Pharmacy Facts That Can Be Useful for Local and State Board ExaminationsThe following material may be of particular importance on state and local board examinations.1. All official dilute acids are 10%w/v, except acetic acid which is 6% w/v.(Both)

2. Phenolphthalein gives colorless endpoint in acidic solution and red with basic solution.(Local)

3. The purpose of NaI or KI in iodine solution or Lugol's solution is to serve as a cosolvent.(Both)

4. PVT TIM HALL is the mnemonics of ten essential amino acids, which are Phenylalanine, Valine, Threonine, Tryptophan, Isoleucine, Methionine, Histidine, Arginine, Leucine and Lysine.(Local)

5. Aluminum acetate solution (Burrow's solution) must be diluted with 10-40 parts water before use.(Both)

6. Vitamin D3isknown as cholecalciferol, and significant for efficient calcium absorption. It is activated in skin by sun rays.(Local)

7. Povidone-iodine (Betadine) 5% solution releases 0.5% free iodine (10:1 ratio) so 30% releases 3% free iodine. Terpin hydrate and codeine elixir = 0.2% codeine and 42% alcohol. White lotion (lotio alba) = 4% zinc sulfate and 4% sulfurated potash.(Local)

8. The usual dose of magnesium citrate is 200ml (entire bottle).(State)

9. Specific Gravity is the ratio of the weight of a substance in air at 25oC to the weight of an equal volume of substance at the same temperature. Water is the usual standard for the specific gravities of liquids and solids; the most useful standard for gases is hydrogen.(Local)

10. Density is the mass per unit of a substance.(Local)11. Simple syrup requires no preservative because of the absence of free water.(Both)12. Most biologicals are stored at between 2-8oC (refrigerator) with the exception of yellow fever vaccine, smallpox vaccine, and live oral polio vaccine which must be stored at 0oC (freezer).(Both)13. Parasympathetic (Cholinergic) is the rest and digest system; dominant during tranquil conditions. Sympathetic (Adrenergic) is the fight or flight symtem; dominant during stressful situations.(Local)

14. Tincture of potent drugs are 10%, while nonpotent drug tincture are 20%.(State)

15. Fluidextracts are considered 100% tinctures (or 1g of drug milliliter).(State)

16. HLB stands for hydrophilic lipophilic balance and an HLB value of 3-6 will give a w/o emulsion while an 8-18 value will give you o/w.(State)

17. Insulin's packaging is color coded relative to the strength and type (e.g., red indicates 40units/ml, green 80units/ml, and orange 100units/ml).(State)

18. Drugs that can be steam sterilized should be done so under 15lb of pressure at 121oC for 20 minutes.(Both)

19. The number of X's on a bottle of witch hazel represents the number of times it has been distilled.(State)

20. Ratio and proportion is the general formula or method in calculating and solving of almost all pharmacy calculations.(Local)

21. In converting adult dosages to infant dosages, you may use one o the following formulas:A. Young's Rule (for patients two years and over):{Age (in years)/[age (in years)+12]} x adult dose = child's doseB. Fried's Rule (patients one year of age):[age (in months)/150] x adult dose = child's doseC. Clark's Rule (two years and older):[weight (in lb)/150] x adult dose = child's doseD. Surface area: Is the most accurate method since it uses a nomogram composed of height and weight which is thought to correlate the physiologic activity with the surface area.(State)

22. Cold place temperature dose does not exceed 8oC; A refrigerator is a cold place held between 2 8oC.(Both)

23. Cool place is a temperature between 8 15oC.(Both)

24. Excessive heat is a temperature above 40oC.(Both)

25. Percentage strengths:A.Percentage weight in weight (w/w) represents the number of grams of a constituent in a 100g of a preparation.B.Percentage weight in volume (w/v) represents the number of grams of a constituent in 100 ml of a preparation.C.Percentage volume in volume (v/v) represents the number of milliliters of a constituent in 100ml of a preparation.(Both)

26. When using calcium hydroxide (lime water), it should not be shaken.(Both)

27. Sucrose hydrolyzes into dextrose (glucose) and fructose (levulose) which are referred to as inverted sugars.(Both)

28. Ipecac syrup is used as an emetic in doses of 15ml and should not be confused with the fluid extract of ipecac which has a dose of 0.5 1.0ml.(State)

29. Thixatrophy occurs when a solution is allowed to stand and become a gel; upon agitation it returns to solution (e.g., bentonite magma).(Both)

30. Incorrect prescriptions can be classified as erroneous, violative or impossible prescription.(Local)

31. These methods for preparation of emulsion are:A.Continental or dry gum method for fixed oils requires mixture of one part acacia with four parts oil and then two parts water (4:2:1).B.English or wet gum method for fixed oils requires mixing of one part acacia with two parts water and then four parts oil (4:2:1).C.Bottle or Forbes' method for oleaginous or volatile substances requires placing one part acacia in bottle, then placing two parts oil and then two parts water are added (2:2:1).(Both)

32. Cocoa butter should not be overheated since it can form a metastable from which will melt below room temperature.(Both)

33. The number following polyethylene glycol represents its average molecular weight (PEG 400), while the number following methylcellulose represents its viscosity in centerpoise (methylcellulose 4000).(Both)

34. Glycerin suppositories are used in constipation and contain sodium stearate as a solidifying agent.(Both)

35. Vitamins A, D, E and K (ADEK) are fat soluble vitamins, while, Vitamins B and C are water soluble vitamins.(Local)

36. Cation in intracellular cell is potassium, and in extracellular cell is sodium. PISO is the mnemonics which means Potassium In, Sodium Out.(Local)

37. Precipitated sulfur should always be used in compounding (in place of sublimed sulfur).(State)

38. Calamine lotion = 8% zinc oxide and 8% calamine, which is 98% zinc oxide and 2% ferric oxide.(Both)

39. Paregoric tincture = 0.4% of anhydrous morphine (40mg morphine per 1000ml).(State)Legend:Both Local and State Board ExamState USA Board ExamLocal Philippine Board Exam

Steps in Dispensing Prescription or OTC DrugsPharmacy is also a business, money can be involved in every transaction. Sales and profit are secondary main goals of a drugstore, which mean the more the buyers and customers are, the more the sales revenue can accumulate per day. Thus, once a customer stops to a drugstore, the establishment must see to it that the customer's needs are available in them and must be given or satisfy, so that another time that customer needs drugs again he shall go back to your drugstore. Also the flow of the dispensing process should be fast but accurate, and proper courtesy and respect must be shown to impress customer that consequently achieving their loyalty. In the Philippines dispensing process is done within 10-15 minutes depending on the number of prescribed drugs, volume of people and the capacity of manpower a drugstore has.

Steps inDispensingDrugs1. The customer will approach the pharmacy and call the attention of one of the personnel.2. The pharmacist or pharmacy assistant will greet the customer and must sustain good manners all through the transaction.3. The personnel will ask the patient about his/her prescription or drug needs.4. After the presentation of prescription/s or details of drug/s needed, the personnel shall check the availability of stock on the shelves, the price, the expiration date and other generic equivalence of that brand or drug/s.5. The prescription/s or drug/s will be priced. Allow the customer to budget his/her money to decide if he/she can afford the brand of that drug/s.6. Introduce to him/her other generic equivalence or other drugs that contain the same generic name, strength, dosage form and alike, which can help him/her to save money or budget his/her money.7. Take time to let the customer to decide what price of drug he/she will buy and the quantities to be sold. Total the amount incurred by the customer and ask for his/her payment. (If the patient is senior citizen, ask for requirements, and deduct the respective percentage).8. If decision was made, prepare the decided drug/s (with the cheapest price) to be bought by acquiring them from the shelves. Blistered or foiled packaging will be cut in the pieces requested by the customer and/or if the packaging is loose count the number of the drug needed in the tablet counter and placing them into compact plastic bottle, wide-mouthed amber bottle or small capsule cellophane that placing the information of the patient, information of the drug and quantity of the drug. Check the drug before and after removing from the shelf if it is the required drug. Check also for expiration of the drug and stability of it.9. When the drug is prepared proceed to billing.10. Take back his/her change if there is and counter-check the drug's name, count and quantities infront of him.11. Counsel the customer about the instruction given to him/her by the physician, the storage condition, and other information about the drugs.12. End the transaction by speaking Thank you! and Come back again!. The prescription shall be filed and kept.You might also like:Pharmaceutical TabletsTabletsare solid dosage forms of medication prepared by compressing or molding. Since the latter part of the 19thcentury up to the present time they are the most popular of all kinds of medicinal preparation intended for oral use.

Advantages of Tablets:1. Accuracy and compactness of dosage2. Simplicity and economy in manufacturing3. Convenience in dispensing and shipping4. Simple to identify5. Blandness of taste to make it easily to swallow6. Available in special-release forms7. Most stable in all dosage forms8. Best suited to large-scale production9. Essential tamper-proof.

Disadvantages:1. Some drugs are incompatible to compress into tablets.2. Some drugs are hardly to reach the adequate bioavailability.3. Undesirable tastes and odor of some drugs cannot be masked.

Tablet Characteristics:

The different specifications by which compressed tablets are characterized includes the diameter size, shape, thickness, weight, hardness and disintegration time. The diameter and shape depend on the die and the punches used for compression. In general, tablets are discoid in shape, however, they may be oval, oblong, round, cylindrical or triangular. The upper and lower surfaces may be flat, round, concave or convex to various degrees. The concave punches maybe shallow, standard and deep cut.

Tablet Types and Classes1. Tablet for oral ingestion

a. Compressed Tabletsare tablets made from crystalline or granular materials, alone or in combination with binders, disintegrants, lubricants and fillers. They are formed by compression and do not contain special coating.b. Multiple compressed tabletsare compressed tablets made by more than one compression cycle. Layered tabletsare tablets prepared by compressing additional tablet granulation on a previously compressed tablet. This operation may be repeated a number of times to produce a multi-layered tablet. Compression-coated tabletsare tablets prepared by feeding a previously compressed tablet into a special tablet machine and compressing another layer around this performed tablet. With this method a compressed tablet in which compatible ingredients may be kept in separate layers. It has all the advantages of the compressed tablet, such as: - sletting, monogramming, speed of disintegration, etc. while retaining the attributes of the sugar-coated tablets in masking the taste of medication in the internal layers.c. Repeat-action tabletsare layered tablets in which the outer layer gives an initial dose, quickly disintegrate in the stomach. The inner layer contains of components that are insoluble in gastric solution but soluble in intestinal solution.

d. Delayed-action and enteric-coated tabletsare tablet coatings that resist solution in gastric fluid but disintegrate and release their medication in the intestines. Among the agents used to enteric-coat tablets are fats, fatty acids, waxes, shellac and cellulose acetate phthalate.

e. Sugar-coated tabletsare coating that cover up medicinal possessing objectionable tastes and odors, and protect sensitive medicinals subject to deterioration. Sugar-coated may be coated with a colored or an uncolored sugar. The process includes seal coating (waterproofing), subcoating, syrup coating (for smoothing and coloring), and polishing. Sugar-coated tablets may be 50% larger and heavier than the usual tablet.f. Chocolate-coated tabletsoriginally chocolate was used as a coloring material, but at present the iron oxide standardized as to color are available and largely replaced chocolate for this purpose.g. Film-coated tabletsare thin layer or film of a water-soluble imparts the same general characteristics as sugar-coated tablets with the added advantage of greatly reduced time required for the coating operation. A number of polymeric substances with film-coating properties are used for this purpose.h. Air suspension-coated tabletsare placed into a vertical cylinder that supported by a column of air and enters from the base of the cylinder. As the coating solution enters the system, it is rapidly applied to the suspended rotating solids. Rounding coats can be applied in less than 1 hour with the assistance of warm air blasts released in the chamber.j. Chewable tabletsare tablets that disintegrate smoothly and quickly when chewed or allowed to dissolve in the oral cavity, giving a creamy base from specially colored and flavored mannitol. This formulation is terrific for children that commonly applied to multivitamin tablets.2. Tablets used in the oral cavity

a. Buccal or sublingual tabletsare small, flat, oval tablets intended to be inserted in the buccal pouch, or beneath the tongue, where the active ingredient may be directly absorbed through the mucosa.

b. Troches, lozenges, and dental conesdissolve slowly in the mouth and provide primarily local effects.

3. Tablets used to prepare solutionsa. Effervescent tabletsare prepared by compressing granular effervescent salts or other materials such as citric acid, tartaric acid, sodium bicarbonate, that have the capacity to release carbon dioxide gas when in contact with water.b. Dispensing tabletsthose tablets are not to be dispensed as such as they contain very large and sometimes lethal doses of the potent drug. They provide a convenient quantity of a potent drug that can be incorporated readily into powders, liquids, and other preparations at the dispensing counter.c. Hypodermic tabletsare tablets made in a tablet triturate mold and are intended for use in making hypodermic preparation for injection. They are made with absolute cleanliness as they usually used to prepare parenteral solution extemporaneously, so they must be completely and rapidly soluble in the vehicle.

Compressed Tablets

Medicinal substances either in crystalline or powdered form intended to be made in dosage form with pressure using available equipment should possess a number of physical characteristics, such as: Ability to flow freely to ensure a uniform fill in the die cavity and to allow continuous movement of the granulation from the sources or food hopper. Cohesiveness ability to hold together the materials thus preventing tablets from crumbling and falling apart on handling. Lubrication to minimize friction and to favor the removal of the compressed tablets from the punch faces. Since these properties are not commonly found in the ingredients methods should be adopted to impart these desirable characteristics to the materials.

Tablet Ingredients:1. Active or therapeutic ingredients2. Additives or excipients are inert materials which can be classified according to their function into: Those which help to impart satisfactory compression characteristics like diluents, binders and lubricants. Those that help to give additional desirable physical characteristics to the finished tablet like disintegrants, colors and flavors.

Tablet Excipients:1. Diluents These are inert substances added to increase the bulk in order to produce a practical size for compression. Dicalcium phosphate, calcium sulfate, lactose, kaolin, mannitol, sodium chloride, dry starch and powdered sugar are some of the common diluents. Mannitol has a pleasant taste, chemically stable and is not hygroscopic hence it is usually employed as a diluent for chewable tablets. Most tablet formulators use only one or two diluents. Care should be observed regarding incompatibilities between active ingredients and diluents. Calcium salts interfere with the absorption of tetracycline from the gastrointestinal tract. Amino bases with lactose and alkaline lubricant will produce discolored tablets on aging.

2. Binders or Granulators These are substances added to the powdered material to impart a cohesiveness to the formula which ensures the tablet to remain intact after compression. Binders also improve the free-flowing qualities by the formulation of granules of desired hardness and size. The most common binders are starch, gelatin, and sugars like sucrose, molasses and lactose. Natural and synthetic gums which have been used include acacia, sodium alginate, extract of Irish mess, carboxymethylcellulose, methylcelluloses, polyvinylpyrrolidone, veegum, and larch arabogalactan. Polyethylene glycol, ethylcellulose, waxes, water and alcohol may also be considered as binders.

3. Lubricants These improves the rate of flow of the tablet granulation, prevent adhesion of the tablet material to the surface of the dies and punches, reduce interparticle friction, and facilitate the ejection of the tablets from the die cavity. Examples of them are talc, calcium and magnesium stearate.

4. Glidants They improve the flow properties of the granules in the food hopper. Examples are talc, starch, lycopedium, calcium and magnesium stearate, boric acid, sugar and sodium chloride.

5. Antiadhesives or antisticking agents Prevent adhesion of the tablet to dies and punches during compression. Examples are paraffin, stearic acid, cocoa butter and soaps.

6. Disintegrants These are substances or mixture of substances, added to a tablet to hasten the disintegration or breaking up after the tablet is administered. Release of the active ingredient should be accomplished as efficiently as possible to allow rapid dissolution. Examples are veegum, methylcellulose, agar, bentonite, cellusloe, wood products, natural sponge, cation-exchange resins, alginic acid, guar gum, citrus pulp and carboxymethlycellulose, surfactants, like sodium lauryl sulfate.

7. Coloring Agents The use of color in compressed tablets is for several reasons. It helps the manufacturer control the product during its preparation, it serves to identify the product and to give and aesthetic appearance to the tablet.

8. Flavoring Agents For compressed tablets, the addition of flavoring agents is not a necessity. But for chewable tablets and lozenges, it is often required. The flavors may be sprayed as an alcoholic solution into the dry granules before compression or dry flavors may be mixed with the other tablet constituents.

Processing Problems1. Cappingis the partial or complete separation of the top or bottom crowns of a tablet from the main body of the tablet. A remedy for capping is to dampen the mixture slightly with water alcohol, a mixture of alcohol and water or glucose solution prior to compressing, as long as there is no incompatibility involved.

2. Laminationis separation of a tablet into two or more distinct layers. Both capping and lamination are problems usually result from air entrapment during processing.

3. Pickingis removal of a tablet's surface material by a punch.4. Stickingis adhesion of a tablet material to a die wall. These problems may result from excessive moisture or substances with low melting temperatures in the formulation.

5. Mottlingis an unequal color distribution on a tablet, with light or dark areas standing out on an otherwise uniform surface. This may result from use of a drug with a color different from that of the tablet excipients or from a drug with colored degradation products. Colorants may solve the problem but may also create other problems.

Quality Control

A. Tablet Hardness:Storage, transportation and handling requires tablets that can resist chipping, abrasion or breakage. A usual rule of thumb test is to break the tablet between the second and third fingers using the thumb as the fulcrum. It is of proper hardness if it breaks with a sharp snap. When dropped on the floor, however, it should not break.

To determine quantitatively the degree of hardness, an instrument, the Mensanto or Stokes hardness tester is tablet when the force generated by a coil spring is applied diametrically to the tablet. Another method of testing hardness is by the use of the Roche friabilator. A number of tablets are weighed and placed in a tumbling apparatus where they are exposed to rolling and repeated shocks resulting form free falls within the apparatus. After a given number of rotations the tablets are weighed. The loss in weight indicates the ability of the tablets to withstand abrasion in packaging, handling and shipping.

B. Tablet Thickness:The density of the granulation and the pressure applied to the tablets may change the thickness of the tablet without causing a change in weight. This should not be tolerated to maintain identical appearance of the tablet and to ensure that every production lot will be usable with a selected packaging components. Thicker tablets may no longer be accommodated in the volume of a given size bottle. Thickness is measured by a caliper like the Ames thickness gauge which gives reading in millimeters. Depending on the size of the tablet, a plus or minus 5% may be allowed.

C. Tablet Weight:The weight of the compressed tablet, determined by the volumetric fill of the die cavity, is the quantity of the granulation which contains the labeled amount of the therapeutic ingredients. After the tablet machine is in operation, the weight of the tablets are checked routinely to ensure that the tablets have the proper weights. This is done by weighing 20 capsules individually and the average weight is calculated. The weight of not more than two of the tablets should not differ from the average weight by more than the percentage, no tablet differ by more than double that percentage.

D. Tablet Disintegration:The in vitro disintegration test uses not necessarily bear a relationship to the in vivo action of a solid dosage form. Regardless of the lack of significance as to the tablets in vivo action, the test provides a means of control in assuring that a given tablet formula is the same as regards disintegration from the product batch to another.

Methods of Preparation

A. Wet Granulation MethodThis is the most widely used and most general method of tablet preparation because the granules formed usually meet the physical requirements for the compression of food tablets. However, this method presents certain disadvantages: the number of separate steps involved and the time and labor needed to carry out the procedure especially on large scale.

The steps in the wet method are:1. Weighing2. Mixing3. Granulation4. Screening the damp mass5. Drying6. Dry screening7. Lubrication8. Compression

B. Dry Granulation MethodDry granulation, precompression, or the double-compression method is employed when the tablet ingredients are affected by moisture, elevated temperature due to drying, and when the ingredients have sufficient inherent binding or cohesive properties. The is shorter.

The steps involved are:1. Weighing2. Mixing3. Slugging4. Dry screening5. Lubrication6. Compression

The active ingredient, diluent (if necessary) and part of the lubricant are blended. The active ingredient or the diluent must have cohesive properties. Since powdered material contains considerable amount of air which when expelled under pressure forms a fairly dense tablet, more time should be allowed for this air to escape to produce a better tablet or slug.

Hints on Answering Board Exam QuestionsMost candidates of board exam practically aim the right answer to each question. Sometimes the right attitude in answering a question is needed to fully understand and choose the correct answer. Probably the candidate who is able to review well pass the board exam; unless luck is with you no matter what happens you will pass. Hints, as it is not connected to the questions and answers, maybe helpful to choose the right answer. Following theguidelinesgiven down list might save you from failing.1. Answer all questions. Do not leave it blank.2. Your first choice is usually your best answer.3. Do not change your answer unless you are convinced that your first choice is wrong.4. It is a good practice to read every question prudently and mark your answer before going on to the next question. If you are doubtful of the answer, avoid staying and reading the question over and over again. Leave it out and go on to the next question. Put an asterisk mark in the margin to remind you that the question was left unanswered.5. When you have finished the examination, go back to the unanswered questions. Do not reread those questions that you believe you have already answered correctly this might confuse you and eventually convince you to change your answer.6. When reviewing the questions that you went back, you can usually do elimination for several choices immediately as being correct. On a multiple-choice question, this will leave you with two or three selections. Make the most logical choice, even with two possible choices you have a 50:50 chance of getting it right. This is much better than guessing from five selections where your chances of guessing correctly are only one in five. Once you have marked your selection leave it alone and go on to the next unanswered question. If you have no idea of which answer is correct, do not guess either the first or last choice.7. Whenever a problem solving or calculation is being asked put in mind that ratio and proportion is the general formula for almost drug solving problems. If possible familiarize the weights and volumes conversion table and some important pharmaceutical formulas.8. For calculations, rounded off or exact answers are usually the choices. Solving needs the correct formula to lead you to the correct answer, wrong formula's answer may be one of the choices and you able to choose it. The examinee should be aware in this case and be prepared when taking board exam.However, most of the given guidelines are only applicable for those questions that are not familiar to you or guess at an answer. When you know the answer do not hesitate to choose it. Never mind the tricks of the question. Because there is only one best answer that you looking for. Avoid too much interpretation of the answer or look for hidden meanings. Best answer can be picked through simple selection.

Hints:Clang association:repetition of a word, phrase, or sounding the question and in the choice.Example:The use of beta-blocker agents in the blood is ___________.A. To decrease blood pressure levelB. To decrease cholesterol levelC. To equalize electrolytesD. To cause dyspneaHint: The word blood in the question and one of the options, A.

Specific determiners:Words such as never and always mean just that never and always. If there is a possibility of an exception, then choices will not be correct.Example:Which of the following is the characteristic of water?A. It boils always to 100oC in any altitude.B. Never transforms to gasC. It becomes solid when it reached 0oC.D. Miscible to tannins and acacia.Hint: A and B contain the specific determiners always and never; D is obviously wrong because of the word miscible, C is the correct answer.

Length hints:Correct answer is always longer than other choices. Be aware though, that it could mislead you.Example:The term adverse effect of a drug refers to _________.A. Additional benefits of the drugB. Potentiate other drug actionC. Any action of a drug in the body other than the one the doctor wanted the drug to haveD. Action of the drugHint: The choice C is a lengthy clue.

Grammatical inconsistency:This could occur when the incorrect choices do not follow grammatical rules.Example:The function red blood cells is to ___________.A. Carry oxygen to the cellsB. Conveying food to the cellsC. Clotting of the bloodD. Fighting diseaseHint: Thetoin the stem is the clue. A, the wordcarryis grammatically correct.