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7/30/2019 3. Dosage Forms and Strength
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Dosage Forms & Strengthtechnical presentation 2 of 4
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Main Goal: To be able to AccuratelyComplete the Audit Sheet Correctly
By the end of this presentation you should beable to:
Look at a package of medicine anddetermine the dosage form
Look at a package of medicine anddetermine its strength
Understand why strength is alwayslisted with the generic name
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Dosage Form
ORAL
Tablets
Syrup
Suspension
Granules
RECTAL Suppository
INTRA-MUSCULAR/
INTRAVENOUS
Injection (powder &liquid)
The physical form of a medication.The route of administration is dependent uponthe dosage form.
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Tablets
The most common dosage form forantimalarials that you will find will
be tablets. But it is still importantto be familiar with the otherdosage forms when you comeacross them.
Capsules and pills are
considered tablets in
this study.
http://images.google.co.ke/imgres?imgurl=http://www.tablets4less.com/custom/intentdesign_capsules.jpg&imgrefurl=http://www.tablets4less.com/page007.html&usg=__AgzFOWkuAYYZt26Ndmp6cxmWOs0=&h=2814&w=4179&sz=2159&hl=en&start=3&tbnid=uMxotE0ZVAHIYM:&tbnh=101&tbnw=150&prev=/images%3Fq%3Dcapsules%26gbv%3D2%26hl%3Den%26sa%3DGhttp://images.google.co.ke/imgres?imgurl=http://corporateportal.ppg.com/NR/rdonlyres/A6B74DBB-C762-470B-8891-498B10902D74/0/AccuTabwhitetabs.jpg&imgrefurl=http://corporateportal.ppg.com/NA/CalHypo/Accutab/industrial/chlorination/Accu-Tab_SI_Tablets.htm&usg=__9L1-DYvu3WA-3gGz14flEPHtSh8=&h=283&w=350&sz=44&hl=en&start=3&tbnid=41cQxsCiZ8pV-M:&tbnh=97&tbnw=120&prev=/images%3Fq%3Dtablets%26gbv%3D2%26hl%3Den%26sa%3DG7/30/2019 3. Dosage Forms and Strength
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A Closer Look at Dosage Forms thatare not as Common: Granules
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A Closer Look At Other Dosage Forms:Suspensions
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A Closer Look at Dosage Forms thatare not as Common: PowderInjection
Powders injections are often accompanied by a liquidsolvent in a vial. The two are blended for injection in a
syringe.
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Suppositories
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Units of Measurement
Medicines are usuallymeasured in milligrams (mg)and milliliters (mL)
This section will explain each
of these units
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A Brief Review of Units of Measurement:There are 3 Things that we Measure
Distance/Length
Volume
Weight
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For Medicine, We Need Small Units:milligram (mg)
20 grains of salt weigh about 1 mg
A paperclip weighs about 1000 mg
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For Medicine, We Need Small Units:milliliter (mL)
15 drops = about 1 mL
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Strength of a
Medication
The strength of a medicationtells how muchactiveingredient is contained withinthe medicine
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Strength for Tablets & Suppositories
2.
Strength
[__|__|__].[__] mg
[__|__|__].[__] mg
[__|__|__].[__] mg
3.
Dosage form
1 = Tablet2 = Suppository
Tablet & Suppository Audit Sheet
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Important Points of MedicineStrengths:
1.The strength of a medicine is alwayslisted with the active ingredient
(generic name)
2.If a medicine has 2 active ingredients,
then it will have 2 strengths: onestrength per active ingredient
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Important Points:
For tablets and suppositories,strength is expressed in mg
Strength indicates how muchactive ingredient is contained
within a single tablet orsuppository
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Important Point#1: The Strength of aMedication is Always Listed with the ActiveIngredient on the Package
1 active ingredient
Quinine,250 mg
This means there is 250 mg of quinine in each tablet
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Important Point#2: There is a Strength for eachActive Ingredient in a Medicine
2 active ingredients: both active ingredientscontained in a single tablet
sulfadoxine-pyrimethamine, 500mg-25mg
This means each SP tablet contains 500mg of sulfadoxine
and 25mg of pyrimethamine
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Important Point#2: There is a Strength for eachActive Ingredient in a Medicine
2 active ingredients: separate tablets per
active ingredients Artesunate (50mg) / Mefloquine (250mg)
250 mg Mefloquine per tablet
50 mg ofArtesunate per tablet
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Why is the Strength Always Listed withthe Active Ingredient?
The same medicine can come in several differentstrengths
Example:Artesunate tablets are available in severaldifferent strengths.
Artesunate
10 mg
Artesunate
40 mg
Artesunate
100 mg
Artesunate
200 mg
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Q1,Q2 & Q3 What is the GenericName, Strength and Dosage Form?
1.Genericname
Amodiaquine
__________
__________
2.Strength
[_2_|_0_|_0_].[_0_]mg
[___|___|___].[___]mg
[___|___|___].[___]mg
3.Dosage form
1 = Tablet
2 = Suppository
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Q1,Q2 & Q3 What is the GenericName, Strength and Dosage Form?
1.Generic name
Artesunate
Sulfadoxine
Pyrimethamine
2.Strength
[_0_|_5_|_0_].[_0_] mg
[_5_|_0_|_0_].[_0_] mg
[_0_|_2_|_5_].[_0_] mg
3.Dosage form
1 = Tablets
2 = Suppository
4.Brand name
Artesunate +SPPediatrique
NoBrandname
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Q1,Q2 & Q3 What is the GenericName, Strength and Dosage Form?
1.
Generic nameSulfadoxine
Pyrimethamine
_______________
2.
Strength[_2_|_5_|_0_].[_0_] mg
[_0_|_1_|_2_].[_5_] mg
[___|___|___].[___] mg
3.
Dosage form1 = Tablets
2 = Suppository
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Suppositories
A suppository is a smallcapsule-like medication
designed for insertion into therectum, where it melts. It isoften given to patients who areto sick to take medication bymouth.
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Example
Strength: 50mg of
Artesunate is in eachsuppository
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Q1,Q2 & Q3 What is the GenericName, Strength and Dosage Form?
1.Genericname
Artesunate
________
________
2.Strength
[_0_|_5_|_0_].[_0_] mg
[___|___|___].[___] mg
[___|___|___].[___] mg
3.Dosage form
1 = Tablet
2 = Suppository
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Activity
Using the antimalarial medicines from thefirst exercise, record the strength on theActivity Sheet.
Do you notice anything different betweenthe strengths of the first set ofantimalarials and the strengths of the
second set of antimalarials (ones withhydrochloride, sulfate, or phosphate inthe generic name)?
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Strengths of Active IngredientsPresented with an Extra Chemical
Recall: Certain medicines have an extra chemical in the name
The active ingredient alone may be written as base onthe packaging
Hydrochloride
Phosphate
Sulfate
From what you have seen, how does this extrachemical effect the strength?
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Important Points about Strengths of
Medicines with an Extra Chemical
Mefloquine hydrochloride, 275 mgEquivalent to
Mefloquine base, 250 mg
Equivalent to is also sometimes listed
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Some Examples:
Artesunate (200mg) + Mefloquine hydrochloride(275mg) equivalent to
Artesunate (200mg) + Mefloquine [base] (250mg)
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Which Strength Should I Record?
You should record the base strength only
Mefloquine, 250 mg
And not
Mefloquine hydrochloride, 275 mg
WHY?
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Review Strength of Tablets
One active ingredient
Artesunate, 40mg
One active ingredient with an extra chemical
Mefloquine [base], 250mg equivalent to
Mefloquine hydrochloride, 275mg
Two active ingredients
SP, 500mg-25mg
Artemether/Lumfantrine, 20mg/120mg
Two active ingredients with an extra chemical
Artesunate + Amodiaquine [base] (250mg) equivalent to
Artesunate (50mg) + Amodiaquine hydrochloride (275mg)
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Review Strength of Tablets
Question: A tablet is considered a _____ form.
Answer: Dosage form
Question: What is the unit of measurement forstrength for tablets?
Answer: milligrams (mg)
What this means: In each tablet, there is acertain weight of the active ingredient.
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Until this Point, We Have OnlyDiscussed Tablets and Suppositories
How is strength expressedfor dosage forms other thantablets and suppositories?
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What about Strengths of OtherDosage Forms?
1.
Genericname
2.
Strength
[__|__|__].[__] mg /[__|__|__] mL
3.
Dosage form3 = Syrup
4 = Suspension
5 = Liquid injectable
6 = Powder injectable
7 = Granule
Note about granules. Their strength is actually expressed in mg;however they will be recorded on this audit sheet, but leaving the mL
section blank.
For dosage forms other than tablets and suppositories,use the Non-Tablet Audit Sheet
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What does mg/mL
mean?
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Example Strength ofSuspension
Artemether,300mg/100mL
There can be lots ofnumbers listed onmedicine package.
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Example - Strength of Liquid Injection
Chloroquine, 200mg/ 5 mLequivalent to
Chloroquine phosphate, 322.5mg/ 5 mL
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1. Genericname
Chloroquine
__________
__________
2. Strength
[_2_|_0_|_0_].[_0_] mg / [_0_|_0_|_5_] mL
[___|___|___].[___] mg / [___|___|___] mL
[___|___|___].[___] mg / [___|___|___] mL
3. Dosage form
3 = Syrup4 = Suspension
5 = Liquid Injection
6 = Poudre injection
7 = Granules
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Example Strength of Syrups
Chloroquine,
25mg/5mL
Strength may be written like
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1.GenericnameQuinine____
___________
___________
2.Strength
[_1_|_0_|_0_].[_0_] mg / [_0_|_0_|_5_] mL
[___|___|___].[___] mg / [___|___|___] mL
[___|___|___].[___] mg / [___|___|___] mL
3.Dosage form3 = Syrup
4 = Suspension5 = Liquid Injection
6 = Poudre injection
7 = Granules
Strength may be written likethis for liquids:
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Example - Strength with 2 Active Ingredients
1. Genericname
Sulfadoxine__
Pyrimethamine
____________
2.Strength
[_2_|_5_|_0_].[_0_]mg/ [_0_|_0_|_5_]mL
[_0_|_1_|_2_].[_5_]mg/ [_0_|_0_|_5_]mL
[___|___|___].[___]mg / [___|___|___]mL
3.Dosage form
3 = Syrup
4 = Suspension
5 = Liquid injectable
6 = Powder injectable
7 = Granule
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We Have Just Discussed the DosageForms that use Mg/Ml for Strength
Syrups
Suspension
Liquid injection
*Powder injectables are less common and are not
covered here. Recording strength for this dosageforms follow the same pattern. Refer to FieldworkersManual on how to record its strength.
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Dosage Forms with StrengthMeasured in mg
recall Tablets
Suppository
Q: Why is there a need for 2different audit forms?
A: To accommodate for the 2different ways in which strength isexpressed: mg or mg/mL
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Review
What are the two ways that the strength of amedication can be written?
mg or mg/mL
What determines if the strength will be in mgor mg/mL?
The dosage form
http://images.google.co.ke/imgres?imgurl=http://www.waynewhitecoop.com/system/images/Light%2520Bulb.jpg&imgrefurl=http://www.waynewhitecoop.com/pages/Audits&h=309&w=278&sz=12&hl=en&start=4&usg=__gyrg7f8UA9h5Oz5zSJ8RBBM7RcY=&tbnid=JnzbIhoRNzfReM:&tbnh=117&tbnw=105&prev=/images%3Fq%3Dlight%2Bbulb%26gbv%3D2%26hl%3Den%26sa%3DG7/30/2019 3. Dosage Forms and Strength
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You Must Pay Very Close Attention &Look at ALL Sides of the Box
This is the front ofthe box. Based onthis, what is thegeneric name and
strength?
Based on this,would you think
the strength ofAmodiaquine baseis greater than orless than 200 mg?
http://images.google.co.ke/imgres?imgurl=http://www.waynewhitecoop.com/system/images/Light%2520Bulb.jpg&imgrefurl=http://www.waynewhitecoop.com/pages/Audits&h=309&w=278&sz=12&hl=en&start=4&usg=__gyrg7f8UA9h5Oz5zSJ8RBBM7RcY=&tbnid=JnzbIhoRNzfReM:&tbnh=117&tbnw=105&prev=/images%3Fq%3Dlight%2Bbulb%26gbv%3D2%26hl%3Den%26sa%3DG7/30/2019 3. Dosage Forms and Strength
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Front Side
Always look at every side of the packaging.The front of this package is misleading.
Questions
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Questions
1. Name all of the dosage forms of antimalarial medicines.
Tablets, syrups, suspensions, injections (liquid & powder),
suppository, granule
2. What does the strength of a medicine describe?
The amount of active ingredient in a medicine
3. On a medicine package, the strength is always listed alongsidewhat?
With the generic name/active ingredient (s)
4. What are the 2 units used for strength? mg or mg/mL
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You Should Now Be Able To:
Look at a package of medicine anddetermine the dosage form of themedicine
Look at a package of medicine anddetermine the strength of the medicine
Understand why strength is alwayslisted with the generic name
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Questions
?
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Activity
Get into groups of 4 or 5 each.
The facilitators will pass out a group ofmedicines
Record answers on Activity Sheet B
Every person must complete an ActivitySheet
You may help each other
Remember: We are only auditingantimalarials!