Pharmacology Quiz – Drug Mechanisms & Therapeutics

There are some compatibility studies for blood and insulin but not for newly marketed biologicals such as infliximab, interferons and recombinant coagulation factors, so mixing is not recommended.

Simple chemical knowledge allows us to understand certain properties and behaviors of chemicals. Based on this knowledge, we can make predictions about potential incompatibilities between different chemicals. For example, we may know that mixing an acid with a base will result in a neutralization reaction. Therefore, it is possible to predict some incompatibilities by applying basic chemical principles.

Chemical incompatibilities can occur between different substances, resulting in potentially dangerous reactions. However, these reactions may not always be visibly observable, meaning that there may not be any visible signs or indications of the incompatibility. This is why it is important to be aware of potential chemical incompatibilities and to follow proper safety protocols when handling different substances, even if there are no visible signs of incompatibility.

"In general, it is not recommended to mix solutions of parenteral because of the potential for incompatibility"

The term "incompatible" is used to describe physiochemical phenomena that result in a change in physical state or protonation-deprotonation equilibria. This can include concentration-dependent precipitation and acid-base reactions. Incompatibility refers to substances or conditions that cannot coexist without causing a reaction or change in state, indicating that they are not compatible with each other.

Drugs that are poorly water soluble can be difficult to formulate. One approach to improve their solubility is to use a water miscible cosolvent. Ethanol, propylene glycol, and polyethylene glycol are all examples of water miscible cosolvents that can be used to enhance the solubility of poorly water soluble drugs. Therefore, the correct answer is "all of the above."

Physical incompatibilities refer to the changes in the appearance of a solution when two drugs combine. This can include alterations in color, clarity, or the formation of precipitates or particles. Unlike chemical incompatibilities, where a chemical reaction occurs between the drugs, physical incompatibilities do not involve a chemical change. Instead, they involve changes in the physical properties of the solution. Therefore, the correct answer is physical incompatibilities.

The statement "Published data on incompatibility studies is complete" is false. This means that the available published data on incompatibility studies is not complete. The answer suggests that there is either missing or insufficient information in the published data regarding incompatibility studies.

Administering medications by I.V. infusion has several advantages. Firstly, it allows for the replacement of essential fluids in the body. Secondly, it enables the drug to be administered over an extended period, ensuring a constant concentration in the body. Lastly, when the drug contacts the walls of the veins, it is less concentrated and therefore less irritating. Therefore, all of the above advantages are true for administering medications by I.V. infusion.

Concentration of amino acids and AA composition both play an important role.

Oxygen may be excluded from the dosage form

Remember OIL RIG... Oxidation Is Loss... Reduction Is Gain

Dr. Moore said to remember "ph-ph-phosphate... f-f-first!"

The term "instable" is the correct answer because it describes chemical reactions that are continuing without interruption, irreversible, and result in distinctly different chemical entities (degradation products). These degradation products can be both therapeutically inactive and possibly exhibit toxicity. The term "instable" suggests that these reactions are not stable and can lead to undesirable outcomes.

Leaching is the opposite effect to adsorption and is when phthalate plasticizers leach out into the solution

Mix two bags of the drugs to be administered. Send one bag immediately to the floor and keep the second bag in the pharmacy. Call the nurse and explain that no drug compatibility information exists on combining these drugs in the same bag. The nurse should hang the bag immediately and observe for any signs of incompatibility. The bag in the pharmacy should also be observed carefully for any signs of incompatibility. Stop I.V. at the first sign of incompatibility.

Precipitation shows a physical incompatibility

Intravenous (I.V.) drug therapy in large-volume fluids is not only a common practice in inpatient settings but also in outpatient settings. This means that it is not true that it is only a common practice in inpatient settings and not in outpatient settings.

Molecular acids are relatively weak (pKa 3-8). Therefore, must force HB (the acid) to relinquish H+ by reacting with a strong base (e.g. NaOH, KOH, Al(OH)3, Ca(OH)2).

Stability refers to the ability of a product or combination of drugs to maintain its original potency over its lifespan. In this case, the correct answer is 90%, which means that the product or drug combination will retain 90% of its original potency throughout its entire lifespan. This indicates a high level of stability, as a significant portion of the drug's effectiveness is maintained over time.

The statement suggests that visually checking for precipitation, turbidity, or color change before administering the mixture guarantees compatibility. However, this is not true because visual checks may not always be accurate indicators of compatibility. Some incompatible mixtures may not exhibit visible changes. Therefore, relying solely on visual checks is not a reliable method to ensure compatibility.

This results in the formation of the molecular acid and base which are water insoluble

solution pH along with DRUG pKa

Neutral quaternary ammonium salts can neither accept nor donate proton, and are compatible in solution with either ionized acids or ionized bases.

Hydrolysis is a common mode of chemical decomposition that occurs when a compound reacts with water, resulting in the breakdown of chemical bonds. This process is a major cause of drug instabilities, as many drugs are susceptible to hydrolysis in the presence of moisture or under certain pH conditions. Hydrolysis can lead to the formation of degradation products, which may result in reduced potency or altered pharmacokinetics of the drug. Therefore, it is important to consider the potential for hydrolysis when formulating and storing pharmaceutical products.

Couple name of unionized acid with name of metal ion from the original metal hydroxide used to make the salt

A change in odor is not a visual change, but rather a change in the sense of smell. It indicates a chemical change or reaction taking place, rather than a physical incompatibility. Visual changes such as changes in color, development of a haze, evolution of a gas, or formation of a precipitate can indicate physical incompatibility.

to name an acid salt, Couple name of original unionized (molecular, :B) base with a modified name of the acid used to make the salt (HX) (e.g. Cl ---> chloride; H2SO4 ---> sulfate).

Use solutions promptly after preparation in order to assure administration of the most stable product, since the degradation of many drugs is time dependent.

Morphine sulfate + Cefazolin Sodium ----->
(ionized acid) (H2O soluble) (ionized base) (H2O soluble)
Morphine + Cefazolin + Na2SO4
(mol. base) (H2O insol.) (mol. acid) (H2O insol.) (H2O sol.)
The ionized acid (+1) donates a proton to the anionic (-1) base, generating the unionized conjugate base of the original acid and unionized conjugate acid of the original base, resulting in precipitation.