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Afifah Machlaurin
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Isi Materi
Pengertian Inkompatibilitas
Tipe-tipe inkompatibilitas
Pengatasan Inkompatibilitas
Inkompatibiitas farmasetik
proses peracikan dan penyiapan obat
Safety
purpo
se
Dampak Inkomp
Appea
rence
Undesire
efficacy
Therapeutic
Tipe
Physical
Inkomp
Chemical
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Type of incompatibility
1 2 3
They exist when failure of the react chemically
the response to drugs to combine when mixed,
one or more drug properly. altering the
is different nature composition of
or intensity than one or more of the
that intended by constituents
the prescriber
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Therapeutic Inkomp !
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Therapeutic Incomp
Antagonistic combinations
Contraindication
Dosage Error
2. Antagonistic combinations
When two or more drugs having opposite
pharmacological action are prescribed together,
their actions cancel each other and the resulting
prescription will have no therapeutic action.
Stimulants with sedatives (hypnotics) e.g. caffeine
with chloral hydrate.
Purgatives with antidiarrheals e.g. MgSo4 with tannins
Acidifiers with alkalinizers e.g. aspirin with AL(OH)3.
Therapeutic incompatibility
3. contraindication
Are drugs when prescribed together
may lead to increased toxicity or
decrease activity.
Tetracycline is contraindicated with
any drug containing Ca2+ ions as it
form non-absorbable complex.
Inactivation of sulfa drugs by
procaine HCI.
Therapeutic Incompatibility
4. Dosage Error:
can result from the administration of a single
high dose, or the too frequent administration.
R/
Atropine sulphate 6 mg
Phenobarbital 360 mg
Ft. caps, i mitte xii
sig. caps, i t.d.s
- Dosing errors, unclear prescription
Therapeutic Incompatibility
Dosage errors
Rx
Codeine phosphate 15 mg
Ammonium chloride 500 mg
Ft. caps, i mitte xx
sig; caps, ii q.h
Whats different ??
qd vs q.d.s ???
Physical Inkomp !
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Physical Incompatibility
Insolubility/Immiscibility
Adsorption-complexation
Liquification
Precipitation
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Insolubility
Example of prescription:
Terpine hydrate 3g
Simple syrup q.s
to make 120ml
MFT solution.
Terpine hydrate is insoluble in simple syrup then
how we make solution? So in this case of the
syrup may be replace by alcohol or iso-alcohlic
elixirs or the drug may be suspended with
accasia tragacanth and dispense with a shake
label.
7/17/17 24 PHR 416
Example Insolubility
Example of prescription:
Magnesium carbonate .. 3.75g
Citric acid . 7.5g
Sodium bicarbonate . 7.5g
Boiled water q.s to make 250ml
MFT solution or MFT citrate solution.
Hint :
Magnesium Carbonate insoluble
Magnesium citrate soluble
Na bicarbonate soluble
7/17/17 25 PHR 416
Example Insolubility
Example of prescription:
Rx/
Sulphamethoxazole 4.0g
Trimethoprim 0.8g
Na- CMC 0.5g
Purified water qs to 100ml
Sulphur
Corticosteroids (hydrocortisone acetate)
Antibiotics
Suspending agent
MethodsOfRectifyingLiquefaction:
By the use of absorbent like kaolin, light
magnesium carbonate.
Rx/
Thymol 250 mg
Camphor 2 mg
Menthol 2 mg
Make powder.
Methode
Rx/
Chloral hydrate 250 mg
Prepare capsules. Supply 10 capsules.
Label: Take the capsules at night time.
Alternate Solvent
Modified
order of
Mixing A C Changing the
form
Concept
Surfactant E D Complexation
Rx
Olive oil 30 ml
Water up to 120 ml
Directions for Pharmacist:
Make an emulsion.
Comments:
Physical incompatibility.
Rx
Phenacetin 3 gm
Caffeine 1 gm
Orange syrup 12 ml
Water up to 90 ml
Directions for Pharmacist:
Make a mixture. Send 25 ml
Comments:
Physical incompatibility.
Menthol 5 gm
Camphor 5 gm
Ammonium chloride 30 gm
Light magnesium carbonate 60 gm
Directions for Pharmacist:
Make an Insufflations. Send 40 gm.
Comments:
Correct prescription.
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Two types of chemical incompatibility
1. Tolerated
In this type of incompatibility, chemical reaction can be
reduced by mixing the solution in dilute forms or by
changing the order of mixing.
2. Adjusted
In this type of incompatibility, change in the formulation
is needed with a compound of equal therapeutic value
e.g. in the mixture of caffeine citrate and sodium
salicylate, caffeine citrate is replaced with caffeine.
Classification 4
1
Racemization
3
Oxidation-
reduction 2 Hydrolisis
Acid-Base Reaction
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Oxidation-reduction
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