INSTRUCTIONS 1.

Records should be written neatly in ink on the right hand pages only, left hand being reserved for diagrams, graph and observations. 2. Record should contain a. The date b. Number and name of the exercise as well as page number c. The signature of the staff against each exercise 3. The record should be neat and tidy. The day to day exercises should be written on the same day preferably before leaving the laboratory. Regularly get your record initialled by the faculty. 4. Take the help of the faculty for your problems, if any and get your doubts clarified. P.S. The place where you are learning the art of dispensing of drug is pharmacy laboratory. Remember that it is not a licensed dispensary. As such never take or advise anybody to take the drugs prepared in the laboratory

INDEX
No Date Name of the experiment/exercise General considerations Metrology Posology Equipments used in dispensing pharmacy Page no. Remarks

Experiments Mixtures
Sodium salicylate mixture Alba mixture

Emulsions
Turpentine liniment Castor oil emulsion

Dentifrices
Tooth powder Tooth paste

Mouth washes
Potassium permanganate mouth wash

Paints
Mandls throat paint The astringent gum paint

Prescription
Prescription writing

Appendix
Latin terms and abbreviations commonly used in prescription writing

Chapter I
Pharmacy

GENERAL CONSIDERATIONS

Pharmacy is the art of identifying, selecting, preserving, compounding and dispensing medicinal substances for easy, effective and palatable administration. Importance of pharmacy a. As a Qualified Doctor one should know the art of the dispensing medicines for treatment. b. Further advance in the pharmaceutical industry. Pharmacopoeias: They are comprehensive books published under the authority of a recognized body, generally constituted by law to ensure uniformity in composition and strength of medicines, used in the treatment of diseases. They consist of approved therapeutic agents defined with respect to their preparations, physical or chemical characteristics, standardization and dosage. Well known examples of Pharmacopoeias 1. 2. 3. 4. British Pharmacopoeia (B P) Indian Pharmacopoeia (I.P.) United States Pharmacopoeia (USP) International Pharmacopoeia (I.P)

National formulary It is published by the American Pharmaceutical Association. The drugs included here are according to their therapeutic merit rather than extent of use. National Formulary of India (NF) is published by Govt. of India. British Pharmaceutical Codex (BPC) is like N.F. and is published by Pharmaceutical Society of Great Britian. Materia Medics is a division of pharmacology that deals with source, descriptions and preparations of drugs. Pharmacology in addition deals with Pharmacodynamics, Pharmacokinetics, and Pharmacotherapeutics

Chapter II

METROLOGY

It is science which deals with weights and measures. Solids are weighed and liquids are measured. Metric system of weights and measure is now official in India. However, the apothecary system of weights and measures is widely used especially by older practitioners. The metric system The basic weight of this system is kilogram and the basic measure of capacity is litre. Weights: 1 Kilogram (Kg) 1 Gram 1 MG 1 mcg Measures 1 Litre I cup 1 Glass I Wine glass 1 Tumblerful 1 Tablespoonful 1 Teasponful I ml Weight I Pound (lb) I Ounce lDram. Measures 1 Pint (o) I Fluid ounce I Fluid dram 16 fluid ounces 8 fluid drams 60 minims (m) 12 ounces (oz) 8 Drams (dr) 60 Grains (gr) 1000 millilitres 5-6 ounces (oz) 8 ounces 2 ounces 240 ml 15 ml 5 ml 20 drops 1000 gms 1000 milligrams (mg) 1000 micrograms (ug) or (mcg) 1000 nanograms (ng)

Apothecary (Imperial) system

Approximate Equivalents Apthecary 1 Grain 1 Fl. ounce 1 minim 1 Dram 2.2 pounds 1 Ounce Metric 65 mg 30 ml 0.065 ml 4 ml 1 Kg 30 gms (approx) Domestic 2 table spoons 1 drop 1 tea spoon -

Basic data for percentage calculations 1% W/W (Weight/Weight) 1% W/V (Weight/Volume) 1% V/V (Volume/Volume) 1 gm of solute in 100 gm of solution 1 gm of solute in 100 ml of solution 1 ml of solute in 100 ml of solution.

Chapter III

POSOLOGY

The term called DOSAGE which literally means "the method of dosing". The science that deals with the study of dosage of medicines is referred to us the POSOLOGY DOSE: It is the required amount of drug in weight, volume, moles or international units that is necessary to provide a desired effect. Doses for infants and children cannot be same as those for adults. They need to be calculated separately. These doses may be found in the USP 'Drug information, the Pediatric Dosage Handbook' and textbooks on pediatrics. Doses should not be calculated when it is possible to obtain actual infant or child's dose. Certain rules are followed for approximate doses for infants and children. YOUNGS RULE: applicable for children below 12 yrs of age. Age of child Pediatric dose = Age + 12 FRIED RULE: Based on age in months Age (in months) Pediatric dose = 150 CLARKS RULE: Based on body weight Wt. of the child (lb) Pediatric dose = 150 Wt. of the child (kg) Pediatric dose = 70 BASED ON BODY SURFACE AREA (BSA) BSA (in sq. m) Pediatric dose =
0.725

X adult dose

X adult dose

X adult dose (70kg=150lb)

OR

X adult dose

X adult dose 1.8

(BSA= W 0.425(kg) X H

(cm) X 0.00718 )

PERCENTAGE OF ADULTS DOSE TO BE ADMINISTERED TO A CHILD = (1.5 Xwt in kg) + 10 OR (0.7 Xwt in lb) + 10

Chapter IV
1. 2. 3. 4. 5.

Equipments used in dispensing pharmacy

13. 14. 15. Glass rods. Ointment jar/Jelly pot. Wide mouth bottles, Tripod stand. Wire gauge. Water bath. Sand bath. Suppository mould. Suppository bath and cone. Dusters.

Dispensing balance. Weight box. Dispensing bottles. Pestle and mortar,(wedge wood) Pestle and mortar (glass) Ointment slabs. Ointment spatula. Horn/bone spatula. Beakers 250 ml and 100 ml Measuring cylinders 5 ml, 10 ml and Porcelain dish. Glass funnel.

16.
17. 18. 19. 20. 21. 22.

6. 7.
8. 9. 10. 100 ml. 11.

12.

Chapter V

EXPERIMENTS MIXTURES

A mixture is a liquid preparation intended for oral administration in which drug or drugs are dissolved, suspended or dispersed in a suitable vehicle and generally several doses are contained in a bottle. When only one dose is dispensed it is known as draught. Mixtures differ from solutions that the mixtures may be homogeneous or heterogeneous and are for oral administration whereas solutions are homogeneous and are for external or internal use. Mixtures are extemporaneously prepared and they are supplied in such doses that whole of the mixture is used up within a few days. If need arises then fresh mixture is prepared. Advantages of mixtures 1. They are more quickly effective than solid dosage forms which require previous disintegration in the body before absorption can take place. 2.Certain substances can only be given in liquid form because they are inconvenient to administer in any other form due to their liquid nature and large dose e.g. castor oil, liquid paraffin, aromatic waters etc. 3.Certain substances like potassium iodide and potassium bromide may cause pain in the stomach if given in the solid form as a powder or a tablet. 4.Certain substances are useful when they are administered in a suspension form e.g. light kaolin and bismuth salts, because in suspension form they afford large surface area for the absorption of toxic substances in the gut. 5. Mixtures are easy to administer and economical as compared to other oral preparations. Disadvantages 1.They are comparatively less stable than solid dosage forms. 2.Incompatibility is more in liquid preparations as compared to solid ones. 3. They are more bulky and difficult to carry. Classification Mixtures may be classified as follows: 1. Simple mixures 2. Mixtures containing diffusible solids. 3. Mixtures containing indiffusible solids. Simple mixtures A simple mixture is one which contains only soluble ingredients e.g. carminative mixture, diaphoretic mixture, cough expectorant etc. Mixtures containing diffusible solids Diffusible solids are those substances which do not dissolve in water, but on shaking. they can be

mixed with it and remain evenly distributed throughout the liquid for sufficient long time allowing uniform distribution of the drug in each dose. However, on. standing, the insoluble solids settle at the bottom of the bottle which require re-shaking of the bottle each time whenever a dose is to be measured. Hence the bottle containing the diffusible mixture must be labelled "Shake the bottle before use". Diffusible solid include: aromatic chalk powder, bismuth carbonate, light kaolin, magnesium oxide, magnesium carbonate, magnesium trisilicate, phenolphthalein and rhubarb powder. Mixtures containing indiffusible solids Indiffusible solids are those substances which do not dissolve in water and they do not remain evenly distributed throughout the vehicle, even after shaking they immediately settle at the bottom therefore it becomes difficult to measure the dose. The indiffusible substances are made diffusible by increasing the viscosity of the vehicle by adding suitable suspending agent i.e. compound tragacanth powder or tragacanth mucilage. The former is used at the rate of 2 gm/100 ml and later at the rate of 1/4th of the volume of mixture to be prepared. Compound tragacanth powder must be used as suspending agent when the vehicle is medicinally active because tragacanth mucilage is prepared by using chloroform water as vehicle which may replace certain amount of medicinally active vehicle-thereby decreasing its medicinal and flavouring properties. The indiffusible mixture must also be labelled "Shake the bottle before use". Indiffusible solid include: prepared chalk powder, sUlfadimidine, acetyl salicylic acid

Exp No 1 SIMPLE MIXTURE

Date :

SODIUM SALICYLATE MIXTURE (SODA SOL MIXTURE) Aim : To prepare and dispense 15ml of soda sol mixture Date: Name: Age: Sex: R Sodium salicylate Sodium bicarbonate Sodium metabisulphite Chloroform water to Fiat: Make a mixture and dispense Sig: Two table spoon full to be taken 3 time a day after food. Dr. Reg. no Type Theory When sodium salicylate comes in contact with hydrochloric acid present in stomach, salicylic acid is formed which gets precipitated and leads to irritation in the stomach. Hence when sodium salicylate is prescribed it is usually prescribed with sodium bicarbonate which will temporarily neutralize the gastric secretion and thus minimize the formation of salicylic acid. Sodium salicylate in solution form, especially when it is alkaline in nature, absorbs oxygen and solution becomes brownish black. Though the therapeutic value is not changed but it may lead to confusion in the mind of the patient that the mixture has spoiled and he may not like to use the mixture. Therefore to prevent the air oxidation, sodium metabisulphite is used as an antioxidant which will considerably retard the change in colour. Procedure Dissolve the weighed quantities of sodium salicylate and sodium bicarbonate in 3/4th of the measured out vehicle. To this dissolve sodium metabisulphite. Filter if any foreign particles are present. Incorporate more of vehicle to produce the required volume. Transfer the mixture to a bottle, cork, label and dispense. Uses This preparation is used as an analgesic, antipyretic and anti-rheumatic mixture. Simple mixture. 1.0 1.0 0.01 15.0 gm gm gm ml Address

Packing: Amber colored bottle with white snap on cap. Storage instructions: Store below 30C out of direct sunlight. Keep out of reach of children. Do not use continuously for more than 10 days. Shake well before use

Exp No: 2 ALBA MIXTURE Aim : To prepare and dispense 15 ml of alba mixture Date: Name: Age: Sex: R Magnesium sulphate Light magnesium carbonate Peppermint water to Fiat: Make a mixture and dispense 30mg 4mg 180ml Address

Date:

Signs: T w o t a b l e s p o o n f u l l t o b e t a k e n i n t h e m o r n i n g b e f o r e b r e a k f a s t . Dr. Reg. no Type Theory Magnesium sulphate is a soluble substance whereas light magnesium carbonate is a diffusible substance so method for mixtures containing diffusible solids will have to be followed. Magnesium sulphate acts as purgative in large doses but in small doses it acts as an antacid. Light magnesium carbonate acts as an adjuvant and potentiates the action of magnesium sulphate, It is also used as an antacid. Peppermint water acts as a flavouring agent. Procedure Mix the calculated quantities of magnesium sulphate and light magnesium carbonate in a mortar. Measure 3/4th of the vehicle. Out of this add small amount of vehicle to the powders. Triturate thoroughly so as to form a smooth cream. Then add remainder of the vehicle. Strain through a piece of muslin if foreign particles are present. Incorporate more of vehicle to produce the final volume. Transfer the mixture to a bottle, cork,and dispense Uses This preparation is used as a saline purgative Label "Shake the bottle before use" Keep away from children. Mixture containing diffusible solid.

EMULSIONS
Emulsions are the biphasic liquid dosage form of medicament in which two immiscible liquids (generally one of which is water and the other is some lipid or oil) are made miscible by The addition of a third substance known as emulsifying agent or emulgent. Milk is an example of natural emulsion. An emulsion may also be defined as a mixture of two immiscible liquids in which one liquid is dispersed as minute globules into the other. The liquid that is broken up into globules is called dispersed phase or internal phase and the liquid in which the globules are dispersed is khown as continuous phase, external phase or dispersion medium. The globules remain dispersed only for a short time, separation takes place quickly upon standing. Therefore a third substance known as emulsifying agent is added to the system which forms a film around the globules of the dispersed phase thereby the globules remain scattered indefinitely in the continuous phase and a uniform, stable product is formed. Purpose of Emulsification 1. Cartain medicinal agents having an unpleasant taste and odour can be made more palatable for oral administration in the form of emulsions which are otherwise difficult liver oil, shark liver oil, castor oil etc. 2. To prepare a homogeneous product containg immiscible liquids (oil and water). 3. The activity of certain drugs can be increased and action prolonged by emulsifying the drug in a suitable vehicle. 4.Sterile, stable intravenous emulsions containing fats, carbohydrates and vitamins all in one preparation can be administered to the patients who are unable to take these vital substances by oral route. Dermatological preparations like liniments, lotions and creams help in quick absorption of drugs from skin surfaces when applied externally. Types of emulsions: There are two types of emulsions. 1. Oil in water type (o/w) emulsions. 2. Water in oil type (w/o) emulsions. In oil in water type emulsions the oil is in the dispersed phase whereas water is in the continuous phase. Oil in water type emulsions are preferred for internal use because the unpleasant taste and odour is masked by emulsification and oil being in a finely dispersed state is more quickly assimilated in the body. Some of the o/w type emulsions can also be used externally.Water in oil type emulsions, the water is in the dispersed phase whereas oil is in the continuous phase. These types of emulsions are mainly used externally. to take e.g cod

Emulsions can be prepared by the following methods: 1. Dry gum method. 2. Wet gum method 3.Bottle method. In dry gum method the oil is triturated with gum and then water is added to make a primary emulsion whereas in wet gum method the gum is triturated with water to form mucilage first and then oil is added for the preparation of primary emulsion. For extemporaneous compounding of emulsions by dry gum method and wet gum method the most efficient apparatus used is mortar and pestle. Wedge wood or porcelain mortar and pestle is used which should be flat bottomed and rough on the inner surface so as to produce fine particles of the dispersed globules. Glass mortars should not be used because of their smooth surface which will not produce a good emulsion. The quantities of oil, gum and water required for primary emulsion are as follows: Proportion of Fixed oils Volatile oils oil 4 4 : : : Water 2 4 : : : Gum 1 2

The most commonly used fixed oils include castor oil, cod liver oil, shark liver oil, olive oil, almond oil and liquid paraffin (mineral oil). The volatile oils include turpentine oil, sandal wood oil, cinnamon oil and peppermint oil. 1. Dry Gum Method This method is also known as 4 : 2: 1 method because these figures represent the proportions of oil, water and gum acacia required for the preparation of primary emulsion. Measure the given quantity of oil with a clean and dry measure and transfer it to a dry mortar, To this add the calculated quantity of acacia and triturate rapidly so as to mix them. To this incorporate water required for primary emulsion and triturate rapidly without ceasing till a clicking sound is produced and the product becomes white or nearly white. At this stage the emulsion is known as primary emulsion. Then add more of water to produce the required volume. If any soluble ingredient is also to be incorporated that must be dissolved in the second part of water to be added after making the primary emulsion and to produce the final volume. 2. Wet Gum Method The proportion of oil, water and gum are same as for dry gum method. in this method the calculated quantity of gum is triturated with water required for primary emulsion, to form a mucilage. Then the given amount of oil is incorporated in small portions with rapid trituration until a clicking sound is produced and the product becomes white or nearly white. Add more of vehicle to produce the final volume. 3. Bottle Method The bottle method is used for the preparation of emulsions of volatile and other non-viscous

oils. The emulsions can be prepared by both dry gum and wet gum methods. Because of low viscosity the volatile oils require greater amount of gum for emulsification than fixed oils. In the preparation of majority of emulsions it is necessary to prepare first the primary emulsion which is diluted afterwards with more of vehicle. It is very difficult to mix whole of the oil with whole of water all at once because the volume of the liquid becomes quite large and the shearing force required to cut the dispersed phase into suitable size of globules is difficult to obtain. However, if the oil is first emulsified with only a small portion of water and emulsifying agent, a primary emulsion is formed by suitably reducing the size of oil globules, which can be diluted afterwards with more of water. The entire process of emulsion formation depends on the proper preparation of primary emulsion. Better the primary emulsion formed better will be the emulsion. Liniments Liniments are the liquid preparations meant for external application to the skin. They are applied with friction and rubbing of the skin. They should not be applied to the broken skin. Liniments should be dispensed in coloured gutted bottles in order to distinguish from preparations meant for internal use. The bottle should be labelled "for external use only" and "shake the bottle before use".

Exp No: 3 TURPENTINE LINIMENT Aim : To prepare and dispense 30 ml of the turpentine liniment Date: Name: Age: Sex: R Soft soap Camphor 90 gm 50 gm Turpentine o i l Purified water q.s to 6 5 0 ml 100 ml Address

Date

Fiat: Make an emulsion Sig : To be applied externally to the affected part with friction. Dr. Reg.no Type Theory 1. Irritants are the agents or substances which do not directly destroy the tissues but cause inflammation in the area to which they are applied. 2. Rubefacients are the substances which produce congestion and redness of the area to which they are applied, producing the initial symptoms of irritation. 3. Counter-irritants are the agents or drugs which are applied locally to irritate the intact skin thus re ducing or relieving another irritation or deep seated pain. They seem to work by producing an inflammation, thus increasing the flow of blood to the affected area. Physical counter-irritants include: hot water bottles, radient heat, short wave diathermy and galvanic electric current. Chemical counterirritants include: volatile substances like turpentine oil, camphor, menthol, thymol and methyl salicylate. 4 Since turpentine oil is a volatile oil which is not miscible with water, to make them miscible with each other soft soap has been used which acts as an emulsifying agent. 5.Turpentine oil is a volatile oil obtained by the distillation and rectification of turpentine which is an oleoresin obtained from various species of pines. 6. Camphor is a volatile substance obtained from wood of cinnamonium camphors. It can be prepared synthetically. Externally it acts as a-mild analgesic and rubefacient. It is used as a counter-irritant in the treatment of fibrositis and neuralgia. : Emulsion type liniment made with alkali soap.

Procedure Dissolve the calculated amount of Camphor in turpentine oil in a dry container. Separately dissolve soft soap in small amount of purified water in a mortar. To this gradually add the camphor solution with thorough triturating after each addition until a thick creamy emulsion is formed. Add sufficient purified water to produce the required volume. Transfer the preparation to a bottle, label and dispense. Apply the secondary label "for external use only" and "Shake the bottle before use." Uses It acts as an irritant, counter- irritant and rubefacient.Liniment of turpentine is applied externally to the patients suffering from arthralgia (pain in the joints), myalgia (muscular pain), fibrositis (ligamental pain) and sprain. Precautions Liniments are not to b e applied to the broken skin-because they may produce excessive irritation of the skin. Label "for external use only" and "Shake the bottle before use." and not to be applied to broken skin.

Exp No 4 CASTOR OIL EMULSION Aim; To preprare and dispense 15 ml 0f castor oil emulsion Date: Name: Age: Sex: R Castor oil Water ad Fiat: Make an emulsion Signs: Administer during morning Dr. Reg. no Type: Theory o/w type emulsion for internal use. 8 ml 30 ml Address

Date

Castor oil is a fixed oil and is not miscible with water. To make it miscible a third substance known as emulsifying agent in the ratio of 4 : 2 : 1 i.e. oil: water: gum will be used for the preparation of primary emulsion. Gum acacia will be used as emulsifying agent because emulsions prepared with gum acacia remain stable for sufficient long time. Formula for primary emulsion: Oil 4 ml 8 ml Water 2 ml 4 ml Gum 1gm 2 gm

Procedure Wet gum method: Thoroughly clean and dry a pestle and mortar. Weigh out 2 gm gum acacia and transfer it to the mortar. Measure 4 ml water and triturate it with gum so as to form a mucilage. To this add 8 ml castor oil in small quantities at a time with thorough trituration after each addition. Triturate briskly without ceasing until a clicking sound is produced and the product becomes white or nearly white. At this stage the emulsion is known as primary emulsion. Add about 10 ml more of vehicle in small quantities at a time with constant trituration so as to get a homogeneous product. Transfer the emulsion to a measure, add more of vehicle to produce the final volume 30 ml, stir thoroughly so as to forma uniform emulsion. Transfer the preparation to a bottle, cork, polish the bottle to remove finger prints, label and dispense.

Attach the secondary label "Shake well before use." Uses Castor,oil is used as purgative. Precautions Because of its prompt action castor oil should not be administered at bed time, preferably it should be given early in the morning. Label The most important auxiliary label is "for oral use"," shake well before use" avoid excessive use" the shelf life is one month. The storage condition is store in cool and dry place, avoid freezing Keep away from children.

DENTIFRICES POWDERS
Powders are the solid dosage form of medicament in which the drug or drugs are dispensed in a finely divided state. They are available in crystalline or amorphous form. Whenever crystalline substances are to be dispensed in powder form, they must be reduced to a fine powder before mixing them with other substances. Powders may be dispensed as divided powders (single doses) by wrapping individually in suitable size papers or as bulk powders in suitable containers.

E x p No 5 T O O T H PO WDE R

Da t e

A i m : T o p r e p a r e a nd d i s p e n s e 1 0 g m of t o o t h p o w d e r a s p e r N F I Date: Name: Age: Sex: R Quantity required for 50gm Thymol Sodium bicarbonate Saccharine sodium Hard soap Calcium carbonate Fiat: Prepare and dispense the powder Sig: Use regularly with a tooth brush Dr. Reg.no Theory: Powders used to clean the teeth are called dentifrices. It is applied with a tooth brush. Packaging: Sifter top metallic or plastic container. Divided powders (i.e. single dose) each dose is separately enclosed in a piece of paper. (1) For wrapping divided powders, white glazed paper (demy paper) is generally used.The powder wrappers are stacked in a paper box and dispensed. Some time double wrapping is required, especially if the powder is hygroscopic. In this case waxed paper is used as inner wrapper, then the demi wrapper as the outer wrapper. 0.6 gm 7.2 gm 2.4gm 7. 2gm 32.6 gm Address

1.
2. 3. 4. 5.

Thymol: Antiseptic , irritant , deoderant, sialogogue( which increases salivary secretion) Sodium bicarbonate: Mucolytic agent and an alkalie which neutralizes acid and prevents acid Saccharin sodium: Sweetening agent Hard soap: Detergent, cleaning agent, lubricating agent Calcium carbonate: It is an abrasive which cleans and polishes the teeth. It helps in loosening

destruction of tooth and caries formation. It acts as an oral antacid.

and removal of food particles and stains from teeth.

Procedure: Calculated amount of thymol, sodium bicarbonate, saccharine sodium, hard soap, and calcium carbonate are weighed separately and taken in a clean dry mortar. Powder well by trituration. Transfer the preparation to a paper pack, label and dispense. Uses To clean and polish teeth To remove dental plague and stains from teeth To maintain good oral hygiene To prevent tartar formation

PASTES Pastes are the semi-solid preparations meant for external application to the skin, They differ from ointments that they generally contain a large amount of finely powdered solids such as starch, zinc oxide, calcium carbonate etc. They are quite thick and stiff than ointments but are less greasy than ointments.

Exp No 6 TOOTH PASTE Aim: To prepare and dispense 10g of toothpaste as per NFI Date: Name: Age: Sex R Quantity required for 100g Calcium carbonate Soft soap Glycerine Saccharine sodium Methyl salicylate Starch Distilled water Sig: Use regularly with a tooth brush Dr, Reg. no Theory 4 gm 20 ml 2 gm 2ml 4 gm 15 ml 52 gm Address

Date:

Fiat: Prepare and dispense the tooth paste

Calcium carbonate- An abrasive which cleans and polishes teeth.It helps in loosening and removal of food particle and stain from the mouth Soft soap- Detergent and cleansing agent Glycerine- Used as solvent or vehicle in which other medicaments are dissolved. It is a hygroscopic agent and keeps the area moist. Because of its viscous nature it retains the medicament in area for sufficient time rendering prolonged action. It is demulcent and smoothens, softens the oral mucosa. Procedure Calculated amount of Calcium carbonate , soft soap, starch are weighed separately and taken in a dry and clean mortar. Powder it. Calculated amount of saccharine, glycerin, methyl salicylate, and distilled water are added. Triturate it well. Transfer to an oil paper. Label and dispense. Uses 1. 2. 3. 4. To maintain good oral hygein To polish and clean teeth To prevent tartar formation To prevent halitosis

MOUTH WASH A mouth wash is an aqueous solution with a pleasant taste and cdour used for rinsing, deodorant, refreshing or antiseptic action. The medicated mouth washes should not be indiscriminately used by a normal person, the continuous use may prove harmful.

Exp No:7 POTASSIUM PERMANGANATE MOUTH WASH

Date:

Aim: To prepare and dispense 100ml of 1:5000 potassium permanganate mouth wash Date: Name: Age: Sex: R Quantity required for 100ml of 1:5000 Kmno4 mouth wash Pottassium permanganate Sodium chloride Distilled water 20 mg 900 mg 100ml Address

Fiat: Prepare and dispense the mouth wash Sig:1. Dilute it with an equal volume of warm water before use. 2. Rinse the mouth in morning and night after brusing. Dr. Reg.no Theory Normal Saline (0.9% Nacl) - used for cleaning of wounds and dehydration Potassium permanganate- antiseptic, deodorant, astringent (Mechanism: When it comes in contact with substance, it releases nascent oxygen, which kills the microbes. Procedure Add 100mg of potassium permanganate to 100ml of distilled water and stirr well. Take 20ml of this add .0.9gm NaCl. Transfer it to a measuring jar, add distilled water to make the volume 100ml. Solution is transferred to an amber coloured bottle because potassium permanganate is decomposed by sunlight. Bottle is labeled properly. Uses Mouth wash(1:5000)- pharyngitis, tonsillitis Cleansing of wounds , ulcers Disinfection of water Cleaning of vegetables Used in antral wash in sinusitis Stomach wash (gastric lavage) in case of alkaloid poisoning In case of snake bite For dressing exudative dermatitis Label : FOR DENTAL USE Not to be swallowed Keep out of reach of children

PAINTS Throat paints are viscous liquid preparations used for mouth and throat infections. Glycerin is commonly used, because it is very viscous and it adheres well to the mucous membrane of mouth and throat. It also gives a sweet taste and warm sensation to the inflamed area. Examples: Compound iodine paint (Mandls paint), boric acid glycerin, phenol glycerin, tannic acid glycerin.

Exp No: 8 MANDLS THROAT PAINT Aim: To prepare and dispense 10 ml of Mandls paint Date: Name: Age: Sex R Potassium iodide Iodine Alcohol 90%v/v Water Peppermint oil Glycerol upto 25g 12.5g 40ml 25ml 4ml 1000ml Address

Date:

Fiat : make a throat paint and dispense 10 ml Sign : to be applied on the affected part 2-3 times a day with a cotton swab. Theory Iodine antiseptic, antifungal and anti viral Potassium iodide helps to dissolve the iodine Distilled water as solvent Peppermint oil flavoring agent Alcohol mild antiseptic and dissolves peppermint oil Glycerine act as vehicle, adherent, soothening agent and demulsent Method of preparation

(i)
(ii) (iii)

Take potassium iodide and iodine in clean and dry glass mortar and powder well and add Peppermint oil is dissolved in alcohol 90%v/v and the alcoholic solution is added to the Volume is made up with glycerin.

distilled water and mix it well to form KI3 (or higher iodides). iodine solution. USES: Pharyngitis, tonsilitis and gingivitis Container Containers: Air-tight, light resistant (required for peppermint oil), fluted bottle. Label: FOR EXTERNAL USE ONLY Not to be swallowed in large amount. Storage: Stored in a cool place.

Exp No: 9 THE ASTRINGENT GUM PAINT Aim: To prepare and dispense 10 ml of astringent gum paint Date: Name: Age: Sex R Tannic acid Potassium Iodide Iodine Glycerine 5 gm 10 gm 5 gm up to 100ml Address

Date:

Fiat : Make and dispense 10 ml Sign : Put a drop or two of gum paint on the tip of the finger and rub gently on to the affected areas every 3-4 hours. THEORY Tannic acid has been used as an astringent for the mucus membranes of the mouth and throat. Gum paint, provides cooling, soothing, astringent effect. Similarly, ingredients like iodine, potassium iodide have germicidal, fungicidal, anaesthetic and healing properties. Menthol provides the cooling effect and also it possesses local anesthetic action. Glycerine helps the healing of the ulcer as well as it has antiinflammatory property. PROCEDURE Required quantities of iodine, potassium iodide and tannic acid are weighed and transferred into a china dish and kept on a water bath and mixed with a glass rod cool it to room temperature and transferred to an amber colored bottle and labeled and dispense. Uses: Stomatitis, Glossitis, Peridontitis, Gingivitis and Aphthous Ulcers. Label: FOR EXTERNAL USE ONLY Not to be swallowed in large amount. Storage: Stored in a cool place

Chapter 6

PRESCRIPTION

Prescription is an order written by a physician, dentist or any other registered medical practitioner to a pharmacist to compound and dispense a specific medication for the patient. The order is accompanied by directions for the pharmacist that what type of preparation is to be prepared and how much is to be is prepared. It is also accompanied with the directions for the patient that how much medicament is to be taken, how many times or at what time and how it is to be taken. Prescriptions were generally written in Latin language which was understood allover the world, so that the ingredients of the prescriptions remain unknown to the patient to avoid self medication. Still the use of Latin abbreviations in the prescription writing is very common especially in dosage instructions. The modern tendency in prescribing drugs is to make prescriptions simple. Instead of prescribing a mixture of numerous drugs, the prescription of a single drug with definite and specific action is desired. More stress is laid on the readymade preparations which are available in the market. Stepwise Procedure: Prescriptions are generally written in English language but Latin words or abbreviations are some times used. So it becomes necessary for Pharmacist to become familiar with the Common Latin terms and abbreviations. Parts of the prescription: 1. Prescriber's office information: It gives information about the prescriber, his/her clinic with address and phone number. 2. Date: Date helps a pharmacist to find out the date of prescribing and date of presentation for filling. Prescription of Narcotic or other habit-forming drugs must bear the date. 3. Name, age, sex and address must be written because it serves to identify the prescription. It also helps the pharmacist to check the prescribed dose of medication in case of children. 4. Superscription: It is represented by a symbol Rx which is written before writing the prescription. It is an abbreviation of Latin word Recipe which means 'You take ' (Take Thou). In olden days, the symbol was considered to be originated from the sign of Jupiter, God of healing. 5. Inscription: This is the main part of the prescription order, contains the Name and Quantities of the prescribed ingredients. The name of each ingredient is written on a separate line along with its quantity.

Inscription can be divided into different parts like Base, Adjuvant and Vehicle. For example in above format sodium bicarbonate is an antacid drug (maximum dose: 5 gm), compound tincture of cardamom for flavour, simple syrup as sweetener and water as vehicle. 6. Subscription: It gives direction to the pharmacist for preparing the prescription and number of doses to be dispensed. 7. Signetur (Signa): This consists of directions to be given to the patient regarding administration of the drug. For example direction given above can be translated into English as: One tablespoonful to be taken three times a day after meals. 8. Refill: Number of authorized refills is indicated to prevent misuse of prescription. 9. Signature, address and registration number of the prescriber: It is important in order to avoid misuse of the preparations. Modern method of prescribing: Though above information describes traditional way of prescribing, with flow of time many changes have taken place. For example, now a days majority of drugs are available in the market as readymade formulations which are more suitable considering sterilization, container suitability, very small size (micro, nano) of drug molecules etc. Thus there is no need to dispense the drugs by the pharmacists. So prescriptions by physicians generally contain the generic name, trade name, dose size, dosage forms, etc. The language use of English terms instead of Latin, metric system weights and measures instead of grains and minims, use of computers for storage of patients related information are salient features. A student has to adopt above changes in his career of professional life, as these are the existing ways. In view of above there are some prescriptions in this manual containing metric system, English language etc. But to learn the basic things and to be perfect in all angles, old ways are retained in few prescriptions.

DENTAL COLLEGE MUVATTUPUZHA Ph. - 04852222222

Date: --/-- /---Name---------------------------------- Age----yrs R (Superscription) Sex---

Address--------------------Body surface area----sq. m. Wt --- kg

Sodium bi-carbonate INSCRIPTIO N Compound tincture of cardamom Simple syrup Water quantity sufficient

3 gm 2 ml 6 ml 90 ml

Fiat: Mistura (subscription)( make a mixture) Signa. Cochleare magnum ter in die post cibos sumenda (Signature) (Take one tablespoon full t.i.d after the meals) Refill:-----------

(Signature) SdlDr. -------------Regd. No. -

LABEL The following information should be written on all the labels: (i) Type of the preparation: The mixture, The Emulsion, The powder etc. It's quantity should also be mentioned. (ii) For: Name of the patient, age and sex. (iii) Registration no. (iv) Date of dispensing. (v) Expiry date if any. (vi) Direction for its use. (vii) Storage conditions. (viii) Name and address of the pharmacy. (ix) In case of liquid preparations which require previous shaking e.g. emultions, suspensions, liniments, lotions etc. must be attached with secondary label "Shake the bottle before use".

(x) The prescriptions meant for external use e.g. liniments, lotions, ointments, eye drops, ear drops etc. must be attached with secondary label "for external use only". Sample label THE POWDER (5 x 250 mg) For:Mrs X.Y.Z. Age: 25 yrs (Y) Regd. no. "47 Date of dispensing: Directions: One to be taken when the pain is severe. Sex

Dispensed by-. Name and address of pharmacy.

Chapter 7
I.

PRECRIPTION WRITING

Write the rational prescriptions for the following and justify it? Problems encountered in clinical practice

1. 2.
3. 4. 5. 6.

Prescribe drugs for chronic bronchial asthma Prescribe drugs for 50 year old patient diagnosed for hypertension(140/95) Prescribe drugs for severe congestive heart failure. Prescribe drugs for acute angina. Prescribe drugs for recurrent case of peptic ulcer. Prescribe drugs for bacillary dysentery Prescribe drugs for pseudo membranous colitis Prescribe drugs for type II diabetes mellitus Prescribe drugs for diabetic coma Prescribe drugs for osteoarthritis Prescribe drugs for anaphylaxis Prescribe drugs for status asthmaticus Prescribe drugs for status epilepticus Prescribe drugs for iron deficiency anaemia Prescribe drugs for pernicious anaemia Problems encountered in dental practice. Prescribe drugs for acute necrotizing ulcerative gingivitis Prescribe drugs for acute herpetic gingivitis Prescribe drugs for acute stomatitis Prescribe drugs for acute gingival abscess Prescribe drugs for pericoronal abscess Prescribe drugs for dental caries Prescribe drugs for aphthous ulcers Prescribe drugs for hypersensitive dentine Prescribe drugs for dentoalveolar abscess Prescribe drugs for xerostomia Prescribe drugs for acute tooth ache Prescribe drugs for post operative pain Prescribe drugs for post extraction pain with swelling Prescribe drugs for oral candidiasis Prescribe drugs for scurvy

7.
8. 9. 10. 11. 12. 13. 14. 15. II.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

Appendix LATIN TERMS AND ABBREVIATIONS COMMONLY USED IN PRESCRIPTION WRITING DOSAGE FORMS Latin Name Auristille Capsula Cataplasma Charta Collutorium Collyrium Cremor Emulsio Haustus lnjectio lnsufflatio Linctus Linimentum Liquor Lotio Mistura Naristillae Nebula Pasta Pilula Pulvis Solutio Suppositorium Tabletta Unguentum TIME OF ADMINISTRATION Latin Name Semel in die Bis in die, Bis d Ter in die Quater in die Sexies in die Abbreviation Sem in die b.i.d., b.d. t.i.d., t.d. q.i.d., q.d. Sex.i.d. English Name Once a day Twice a day Three times a day Four times a day Six times a day Abbreviation auristill. caps. cataplasm chart. collut. collyr. crem. emul. ht. inj. insuff. linct. lin. liq. lot. m,mist narist. neb. past. pil. pulv. sol. suppos tab. ung. English Name Ear drops A Capsule A poultice A powder A mouth wash An eye wash An cream An emulsion A draught An injection An insufflation A linctus A liniment A solution A lotion A mixture Nasal drops A spray solution A paste A pill A powder A solution A suppository A tablet An ointment

METHOD OF ADMINISTRATION OR APPLICATION Latin Name Addendus Applicandus Capiendus Dandus Deglutiendus lnfricandus inhaletur Miscendus Signa Sumendus Utendus OTHER TERMS Dolore urgent Frequenter Lente More dicto Modo dicto Si opus sit Statim Tussi urgent PARTS OF BODY Auris dexter Auris laevus Brachio Corpori Jugulo Naso Oculis dexter Oculis laevus Os, oris Pro oculus Sterno m.d. m.d. S.O.S. stat. tuss.Urg. When required or When necessary Immediately When the cough is troublesome dol.urg. f req When the pain is severe Frequent Slowly As directed addend. applicand. capiend. dand. deglut. infricand. inhal. miscend. sig. S or sum. U or utend. Abbreviation English Name To be added To be applied To be taken To be given To be swallowed To be rubbed in Let (it) be inhaled To be mixed Label To be taken To be used

a.d. a.1. brach, Corp jug. -----0.d. 0.1. O.S. pro.ocul. Stern

To right ear To left ear To the arm 10 the body To the throat To the nose To right eye To left eye To mouth For the eyes To the chest

DIFFERENT TIME OF THE DAY Primo mane Mane Omni mane Omni nocte Inter noctem Nocte Jentaculum Nocte et mane Nocte maneque Omini hora Omini Quarta ho Singulis horis Alternis horis Tertis horis Quartis horis Sextis horis Ante cibos Post cibos prim.m. m 0.m. 0.n. Inter noct n jentac n.et.m. n.m. 0.h. 0.q.h. Sing. hora Alt. hor. Tert.hor Quart.hor. sext. Hor a.c p.c Early in the morning In the morning Every morning Every night During the night At night Breakfast Night and morning Night and morning Every hour Every fourth hour Every hour Every two hours Every three hours Every four hours Every six hours Before meals After meals Between meals

Inter cibos i.c VEHICLE USED AND MEANS OF APPLICATION Cocheare amplum Cocheare magnum Cocheare maximum Cochleare medium Cochleare minimum Cum Cum duplo Cum parte aequale Cum tanto Cyathus amplus Cyathus magnus Cyathus vinosus E.lacte Ex.aqua Coch amp Coch mag Coch max coch. med. coch. min. c.c. c. dup. c. pt. aeq. c. tant. cyath. amp. cyath. mag. cyath. vin. e. lact. ex. aq.

One tablespoonful

One dessertspoonful One teaspoonful With With twice as much With an equal quantit With as much A tumbler A tumbler A wine glass With milk With water

MISCELLANEOUS Ana Ante Aqua Aqua distillate Cibos Fiat Gutta, guttae Hora Laevo Misce Mitte Mitte tales More dicto Omni Pro dosi Quantum sufficiat Recipe Semi Solve Talis, tales aa a aq aq.dest cibos ft . gtt. h L m mitt. mitt tal m.dict. omn ----- q.s. R SS ----tal Of each Before Water Distilled water Meals, food Make, let (it) be made A drop, drops An hour Left Mix, let it be mixed Send Send such In the manner prescribe Every As a dose As much as is sufficient Take Half Dissolve Such

NUMERALS Unus Duo Tres Quatuor Quinque Sex Septem Octol Octem Novem Decem Undecim Duodecim Quatuordecim Quindecim Viginti Quinquaginta Centum I II III IV V VI VII Vlll IX X XI XII XIV XV XX L C One Two Three Four Five Six Seven Eight Nine Ten Eleven Twelve Fourteen Fifteen Twenty Fifty One hundred