C-10 Ointment 2
C-10 Ointment 2
INTRODUCTION
Ointments, Creams, and Gels TOPICAL APPLICATION * to the skin * place on the surface of the eye * vaginally, nasally, rectally TOPICAL DERMATOLOGICAL designed to deliver drug into the skin dermal disorders (SKIN AS TARGET ORGAN) TRANSDERMAL designed to deliver drug through skin (percutaneous absorption) general circulation SKIN NOT BEING THE TARGET ORGAN NOTE: SYSTEMIC ABSORPTION always considered
OINTMENTS
are semisolid preparations for external application of such consistency that they maybe readily applied to the skin with or without inunction (rubbing) Ointments should be of such composition that they soften but not necessarily melt when applied to the body.
Unguents
Types Of Ointments 1.Medicated - those with medicaments for treatments of cutaneous (skin diseases). Examples: Sulfur Ointment, Zinc Oxide Ointment and Compound Resorcinol 2.Non-medicated - also referred to as ointment bases and use as such for their emollient or lubricating effect or use as vehicles in medicated ointments. Example: White Ointment
The USP and NF Classify Ointment Bases into Four General Groups
1. Hydrocarbon bases or Oleaginous bases 2. Absorption bases 3. Water removable bases or Emulsion Ointment bases 4. Water soluble bases
HYDROCARBON BASES
Are
water-free, and aqueous preparations may only be incorporated into them in small amounts and then with difficulty. USES: HC are use mainly for their emollient effect and not intended for penetration into the skin. They are difficult to wash off. They do not dry out or change noticeably upon aging.
Characteristics
1. Retained on the skin for prolong period of time 2. Do not permit the escape of moisture to the skin to the atmosphere 3. Difficult to wash as such they acts as occlusive dressing 4. They do not change noticeably upon aging
Sources Of Hydrocarbon Bases 1. Vegetable Oil - Mineral oil 2. Animal Fat - Oleic oil 3. HC from Petrolatum 3 Forms of HC a. Liquid hydrocarbon - Mineral oil b. Semi-solid HC petrolatum Vaseline c. Solid HC - Paraffin
HYDROCARBONS BASES
Characteristics Insoluble in water Not water-washable waterAnhydrous Will not absorb water Emollient Occlusive Greasy Nonirritating Inexpensive, non reactive
NF - mixture of semisolid HC obtained from petroleum Properties: An unctous mass, color yellowish to light amber, melts between 380C -600C Synonyms: Yellow petrolatum, Petroleum jelly Commercial Product: Vaseline Petrolatum, USP - is petrolatum that has been decolorized Used: diaper rash, dry skin Synonym: White Petroleum Jelly Commercial Product: White Vaseline
White
Yellow Ointment - Each 100 g contains 5 g yellow wax and 95 g of petroleum. Yellow wax is purified wax obtained from honeycomb of the bee (Apis mellifera) Synonym: Simple Ointment
White
Ointment, USP - 100 g contains 5% of white wax (bleached purified beeswax) and 95% white petrolatum
Paraffin,
NF - is a purified mixture of solid HC obtained from petroleum Characteristics: colorless or white, more or less translucent mass that may be used to harden or stiffen oleaginous semisolid ointment bases. Oil, USP - is a mixture of liquid HC obtained from petroleum. Useful in levigating of substances insoluble in it in the preparation of ointment base e.g. Salicylic acid, Zinc oxide Synonym: Liquid Petrolatum
Mineral
Olive
Characteristics 1.Not
easily removed from skin with water washing, 2.May possess some power of penetration into the deepest layers of the skin 3.And therefore are used for endodermic ointment. USES 1.As emollient but do not provide the degree of occlusion 2.Incorporates aqueous solutions into oleaginous bases
EXAMPLES OF ABSORPTION BASES 1. Hydrophilic Petrolatum, USP - composed of cholesterol, stearyl alcohol, white wax and white petrolatum Characteristics: It has the ability to absorb water with the formation of W/O emulsion Example: Aquaphor 2. Anhydrous Lanolin, USP - may contain NMT 0.25% water. Characteristics: It is insoluble in water but mixes without separation with about 2x its weight in water. The incorporation of water results in the formation of a W/O emulsion Synonym: Refined Wool Fat
3. Lanolin, USP - is a semisolid fat like substance obtained from the wool of sheep (Ovis aries) Characteristics: It is a W/O emulsion that contains between 25 to 30% water. Additional water may be incorporated into lanolin by mixing Synonym: Hydrous Wool Fat 4. Cold Cream, USP - is a semi solid white W/O emulsion prepared with cetyl esters wax, white wax, mineral oil, sodium borate, and purified water Examples: Eucerin cream - is a W/O emulsion of petrolatum, mineral oil, mineral wax, wool wax, alcohol and bronopol. Cold cream emollient and base.
2. Water-in-oil Emulsion Water-inCharacteristics Insoluble in water Not water washable Contains water (limited) Emollient Occlusive Greasy
Examples Hydrous Lanolin Cold Cream Eucerin Hydrocream Rose Water Ointment
oil-in-water emulsion that are capable of being washed from skin or clothing with water. For this reason, they are frequently referred to as water-washable ointment base.
1. Resemble creams in their appearance 2. May be diluted with water or with aqueous solution 3. From therapeutic viewpoint, no ability to absorb serous discharge in dermatologic conditions 4. Certain medicinal agents may be better absorbed in the skin
Hydrophilic Ointment, USP - is water loving . It contains sodium lauryl sulfate as the emulsifying agent, with stearyl alcohol and white petrolatum representing the oleaginous phase of emulsion and propylene glycol and water representing the aqueous phase. Methyl and Propyl parabens are used as preservatives USE: employed as water removable vehicle for medicinal substances
water-removable bases, which contains both water soluble and water insoluble components. Like water-removable bases, however, water soluble bases are water washable and are commonly referred to as greaseless because of the absence of any oleaginous materials
Characteristics
1. Because they soften greatly with the addition of water, aqueous solutions are not effectively incorporated into these bases. Rather, they are better used for the incorporation of non-aqueous or solid substance. 2. These penetrated the skin and better used for absorption of medicament and therefore used for diadermic ointment . Example: Polyethylene Glycol Ointment, USP is a combination of 400 g of polyethylene glycol 4000 (solid) and 600 g of polyethylene glycol 400 (liquid) to prepare 1000 g of base.
The desired release rate of the particular drug substance from the ointment base. The desirability for enhancement by the base of the percutaneous absorption of the drug. The advisability of occlusion of moisture from the skin by the base. The short term and long term stability of the drug in the ointment base The influence, if any, of the drug on the consistency or other features of the ointment base.
PREPARATION OF OINTMENT
1. INCORPORATION The components of the ointment are mixed together by various means until a uniform preparation has been attained. In small scale or in extemporaneous compounding of the Rx, the pharmacist may use 2 means: a. Mixing ingredients in a mortar with pestle until smooth ointment produced b. Use a spatula and an ointment slab (a large glass or porcelain plate) to rub the ingredients together (spatulation)
Incorporation
Of Solid
In preparing ointment by spatulation, the pharmacist works the ointment with a stainless steel spatula but if the components react with metal (such as iodine, tannins, mercuric salts) the hard rubber is used 1. The ointment base is placed on one side of the working surface. 2. The powdered components (previously reduced into fine powders) are placed on the other side. 3. Then a portion of the powder is mixed with a portion of the base until uniform. 4. Repeat until all portions of the product and based are combine. 5. The portions of prepared ointment are then combined and thorough blended by continuous movement of the spatula.
Incorporation
Of Liquids
Liquid substances or solutions of drugs are added to an ointment only after due consideration of the ointment nature. An aqueous solution would be added with difficulty to the oleaginous ointment, except in very small amount. However, water absorbable hydrophilic ointment bases would be quite suitable for the absorption and incorporation of the aqueous solution. In case of of hydrophobic base and an aqueous solution is to be added, a portion of the hydrophobic base is replaced by a hydrophilic base.
2. FUSION METHOD
By this method, all or some of the components of an ointment are combined by melting together and cooled with constant stirring until congeal. Those components not melted are generally added to the congealing mixture as it is cooled and stirred. The heat labile substances and volatile constituents are added last when temperature is low enough not to cause decomposition.
Packaging
Semisolid pharmaceuticals frequently either in jars or in tubes. The jars may be made of glass, uncolored, colored green, amber or blue or opaque and porcelain white. Plastic jars are used in limited extent. The tubes are made of tin or plastic. These are called collapsible tube .
May Be Filled By The Following Steps 1. The prepared ointment is rolled into a cylinder shape of a piece of parchment paper, the diameter is smaller than that of the tube. 2. With cap of the tube off to permit escape of air, the cylinder of ointment with the paper is inserted into the open bottom of the tube 3. The piece of paper covering the ointments is grasped in one hand, the other hand forces a heavy spatula down on the extreme end of the tube, collapsing it and retaining the ointment while the paper is slowly pulled from the tube. About one half (1/2) inch of the bottom is then flattened with the spatula. 4. About 1/8 folds are made from the flattened end of the tube and sealed by pliers or sealing clip on foot operated crimper machine. Note: Ointments made by fusion may be poured directly into the tubes. Stored at temperatures below 30oC to prevent softening.
Tubes
CREAMS
Are
solid emulsion containing suspensions or solutions of medicinal agents for external application.
Creams
of the O/W type include foundation creams; hand creams; shaving creams; and vanishing creams. Creams of W/O type include cold creams; emollient creams Product referred to as creams may not actually conform to the above definition. Many products that are creamy in appearance but do not have an emulsion-type base are commonly called creams
Example of Cream:
Bacitracin Anti-bacterial Anti
Example of Cream
NystatinNystatin- Mycostatin cream Antifungal
Example of Cream
TretinoinTretinoin- Retin A Cream Antiacne drug
Example of Cream
CrotamitonCrotamiton- Eurax cream Scabicides
Example of Cream
TIOCONAZOL TROSYD
Example of Cream
LuorouracilLuorouracil-Efudex Cream Antineoplastic
1. Chloramphenicol 2. Dexamethazone Na phosphate 3. Gentamicin sulfate 4. Isoflurophate 5. Polymixin B-Bacitracin 6. Polymixin B Bacitracin neomycin 7. Sulfacetamide Na 8. Tobramycin 9. Vidarabine
Chloromycetin Ophthalmic Decadrone Phosphate Garamycin Floropryl Sterile Polysporin Neosporin Sodium sulamyd Tobrex Vira A
Antibacterial Anti-inflammatory adrenocortical steroid Antibactrial Cholinasterase inhibitor Antimocrobial Antimicrobial Antibacterial Antibacterial Antiviral
Examples of Rectal and Vaginal Creams and Ointments Product RECTAL Anusol Tronolane VAGINAL Mycelex 7 AVC Cleocin Terazol 7 Ogen Premarin Clotrimazole Sulfanilamide Clindamycin PO4 Terconazole Estropipate Cream Cream Cream Cream Cream Antifungal Vulvovaginitis- Candida albicans Bacterial vaginosis Antifungal Candida albicans Estrogen for vulvar, vaginal atropy Atrophic vaginitis, kraurosis vulvae Starch Pramoxine Ointment Cream Hemorrhoidal Treatment Hemorrhoidal Analgesic, Antipruritic Active Ingredient Product Type Primary Use
Gels
Are
semisolid systems consisting of either suspensions made up of small inorganic particles or large organic molecules in an liquid vehicle rendered jelly like by the addition of a GELLING AGENT. Sometimes called JELLIES
Classes of Gel
2 phase systems - separation between the insoluble matter and liquid vehicle is observed. This type contains inorganic materials Example: Al(OH)3 Gel Single phase gel - consist of organic macromolecules uniformly distributed throughout the liquid where no apparent boundary is seen Example: Na CMC and Tragacanth Gel Continuous phase - commonly aqueous where alcohol and gels may be use as continuous phase Example: Mineral oil + polyethylene resin = oleaginous ointment base
Characteristics of Gels
Gels may be thicken on standing, forming a THIXOTROPE, and must be shaken before use to liquefy the gel and enable pouring Aluminum Hydroxide Gel Because of high degree of attraction between the dispersed phase and water medium, the gels remain fairly uniform upon standing and does not readily settle
Example of Gel
Example of Gel
Example of Gel
ProgesteroneProgesterone- Crinone Gel Vaginal: Bioadhesive gel; Progesterone supplement and replacement
Uses of Gels
Lubricant for catheters Bases for patch testing NaCl gel for electrocardiography Floucinonide Gel for anti- inflammatory anticorticosteriod Na Fluoride & Phosphoric acid gel dental care prophylactic Tretionoin Gel for treatment of acne Prostaglandin Gel intravaginal
Preparation of Gels 1.By freshly precipitating the disperse phase upon reacting an inorganic agents, a gelatinous precipitate results Example: Preparation of Al(OH)3 gel is by reacting Al(Cl)3 + Na2CO3 NaHCO3
Preparation of Gels 2. By direct hydrating the inorganic material in water Al2O3 + H2O Al(OH)3
Examples: Aluminum Hydroxide Gel; Alugel; Amphogel; Ce-lu-gel; Cremalin; Hydroxal; Vanogel; Aluminum Phosphate Gel (Phosphagel) - Antacid
Erythromycin and benzoyl peroxide topical gel - Benzamycin Clindamycin Topical gel - Cleocin T Topical Gel Benzoyl Peroxide Gel - Desquam-X 10 Gel acne vulgaris Hydroquinone Gel - Solaquin Forte Gel bleach for hyperpigmented skin Salicylic Acid Gel - Compound W Gel keratolytic Desoximetasone Gel - Topicort - antiInflammatory, antipruritic agent
Proprietary
Gelling agent
3. Benzoly peroxide Desquam-X Gel 4. Clindamycin 5. Clobetasol Cleocin T Gel Termovate Gel
Carbomer 940 Acne vulgaris Carbomer 934P Acne vulgaris Carbomer 934 Antipruritic
6. Cyanocobalamin Nascobal 7. Desoximetasone Topicort Gel 8. Metronidazole 9. Progesteron 10. Tretinoin Metro-Gel Crinone Gel Retin A
Carbomer 934P Vaginal-bacterial Carbomer 934P Progesterone supplement Hydroxypropyl cellulose Acne vulgaris
TRANSDERMAL PREPARATIONS
Ointments, creams, gels designed to deliver a drug systematically by addition of PENETRATION ENHANCERS to the topical vehicle
Paste
Dermatologic paste are ointment like preparations employed in practice of dermatology Usually stiffer, less greasy and more absorptive than ointments such as starch, ZnO, CaCO3 , and talc in the base
Characteristics
1. Stiffness and impenetrability, not suited for hairy parts of the body 2. Absorbs serous secretions and are preferred for acute lesions having a tendency to ooze 3. Are less penetrating than ointment 4. Are less macerating than ointment
Types of Paste
Dermatologic
Examples of Paste
1.
2.
3.
Zinc Oxide Paste with acid - Lassars Paste - Salicylic acid 20 g; and ZnO paste q.s. to make 1000g Zinc Oxide Paste - ZnO 250 g; Starch 250 g ; White petrolatum 500 g to make 1000 g Triamicinolone Acetonide Dental Paste
Plasters
Substances
intended for external application, made of such materials and consistency as to adhere to the skin and thereby attach as dressing
Purposes of Plasters
To afford protection and mechanical support To furnish an occlusive macerating action To bring medication into close contact with surface of skin
Example of Plasters
Example of Plaster
Modern Plasters are practically all machine made and are available in colors such as flesh, striped, and others
2. Salonpas
Backing materials used; Paper Cotton Felt, Plastic Linen, Moleskin Muslin silk
CERATES
Are unctuous preparations of such consistency that may be easily spread at ordinary temperature upon muslin cloth or similar material with spatula yet not soft to liquefy and run when applied to the skin Contents Contents: oil, hard petrolatum and beeswax Examples: Cantharides cerates; Rosin cerate; Camphor cerate; Cerate of lead acetate; Compound Rosin Cerate
Cataplasm
Are viscous preparation intended for warm, external application to a body for purpose of reducing inflammation Are soft semisolid, external applications which either stimulate a body surface or alleviate an inflamed area by supplying medication substance in the presence of heat and mixture. Example: Numotizine
Cements
Are dental preparation employed primarily as temporary protective coverings for exposed pulps; also for holding medicinal agents in tooth cavities and re-basing of redentures.
Mixing a powder consisting of ZnO, and other metallic salts with a liquid consisting of either eugenol or clove oil mixed with a bland oil. Zinc acetate and other metallic salts accelerate the settling time The consistency of the cement may be altered by varying amount of the liquid.
GLYCEROGELATINS
Are plastic masses intended for topical application and containing gelatin, glycerin, and water and a medicament suitable for application in dermatological practice.
ADMINISTRATON OF GLYCEROGELATIN Glycerogelatins are melted prior to application, cooled to only slightly above body temperature, and applied to the affected area with a fine brush. After application the glycerogelatins hardens, usually covered with bandage. Example: Zinc Gelatin Boot Zinc Gelatin is a firm, plastic mass containing 10% zinc oxide in a glycerogelatin base - treatment of varicose ulcers because of its ability to form pressure bandage known as gelatin boot
General Formula: Medicinal substance Gelatin Glycerin Purified water To make about 100 g 150 g 400 g 350 g 1000 g
DRESSINGS
Dressings are external application resembling ointments in consistency, but remaining semisolid at body temperature, they liquefy at 500C and remain pliable in thin films below 280C.
Classes Of Dressings
1. Primary wound dressing or now as wet dressing 2. Absorbents - surgical cotton and gauze 3. Bandages 4. Adhesive tapes
Examples of Dressings
1. Paraffin dressing, formerly official in the NF VI, was employed as an air-excluding, soft, pliable, analgesic, splint-like covering for surface denuded by burns 2. Petrolatum Gauze, USP - is absorbent gauze saturated with white petrolatum. 3. Furazone gauze pads-sterile - antibacterial dressings containing nitrofurazone 4. Surgical dressing is any material used as covering, protective, or support for a diseased part (1) Adhesive bandage, USP (2) Gauze bandage