Analysis of the most popular multi dose packaged o

2022-07-30
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Analysis of multi dose packaged oral drugs (Part 2)

3 discussion on whether multi dose packaged oral drugs can be used

multi dose packaged oral drugs are more economical and acceptable to patients. Whether oral drugs are suitable for multi dose packaging should be determined according to the chemical properties and drug use. The drugs that can be packaged in multiple doses should have stable chemical properties, such as isosorbide nitrate, verapamil hydrochloride, captopril, enalapril maleate, etc. Verapamil hydrochloride has good chemical stability, and its properties remain unchanged under heating and photochemical degradation conditions; No significant decomposition was found in captopril solid crystals stored at 5 ℃, 33 ℃ and 50 ℃ for 6 months or exposed to light for 30 days; Enalapril maleate will not degrade after storage at room temperature for several years [3, 4]. In addition, it is necessary to use multi-dose packaging for drugs that need to be taken for a long time, such as prednisone, diethylstilbestrol but lose detection efficiency for particles larger than 2 microns, norethisterone, megestrol, methimazole, folic acid, vitamin B4, troxerutin, piracetam, etc

3.2 oral drugs that should be packaged in a single dose

3.2.1 perishable drugs: different drugs need different storage conditions due to their physical and chemical properties and the influence of external conditions such as air, sunlight, temperature and humidity. Phenytoin sodium can absorb carbon dioxide in the air and decompose into phenytoin; The efficacy of carbamazepine tablets can be reduced to 1/3 of the original when stored in humid environment; Aspirin is slowly hydrolyzed to salicylic acid when it meets with moisture, and can gradually turn into light yellow, red brown or even dark brown in the air; Aminophylline can absorb carbon dioxide in the air and decompose into theophylline. The drugs with hygroscopic properties also include chlorpromazine, glibenclamide, ethambutol, vitamin B1, sodium bicarbonate, etc. In order to avoid the change of physiological and chemical properties caused by contact with air, the above drugs should be stored in a sealed manner. If multi-dose packaging is adopted, the stability of the drugs will be affected after unpacking. In addition, some drugs are unstable to light, and single dose packaging is also conducive to drug preservation. Haloperidol is stable at room temperature and away from light, and can be stored for 5 years, but its color darkens after exposure to natural light; Vitamin A is not suitable for this experiment. It is unstable to ultraviolet light and is easy to be oxidized by air; When metoclopramide turns yellow or yellowish brown when exposed to light, its toxicity increases. Propranolol hydrochloride, nifedipine, vitamin C, nitrendipine, vitamin B6, isoniazid, rifampicin, adenosine B12, etc. are easy to deteriorate when exposed to light [3, 4]

3.2.2 psychotropic drugs: psychotropic drugs refer to drugs that act on the central nervous system to excite it or 13. Vicat softening point: gb/t 8802 (2) 001 determination and inhibition of Vicat softening temperature of thermoplastic pipes and fittings. Continuous use can produce dependence. Article 2 of the law on the administration of psychotropic drugs stipulates that doctors should reasonably use psychotropic drugs according to medical needs, and abuse is strictly prohibited. Except for special needs, the prescription of class I psychotropic drugs shall not exceed 3 daily doses each time; The prescription of class II psychotropic drugs shall not exceed 7 daily doses each time. If triazolam is used for hypnosis, it should be taken 0.25mg ~ 0.5mg before going to bed, i.e. 1 ~ 2 tablets, 7 ~ 14 tablets for 7 days; The common dosage of alprazolam is 0.4mg ~ 0.8mg, i.e. 1 ~ 2 tablets, 3 times a day, and 21 ~ 42 tablets in 7 days. Such drugs include diazepam, nitrazepam, clonazepam, estazolam, etc. In order to prevent the abuse of psychotropic drugs, single dose packaging should be implemented for psychotropic drugs

3.2.3 some drugs related to the course of disease: some drugs are not suitable for long-term clinical application, and are only used for symptomatic treatment or symptom relief. For example, antipyretic analgesics APC and Qutong tablets, take 1-2 tablets if necessary; Some antispasmodics, antiemetics, cathartics and other drugs can obtain curative effect immediately after application, and they do not need to be administered again to maintain the curative effect in clinical practice, such as prubenchine, 654-2, metoclopramide, methenamine, and phenolphthalein. When only a few tablets (tablets) are needed, the patient gets dozens or hundreds of tablets (tablets), which not only wastes resources, but also increases the economic burden of the patient, so it should be packaged in a single dose

3.3 multi dose packaged oral drugs repacking problem

due to the existence of multi dose packaged oral drugs, in practical work, some of them have to be repacked again, and there are many disadvantages in drug repacking. First of all, the sub packaging of drugs increases the burden on the dispensing personnel in the pharmacy. The sub packaging of drugs is required to be accurate. The name, content, quantity and expiry date of drugs shall be printed on the sub packaging bag first. After the sub packaging, it is necessary to check whether the sub packaged drugs are consistent with the contents of the original packaged drugs one by one. Secondly, patients can only learn the name, content, expiry date and other simple information of the drug from the sub packaged drug bag, but can not learn the details of adverse drug reactions, contraindications and drug interactions. Thirdly, drugs with the same composition produced by different manufacturers may bring doubt to patients who have taken drugs from another manufacturer due to their different size, thickness and color. Sunjianmin [5] made statistics on chlorpromazine, perphenazine, promethazine, etc., and found that promethazine hydrochloride tablets produced by different manufacturers have different colors, including light blue, white, light green, etc., and their appearance is also different. Finally, the validity period of drugs is affected by the storage conditions. After the drugs are repackaged, the packaging and storage conditions change. It is unknown whether the drugs still have the same validity period as the original packaging conditions

4 suggestion

in order to ensure the safety, effectiveness and convenience of patients' medication, pharmaceutical enterprises, doctors, drug dispensing personnel and other aspects need to make joint efforts. It is suggested that pharmaceutical enterprises should produce drugs suitable for use according to the nature of drugs and clinical needs: first, unreasonable multi-dose packaging should be replaced by single dose packaging; Second, the drug instructions and the minimum sales package of drugs should be put together so that patients can carefully read the instructions before taking drugs; Third, drugs that need to be sealed should be sealed and packaged; Fourth, improve the packaging process and eliminate the phenomenon of drug label falling off

author/zhangyanmei, huyongfu, liangliping, zhangzhiqing

source: China Pharmacy

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