3. dosage forms and strength

7/30/2019 3. Dosage Forms and Strength

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Dosage Forms & Strengthtechnical presentation 2 of 4


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Main Goal: To be able to AccuratelyComplete the Audit Sheet Correctly

By the end of this presentation you should beable to:

Look at a package of medicine anddetermine the dosage form

Look at a package of medicine anddetermine its strength

Understand why strength is alwayslisted with the generic name


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Dosage Form

ORAL

Tablets

Syrup

Suspension

Granules

RECTAL Suppository

INTRA-MUSCULAR/

INTRAVENOUS

Injection (powder &liquid)

The physical form of a medication.The route of administration is dependent uponthe dosage form.


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Tablets

The most common dosage form forantimalarials that you will find will

be tablets. But it is still importantto be familiar with the otherdosage forms when you comeacross them.

Capsules and pills are

considered tablets in

this study.
http://images.google.co.ke/imgres?imgurl=http://www.tablets4less.com/custom/intentdesign_capsules.jpg&imgrefurl=http://www.tablets4less.com/page007.html&usg=__AgzFOWkuAYYZt26Ndmp6cxmWOs0=&h=2814&w=4179&sz=2159&hl=en&start=3&tbnid=uMxotE0ZVAHIYM:&tbnh=101&tbnw=150&prev=/images%3Fq%3Dcapsules%26gbv%3D2%26hl%3Den%26sa%3DGhttp://images.google.co.ke/imgres?imgurl=http://corporateportal.ppg.com/NR/rdonlyres/A6B74DBB-C762-470B-8891-498B10902D74/0/AccuTabwhitetabs.jpg&imgrefurl=http://corporateportal.ppg.com/NA/CalHypo/Accutab/industrial/chlorination/Accu-Tab_SI_Tablets.htm&usg=__9L1-DYvu3WA-3gGz14flEPHtSh8=&h=283&w=350&sz=44&hl=en&start=3&tbnid=41cQxsCiZ8pV-M:&tbnh=97&tbnw=120&prev=/images%3Fq%3Dtablets%26gbv%3D2%26hl%3Den%26sa%3DG


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A Closer Look at Dosage Forms thatare not as Common: Granules


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A Closer Look At Other Dosage Forms:Suspensions


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A Closer Look at Dosage Forms thatare not as Common: PowderInjection

Powders injections are often accompanied by a liquidsolvent in a vial. The two are blended for injection in a

syringe.


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Suppositories


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Units of Measurement

Medicines are usuallymeasured in milligrams (mg)and milliliters (mL)

This section will explain each

of these units


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A Brief Review of Units of Measurement:There are 3 Things that we Measure

Distance/Length

Volume

Weight


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For Medicine, We Need Small Units:milligram (mg)

20 grains of salt weigh about 1 mg

A paperclip weighs about 1000 mg


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For Medicine, We Need Small Units:milliliter (mL)

15 drops = about 1 mL


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Strength of a

Medication

The strength of a medicationtells how muchactiveingredient is contained withinthe medicine


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Strength for Tablets & Suppositories

2.

Strength

[__|__|__].[__] mg

[__|__|__].[__] mg

[__|__|__].[__] mg

3.

Dosage form

1 = Tablet2 = Suppository

Tablet & Suppository Audit Sheet


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Important Points of MedicineStrengths:

1.The strength of a medicine is alwayslisted with the active ingredient

(generic name)

2.If a medicine has 2 active ingredients,

then it will have 2 strengths: onestrength per active ingredient


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Important Points:

For tablets and suppositories,strength is expressed in mg

Strength indicates how muchactive ingredient is contained

within a single tablet orsuppository


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Important Point#1: The Strength of aMedication is Always Listed with the ActiveIngredient on the Package

1 active ingredient

Quinine,250 mg

This means there is 250 mg of quinine in each tablet


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Important Point#2: There is a Strength for eachActive Ingredient in a Medicine

2 active ingredients: both active ingredientscontained in a single tablet

sulfadoxine-pyrimethamine, 500mg-25mg

This means each SP tablet contains 500mg of sulfadoxine

and 25mg of pyrimethamine


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Important Point#2: There is a Strength for eachActive Ingredient in a Medicine

2 active ingredients: separate tablets per

active ingredients Artesunate (50mg) / Mefloquine (250mg)

250 mg Mefloquine per tablet

50 mg ofArtesunate per tablet


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Why is the Strength Always Listed withthe Active Ingredient?

The same medicine can come in several differentstrengths

Example:Artesunate tablets are available in severaldifferent strengths.

Artesunate

10 mg

Artesunate

40 mg

Artesunate

100 mg

Artesunate

200 mg


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Q1,Q2 & Q3 What is the GenericName, Strength and Dosage Form?

1.Genericname

Amodiaquine

__________

__________

2.Strength

[_2_|_0_|_0_].[_0_]mg

[___|___|___].[___]mg

[___|___|___].[___]mg

3.Dosage form

1 = Tablet

2 = Suppository


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1.Generic name

Artesunate

Sulfadoxine

Pyrimethamine

2.Strength

[_0_|_5_|_0_].[_0_] mg

[_5_|_0_|_0_].[_0_] mg

[_0_|_2_|_5_].[_0_] mg

3.Dosage form

1 = Tablets

2 = Suppository

4.Brand name

Artesunate +SPPediatrique

NoBrandname


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1.

Generic nameSulfadoxine

Pyrimethamine

_______________

2.

Strength[_2_|_5_|_0_].[_0_] mg

[_0_|_1_|_2_].[_5_] mg

[___|___|___].[___] mg

3.

Dosage form1 = Tablets

2 = Suppository


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Suppositories

A suppository is a smallcapsule-like medication

designed for insertion into therectum, where it melts. It isoften given to patients who areto sick to take medication bymouth.


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Example

Strength: 50mg of

Artesunate is in eachsuppository


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1.Genericname

Artesunate

________

________

2.Strength

[_0_|_5_|_0_].[_0_] mg

[___|___|___].[___] mg

[___|___|___].[___] mg

3.Dosage form

1 = Tablet

2 = Suppository


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Activity

Using the antimalarial medicines from thefirst exercise, record the strength on theActivity Sheet.

Do you notice anything different betweenthe strengths of the first set ofantimalarials and the strengths of the

second set of antimalarials (ones withhydrochloride, sulfate, or phosphate inthe generic name)?


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Strengths of Active IngredientsPresented with an Extra Chemical

Recall: Certain medicines have an extra chemical in the name

The active ingredient alone may be written as base onthe packaging

Hydrochloride

Phosphate

Sulfate

From what you have seen, how does this extrachemical effect the strength?


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Important Points about Strengths of

Medicines with an Extra Chemical

Mefloquine hydrochloride, 275 mgEquivalent to

Mefloquine base, 250 mg

Equivalent to is also sometimes listed


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Some Examples:

Artesunate (200mg) + Mefloquine hydrochloride(275mg) equivalent to

Artesunate (200mg) + Mefloquine [base] (250mg)


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Which Strength Should I Record?

You should record the base strength only

Mefloquine, 250 mg

And not

Mefloquine hydrochloride, 275 mg

WHY?


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Review Strength of Tablets

One active ingredient

Artesunate, 40mg

One active ingredient with an extra chemical

Mefloquine [base], 250mg equivalent to

Mefloquine hydrochloride, 275mg

Two active ingredients

SP, 500mg-25mg

Artemether/Lumfantrine, 20mg/120mg

Two active ingredients with an extra chemical

Artesunate + Amodiaquine [base] (250mg) equivalent to

Artesunate (50mg) + Amodiaquine hydrochloride (275mg)


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Review Strength of Tablets

Question: A tablet is considered a _____ form.

Answer: Dosage form

Question: What is the unit of measurement forstrength for tablets?

Answer: milligrams (mg)

What this means: In each tablet, there is acertain weight of the active ingredient.


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Until this Point, We Have OnlyDiscussed Tablets and Suppositories

How is strength expressedfor dosage forms other thantablets and suppositories?


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What about Strengths of OtherDosage Forms?

1.

Genericname

2.

Strength

[__|__|__].[__] mg /[__|__|__] mL

3.

Dosage form3 = Syrup

4 = Suspension

5 = Liquid injectable

6 = Powder injectable

7 = Granule

Note about granules. Their strength is actually expressed in mg;however they will be recorded on this audit sheet, but leaving the mL

section blank.

For dosage forms other than tablets and suppositories,use the Non-Tablet Audit Sheet


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What does mg/mL

mean?


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Example Strength ofSuspension

Artemether,300mg/100mL

There can be lots ofnumbers listed onmedicine package.


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Example - Strength of Liquid Injection

Chloroquine, 200mg/ 5 mLequivalent to

Chloroquine phosphate, 322.5mg/ 5 mL


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1. Genericname

Chloroquine

__________

__________

2. Strength

[_2_|_0_|_0_].[_0_] mg / [_0_|_0_|_5_] mL

[___|___|___].[___] mg / [___|___|___] mL

[___|___|___].[___] mg / [___|___|___] mL

3. Dosage form

3 = Syrup4 = Suspension

5 = Liquid Injection

6 = Poudre injection

7 = Granules


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Example Strength of Syrups

Chloroquine,

25mg/5mL

Strength may be written like


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1.GenericnameQuinine____

___________

___________

2.Strength

[_1_|_0_|_0_].[_0_] mg / [_0_|_0_|_5_] mL

[___|___|___].[___] mg / [___|___|___] mL

[___|___|___].[___] mg / [___|___|___] mL

3.Dosage form3 = Syrup

4 = Suspension5 = Liquid Injection

6 = Poudre injection

7 = Granules

Strength may be written likethis for liquids:


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Example - Strength with 2 Active Ingredients

1. Genericname

Sulfadoxine__

Pyrimethamine

____________

2.Strength

[_2_|_5_|_0_].[_0_]mg/ [_0_|_0_|_5_]mL

[_0_|_1_|_2_].[_5_]mg/ [_0_|_0_|_5_]mL

[___|___|___].[___]mg / [___|___|___]mL

3.Dosage form

3 = Syrup

4 = Suspension

5 = Liquid injectable

6 = Powder injectable

7 = Granule


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We Have Just Discussed the DosageForms that use Mg/Ml for Strength

Syrups

Suspension

Liquid injection

*Powder injectables are less common and are not

covered here. Recording strength for this dosageforms follow the same pattern. Refer to FieldworkersManual on how to record its strength.


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Dosage Forms with StrengthMeasured in mg

recall Tablets

Suppository

Q: Why is there a need for 2different audit forms?

A: To accommodate for the 2different ways in which strength isexpressed: mg or mg/mL


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Review

What are the two ways that the strength of amedication can be written?

mg or mg/mL

What determines if the strength will be in mgor mg/mL?

The dosage form
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You Must Pay Very Close Attention &Look at ALL Sides of the Box

This is the front ofthe box. Based onthis, what is thegeneric name and

strength?

Based on this,would you think

the strength ofAmodiaquine baseis greater than orless than 200 mg?
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Front Side

Always look at every side of the packaging.The front of this package is misleading.

Questions


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Questions

1. Name all of the dosage forms of antimalarial medicines.

Tablets, syrups, suspensions, injections (liquid & powder),

suppository, granule

2. What does the strength of a medicine describe?

The amount of active ingredient in a medicine

3. On a medicine package, the strength is always listed alongsidewhat?

With the generic name/active ingredient (s)

4. What are the 2 units used for strength? mg or mg/mL


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You Should Now Be Able To:

Look at a package of medicine anddetermine the dosage form of themedicine

Look at a package of medicine anddetermine the strength of the medicine

Understand why strength is alwayslisted with the generic name


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Questions

?


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Activity

Get into groups of 4 or 5 each.

The facilitators will pass out a group ofmedicines

Record answers on Activity Sheet B

Every person must complete an ActivitySheet

You may help each other

Remember: We are only auditingantimalarials!

3. dosage forms and strength

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