Author: Pankaj Saha

Welcome to MyPharmaGuide in this post we are going to discuss some important Pharmaceutics Unit 1 Questions and Answers that are very much important from the perspective of the exam.

We have discussed 5 Marks and 2 Marks Questions in this post.

5 Marks Question and Answers

Question 1: Define prescription. with the help of an ideal example describe the importance of all the parts of a prescription.

Answer:

Definition: A prescription is a legal document or order written by a qualified health care professional for diagnosis, prevention, or treatment of a specific patient’s disease.

Parts of a Prescription: A Prescription contains many parts. A list of parts of a prescription has been given below.

• Date
• Patient Information
• Superscription
• Inscription
• Subscription
• Signatura
• Signature
• Prescriber information

Date: All prescriptions expire after one year. In the case of narcotics and other habit-forming drugs, the date prevents the misuse of the drugs by the patient. It helps a pharmacist to know when the medicine was last dispensed if the prescription is brought for dispensing.

Patient Information: This part of a prescription contains some basic information about the patient like Name, Address, Age, Weight (optional, but useful – especially in pediatrics), Time (used only with inpatient medication orders).

Superscription: Represented by symbol Rxe traditional symbol for a prescription which is always written before writing the prescription. This is derived from the Latin word ‘recipe’ which means to take. Instruction is given to the pharmacist as well as the patient to take the medicine as prescribed. Another theory proposed by some scholars is that it drives by the symbol for the god Jupiter. The connection to healing was via prayers that a specific treatment would be effective and the individual would get better.

Inscription: This is the main body of prescription which includes the name and quantity of medicine that are prescribed. This is written in the English language. All medicines are written in separate lines along with the required quantity needed to treat the disease.
Drug Name
Dose = Quantity of drug per dose form
Dose Form = The physical entity needed, i.e. tablet, suspension, capsule
Simple versus compound prescriptions
Manufactured versus compounded prescriptions
Clarity of number forms 0.2, 20 not 2.0 (Zeros lead but do not follow!)

Subscription: These are instructions given to the pharmacist for dispensing the number of doses to the patient and how the medicine has to be taken before meal or after a meal. Quantity to be dispensed (determines the amount in bottle) Dispense # 24. For controlled substances write in numbers and letters (like a bank cheque) i.e., 24 (twenty-four) Any special compounding instructions.

Signatura:

Sig – write, or let it be labeled (Latin terms: Signa or signature) Instructions for the patient
Route of administration – Oral, nasally, rectally, etc, Take by mouth, Give, Chew, Swallow whole, etc.
The number of dosage units per dose – Take one tablet, Give two teaspoonfuls, etc.
Frequency of dosing – every six hours, once a day

Signature and Prescribers Information: This makes the prescription a legal document. A signature, prescriber registration number are necessary especially in the case of habit-forming drugs. The prescriber must write “brand necessary,” “brand medically necessary,” or “DAW” (Dispense As Written) to get non-generics.

Question 2: Write a note on pharmacy as a career.

Answer: The word Pharmacy is derived from Greek pharmakon which means drug. Pharmacy is the health profession that links the
health sciences with the chemical sciences, and it are charged with ensuring the safe and effective use of medication.

Types of Pharmacy Practice Areas

Pharmacists practice in a variety of areas including retail, hospitals, clinics, nursing homes, the drug industry, and regulatory agencies. Pharmacists can specialize in various areas of practice including hematology/oncology, infectious diseases, nutrition support, drug
information, critical care, pediatrics, etc.

Wholesale Pharmacy
It offers opportunities to a limited number of pharmacists to run wholesale businesses of drugs and medicines. The wholesalers serve as an intermediary between manufacturer and retailer.

Industrial Pharmacy

The pharmaceutical industry offers opportunities to pharmacists of all educational levels. It provides jobs to a pharmacist in the following fields:

• Production: In production, the pharmacist works as a manufacturing chemist. He has to supervise the production of various types of pharmaceutical formulations, packaging, labeling, and storage. Pharmacists with a bachelor degrees in pharmacy are absorbed as a manufacturing chemist.
• Analytical and Quality Control: A manufacturing unit needs the service of analytical chemists in its analytical laboratory to do testing of raw materials and finished goods manufactured by it. Pharmacists with bachelor degree in pharmacy get job of analytical chemist.
• Research and Development and New drug discovery: Mostly Pharmaceutical Industries have their own separate Research and Development unit. A pharmacist with having Doctorate or master’s degree in pharmacy is ideally suited for Research and Development department in the pharmaceutical industry.
• Medico-marketing and sales: Pharmaceutical marketing means the performance of pharmaceutical business activities that direct the flow of pharmaceutical formulations and services from producer to consumers. Sale team consists of medical representatives, sales representatives, field officers, area managers, regional managers, and sales managers. A pharmacist with bachelor’s degree in pharmacy, having an aptitude for sale, is best-fitted in this field, because there is a lot of scope of promotion.
• Clinical Trials

Pharmacy Education (Academics)
Due to the rapid growth of the pharmaceutical industry and the expansion of health services in the country, there is a steep increase in the number of pharmacy teaching institutions in the country. In order to fulfill the demand, there is a need for qualified and experienced faculty members. So there is more scope for fresh pharmacy graduates to be absorbed as faculty members in these teaching institutions.

Pharmacy has also scopes in Community Pharmacy, Hospital Pharmacy, Clinical Pharmacy, and Veterinary Pharmacy.

Question 3: Explain the factors affecting dose selection.

Answer: The factors that affect the dose selection are described below.

• Age: The pharmacokinetics of many drugs changes with age. So while determining the dose of a drug, the age of an individual is of great significance. Children and old people need a lesser amount of drugs than the normal adult dose because they are unable to excrete drugs to that extent as adults. Children can tolerate relatively larger amounts of belladonna, digitalis, and ethanol, whereas elderly patients are more sensitive to some drug effects. For example, hypnotics and tranquilizers may produce confusion states in them.
• Gender: Women do not always respond to the action of drugs in the same manner as it is done in men. Morphine and barbiturates may produce more excitement before sedation in women. Special care should be taken when drugs are administered during menstruation, pregnancy, and lactation. There are certain drugs that on the administration to the mother are capable of crossing the placenta and affecting the fetus e.g. alcohol, barbiturates, narcotic and non-narcotic analgesics, etc.
• Bodyweight: The average dose is mentioned either in terms of mg per kg body weight or as a total single dose for an adult weighing between 50-100 kg. However, the dose expressed in this fashion may not apply in cases of obese patients, children and malnourished patients. It should be calculated according to body weight.
• Route of administration: Intravenous doses of drugs are usually smaller than oral doses because the drugs administered intravenously enter the bloodstream directly. Due to this reason, the onset of drug action is quick with the intravenous route and this might enhance the chances of drug toxicity. The effectiveness of drug formulation is generally controlled by the route of administration.
• Time of administration: The presence of food in the stomach delays the absorption of drugs. The drugs are more rapidly absorbed from the empty stomach. So the amount of drug which is very effective when taken before a meal may not be that much effective when taken during or after meals. The irritating drugs are better tolerated if administered after meals for example, iron, arsenic and cod-liver oil should always be given after meals.
• Environmental factors: Daylight is a stimulant, enhancing the effect of stimulating drugs and diminishing the effect of hypnotics. Darkness is sedative. Hypnotics are more effective at night. The amount of barbiturate required to produce sleep during the daytime is much higher than the dose required to produce sleep at night. Alcohol is better tolerated in cold environments than in summer.
• Emotional factors: The personality and behavior of a physician may influence the effect of drugs especially the drugs which are intended for use in a psychosomatic disorder. The females are more emotional than males and require less dose of certain drugs.
• Presence of disease: Drugs like barbiturates may produce an unusual prolonged effect in patients having liver cirrhosis. Streptomycin is excreted mainly by the kidney may prove toxic if the kidney of the patient is not working properly.
• Additive effect: When the total pharmacological action of two or more drugs administered together is equivalent to the sum of their individual pharmacological action, the phenomenon is called an additive effect. For example, a combination of ephedrine and aminophylline in the treatment of bronchial asthma.
• Synergism: When two or more drugs are used in the combination their action is increased. The phenomenon is called synergism.
• Accumulation
• Antagonism
• Idiosyncrasy
• Tolerance
• Metabolic disturbances

Question 4: Define posology? Give any two formulae to calculate children’s dose.

Answer:

Posology: The word posology is derived from the Greek words ‘posos‘ meaning how much and ‘logos‘ meaning science. So posology is a branch of medical science that deals with the dose or quantity of drugs that can be administered to a patient to get the desired pharmacological actions.

1. Clark’s formula:
   Child’s dose = weight in (lbs)/150 x Adult dose
   Child’s dose = weight in (kg)/70 x Adult dose
2. Dilling’s formula: Used for calculating dose of child from 12-20 years of age. Child’s dose = Age in years /20 x Adult dose

Question 5: Explain the handling of prescriptions?

Answer:

The following procedures should be adopted by the pharmacist while handling the prescription for compounding and dispensing:
(1) Receiving.
(ii) Reading and checking.
(iii) Collecting and weighing the materials.
(iv) Compounding, labeling, and packaging.

• Receiving: The prescription should be received by the pharmacist himself /herself. While receiving a prescription from a patient, a pharmacist should not change his/her facial expression that gives an impression to the patient that he/she is confused or surprised after seeing the prescription.
• Reading and checking: Reading the prescription and checking for –
  • Legality – A prescription is legal when: 1. It is written (can also be typed) by a R.M.P (Registered medical practitioner).2. Signed by the R.M.P. 3. It has all the information required to be contained with respect to parts of prescription.
  • Legibility: Legibility is a problem requiring alertness and critical judgment on the part of the pharmacist. Careless handwriting and similarity in spelling of names of different drugs add to the difficulty. e.g. Prednisone and Prednisolone, Digoxin and Digitoxin. When handwriting is illegible, the best thing to do is to contact the physician over the phone and confirm.
  • Completeness and correctness: The prescription serves as a vehicle for communication from the licensed practitioner to the pharmacist about the Pharmaceutical care of the patient. Details to be checked are (1) Physician’s details. (ii) Patient’s details. (iii) Product details. Checking the product details will include checking Name of the product, Dosage form, Strength/potency of the medicine, Total amount to be dispensed and its availability Dosage and directions for use, Frequency of administration.
• Collecting and weighing the material: Before compounding a prescription all the materials required for it should be collected from the shelves or drawers and kept in the left hand side of the balance. After measuring each material should be kept on the right hand side of the balance. After compounding the prescription the materials are replaced back to the shelves / drawers where from they were collected. While compounding the label of every container of material should be checked thrice in the following manner: When collected from the shelves/drawers. When the materials are measured. When the containers are replaced back to the shelves/drawers.
• Compounding, labeling and packaging: Only one prescription should be compounded at a time. Compounding should be done on a clean table. All equipment required should be cleaned and dried. The preparation should be prepared according to the direction of the prescriber or as per methods given in pharmacopoeia or formulary and are according to established pharmaceutical art of compounding. The compounded medicament should be filled in a suitable container with appropriate label depending upon the quantity and use. While delivering the prescription to the patient, the pharmacist should explain the mode of administration, direction for use and storage.

Question 6: Write about the sources of errors in prescription.

Answer:

• Abbreviation: In most of the prescriptions abbreviated terms are used by the prescriber which leads to major errors during interpretation by the pharmacists. For example: ‘SSKI’ is the abbreviated term of ‘Saturated Solution of Potassium Iodide’. It is preferable to avoid these types of misleading abbreviations.
• Name of the drugs: Names of some drugs (especially the brand names) either looks or sounds alike. So any error in the name of a drug will lead to major danger to the patient. e.g. Althrocin – Eltroxin, Acidin – Apidin etc
• Strength of the preparation: Drugs are available in the market in various strengths. So a drug must not be dispensed if the strength is not written in the prescription. For example, Paracetamol tablet 500 mg should not be dispensed when no strength is mentioned in the prescription.
• Dosage form of the drug prescribed: Many drugs are available in more than one dosage forms e.g. liquid, tablets, injections or suppositories. The dosage form intended for the patient must be mentioned in the prescription to reduce ambiguity.
• Dose: If unusually high or low dose is mentioned in the prescription then it must be consulted with the prescriber. Some time a sustained release (SR) dosage form is prescribed thrice or more times daily. Actually Sustained Release dosage forms should be given once or twice a day.
• Instructions to the patient: Sometimes the instruction for a certain preparation is either omitted or mentioned partially. The quantity of the drug to be taken, the frequency and timing of administration and route of administration should be mentioned clearly so that it is easy for patients to take medicine.
• Incompatibilities: It is essential to check that there is no pharmaceutical or therapeutic incompatibilities in the prescription. If more than two medicines are prescribed then it is the duty of the pharmacist to see whether their interactions will produce any harm to the patient or not. Certain drugs has interactions with food. The pharmacist has to advise the patient about it. For example: Tetracycline should not be taken with milk or antacid.

Question 7: Define dosage form and classify with examples.

Answer:

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2 Marks Question and Answers

Question 1: What is Pharmacopoeia? Discuss all the editions of Indian Pharmacopoeia.

Answer: The word Pharmacopoeia is derived from two Greek words ‘Pharmakon‘ which means drug in English and ‘Poeia‘ means which means to make in English. The books containing the standards for drugs and other related substances are known
as pharmacopeias and formularies. The pharmacopeias contain a list of drugs and other related substances regarding their source, descriptions, tests, formulae for preparing the same, action and uses, doses, storage conditions, etc.
It is a legal and official book issued by recognized authorities usually appointed by the Government of each country.

• First Edition in 1955 that Contains both western and traditional system drugs  commonly used in India.
• Second Edition in 1966 that Contains both western and traditional system drugs  commonly used in India.
• Third Edition was published in the year 1985.
• Fourth Edition was published in the year 1996
• Fifth Edition was published in the year 2007
• sixth Edition was published in the year 2012.
• Seventh Edition was published in the year 2014.
• Eight edition was published in the year 2018.