks – The substitution of Kollidon 30 by Kollidon 90F gives a m ore com pact sedim ent. Fill 50 g of the granules in a 100 m l flask (= dry syrup) or 5 g in sachets (= instant granules) 3. Adm inistration form s Dry syrup (200 m g albendazole /10 m l): Fill the flask containing 50 g of granules with water to the 100 m l m ark. Instant granules (200 m g albendazole sachet): Suspend 5 g of the granules (= 200 m g albendazol) in a glass of water. Properties of the solution Clear, colourless liquid which can be diluted with water. Rem ark For the production of tables cores for coating purposes the oblong form would be better. Rem ark If the content uniform ity does not m eet the requirem ents it would be recom m ended to prepare a prem ix of the active ingredient with a sm all part of the Ludipress or with lactose m onohydrate before m ixing with the other com ponents of the form ulation. Preparation of the suspension for adm inistration Shake 58 g of the granules with 100 m l of water. Properties of the suspension – Hom ogeneous and without sedim entation during m ore than 24 h. Properties of the tablets pressed w ith tw o different diam eters 12 m m 20 m m W eight.................................................... Properties of the suspension There was only a slow sedim entation during storage and the redispersi- bility after weeks was excellent. Rem arks Due to the poor flowability of the powder the tabletting m achine should be equipped with a special technical device providing a continuous and hom ogenous filling of the dies. M anufacturing (Direct com pression) M ix all com ponents, sieve and press on a rotary press to tablets with low com pression force. Rem arks Due to the reduced flowability the tabletting m achine should be equipped with a special technical device providing a continuous and hom ogenous filling of the m olds. M anufacturing (Direct com pression) M ix all com ponents, pass through sieve and press with low com pression force. Colour stability After 2 weeks at room tem perature no change of the colour of the tab- lets was observed but the long term com patibility between am inophylline and lactose should be controlled. Preparation of the suspension for adm inistration To 66 g of the powder add water to fill to a total volum e of 100 m l shaking very well.