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Compounding Test 1
Discussion 4 (Alligation calculations)
26
Other
Professional
01/21/2013

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Term

USP <1160>

(11)

Definition
  • Pham Calcs in Prescription Compounding 
    • Basic math concepts
    • Basic pharmaceutical calculations
      • Ratios, Dosage calculations, % calculations 
      • Specific gravity
      • Concentration, Dilution, Reconstitution
      • Alligation
      • Molar, Molality, Normality
      • Milliequivalents, Millimoles, Osmolarity 
      • Flow rates
      • Temperature / Mean Kinetic Temp 
Term

Alligation

(6)

Definition
  • Arithmetic methods for solving mixtures of ingredients
  • Alligation Alternate
    • Use to determine amounts of individual ingredients to make a given mixture
  • Alligation Medial
    • Use to determine the final quantity of a mixture, if given quantities of individual ingredients
    • Weighted mean 
Term

Alligation Alternate

(7)

Definition
  • Rapid method of calculation that is commonly used in pharmacy
  • Find proportions of substances with diff conc. to yield a desired conc
  • Rules
    • Line up conc of start materials in one column from high to low; solvent = 0%, pure = 100%
    • Desired conc. placed in middle
    • Cross-subtract two columns to give parts
    • Sum parts for total 
Term

Alligation Alternate-algebraic Method

(14)

Definition
  • Step 1 Define 2 equations
    • 1st equation for what percentages are being mixed
      • 95% + 50% = 70%
    • 2nd equation for amounts of each percentage. Let x represent either 95 or 50%, and 70% equal total amount.
      • [x] + [total x] = total 
  • Step 2 Combine equations 
    • 95[x] + 50[total x] = 70[total]
  • Step 3 Solve for x [total = 1Liter] 
    • 95x + 50[total] 50x = 70[total] 
    • 95x + 50[1L] 50x = 70
    • 45x + 50L = 70L
    • 45x = 20L
    • 20/45 = x; this is how much 95% to add 
    • 1 x = 1 - [20/45] = 25/45; is how much to add of 50% 

 

 

 

Term

Alligation Medial

(7)

Definition
  • Used to determine final percentage of a drug when two or more substances are combined
    • Weighted mean
  • What is v/v% ethanol of solution consisting of
    • 3,000 mL of 40% v/v, 
    • 1,000 mL of 60% v/v 
    • and 1,000 mL of 70% v/v? 

 

Term

Molarity, Molality, Normality

Defs

Definition
  • Molarity
    • [Moles of solute / L of solution]
  • Molality
    • [Moles of solute / kg of solvent]
  • Normality
    • [Gram Equiv Weight of solute / L of solution] 
Term

Molarity, Molality, Normality

Gm Eq
(6)
Definition
  • Gram Equivalent Weight =
    • MW of compound in gm / highest valence
    • Equiv Wt =
Term

Molarity, Molality, Normality

Valence

Definition
  • If the highest valence contained in the compound is 1, then a gram eq weight would equal 1 mole and normality would equal molarity for that compound. This is not true if the compound contains valence higher than 1
  • To know valence you need to know how the compound is broken up
    • Ca(gluconate)2 Ca2+ + 2 gluconate 1-
  • Choose highest valence 
Term

Molarity, Molality, Normality

mole and mmol

Definition
  • 1 mole = MW of compound in grams

  • 1mmol = MW of compound in mg

  • If the compound has waters of hydration, this must be included in the molecular weight


    MgSO4 • 7H2O = MW of 246 

     

Term

Definitions: mEq, mMol, mOsm, MW, mg

(9)

Definition
  • What to think:
    • mEq = think “charge” or “valence”
      • mEq = valence x [1 mmol / MW] 
      • mEq = [MW/1 mmol] / valence 
      • mEq = mmol / valence
    • mmol = milligram molecular weight
    • mosm = think “# of particles” or “# of ions”
    • mw = mg/mol or gm/mol
    • tonicity = term used in place of osmotic pressure (usually osmolarity describes blood and tonicity describes IV solutions) 
Term

Converting: mEq, mMol, mOsm, MW, mg

(8)

Definition
  • CaCl2 of 111 mg (theMW) yields: 
    • 1 mole CaCl2 (3 total particles) 
    • 1 mole Ca2+ (1 particle) 
    • 2moleCl1- (2particles)
  • For non electrolytes
    • 1 mOsm = 1 mMol = MW of compound
  • Normal serum osmolarity = 275-295 (308)
  • Increase Osm = increase freezing point depression 
Term

Osmols and Osmolarity

(2)

Definition
  • Ideally solutions given intravenously should be isotonic with blood however this is not practical in practice.

  • Osmotic pressure is proportional to the number of particles in solution not the type, valence or weight. 

Term

Tonicity

(3)

Definition
  • Tonicity is a term frequently used in place of osmotic pressure or tension, is related to the number of particles found in solution. 
  • Isotonic solutions have the exact same number of particles in both solutions. 
  • Usually osmolarity is used when speaking of blood and tonicity when referring to IV solutions but the terms are often used interchangeably. 
Term

Osmolarity

(3)

Definition
  • Pharmaceutics taught you to calculate the force required to push the fluid back to equilibrium.

  • We are concerned primarily with the movement of water.

  • Normal osmolarity of blood ranges in the 285-290 mOsm/L range 

Term

Non-Electrolytes

(6)

Definition
  • One osmol = 1 gram molecular weight 
  • One mOsm = 1 mg molecular weight 
  • Sucrose MW 342
    • 1 mOsm = 342 mg
  • Anhydrous dextrose MW = 180
    • 120 mOsm = 180 mg/mOsm = 21.6 gm 
Term

Normality

(4)

Definition
  • A 1Normal solution is defined as a solution with one gram equivalent per liter of solution.

  • A gram equivalent is the molecular weight of the compound divided by the highest valence.

  • One Equivalent = 1,000 mEq

  • N = # mEq/mL (= # gm equiv/Liter) 

Term

Normality

Contd

(7)

Definition
  • 1 gm equivalent for HCl = MW = 36
  • 1 gm equivalent for H2SO4 = MW ÷
  • 1 gm equivalent for H3PO4 = MW ÷
  • But
    • HCl is 36-38% w/w Density of 1.18 
    • H2SO4 is 96.5% w/w Density of 1.84 
    • H3PO4 is 86.5% w/w Density of 1.71 
Term

Kcals

(7)

Definition
  • Calorie = energy to raise 1 gm H2O by 1oC
    • kcal = energy to raise 1kg H2O by 1oC
  • Carbohydrates (CHO) = 4 kcal/gm 
  • Dextrose (IV) = 3.4 kcal/gm
  • Protein = 4 kcal/gm
  • Fat = 9 kcal/gm
  • Alcohol = 7 kcal/gm 
Term

Kcal Calculations 

Lipid Emulsions

Definition
  • 10% = 1.1 kcal/mL, 0.9 from fat and 0.2 from glycerol to make isotonic

  • 20% = 2 kcal/mL, 1.8 kcal from fat and 0.2 from glycerol to make isotonic

  • 30% = 3 kcal/mL, there is some serious rounding of significant numbers to get this amount. 

Term
Kcal Using Lipid
Definition
  • TPN calls for 630 Kcal from IV lipid emulsion. How many mL of 20% lipid emulsion is needed?

  • 630 Kcal X 1 mL/2Kcal = 315 mL of 20% lipid emulsion 

Term

Kcal Calculations Involving aas

(7)

Definition
  • Controversial and complex
  • Protein is approximately 16% nitrogen
    • 16 gm nitrogen in 100 gm of protein
    • 16/100 = 0.16 or 6.25 gm protein/gm N
  • Manufacturers list the amount of nitrogen in their product.
    • N X 6.25 pro/N = grams of “protein” 
    • Grams of protein X 4 Kcal/gm = Kcal 
Term

Nitrogen Balance Calculations

(5)

Definition
  • Nitrogen in nitrogen out = N balance
    • Nitrogen in is the nitrogen in the TPN
    • Nitrogen out is primarily Urine Urea Nitrogen 
      • (UUN) plus fudge factors
    • Nitrogen balance: Positive balance assumes protein synthesis but negative balance assume catabolism. 

 

Term

Nitrogen Balance

(3)

Definition
  • Nitrogen in is obtained from the amount of amino acids infused into the patient.
  • Nitrogen out is 24H UUN + 2-4 grams for non-urea loss.
  • If a patient is getting 15 gm N in but excreting 10 gm of UUN they would be in a + 1-3 gm balance 
Term

Reconstitution of Dry Powder

(9)

Definition
  • Step1: 
    • Calculate the final volume from the manufacturer directions
  • Step 2:
    •  Subtract the SWFI added to vial from the final volume. Remainder is volume of vial taken up by the powder
      • since the powder volume remains constant, so does the amount of sterile water taken up so you cannot use ratios
  • Step 3: 
    • Decide the new final volume needed to achieve the desired concentration.
  • Step 4: 
    • Determine how much SWFI to add by subtracting the powder volume (calculated in step 2) from the desired final volume (calculated in step 3). 

 

Term

Amount of Active Ingredient

(13)

Definition
  • Have you ever wondered does the mg listed on this package mean the drug alone, the drug + salt, or the drug + salt+ inactive ingredients?
    • This does happen: Fentanyl Citrate, for example, is dosed on fentanyl content. 
  • You may need to convert between active drug and drug plus salt etc.
    • W=
Term

Amount of Active Ingredient Using Ratio

(4)

Definition
  • Same problem as last slide
    • 2.5 gm/951 : X/1442
    • Solving for X will give the amount if the product does not have any residual water
  • Divide the answer above by the percentage of dry weight, 0.88 in this case, to get the amount of Netilmicin Sulfate 
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