TYPES OF DOSAGE FORMS - LECTURE

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CAPSULES

CAPSULES

  Are solid dosage forms in which one or more medicinal and or inert substances are enclosed within a small shell or container generally prepared from a suitable form of gelatin.  Depending upon their formulation, the gelatin capsule shells may be hard or soft.

Characteristics:

1.  May be swallowed whole by the patient

2.  May be inserted into the rectum for drug release and absorption from the site

3.The contents may be removed from the gelatin shell and employed as a pre measured medicinal powder, the capsule shell being use to contain a dose of the medicinal substance.

Example: Theo-dur Sprinkle

4.  Elegance

5.  Ease of use

6.  Portability

7. Tasteless shell to mask the unpleasant taste/odor of the drug

8. Permits physician to prescribe the exact medication needed by the patient

9.  conveniently carried

10. readily identified

11. easily taken

12. tasteless when swallowed

13. commonly embossed or imprinted on their surface the   manufacturer’s name and product code readily identified

14. available in variety of dosage strength

15. provide flexibility to the prescriber and accurate individualized dosage for the patient

16. packaged and shipped by manufacturers at lower cost less breakage than liquid forms

17. more stable and longer shelf life

Components Of Capsules

1.  Gelatin

2.   FD & C and D & C colorant

3.  Sugar

4.  Water - 12 to 16 % but may vary depending on the storage condition

5.  Sulfur dioxide (.15%) - prevent decomposition during manufacture

6.  Opaquants/Opacifying agent - titanium dioxide

H   HARD GELATIN CAPSULES

A   Also referred to as “DFC” Dry Filled Capsule. Manufactured into two sections, the capsule body and a  shorter cap. 

A A recent innovation in capsule shell design is the Snap-Fit, Coni-Snap, and Coni Snap Supro hard gelatin capsules.

CaCapsule size

F  For human use, empty capsules ranging in size from 000 the largest to 5 the smallest.   Generally, hard gelatin capsule are used to encapsulate between 65 mg to 1 gram.


  SOFT GELATIN CAPSULES 
Also referred to as as Soft ElasticCapsule.  Are prepared from shells of gelatin from which glycerin or a polyhydric alcohol and as sorbitol has been added to render the gelatin elastic or plastic like.
Tthe gelatin is plasticized by the addition of glycerin, sorbitol or polyol.  The shell may contain preservatives to prevent from fun 

soft gelatin capsule has a seam at the point of closure of the 2 halves, and the contents can be liquid, paste or powder.

ACCORDING TO WHO ROLE OF HOSPITAL PHARMACIST

Hospital pharmacy

Hospitals and other institutions and facilities, such as outpatient clinics, drug-dependency treatment facilities, poison control centres, drug information centres, and long-term care facilities, may be operated by the government or privately. While many of the pharmacist’s activities in such facilities may be similar to those performed by community pharmacists, they differ in a number of ways. 

Additionally, the hospital or institutional pharmacist:

• has more opportunity to interact closely with the prescriber and, therefore, to promote the rational prescribing and use of drugs;

• in larger hospital and institutional pharmacies, is usually one of several pharmacists, and thus has a greater opportunity to interact with others, to specialize and to gain greater expertise;

• having access to medical records, is in a position to influence the selection of drugs and dosage regimens, to monitor patient compliance and therapeutic response to drugs, and to recognize and report adverse drug reactions;

• can more easily than the community pharmacist assess and monitor patterns of drug usage and thus recommend changes where necessary;

• serves as a member of policy-making committees, including those concerned with drug selection, the use of antibiotics, and hospital infections (Drug and Therapeutics Committee) and thereby influences the preparation and composition of an essential-drug list or formulary;

• is in a better position to educate other health professionals about the rational use of drugs;

• more easily participates in studies to determine the beneficial or adverse effects of drugs, and is involved in the analysis of drugs in body fluids;

• can control hospital manufacture and procurement of drugs to ensure the supply of high-quality products;

• takes part in the planning and implementation of clinical trials.

MANAGEMENT- COMMUNICATION

Communication

The exchange of ideas, messages, or information by speech, signals, or writing.

Communication Skills

Communication skills are the tools that we use to remove the barriers to effective communication.

Goal

·         The goal of communication is to convey information &

·         the understanding of that information

from one person or group to another person or group.

THE COMMUNICATION PROCESS

The main components of communication process are as follows:

1.         Context - Communication is affected by the context in which it takes place. This context may be physical, social, chronological or cultural. Every communication proceeds with context. The sender chooses the message to communicate within a context.

2.         Sender / Encoder - Sender / Encoder is a person who sends the message. A sender makes use of symbols (words or graphic or visual aids) to convey the message and produce the required response. Sender may be an individual or a group or an organization. The views, background, approach, skills, competencies, and knowledge of the sender have a great impact on the message.

3.         Message - Message is a key idea that the sender wants to communicate. It is a sign that elicits the response of recipient. It must be ensured that the main objective of the message is clear.

4.         Medium - Medium is a means used to exchange / transmit the message. The choice of communication medium varies depending upon the features of communication.

5.         Recipient / Decoder - Recipient / Decoder is a person for whom the message is intended / aimed / targeted. The degree to which the decoder understands the message is dependent upon various factors such as knowledge of recipient, their responsiveness to the message, and the reliance of encoder on decoder.

6.         Feedback - Feedback is the main component of communication process as it permits the sender to analyze the efficacy of the message. It helps the sender in confirming the correct interpretation of message by the decoder. Feedback may be verbal (through words) or non-verbal (in form of smiles, sighs, etc.). It may take written form also in form of memos, reports, etc

FORMS OF COMMUNICATION:

Oral

Oral communication makes up the bulk of business communication today. Effectively communicating orally requires knowledge of the topic at hand, critical thinking ability and great interpersonal skills. Those skilled with oral communication are also typically good listeners who pay attention to verbal and nonverbal communication clues.

Nonverbal

People communicate nonverbally via body language and facial expressions. Eye contact, gestures and proximity to the speaker are all examples of nonverbal communication.  It's important to pay attention to your body language and posture when speaking or listening to someone else.

Written

Written communication in today's workplace commonly takes the form of email. Effective communication and proper etiquette are no less important in electronic form than they are on the written page. Keep business correspondence professional. Use correct grammar, punctuation and spell check every message before sending. Follow the same rules of etiquette in email that you would in any other business setting. Many employees consider email the most effective form of office communication.

  

COMMUNICATION BARRIERS

Communication Barriers are the various obstacles and hurdles which arise in between of an effective communication leading to misunderstandings and misinterpretations by the receiver. They result in distortion of the message and the goal is never accomplished.

Impatient Listener

The listener should be patient enough to absorb the complete information and then respond accordingly. Always jot down your points and start off with your queries once the sender is through with the communication. Don’t jump in between the conversation.

           

Misinterpretation

This can stem from poor communication efforts by the message sender. Language and communication differences are common as companies become more diverse. Additionally, noises and distractions in the work environment can cause confusion during the reception and interpretation of messages.

Low pitch and tone

Sometimes even the pitch and tone can play a communication barrier. Your content might be accurate and related, but if your pitch is low your information will never reach the listeners. The tone has to be very clear and loud for delivering correct information.

Ignoring the content

One should lay emphasis on the content of his speech. The content has to be clear and above all interesting. Don’t just speak; take some time to find out what you are speaking. Don’t make your speech monotonous otherwise the listeners after sometime will definitely fall asleep or bored.

Unorganized Thought

Unorganized and haphazard thoughts also are instrumental in poor communication and a very important barrier to effective communication.

Cultural level

In any organization, an individual can never think on the same line as his boss does. There is always a difference in their thought process.

Lack of Knowledge

 Employees generally lack knowledge about the company, its products and their jobs. This can contribute to poor production, creativity and results within the organization. It can also lead to poor communication and ineffective results during interactions with clients or customers.

7Cs OF COMMUNICATION

The 7 Cs provide a checklist for making sure that your meetings  , emails  , conference calls  , reports  , and presentations   are well constructed and clear ,so your audience gets your message.

According to the 7 Cs, communication needs to be:

Clear.

Concise.

Concrete.

Correct.

Coherent.

Complete.

Courteous.

1. Clear

Your messages need to be clear if they are to be effective. When writing or speaking to someone, be clear about your goal or message. What is your purpose in communicating with this person? If you're not sure, then your audience won't be sure either.

To be clear, try to minimize the number of ideas in each sentence. Make sure that it's easy for your reader to understand your meaning. People shouldn't have to make assumptions on their own to understand what you're trying to say.

2. Concise

If you want your messages to be read by busy people, make them brief. Remove all words phrases and sentences that serve no purpose. You can also eliminate wordiness by substituting one word for wordy, overused expressions.When you're concise in your communication, you stick to the point and keep it brief. Make sure to check,

Are there any unnecessary sentences?

Have you repeated the point several times, in different ways?

3. Concrete

When your message is concrete, then your audience has a clear picture of what you're telling them. There are details (but not too many) and vivid facts, Your message is solid. You have a choice in your writing to use concrete (specific) or abstract (vague) words. However, concrete items terms are typically mare accurate and, in some cases, more believable.

4. Correct

Correctness includes proposes spelling, grammar, punctuation, and format. For spelling, punctuation and grammar.

When your communication is correct, it fits your audience. And correct communication is also error-free communication.

5. Coherent

When your communication is coherent, it's logical. All points are connected and relevant to the main topic, and the tone and flow of the text is consistent. Ideas need to flow from on to the next through smooth transitions. You can achieve this by outlining your messages, writing simple sentences ad focusing each paragraph on one idea.

6. Complete

In a complete message, the audience has everything they need to be informed and, if applicable, take action. Make sure that you included all relevant information, contact names, dates, times and locations etc.

7. Courteous

Your message should be positive i.e. building goodwill and focused upon the reader. Courteous communication is friendly, open, and honest. There are no hidden insults or passive-aggressive tones. You keep your reader's viewpoint in mind, and you're empathetic to their needs.

 IMPORTANCE OF COMMUNICATION SKILLS:

Communication skills are very important for all managers and leaders.

Good communication skills allow managers and leaders to perform their role more effectively. Their role requires that they communicate. They must communicate many things to many people: they must communicate effectively to the team, to their suppliers, to their customers and financiers.

So it is important that leaders and managers are good communicators.

Communication skills for managers and leaders consist, mainly, of six subset skills:

1.         The ability to set out the goal or the target to be hit.

2.         The ability to communicate the plan of action that, it is hoped will describe successful action, capable of achieving the goal.

3.         The ability to communicate delegated actions: who is going to do which task?

4.         The ability to give corrective critical feedback to the people who are not performing in the proper manner and, in addition, to be able to get them to correct their performance and get "back on track".

5.         The ability to give praise and appreciation to those who are doing a good job.

6.         The ability to communicate the need for constant change, adaptation, refinement and flexibility to the conditions, whilst still remaining faithful to the overall goal and plan.

What are STEROID HORMONES

Steroid hormone is a steroid that acts as a hormone.

They are grouped on the basis of the receptors they bind.

vGlucocorticoids

vMineralocorticoids,

vProgesterone

vAndrogens

vEstrogens

•The natural steroid hormones are generally synthesized from cholesterol in the gonads and adrenal glands.

• These forms of hormones are lipids.

•They can pass through the cell membrane as they are fat-soluble, and then bind to steroid hormone receptors which may be nuclear or cytosolic depending on the steroid hormone, to bring about changes within the cell.

•Steroid hormones are generally carried in the blood bound to specific carrier proteins such as SHBPs and CHBPs.

•Further conversions and catabolism occurs in the liver, in other "peripheral" tissues, and in the target tissues.

•A variety of synthetic steroids and sterols have also been contrived.

•Most are steroids, but some non-steroidal molecules can interact with the steroid receptors because of a similarity of shape.

•Some synthetic steroids are weaker, and some much stronger, than the natural steroids whose receptors they activate.

Examples Of Synthetic Steroids

ØGlucocorticoids: alclometasone, prednisone,dexamethasone,

ØMineralocorticoid: fludrocortisone

ØVitamin D: dihydrotachysterol

ØAndrogens: apoptone, oxandrolone, oxabolone, testosterone, nandrolone (also known as anabolic steroids)

ØEstrogens: diethylstilbestrol (DES)

ØProgestins: danazol, norethindrone, medroxyprogesterone acetate, 17-Hydroxyprogesterone caproate.

Some steroid antagonists:

ØAndrogen: cyproterone acetate

ØProgestins: mifepristone, gestrinon

ADRs

Introduction to ADRs

Adverse drug reactions (ADRs), also known as ‘side effects’, ‘adverse
drug events’, or ‘drug misadventures’, are a frequent cause of morbidity in hospital and the community. They have a significant cost both financially and in terms of quality of life. 
Few studies of ADRs have been carried out in the community so the effect on primary care is harder to assess, but studies in the hospital environment have shown the following.

• ADRs occur in 10–20 % of patients in hospital.
• ADRs are responsible for 5 % of admissions to hospital.
• ADRs might be responsible for 1 in 1000 deaths in medical wards.
• ADRs are the most common cause of iatrogenic injury in hospital
patients.

The World Health Organization (WHO) defines an ADR as follows:
‘ a drug-related event that is noxious and unintended and occurs at doses used in
humans for prophylaxis, diagnosis or therapy of disease or for the modification
of physiological function .’

However, this definition does not take into account the following
scenarios, all of which can also cause ADRs:
• overdose (including prescribing or administration errors)
• therapeutic failure
• drug interactions
• drug withdrawal.

Pharmacists have an important role in identifying, reporting, and preventing
ADRs.

Terminology in liver disease

Hepatocellular injury
Damage to the main cells of the liver (hepatocytes)

Hepatitis
 Inflammation of the liver, a type of hepatocellular injury. Could
be caused by viruses, drugs, or other agents, or could be
idiosyncratic.

Cirrhosis
 Chronic, irreversible damage to liver cells, usually caused by
alcohol or hepatitis C. If the remaining cells cannot maintain
normal liver function (compensated disease), ascites, jaundice,
and encephalopathy can develop (decompensated disease).

Cholestasis 
Reduction in bile production or bile fl ow through the bile
ducts.

Liver failure 
Severe hepatic dysfunction where compensatory mechanisms
are no longer suffi cient to maintain homeostasis. Could be
acute and reversible, or irreversible (e.g. endstage cirrhosis).