Hospital Pharmacy Lab Manual

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS

Experiment 1 To study the hot air oven and study its different parts Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:473. Theory: sterilization can be defined as a pharmaceutical pharmaceutical process in which almost

99.9% of micro-organisms are removed from the Pharmaceutical products or equipments by the application of a single or multiple techniques. An article would be deemed sterile only only when there is complete complete absence of viable micro-organisms micro-organisms from it. The methods for sterilization can be divided in to three main categories. I. Phys Physic ical al metho ethods ds Dry hear sterilization, moist heat sterization Radiation sterilization II. Chemic Chemical al methods methods:: Sterilization by heating with bactericide Gaseous sterilization III

Mechanical methods Ceramic filter, Sintered glass filter Membrane filter

Hot air Oven (Dry heat sterilization): This process is suitable for heat-stable,

non-aqueous products, products, powders as well glassware and metal equipments. equipments. A preparation to be sterilized sterilized by dry heat is distributed in the final containers containers which are then either finally sealed or temporarily closed to exclude micro-organisms and then heated so as to ensure that the entire contents of each container are maintained for an effective combination of time and temperature to provide an adequate assurance of sterility. Cycles of a minimum of 180º for not less than 30 minutes, a minimum of 170º for not less than 1 hour or a minimum of 160º for not less than 2 1


hours may be employed but other combinations of time and temperature may be necessary for certain preparations. Containers that have been temporarily closed during the sterilisation procedure are then finally sealed using aseptic technique so as to exclude micro-organisms. Dry heat sterilization is usually carried out in a sterilizing oven designed specifically for the purpose. The oven is supplied with heated, filtered air, distributed uniformly uniformly throughout the chamber and employing employing a blower system with devices for sensing, monitoring, monitoring, and controlling the critical critical parameters. A vent is provided on both sides sides for the escape of vapors. A thermometer thermometer is provided in door side to record the inside temperature temperature of the chamber. During dry heat sterilization sterilization the micro-organisms micro-organisms and bacterial spores are killed by oxidation. Since dry heat is less effective effective than moist moist heat, hence higher temperature and longer period is required. Applications: Material/equipment(s) Material/equipment(s) which is sterilized by dry heat include: Fixed

oils, glycerine, liquid paraffin, propylene glycol, glasswares, powders, surgical instruments etc. Disadvantages:

1. It requires requires long long heating heating,, high temperat temperature ure and and long exposur exposure, e, unsuitab unsuitable le for thermolabile substances. 2. Moist medicaments, medicaments, rubber and plastic articles articles are are destroyed by this this method. 3. Preparations containing water, alcohol alcohol or other volatile volatile substances substances cannot be sterilized by this method. 4. It is unsuitable unsuitable for surg surgical ical dressings dressings

Experiment 2 2

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS To study the Autoclave Autoclave and study its different different parts parts Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:478. Theory: This process involving heating in an autoclave with saturated steam under

pressure should be used whenever possible for for aqueous preparations preparations and for for surgical materials. An aqueous product which is to be sterilized by this method is distributed into suitable containers which are then sealed so as to exclude microorganisms. It is than exposed to saturated steam for a time sufficient to ensure that the entire contents of each container are maintained for an effective combination of time and temperature to ensure sterility. The following combinations of temperature and time are normally employed.

Holding temperature (ºC)

Minimum holding time (minutes)

115 to 118

30

121 to 124

15

126 to 129

10

134 to 138

3

In this method micro-organisms are killed due to coagulation or denaturation of proteins in living cell cell of micro-organisms. micro-organisms. It It is more effective than dry heat because saturated steam steam has more penetrating penetrating power than dry heat. More over the thermal capacity of steam is much higher than the thermal capacity of dry heat. Working: autoclave is a strong metallic chamber usually made up of stainless steel. The material to be sterilized is packed in a clean fabric cloth and is placed in 3


perforated chamber chamber of an autoclave. The water water level is checked so that it should not touch the bottom perforated metallic chamber. chamber. The lid is closed with the help of nuts and bolts. Autoclave is switched on and water is allowed to boil. Remove the trapped air. Steam vent is then closed and pressure is allowed to rise up to 15 o lb/sq inch and at this pressure saturated steam has a temperature of about 121 C. The pressure is maintained for 30 min. the autoclave is switch off allowed to cool, remove the steam and open it. Applications:

This method is used to sterilize sterilize bulk solutions, glassware, glassware, surgical dressings, dressings, rubber gloves, culture media and surgical instruments are efficiently sterilized by this method. Solutions packed in sealed containers such as SVP, LVP can be sterilize by this method. Disadvantages:

1. It requires requires high temperature temperature and moisture, unsuitable for thermolabile thermolabile substances. 2. This method method cannot cannot be used used for oily oily injection injections, s, fats, fats, powders, powders, ointme ointments nts because steam cannot cannot penetrate them. them. 3. Moist medicaments, medicaments, rubber and plastic articles articles are are destroyed by this this method. 4. Preparations containing water, alcohol alcohol or other volatile volatile substances substances cannot be sterilized by this method. 5. It is unsuitable unsuitable for surg surgical ical dressings dressings

4


Experiment 3 To sterilize conical flask by Dry heat sterilization sterilization Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) publications(p) Ltd Delhi, page no:473. Requirement: absorbent cotton, brown paper, warm water, warm water, alcohol, alcohol, soap solutio solution, n,

chromic acid, hot air oven and conical conical flask. flask. Theory: This process is suitable suitable for heat-stable, heat-stable, non-aqueous products, products, powders as

well glassware and metal equipments. A preparation to be sterilized by dry heat is distributed in the final containers which are then either finally sealed or temporarily closed to exclude micro-organisms and then heated so as to ensure that the entire contents of each container are maintained for an effective combination of time and temperature to provide an adequate assurance of sterility. Cycles of a minimum of 180º for not less than 30 minutes, a minimum of 170º for not less than 1 hour or a minimum of 160º for not less than 2 hours may may be employed but other combinations of time and temperature may be necessary for certain preparations. Containers that have been temporarily closed during the sterilization procedure are then finally sealed using aseptic technique so as to exclude micro-organisms. During dry heat sterilization the micro-organisms and bacterial spores are killed by oxidation. Since dry heat is less effective than moist heat, hence higher temperature and longer period is required.

5

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS Procedure: I) Preparatio Preparation n of articles articles before before loading loading in hot air oven: oven:

a. Conical Conical flask flask should should be thorough thoroughly ly washed washed in followi following ng order Acid wash (chromic acid), detergent wash, rinse with distilled water followed by rinsing with alcohol. o

b. Dry the container at 65 C c. The flask flask should should be stopped stopped with the the help of cotton cotton and and a piece of paper and with a thread. thread.

II: Loading of articles in hot air oven: a. The container container should should be placed placed inside inside the the hot hot air oven. oven. b. Close the door and switch switch it on o

c. Adjust Adjust the temper temperatu ature re at at 180 180 C, wait for the temperature to rise up o

to 180 C. Maintain the temperature for 30 minutes. d. Switch Switch off the source source and and wait for for 15 to 20 minute minutess until the the o

temperature of hot air oven fell down below 60 C. e. Open the hot hot air oven, oven, unload unload the materia materials ls and and transfer transfer to asept aseptic ic room for further processing. processing.

Conclusion: The Conical flask flask was sterilized sterilized and submitted.

Experiment 4 6

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS To prepare 5%w/w dextrose solution and sterilize by autoclave Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:481. Requirement: Dextrose, distilled distilled water, Conical flask, autoclave. Theory: In this method micro-organisms micro-organisms are killed due to coagulation or denaturation of proteins in living cell of micro-organisms. micro-organisms. It is more more effective than dry heat because saturated steam has more penetrating power than dry heat. More over the thermal capacity of steam is much higher than the thermal capacity of dry o heat. The standard operating conditions are at 121 C for 15 minute minutess at 15 lb/sq inch. Procedure: I) Preparatio Preparation n of Mater Material ial for for loading loading in autocl autoclave ave

First weight 2.5 gm dextrose and make volume up to 50ml with water in conical flask. Then flask used is plugged with non-absorbent cotton wool, and then it is covered with brown paper, held by string. II) Loading inside inside an autoclave: autoclave: The sufficient water was placed inside an autoclave and place the tray just above it. Close Close the lid of autoclave, autoclave, switched on and water is allowed to boil. Remove the trapped air. Steam vent is then closed and pressure is allowed to rise up to 15 lb/sq inch and at this pressure saturated saturated steam has o a temperature of about 121 C. The pressure is maintained for 30 min. the autoclave is switch off allowed to cool, remove the steam and open it. Conclusion: The Conical flask flask was sterilized sterilized and submitted.

Experiment 5 7

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS To carry out filling and sealing of given ampoules Reference: Remington’s Remington’s The Science & Practice of Pharmacy, Mack Publishing Co. Easton, PA Requirements: Sodium chloride, distilled water, syringe, methylene blue, beaker, Bunsen burner, forceps, ampoules. Theory: Glass Ampoules Ampoules are primary containers containers used packaging of single single dose

small volume parenterals. The product is filled in to ampoules with semi-automatic semi-automatic or automatic machines under aseptic conditions. The materials to be used must be sterile. The filling of materials can be done with hypodermic syringe attached with long needle. While filling in to ampoules, ampoules, precautions should be taken that needle don’t touch to the site of ampoules to prevent cracking and staining at the time of sealing. The filling and sealing operation should be carried out under aspetic conditions. The sealing of ampoules can be done by two methods 1. Tip Tip sea seali lin ng 2. Pull Pull sealin sealing g metho method. d. Procedure:

1. Prepare sodium sodium chloride chloride solution by dissolving dissolving 0.9 gm of sodium chloride chloride in 100 ml of distilled water, filter it. 2. Transfer the sodium sodium chloride solution solution in to ampoules ampoules with with hypodermic hypodermic syringe. 3. Ampoule tip was melted melted using Bunsen burner burner with continuous rotation rotation of the ampoule. 4. When the glass was was melted, the tip of of the ampoule was stretched by using forcep. 5. Now the the sealing sealing of ampoule ampoule completed. completed. 8


6. Put the sealed sealed ampoules ampoules in methyle methylene ne blue solutio solution n to detect the leakage. leakage. 7. Take out out the ampoule ampouless from the methyl methylene ene blue solutio solution, n, wash wash the extern external al surface. And observe under light. 8. Color of the solution in the ampoules ampoules should should remain unchanged. If blue color observed, discard the ampoule. 9. Label the the ampoule ampoule and and stored stored for for steriliza sterilizatio tion. n.

Result: Filled, sealed and the labeled ampoules are submitted to laboratory.

Experiment 6 To prepare Calcium Gluconate I.V Injection

9

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS Reference: Controller of Publications, ministry of Health and family family welfare, GOI, “Indian Pharmacopoeia”2007, Vol II, page no:841 Requirement: Bunsen burner, syringe, syringe, beaker, beaker, ampoules, water water for injection, calcium gluconate, Methylene blue. Theory: Pharmaceutical injections are sterile dosage forms meant to introduce parenterally ( i.v, i.m, i.m, s.c, etc).

Calcium gluconate is White, White, crystalline powder powder or granules, Sparin Sparingly gly soluble in water but but freely soluble in in boiling water ; insoluble in ethanol (95%).it is used as Calcium replenisher. pH of the injection should be Between 6.0 and 8.2 Usual strengths: The equivalent of 500 mg calcium calcium gluconate in 5 ml; ml; the equivalent of 1 g of calcium gluconate in 10 ml (10% w/v). Procedure: 1. Take washed and sterilized glassware. 2. Weight Weight 10 gm of calciu calcium m glucona gluconate te powder powder dissol dissolve ve in 100ml 100ml of of water water for injection by boiling. 3. Allow to cool the solution solution and make make up to to 100ml with water for injection. 4. Check the the pH of the the solutio solution, n, Filter Filter the solution. solution. 5. Transfer Transfer 2ml of calcium calcium gluconate gluconate solution solution in to glass ampoule ampouless with hypodermic syringe aseptically. 6. Seal the filled filled ampoules, ampoules, perform perform the leakage test test using methylene blue and sterilize by autoclave. 7. The steriliz sterilizee ampoules ampoules are are taken out, out, labeled labeled and and submit. submit.

Report: Calcium gluconate i.v injection was prepared and submitted .

Experiment 7 To prepare prepare water for injection (2ml) 10

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:485. Requirements: Distillation still, still, autoclave, ampoules, ampoules, syringe, Bunsen burner, burner, forceps. Theory: This article is water purified by distillation or by reverse osmosis and it

meets the purity requirements stated under Purified Water (see IP monograph). monograph). It is not intended to be sterile but should comply comply with the tests for pyrogens, pyrogens, or with the test for a limit of bacterial endotoxins, endotoxins, it must be produced, stored and distributed distributed under conditions designed to prevent production of pyrogens or endotoxins. The bacterial endotoxins test (BET) measures the concentration of bacterial endotoxins that may be present in or on the sample of the article to which the test is applied using a lysate derived from the hemolymph cells or amoebocytes from the polyphemus . The Endotoxin horseshoe crab, Limulus polyphemus Endotoxin limit for a given test test material

of preparation is calculated from the expression K/M, where K is the maximum number of Units of endotoxin which the patient may receive without suffering toxic reactions and M is the maximum dose administered to a patient per kg per hour. The value of K is 5.0 EU/kg for injectable preparations except for those administered intrathecally and is 0.2 EU/kg for intrathecal preparations. For this calculation, it is assumed that the average person weights 70kg.

Procedure:

1. Glass distillati distillation on unit unit is used used for preparing preparing water water for for injectio injection. n. 11


2. The ampoules ampoules and and glassw glassware are to be be used used should should be treated treated with with chromic chromic acid, acid, followed by washing with purified water. 3. Switch Switch on the the distill distillat ation ion unit. unit. 4. Reject Reject the first first part part of the distil distillate. late. 5. Collect Collect the water water for for injection injection in a receiver. receiver. 6. Transfer Transfer 2 ml of water water for injection injection in to an ampoule ampoule with the the help of syringe. 7. Seal Seal the ampou ampoule le immed immediat iately ely.. 8. Sterilize Sterilize with with in 12 hr of of production production,, label and submit. submit. Report: the water for injection was prepared, labeled and submitted to the

laboratory.

Experiment 8 To sterilize the rubber gloves by Moist Heat Sterilization 12

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:479. Requirements: Autoclave, conical flask, cotton, rubber gloves. Theory: Autoclave is a strong metallic chamber usually made up of stainless steel.

The material to be sterilized is packed in a clean fabric cloth and is placed in perforated chamber chamber of an autoclave. The water water level is checked so that it should not touch the bottom perforated metallic chamber. chamber. The lid is closed with the help of nuts and bolts. Autoclave is switched on and water is allowed to boil. Remove the trapped air. Steam vent is then closed and pressure is allowed to rise up to 15 o

lb/sq inch and at this pressure saturated steam has a temperature of about 121 C. The pressure is maintained for 30 min. The autoclave is switch off allowed to cool, remove the steam and open it. Procedure:

1. The rubber rubber gloves gloves require require packing packing in such a way that that it should should allow allow the steam penetration inside the fingers and all the surface of the gloves. 2. The gloves gloves are lubricated lubricated with talcum talcum powder powder or starch powder powder before before sterilization. 3. The wrist wrist are turned back so that that the outside outside need not be handled handled when the gloves are put on 4. Close Close the lid of the the autocla autoclave, ve, Remove Remove the trappe trapped d air. Steam Steam vent is then closed and pressure is allowed to rise up to 15 lb/sq inch and at this pressure o saturated steam has a temperature of about 121 C. The pressure is maintained for 30 min. the autoclave is switch off allowed to cool, remove the steam and open it.

Precautions: 13


1. Don’t Don’t open open the the lid imme immedia diatel tely. y. 2. While While loading the the autoclave, autoclave, each each article article should should be placed in such such a way that it should be exposed to the steam uniformly. 3. The complete complete wrappi wrapping ng of the material material is essent essential ial to avoid avoid the contamination by non-sterile factors. Report: The rubber gloves were sterilized by moist heat sterilization.

Experiment 9 To Evaluate the Given Prescription Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:278. 14


Theory: Prescription drug order is defined as a lawful order from a practitioner for a drug or device for a specific patient, including orders derived for collaborated Pharmacy practice that is communicated directly to a pharmacist, pharmacist, in a licensed pharmacy.

The terms prescription drug order, prescription order and prescription are one and the same used interchangeably by health care workers and the public. Prescriptions are most commonly used to describe drug orders for ambulatory patients (out patients) patients) who get their prescribed medications from from retail pharmacies. pharmacies. The term medication order order is usually used when referring referring to drug orders for persons who are patients patients in hospitals. hospitals. These These patients are referred referred to as in patients. Different parts of Prescription: Prescription: 1. 2. 3. 4. 5. 6. 7. 8.

D at e Name, age, gender gender and address address of the patie patient nt Supe Supers rscr crip ipti tion on Insc Inscri ript ptio ion n Subs Subscr crip ipti tion on Sig Signatu naturra Renewa Renewall instru instructi ction onss Signature, Signature, address address and and registration registration number number of the Physician Physician

H O S H I AR AR P U R M E D I C A L C E N T R E A L - M A D I NA NA S T R E E T

HOSHIARPUR, PUNJAB

Nam e : S URI NDER

15

Date : 00/00/00

Rx 1120

LAB MANUAL MANUAL OF HOSPITAL HOSPITAL PHARMACY PHARMACY FOR PTU PTU STUDENTS STUDENTS AddressL 110, MAIN STREET, CENTRAL TOWN, HOSHIARPUR

Age: 40 yr.

Wt:

Ht:

Rx

P H E N O B AR AR B I T O N E T A B L E T – 1 0 m g

ALUMINIUM HYDROXIDE TABLETS

# 30

S i g : 1 Ta Ta b E a c h t . i . d . f o r 1 0 d ay ay s

Refill: 0

Dr. N.K SHARMA, MD

R E G N o . _ _ __ _ _ _ __ __

Report: The given prescription was evaluated.

16


Experiment 10 To Prepare Distilled Water Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical pharmacy” Theory and Practical,6th edition, Birla publications(p) Ltd Delhi, page no:485.

Theory:

Distillation ca n be defined defined as as a process process or unit operation in which the separation of two different liquids or the separation of impurities from a liquid can be done. It is based on the boiling point and the volatility of the components present in the mixture. When two liquids are mixed together, they may be miscible with each other, such type of liquid mixture is known as binary mixture of liquid Example: ethanol and water Liquid boils when its vapor pressure is equal to atmospheric vapor pressure. Simple distillation is conducted at its boiling point of the liquid. So higher the volatility of liquid, better is the separation by simple distillation. Applications of distillation: distillation:

1. Simple distillation distillation method method is used for preparation of distilled water and this can be used further for preparation of water for injection. 2. Volatile Volatile and and aromat aromatic ic water water are are prepare prepared. d. 3. Organi Organicc solven solvents ts are are purifi purified ed 4. Non volatile volatile solids solids are separat separated ed from the the volatile volatile liquids. liquids. Procedure:

The normal tap water was introduced introduced in to the distillation flask, flask, was heated to the boiling point.

17


The vapor is cooled, condensed by the condenser and is collected.

Precautions: rd

1. The water water should should be filled filled up up to 2/3 volume of the flask. 2. The porcelai porcelain n bits may may be added as as antibump antibumping ing agents. agents. 3. First First some part part of the distill distillate ate should should be discar discarded. ded. Report: Distilled water 50 ml was prepared and submitted. submitted.

18


Experiment 11 To find out the percentage variation in length and width of the given sample of bandages. Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:490. Requirement: Roll of bandage, Meter scale, Thin wire Theory: It is a strip strip of plain plain woven clot cloth h for wrapping and binding body parts. It is available in continuous length which is used along with medicaments on wounded surface. Fabric is woven from the staples of bleached white cotton having cotton having no taste or odor. Cloth is free from defects of weaving. Procedure:

Length: length of bandage is measured after equilibrating the sample in a humidity o chamber at 65± 20% humidity and 27± 2 C temperature for 24 hours or more. The sample of bandage is unrolled and stretched from one end on wards. The sample of the bandage is unrolled and stretched from one end onwards. The length is measured from one end to other end with meter scale avoiding any wrinkles or creases. Percentage of length is calculated from the following formula. A = % of length = M/D x100 M= Measured length of bandage D = Declared length of bandage on label. The variation in length can be calculated as: V = A-100 Where A = % of declared length available. The variation is indicated by the sign + or -. The variation in the width is measured in the same manner.

19


Experiment 12 To perform the identification test for absorbent cotton wool Reference: Nand Pratibha, Khar Roop K “ A text book of hospital and clinical th pharmacy” Theory and Practical,6 edition, Birla publications(p) Ltd Delhi, page no:489. Requirements: Test tube, Test tube holder, Iodine holder, Iodine solution, sulphuric acid hydrochloric acid, ammonical copper oxide solution, formic acid Phenol, acetone. Identification test Ignition test: 1. a. b. c.

Ignition test can be done by two methods. By advanci advancing ng the the fibre fibre toward towardss the the flame flame.. By heating in a porcelain porcelain dish. Cotton Cotton burns with with a flame flame and gives gives very bitter bitter odour odour or fumes. fumes.

2. Cotton fibres are moistened with N/50 iodine and when dry, 80% w/w. sulphuric acid is added, blue color is produced. 3. Absorbent cotton wool dissolve completely with uniform swelling in ammonical copper oxide solution. 4. In sulphuric acid 80% w/w solution, it dissolves. 5. In cold sulphuric acid 60% w/w solution is insoluble. 6. In warm Hcl, it is insoluble. 7. It is insoluble in formic acid and phenol. 8. It is insoluble in acetone.

20

Hospital Pharmacy Lab Manual

Recommend Documents