Pharmaceutical Dispensing and Compounding

By Dr. Willbrord Maddo Kalala and Dr. Betty Allen Maganda

The authors have been teaching Dispensing and Compounding practice for a very long period. One of the challenges in their carrier was the lack of a proper, user friendly and comprehensive reference in compounding to use for teaching and instructing students as well as in hospital pharmacy practice. This book was constructed with this challenge in mind, and therefore simply presents such a reference. It is simply written, covers a wide spectrum of compounding practice with many formulae. The book is also useful for entrepreneurial individuals interested in small scale manufacturing of extemporaneous products.

• Language: English
• Publisher: Xlibris US
• Release date: Jul 27, 2020
• ISBN: 9781984588517

Book preview

Pharmaceutical

Dispensing and

Compounding

DR. WILLBRORD MADDO KALALA (B. Pharm, M.Sc., PhD)

&

DR. BETTY ALLEN MAGANDA (B. Pharm, M.Sc., PhD)

Copyright © 2020 by Dr. Willbrord Kalala.

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Any people depicted in stock imagery provided by Getty Images are models, and such images are being used for illustrative purposes only.

Certain stock imagery © Getty Images.

Rev. date: 07/27/2020

Xlibris

1-888-795-4274

www.Xlibris.com

814600

Contents

FOREWORD

PREFACE

PART 1 COMPOUNDING PRACTICE

CHAPTER 1. ESSENTIALS OF PHARMACEUTICAL COMPOUNDING

1.1 Introduction

1.2 Essential equipment in Compounding practice

1.2.1 Balances

1.2.2 Measures and their accessories

2.2.3 Other Compounding equipment

1.3 Design of a Compounding laboratory

1.4 Ensuring good Dispensing Practice

1.5 Labeling of compounded product

1.6 List of common equipment in a compounding laboratory

PART II FORMULA

RY.

COMMON PREPARATIONS IN PHARMACEUTICAL COMPOUNDING

CHAPTER 2. PHARMACEUTICAL SOLUTIONS

2.1. APPLICATIONS

2.1.1. BENZYL BENZOATE APPLICATION

2.2 AROMATIC WATERS

2.2.1. ANISE WATER, CONCENTRATED

2.2.2 CAMPHOR WATER AND CAMPHOR WATER, CONCENTRATED P.CX.

2.2.3 CARAWAY WATER, CONCENTRATED

2.2.4 CHLOROFORM WATER and CHLOROFORM WATER DOUBLE STRENGTH P.CX.

2.2.5 CINNAMON WATER, CONCENTRATED

2.3.6 DILL WATER, CONCENTRATED

2.3.7 PEPPERMINT WATER, CONCENTRATE PCX

2.4 DOUCHES

2.4.1. ASTRINGENT DOUCHE

2.4.2 POTASSIUM PERMANGANATE DOUCHES

2.5 EAR DROPS

2.5.1 ALUMINIUM ACETATE EAR DROPS

2.5.2 BORIC ACID EAR DROPS

2.5.3 CHLORAMPHENICOL EAR DROPS

2.5.4 FRAMYCETIN EAR DROPS

2.5.5 GLYCERINE MAGNESIUM SULPHATE EAR DROPS

2.5.6 GLYCEROL AND SPIRIT EAR DROPS

2.5.7 HYDROCORTISONE AND NEOMYCIN EAR DROPS

2.5.8 HYDROGEN PEROXIDE EAR DROPS

2.5.9 ICHTHAMMOL EAR DROPS

2.5.10 PHENOL EAR DROPS

2.5.11 PHENOL AND AMETHOCAINE EAR DROPS

2.5.12 SALICYLIC ACID EAR DROPS

2.5.13 SODIUM BICARBONATE EAR DROPS

2.5.14 SPIRIT EAR DROPS

2.6 ELIXIRS

2.6.1 CHLORAL ELIXIR, PAEDIATRIC

2.6.2 CHLORPROMAZINE ELIXIR

2.6.3 DIPHENHYDRAMINE ELIXIR

2.6.4 EPHEDRINE HYDROCHLORIDE ELIXIR

2.6.5 HIGH ALCOHOL ELIXIR

2.6.6 ISONIAZID ELIXIR

2.6.7 LOW ALCOHOL ELIXIR

2.6.8 PARACETAMOL ELIXIR, PAEDIATRIC

2.6.9 PIPERAZINE CITRATE ELIXIR

2.6.10 PHENOBARBITONE ELIXIR

2.6.11 PROMETHAZINE ELIXIR

2.6.12 SIMPLE ELIXIR

2.6.13 TERPIN HYDRATE ELIXIR

2.6.14 VITRIOL ELIXIR

2.7 ENEMAS

2.7.1 ARACHIS OIL ENEMA

2.7.2 CHLORHYDRATE ENEMA

2.7.3 MAGNESIUM SULPHATE ENEMA

2.7.4 OPIUM ENEMA

2.7.5 PARALDEHYDE ENEMA

2.7.6 SIMPLE ENEMA (SOAP ENEMA).

2.8 GARGLES

2.8.1 Hydrogen Peroxide Gargle

2.8.2 PHENOL GLYCERIN GARGLE

2.8.3 POTASSIUM PERMANGANATE GARGLE 1:4000

2.9 GLYCERITES

2.9.1 BORAX GLYCERIN

2.9.2 BORIC ACID GLYCERIN

2.9.3 TANNIC ACID GLYCERIN

2.9.4 PHENOL GLYCERIN

2.9.5 STARCH GLYCERIN

2.10 INHALATIONS

2.10.1 AQUEOUS INHALATION

2.10.2 BENZOIN INHALATION

2.10.3 MENTHOL INHALATION

2.10.4 MENTHOL AND EUCALYPTUS INHALATION P.CX.

2.11 LINCTUSES

2.11.1 CODEINE LINCTUS

2.11.2 PEDIATRIC CODEINE LINCTUS.

2.11.3 METHADONE LINCTUS

2.11.4 NOSCAPINE LINCTUS

2.11.5 OPIATE SQUILL LINCTUS

2.11.6 OPIATE SQUILL LINCTUS, PEDIATRIC

2.11.7 PHOLCODINE LINCTUS

2.11.8 SIMPLE LINCTUS

2.11.9 SIMPLE LINCTUS, PEDIATRIC

2.12 LINIMENTS

2.12.1 CAMPHOR LINIMENT, NF, BP

2.12.2 CAMPHOR AND SOAP LINIMENT, NF

2.12.3 CHLOROFORM LINIMENT, NF

2.13 LOTIONS

2.13.1 ACRIFLAVINE LOTION

2.13.2 ANTIDANDRUFF LOTION

2.13.3 ANTIFUNGAL LOTION

2.13.4 BORIC ACID LOTION

2.13.5 CALAMINE LOTION

2.13.6 CALAMINE LOTION, OILY

2.13.7 COPPER AND ZINC SULPHATE LOTION

2.13.8 CETRIMIDE LOTION

2.13.9 DICHLOROXYLENOL LOTION

2.13.10 POTASSIUM PERMANGANTE LOTION

2.13.11 SALICYLIC ACID LOTION

2.13.12 SULPHUR LOTION, COMPOUND

2.13.13 THIOMERSAL LOTION

2.13.14 ZINC SULPHATE LOTION

2.14 MOUTHWASHES

2.14.1 ALKALINE PHENOL MOUTHWASH

2.14.2 CETYLPYRIDINIUM MOUTHWASH

2.14.3 HYDROGEN PEROXIDE MOUTHWASH

2.14.4 POTASSIUM PERMANGANATE MOUTHWASH

2.14.5 SODIUM CHLORIDE MOUTHWASH, COMPOUND

2.15 MUCILAGES

2.15.1 STARCH MUCILAGE B.P.C. 1973

2.15.2 TRAGACANTH MUCILAGE B.P.C.

2.16 PAINTS

2.16.1 BRILLIANT GREEN AND CRYSTAVIOLET PAINTS P.CX.

2.16.2 CASTELANNI’S PAINT WITHOUT MAGENTA

2.16.3 CRYSTAL VIOLET PAINT P.CX.

2.16.4 IODINE PAINT P.CX.

2.16.5 PODOPHYLLIN PAINT, COMPOUND P.CX

2.17 SYRUPS

2.17.1 ACACIA SYRUP

2.17.2 COCOA SYRUP

2.17.3 CODEINE SYRUP

2.17.4 GINGER SYRUP

2.17.5 LEMON SYRUP

2.17.6 ORANGE SYRUP

2.17.7 SIMPLE SYRUP

2.17.8 TOLU SYRUP

2.17.9 VASAKA EXPECTORANT SYRUP

2.18 SOLUTIONS

2.18.1 ALUMINIUM ACETATE SOLUTION.

2.18.2 AMARANTH SOLUTION

2.18.3 AMMONIA ACETATE SOLUTION, STRONG

2.18.4 BENZOIC ACID SOLUTION

2.18.5 CALCIUM HYDROXIDE SOLUTION

2.18.6 CETRIMIDE SOLUTION

2.18.7 CETRIMIDE SOLUTION, STRONG

2.18.8 CHLORINATED LIME AND BORIC ACID SOLUTION

2.18.9 CHLOROXYLENOL SOLUTION

2.18.10 COAL TAR SOLUTION

2.18.11 COAL TAR SOLUTION, STRONG

2.18.12 CRESOL WITH SOAP SOLUTION

2.18.13 IODINE SOLUTION, AQUEOUS

2.18 14 IODINE SOLUTION, STRONG

2.18.15 IODINE SOLUTION, WEAK

2.18.16 LEAD SUBACETATE SOLUTION, STRONG

2.18.17 LEAD SUBACETATE SOLUTION, DILUTE

2.18.18 PROFLAVINE SOLUTION BNF 1963

2.18.19 SODIUM HYPOCHLORITE

2.18.20 TATRAZINE SOLUTION, COMPOUND

2.19 SPIRITS AND SANITIZERS

2.19.1 AROMATIC AMMONIA SPIRIT

2.19.2 METHYLATED SPIRIT

2.19.3 PEPPERMINT SPIRIT

2.19.4 HAND SANITIZER

2.19.4.1 WHO FORMULA SANITIZER

2.19.4.2 HAND SANITIZER GEL

2.19.4.3 ALOE VERA GEL HAND SANITIZER

2.20 TINCTURES

2.20.1 BELLADONA TINCTURE

2.20.2 COMPOUND BENZOIN TINCTURE

2.20.3 COMPOUND CARDAMOM TINCTURE U.S.P.

2.20.4. ORANGE TINCTURE

2.20.5 AROMATIC CARDAMOM TINCTURE B.P.

CHAPTER 3. DISPERSED SYSTEMS

3.1 EMULSIONS

3.1.1 CASTOR OIL EMULSION

3.1.2 COD-LIVER OIL EMULSION

3.1.3 LIQUID PARAFFIN EMULSION

3.1.4 LIQUID PARAFIN AND MAGNESIUM HYDROXIDE EMULSION

3.1.5 PEPPERMINT EMULSION, CONCENTRATED P.CX.

3.2 SUSPENSIONS

3.2.1 AMOXYCILLIN TRIHYDRATE SUSPENSION

3.2.2 CORTISONE ACETATE SUSPENSION

3.2.3 ANTACID SUSPENSION

3.3 MIXTURES

3.3.1 AMMONIUM CHLORIDE MIXTURE P.CX.

3.3.2 AMMONIA AND IPECACUANHA MIXTURE P.CX.

3.3.3 ASTHMA MIXTURE

3.3.4 BELLADONNA MIXTURE, PAEDIATRIC P.CX.

3.3.5 BELLADONNA AND EPHEDRINE MIXTURE, PAEDIATRIC

3.3.6 BELLADONNA AND IPECACUANHA MIXTURE, PAEDIATRIC P.CX.

3.3.7 CALCIUM CARBONATE MIXTURE, COMPOUND, PEDIATRIC B.P.C.

3.3.8 CASCARA AND BELLADONA MIXTURE

3.3.9 CHALK MIXTURE, PAEDIATRIC P.CX.

3.3.10 CHLORAL MIXTURE

3.3.11 FERRIC AMMONIUM CITRATE MIXTURE P.CX.

3.3.12 FERRIC AMMONIUM CITRATE MIXTURE, PAEDIATRIC P.CX.

3.3.13 FERROUS SULPHATE MIXTURE

3.3.14 FERROUS SULPHATE MIXTURE, PAEDIATRIC P.CX.

3.3.15 IPECACUANHA AND AMMONIA MIXTURE, PAEDIATRIC P.CX.

3.3.16 KAOLIN MIXTURE P.CX.

3.3.17 KAOLIN MIXTURE, PAEDIATRIC P.CX.

3.3.18 MAGNESIUM CARBONATE MIXTURE AROMATIC

3.3.19 MAGNESIUM CARBONATE MIXTURE P.CX.

3.3.20 MAGNESIUM SULPHATE MIXTURE

3.3.21 MAGNESIUM TRISILICATE MIXTURE P.CX

3.3.22 MAGNESIUM TRISILICATE AND BELLADONNA MIXTURE P.CX.

3.3.23 PHENYTOIN MIXTURE P.CX

3.3.24 SODIUM CITRATE MIXTURE P.CX.

3.3.25 SULPHADIMIDINE MIXTURE, PAEDIATRIC P.CX

3.4 CREAMS

3.4.1 AQUEOUS CREAM P.CX.

3.4.2 BUFFERED CREAM

3.4.3 BILITAR CREAM

3.4.4 CALAMINE CREAM, AQUEOUS P.CX.

3.4.5 CETRIMIDE CREAM

3.4.6 COLD CREAM USP XXI

3.4.7 HAND CREAM

3.4.8 LIME CREAM

3.4.9 SALICYLIC ACID AND SULPHUR CREAM

3.4.10 VANISHING CREAM

3.4.11 ZINC CREAM

3.4.12 ZINC AND ICHTHAMMOL CREAM

3.5 OINTMENTS

3.5.1 CALAMINE OINTMENT P.CX.

3.5.2 CALAMINE AND COAL TAR OINTMENT P.CX.

3.5.3 COAL TAR AND ZINC OINTMENT P.CX.

3.5.4 COMPOUND BENZOIC ACID OINTMENT P.CX.

3.5.5. DITHRANOL OINTMENT P.CX.

3.5.6 EMULSIFYING OINTMENT P.CX.

3.5.7 HYDROCORTISONE OINTMENT

3.5.8 HYDROUS WOOL FAT P.CX.

3.5.9 HYDROUS WOOL FAT OINTMENT P.CX.

3.5.10 IODINE OINTMENT, NON-STAINING B.P.C. 1968

3.5.11 MENTHOL AND EUCALYPTUS OINTMENT B,N.F 1963

3.5.12 PARAFFIN OINTMENT P.CX.

3.5.13 SALICYLIC ACID OINTMENT P.CX.

3.5.14 SIMPLE OINTMENT P.CX.

3.5.15 SULPHUR OINTMENT P.CX.

3.5.16 WOOL ALCOHOLS OINTMENT P.CX.

3.5.17 ZINC OINTMENT

3.5.18 ZINC AND CASTOR OIL OINTMENT

3.5.19 COAL TAR AND SALICYLIC ACID OINTMENT

3.6 PASTES

3.6.1 COMPOUND ALUMINIUM PASTE

3.6.2 RESORCINOL AND SULPHUR PASTE

3.6.3 COMPOUND ZINC PASTE P.CX.

3.6.4 COMPOUND ZINC AND COAL TAR PASTE P.CX

3.6.5 COAL TAR PASTE P. CX.

3.6.6 DITHRANOL PASTE P.CX.

3.6.7 TITANIUM OXIDE PASTE

3.6.8 ZINC AND SALICYLIC ACID PASTE

3.6.9 TOOTH PASTE

3.7 GELS, MILKS AND MAGMAS

3.7.1 MILK OF MAGNESIA USP

3.7.2 ALUMINIUM HYDROXIDE GEL

3.7.3 POISON IVY GEL

3.7.4 ULTRASOULD GEL

3.7.5 LIGNOCAINE GEL

3.7.6 BENTONITE MAGMA

3.8 POULTICES

3.8.1 KAOLIN POULTICE P.CX.

3.9 SUPPOSITORIES

3.9.1 BISTHMUS SUBGALLATE, COMPOUND SUPPOSITORIES

3.9.2 GLYCEROL SUPPOSITORIES

3.9.3 GLYCERIN SUPPOSITORIES

3.9.4 GLYCERATED GELATIN SUPPOSITORIES

3.9.5 TANNIC ACID SUPPOSITORIES

CHAPTER 4. SOLID DOSAGE FORMS

4.1 TABLETS

4.1.1 ACETYLSALICYLIC ACID TABLETS

4.1.2 ACETYLSALICYLIC ACID SOLUBLE TABLETS

4.1.3 AMINOPHYLINE TABLETS

4.1.4 ASPIRIN EFFERVERCENT TABLETS

4.1.5 CHEWABLE ANTACID TABLETS

4.1.6 FERROUS SULPATE TABLETS

4.1.7 PARACETAMOL TABLETS

4.1.8 PHENOBABITAL TABLETS

4.2 CAPSULES

4.2.1 AMOXYCILLIN CAPSULES

4.2.2 IBUPROFEN CAPSULES

4.3 POWDERS

4.3.1 AROMATIC CHALK POWDER

4.3 2 ATROPINE SULPHATE POWDER

4.3.3 BARIUM SULPHATE POWDER

4.3.4 COMPOUND BISMUTH ORAL POWDER

4.3.5 CALCIUM CARBONATE POWDER, COMPOUND P.CX

4.3.6 CODEINE COMPOUND POWDER

4.3.7 EFFERVESCENT GRANULES

4.3.8 GREGORY’S POWDER (BULK ORAL POWDER)

4.3.9 LIQUORICE COMPOUND POWDER

4.3.10 MAGNESIUM CARBONATE POWDER, COMPOUND P.CX.

4.3.11 MAGNESIUM TRISILICATE POWDER, COMPOUND P.CX.

4.3.12 ORAL REHYDRATION SALTS (ORS), WHO RECOMMENDATION

4.3.13 SALICYLIC ACID COMPOUND DUSTING POWDER

4.3.14 SEIDLIZ POWDER

4.3.15 SODIUM CHLORIDE AND DEXTROSE POWDER, COMPOUND P.CX.

4.3.16 TALC DUSTING POWDER P.CX.

4.3.17 TOOTH POWDER

4.3.17.1 HOME-MADE TOOTH POWDER

4.3.17.2 TOOTH POWDER (II)

4.3.17.3 TOOTH POWDER (III)

4.3.18 TRAGACANTH POWDER, COMPOUND

4.3.19 ZINC OXIDE AND STARCH DUSTING POWDER

4.3.20 ZINC UNDECYLENATE DUSTING POWDER

CHAPTER 5. STERILE PREPARATIONS

5.1 INJECTIONS

5.1.1 WATER FOR INJECTION

5.1.2 ASCORBIC ACID INJECTION

5.1.3 CHLORAMPHENICOL INJECTION

5.1.4 CYANOCONBALAMIN INJECTION

5.2 INTRAVENOUS INFUSIONS

5.2.1 ACID CITRATE DEXTROSE SOLUTION (ACD)

5.2.2 CALCIUM GLUCONATE INJECTION

5.2.3 DARROW’S SOLUTION

5.2.4 DARROW’S SOLUTION, HALF STRENGTH WITH 2.5 % DEXTROSE

5.2.5 DEXTROSE SOLUTION

5.2.6 RINGER’S SOLUTION

5.2.7 RINGER LACTATE SOLUTION

5.2.6 MANNITOL SOLUTION

5.2.9 NORMAL SALINE (NS)

5.2.10 NORMAL SALINE AND DEXTROSE SOLUTION (DNS)

5.2.11 SODIUM CITRATE ANTICOAGULANT INJECTION

5.2.12 SODIUM LACTATE, COMPOUND INJECTION

5.3 OPHTHALMIC PREPARATIONS

5.3.1 EYE DROPS

5.3.1.1 AMETHOCAINE EYE DROPS

5.3.1.2 ATROPINE SULPHATE EYE DROPS

5.3.1.3 FRAMYCETIN EYE DROPS

5.3.1.4 SOLUTION FOR EYE DROPS

5.3.1.5 ZINC SULPHATE EYE DROPS

5.3.1.6 ZINC SULPHATE AND ADRENALIN EYE DROPS

5.3.2. EYE OINTMENTS

5.3.2.1 SIMPLE EYE OINTMENT

5.3.2.2 CHLORAMPHENICOL OINTMENT

FOREWORD

In the last two to three decades, pharmaceutical compounding declined due to availability of mass-produced medicines. However, it was soon realized that it is not possible to satisfy patient requirements by supplying specific medicines only. Patients have a variety of needs according to their individual differences in metabolism, disposition and handling of various substances administered to them. Inter-individual variation, disease difference, drug-drug interactions and food-drug interactions, pose a needful requirement of individualization of doses and dosage forms according to specific patients’ needs. These and other situations reverberate the need for compounding, a role that pharmacists, pharmaceutical technicians and pharmaceutical assistants will continue to play to enhance the pharmaceutical care in modern therapy, the patient centered health care system. Compounding may also be associated with economic savings in terms of hospital visits and provision of effective treatment to specific patients. Compounding enables drug compounders to have a direct communication to both patients and prescribers as they try to customize medications according to patients’ and/or prescribers’ needs. This has a special attention particularly when the compounded medicine is not commercially available.

The art of compounding to pharmacy personnel is built by instructors and tutors in pharmaceutical colleges. To be quite effective in delivering the required knowledge and skills to their students, instructors need adequate space, instruments, appropriate equipment, reagents and chemicals as well as good reference materials and textbooks. I wish to congratulate the authors of this book for their efforts to make available one of the most important tools in teaching and learning, the pharmaceutical dispensing and compounding book. This book covers a great variety of preparations that may be needed to be compounded as such or modified to satisfy the individual patients. Inclusion of both common and uncommon (but equally important) formulae makes this book unique and obviates the need of many references, because a lot of information is covered already. It is my best hope that the book will live to quench the academic thirst of our students and practitioners.

The need for textbooks and other reference materials in training of all fields and sectors cannot be overemphasized. I wish to encourage all, especially personnel in the academics to emulate the example set by the authors of this book to make relevant materials in their field of specialty available locally. Not only will this make teaching and learning simple and comfortable, but will also lessen dependence on foreign materials which are expensive and sometimes unavailable when needed. It is possible, it can be done, just play your part.

Elizabeth Shekalaghe

Registrar, Pharmacy Council

Ministry of health, Community Development, Gender, Elderly and Children

United Republic of Tanzania.

PREFACE

Before industrial revolution back in the 1950’s, nearly all prescriptions were compounded by druggists, pharmacists and their helpers. Every prescription would be prepared to a certain drug dosage in order to fit the patient’s needs. The great demand of medicines during the Second World War evolved pharmaceutical industries which started to mass produce various drugs and dosages. Slowly the practice of compounding dwindled with availability of ready-made tablets, capsule, powders, solutions, emulsions and ointments. The pharmacist’s role as a preparer of medications quickly changed to that of a dispenser of manufactured dosage forms. However, in the late 1970’s to early 1980’s pharmacy and medical practice awakened to realize that not everyone can take the same dosage form, or a patient may require a specific dose that is only effective for that particular individual. Doctors would prescribe a specific dose or dosage form for an individual patient which is unavailable in commercial products. This then called for compounding pharmacists and technicians to compound a specific and unique medication needed. Compounding practice came back on board. It will continue to play a vital role in medicine because the population is growing and more drugs are being invented and added to the existing arsenal. When doctors prescribe higher or lower dose strength, the compounding pharmacist or technician will custom make the medication according to the prescription. Even some excipients to which some patients are allergic may be substituted with other suitable ones in compounding. The compounder can alter a dosage form to make it easier for the patient to use or may add flavour to it to make it more palatable. The pharmacist may also formulate a unique delivery system, such as a sublingual troche or lozenge, a lollipop or a transdermal gel. For patients having difficulty swallowing a capsule, a compounding pharmacist can make a suspension instead. Compounding practice is thus here to stay.

Although the practice of compounding abated due to availability of ready-made medicines, colleges of pharmacy retained teaching of the practice. Compounding is taught in all levels of pharmaceutical training. However, there are constraints in the teaching, particularly in resource-limited countries. Essential ingredients in compounding are not available in sufficient quantities all the time. More important, textbooks may not be available for all students and practitioners and those available may not address all issues and practices of interest. The later issue is what motivated us to write the Dispensing and Compounding Companion book, to address the gaps found in the available Compounding practical books.

Pharmaceutical Dispensing and Compounding is indeed a companion to pharmacy students at all levels of pharmaceutical colleges and practicing pharmacists in hospital and community pharmacy settings. The book gives both theoretical and practical guide profoundly needed for extemporaneous compounding and dispensing. It covers a wide variety of dosage forms, and for each preparation there is a theoretical background, the formula, the procedure and other pertinent information unique for that preparation. This book has been designed to provide as much information as possible to obviate the need for referencing several sources and hence to make the compounding exercise easier, faster and more convenient. Other standard pharmaceutical references however, such as The British Pharmacopoeia, British Pharmaceutical Codex, United Stated Pharmacopoeia, European pharmacopoeia and Martindale’s Extra Pharmacopoeia must be available in the laboratory for deeper information that may be required. The National and Regional references such as Tanzania Pharmaceutical Handbook and the National formulary must be in stock as well.

The Pharmaceutical Dispensing and Compounding book is organized according to pharmaceutical dosage forms, namely Solutions, Dispersed systems, Solid dosage forms and Sterile Preparations. The unique presentation of the book is that each dosage form starts with introductory notes to remind the user the theoretical background of the dosage form. Each preparation also begins with its relevant introductory notes.

It is the best hope of authors that the book will meet expectations of the users as intended.

Dr Willbrord Maddo Kalala, Senior Lecturer, Kampala International University (Tanzania Campus)

Part-time Lecturer, Muhimbili University of Health and Allied Sciences, Tanzania.

Dr Betty Maganda, Lecturer, Muhimbili University of Health Sciences, Tanzania

PART 1 COMPOUNDING PRACTICE

CHAPTER 1. ESSENTIALS OF

PHARMACEUTICAL COMPOUNDING

1.1 Introduction

Compounding in pharmacy is defined as the art and science of preparing medications for patients, usually based on individual needs as prescribed by an authorized practitioner. Ingredients are mixed together (or compounded) in the exact strength and dosage form required by the patient.

Compounding is especially useful when

• When management requires tailored dosage strength for patients with unique needs (for example, infants, elderly patients or pregnant women)

• When a pharmacist needs to combine several medications, a patient is taking simultaneously in order to increase compliance

• When a patient is allergic to certain ingredients in the available medicines such as flavours, binders, preservatives, dyes or sweeteners

• When the needed medications have been discontinued by or generally unavailable from pharmaceutical companies, such as when the medications are no longer profitable to manufacture

• When a patient cannot ingest the medication in their commercially available forms and a pharmacist can prepare the medication in cream, liquid or other form that the patient can easily take and

• When medications require flavour or sweet additives to make them more palatable for some patients, most often, children or choosy adults.

Sometimes the term compounding is confused or interchanged with dispensing.

Difference between Compounding and Dispensing

Compounding involves preparation, mixing, labeling and packing of a medicine whereas dispensing involves giving already available packed medicine manufactured by pharmaceutical manufacturers to patient or patient’s caretaker.

i. Compounding can be performed only in Pharmacy whereas dispensing is performed both in Pharmacy and in a Druggist/Chemist shop.

ii. Technical knowledge is required for compounding, so it must be carried out by a pharmacist or a pharmaceutical technician whereas dispensing doesn’t require deep technical knowledge, so it can be carried out by a dispenser under supervision of Pharmacist.

iii. Standard references should be followed during compounding and compounded medicines should be labeled properly whereas dispensing doesn’t necessarily need standard reference to follow because already packed medicines involves in the process.

Table 1: Essential Equipment and consumables in the Compounding laboratory