PHARMACOLOGY PRACTICAL CLASSES

3rd YEAR
University of Novi Sad

Edited by:
Emőke Csernus
University of Novi Sad
 PHARMACOLOGY PRACTICAL CLASSES
Table of contents

1. Recepies.....................................................................................................1
2. The solid forms of drugs - powders and teas.............................................6
3. Solid forms of drugs - capsules, tablets, suppositories............................10
4. The liquid forms of drugs – Solutions.....................................................15
5. The liquid forms of medications - drops, extracts (teas), tinctures.........19
6. The liquid forms of drugs – mixtures......................................................23
7. Liquid forms for parenteral administration of drugs...............................26
8. Semi-solid forms of drugs - ointments, creams, gels and pastes.............29
9. Inhalation.................................................................................................32
 1. DRUG / MEDICINE / MEDICATION (medicamentum)

- is natural or synthetic substance or mixture of substances, which can be used for therapeutic,
prophylactic or diagnostic purpose.

Drugs are used in order to:

1 – to cure disease (e.g. antibiotics),
2 – to prevent disease (e.g. vaccination),
3 – to identify a disease/disorder (diagnostics)

Classification :

→ content:
- simple– only one active compound
- complex – 2 or 2< active compounds

→ strength:
- with weak, almost indifferent activity; not divided in doses
- drugs with strong activity, easy become toxic; divided into doses

→ use:
- external – topical use, possesing local effect (exception! drugs for topical use with systemic effect);
- internal use – possessing systemic effect (exception! drugs for internal use with local effect).

→ consistence at room temperature:

- solid
- liquid
- gaseous
- semisolid (semi liquid)

→ origin:
- natural products (herbal, animal, mineral origin); called “drugs” meaning raw (crude) or dried parts
or whole part of herbs, animal tissue, or some minerals (talc, kaolin)
- semi-synthetic/synthetic (chemical) origin
- Galenic products/formulations – produced in pharmacy or in pharmaceutical industry using various
drugs, exposing them to various procedures (mixing, dissolving, grinding)

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Nomenclature of drugs:

1 – full chemical name,

2 – nonproprietary (official, aspproved, generic) name, used in PHARMACOPOEIAS and/or WHO;
rINN = recommended International Nonproprietary Name,
3 – proprietary ( brand,licenced) name, which is commercial property of pharmaceutical company (it
has initial capital letter). It is a trade mark applied to particular formulation(s) of a particular substance
by a particular manufacturer.

Sources of drug data:

PHARMACOPOEIA – (international, national) a book describing drugs, chemicals, and medicinal

preparations ; issued by an officially recognized authority (government, medical and/or pharmaceutical
society) and serving as a standard.
The International Pharmacopoeia (Ph. Int.)
European Pharmacopoeia (Ph. Eur.) 6th ed.
The British Pharmacopoeia (BP)
Pharmacopoeia Yugoslavica, (Ph. Yug. V), (2000)

International/national monographs:
Martindale: The Extra Pharmacopoeia - contains information on drugs in clinical use worldwide, as
well as selected investigational and veterinary drugs, herbal and complementary medicines,
pharmaceutical excipients, vitamins and nutritional agents, vaccines, radiopharmaceuticals, contrast
media, medicinal gases, drugs of abuse and recreational drugs, toxic substances, disinfectants, and
pesticides.

The Physicians' Desk Reference (PDR) is a commercially published compilation of manufacturers'

prescribing information (package insert) on prescription drugs, updated annually. It is designed to
provide physicians with the full legally mandated information relevant to writing prescriptions.

The British National Formulary (BNF) is jointly published by the Royal Pharmaceutical Society of
Great Britain and the BMJ Group, which is owned by the British Medical Association. It is published
twice a year (in March and September)

The British National Formulary for Children (BNF-C) is the standard UK paediatric reference for
prescribing and pharmacology, among others indications, side effects and costs of the prescription of all
medication drugs available on the National Health Service.

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 PRESCRIPTION

PRESCRIPTION (lat. preceptum – order to take) is a direction, order for pharmacist to prepare or to
give a drug to a patient.
A prescription is the prescriber’s (MD’s) order to prepare or dispense a specific treatment – usually
medication – for a specific patient.

Inscriptio – contains data about patient and MD (name, age ...) (1-7)
Invocatio – Rp/ (recipe = take)
Ordanatio – main part, defines drug; (8-9) FM, FO, specialty
Subcriptio – describes how to mix substances or how to give them (divided in doses or not) (10);
Signatura (Signa) – label, directions for use (11). Trying to increase compliance.

- Regarding ORDINATIO the prescription can be written using 3 forms/formulas:

FORMULA MAGISTRALIS
FORMULA OFFICINALIS
SPECIALTY

- Regarding SUBSCRIPTIO for divided drugs the prescription can be written using 2 methods:

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Dispensing method (single therapeutic dose is used)
Division method (used for large amount of doses)

A. FORMULA MAGISTRALIS

Rp./
ORDINATIO
name of drugs in amount in grams in arabic number
latin and genitive

Remedium cardinale (Basis) 0.1 (100 mg)

Remedium adiuvans 0.01 (10 mg)
Remedium corrigens to increase taste
Remedium constituens 3.0 (3 g)
(vechiculum)

SUBSCRIPTIO
Misce fiat ... pulvis, solutio, unguentum,...
Mix to prepare/make ... powder, solution, ointment..

a. for undivided drugs (how to deliver them)

Da ad ... sacculum, scatulam, vitrum...
Place in .... paper bag, box, bottle...

b. for divided drugs (instructions how many doses to give)

IIa - Da tales doses No .n. – Give ...(No) doses .
IIb - Divide in doses aequales No .n. – Divide into ...(No) equal doses.

Number of doses is written in ROMAN numerals !

SIGNATURA – SIGNA. or S.
Signa. .... – it is written in NATIONAL/SPOKEN language.
- When the drug is for external/topical use, than it is obligatory to put:
Signa. For external use only before the instructions on how to take drug.
- If the MD is going to administer the drug than it states:
Signa suo nomine. – which means: put the name of the drug on label.

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B. FORMULA OFFICINALIS

Rp./
ORDINATIO
name of drug and its formulation amount in grams and arabic numbers
in latin and genitive

SUBSCRIPTIO
I Da ad ...
IIa Da tales doses No .n.
IIb Divide in dosed aequales No .n.

SIGNATURA
Signa. ...
exceptions! Signa suo nomine.

C. SPECIALTY

Rp./
ORDINATIO
trade name of the drug amount/dose in grams

SUBSCRIPTIO
Da scatulam originalem No I. - Give one original box of drug
Da scatulas originales No II (duo). Necesse est!
lagenam, tubam, ampullam

SIGNATURA
Signa. ...
exception! S. Ad manum medici. – To be administered by MD only.

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 2. SOLID DRUG PREPARATIONS - POWDERS

A. Powders (Pulveres)
- external use
- internal use
- granulated powders
B. Teas (Species)
C. Capsules (Capsulae)
D. Tablets (Tabbletae)
E. Suppositories (Suppositora)

A. POWDERS
- solid, loose and dry particles
- different degrees of fineness
- obtained by crushing herbal drugs and chemicals + sifting through appropriate sieves

A.1. EXTERNAL USE - FM, FO, Specialy

- undivided forms
- for sprinkling on affected skin and mucous membranes
- active compounds: antiseptics, fungicides, antibiotics, disinfectants
+bases (constituens) : neutral powders
for absorbing of secretion, drying and
cooling skin

- mineral origin bases: Talcum, Kaolinum, Magnesii oxydum, Zinci oxydum

- herbal origin bases: Amylum Oryzae, Amylum Tritici

Parameters:
- 20, 50, 100 g powdres
- in box (scatula acc. scatulam)
- Signatura: “For external use only…”
- Amount of active compound: %

EXAPMPLE 1.

Bizmut subgalat (Bismuti subgallas) is a mild antiseptic with local protective effect. It can be used in
the treatment of intertrigo and other dermatitis. Prescribe by FO the 10% powder for external use of
Bismuti subgallas in the total amount of 30 g.
Genitive of subgallas is subgallatis

Rp./ Bismuti subgallatis 30,0

Da ad scatulam.
S. For external use only, sprinkle on affected skin.

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A.2. INTERNAL USE

- per os
- undivided and divided
- should be dissolved in water or swallowed directly with water

A.2.a. UNDIVIDED POWDERS FOR INTERNAL - FM, FO, Specialty

- solid pharmaceutical form

- one or more active compounds
- large therapeutic range, weak action
- Patient can measure doses by himself by teaspoon or table spoon
- 10-200 g
- into sachet (sacculus) and box (scatulam)

A.2.a. DIVIDED POWDERS FOR INTERNAL - FM, FO, Specialty

- divided into doses (STD=Single Therapeutic Dose)

- small therapeutic index
- weight of one powder: 0,3-0,5-1 g
- into sachet (sacculus)
- patient should take content of one sachet=one dose

Remedium constituens: Saccharosum, Lactosum, Fructosum

- When prescribing dosipulveres, you should know: single therapeutic dose (STD) of active substance
number of doses (n), weight/mass (M) of powder (0,3-0,5-1 g) for FM

FM Dispension method FM Division method

Rp./ Remedium cardinale STD Rp./ Remedium cardinale n x STD
Remedium constituens ad M Remedium constituens ad n x M
Misce fiat pulvis. Misce fiat pulvis.
Da tales doses No. n Divide in doses aequales No. n
S. Drink the content of one sachet. S. Drink the content of one sachet.

FO Dispension method FO Division method

Rp./ Drug name STD Rp./ Drug name n x STD
Da tales doses No. n Divide in doses aequales No. n
S. Drink the content of one sachet. S. Drink the content of one sachet.

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Specialty
Rp./ Licensed drug name + powder + STD
Da scatulam originalem No. n
S. Drink the content of one sachet.

EXAMPLE 1.

Belladona dry extract (Belladonnae extractum siccum) (STD 0,02 g) and Papaverine (Papaverini
chloridum) (STD 0,04 g) are spasmolytic substances which are used in the treatment of biliary and
renal colics.They can be used in the form of powder. They are strong drugs, so, they should be
prescribed as divided powders. Prescribe 20 doses of this powder using FM division method.

Rp./ Belladonnae extracti sicci 0.4

Papaverini chloridi 0.8
Saccharosi ad 6.0
Misce fiat pulvis.
Divide in doses aequales No XX (viginti).
S. Drink the content of one sachet.

EXAMPLE 2.

Belladonnae extractum siccum (STD 0,02 g) and Papaverini chloridum (STD 0,04 g) are spasmolytic
substances used to treat biliary and urinary colices. Because of narrow therapeutic range are prescribed
as divided powders.
Prescribe 10 doses (n) dispension method (→ FM!) .(we use STD)

Rp./ Belladonnae extracti sicci 0,02

Papaverini chloridi 0,04
Saccharosi ad 0,3 / 0.24
Misce fiat pulvis.
Da tales doses No X (decam).
S. Take 1 powder when pain starts.

Division method : Belladonnae extracti sicci 0.2

Papaverini chrolidi 0.4
Saccharosi ad 3.0
Divide in doses aequales No.X (decam).

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EXAMPLE 3.

Lithium carbonate (Lithii carbonas) is used in the treatment of manic phase of bipolar disorder. It is
drug with small therapeutic index and should be carefully dosed. STD of this powder is 0,3 g. Prescribe
10 doses of this drug using FO (dispensing and division method) and Specialty as well.

FO Division method
Rp./ Lithii carbonatis 3,0
Divide in doses aequales No. X (decam)
S. Drink the content of one sachet.

FO Dispensing method
Rp./ Lithii carbonatis 0,3
Da tales doses No. X (decam).
S. Drink the content of one sachet.

EXAMPLE 4.

Ispagula husk is a laxative. Prescribe one original box.

Rp./ Mukofalk powder 5.0

Da scatulam originalem No I.
S. Drink the content of one sachet.

EXAMPLE 5.

Magnesii oxydum is an anacid used in therapy of gastric hyperacidity and gastritis. 1 tsp of Magnesii
oxydum weights approximately 0.4-0.5 g = 1 STD. Can be combined with Calcii carbonas (STD =2g)
When combined, their STD are divided by two.
Prescribe 40 doses.

Rp./ Magnesii oxydi 10.0

Calcii carbonatis 40.0
Misce fiat pulvis.
Da ad scatulam.
S. Take 1 teaspoon after meal 3 times a day.

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 3. SOLID DRUG FORMS – CAPSULES,TABLETS,SUPPOSITORIES

C. CAPSULES (Capsulae) - primarily Specialty, sometimes FO

- divided pharmaceutical form

- for medicinal agents with small therapeutic index
- active substance is placed in specific form – capsule; do not need corrective and/or vehicle

Purpose:
- to protect patient from unpleasant taste and smell
- to protect mucosa and teeth from damage
- to enable the release of active principle in an appropriate part of intestinal tract

Types:
1. gelatinous capsules (capsule gelatinosae) – round or egg shaped; can contain liquid or paste-like
medicines; decomposition starts in stomach and finishes in small intestine,
2. capsules with cover (capsulae gelatinose operculate) – tube like with round ends; usually contain
powders; decomposition starts in stomach and finishes in small intestine,
3. capsules enforced with formaldehyde (capsulae geloduratae) – decomposition starts in small
intestine or in colon.

- weight of one capsule 0.3-1 g, while the weight of active compound can be much smaller (< 1 mg!)
- packed in sachet (sacculus), box (scatulum) or bottle (lagena)
- quantity 5-100 doses

Capsules - Specialty: Capsules – FO: Dispersion only! Know STD and n

Rp./ Licensed drug name + capsules + STD Rp./ Generic name including drug form + STD
Da scatulam originalem No I. Give n. doses
Signa. Drink one capsule … S. Drink one capsule.....

EXAMPLE 1.

Cefalexin is an antibiotic, from the group of cephalosporins. On the market we can find it in a form of
capsules (250 and 500 mg), tablets and oral suspension (250 mg/5 mL). It is indicated for the treatment
and prophylaxis of recurrent urinary-tract infection.
a. Prescribe two original package (→ specialty!) (16x2) of cefalexin capsules. Dosage: 500 mg every 6
hours.
b. Prescribe 30 capsules using FO.

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a. Rp./ Palitrex capsules 0.5
Da scatulas originales No II (duo). Necesse est!
S. Take one capsule every 6 hours.

b. Rp./ Cefaleksini capsularum 0.5 (pharmacist only needs to know the n of doses)
Da tales doses No XXX (triginta).
S. Take one capsule every 6 hours.

D. TABLETS (Tablettae) - primarily Specialty, sometimes and some types FO.

- divided pharmaceutical form

- for medicinal agents with small therapeutic index
- active substance is mixed with vehicle(s) in a form of compressed powder, variously shaped;
vehicle(s) help the tablet stability, dissolution in gut and other conditions

- weight of one tablet 0.1-0.5 g, while the weight of active compound can be much smaller (< 1 mg!)
- packed in sachet (sacculus), box (scatulum) or bottle (lagena)
- quantity 5-100 doses

Types:

- ordinary (simple) tablets (FG, FO),

- coated tablets – coated with sugar or other cover, colored; the purpose is similar as for capsules
- retard tablets – slow release tablets, controlled release forms, long-acting forms
- sublingual tablets – ordinary tablets, small, placed sublingually, fast absorption and action (FG, FO)
- buccal tablets – placed buccally, fast absorption and action, too
- pastille or pastil – oral tablets, suckle in mouth
-dispersible tablets – first to be dissolved in water!, than use the solution

Tablets – Specialty: Tablets – FO:

Rp./ Licensed drug name + tablets + STD Rp./ Generic name including drug form + STD
Da scatulam originalem No I. Give n of doses
Signa. Take one tablet … Signa. Swallow one tablet...

EXAMPLE 2.

Rp./ Amoxil capsules 0.5

Da scatules originales No. II. (duo)
Necesse est!
Signa. Take 1 capsule 3times a day and 1 glass of water.

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EXAMPLE 3.

Combination of two diuretics: amiloride (potassium-sparing) and methyclothiazide

(thiazides) in a fix combination., for the management of hypertension.
Prescribe as a specialty.

Rp./ Lometazid tablets

Da scatulam originalem No I.
S. Take1 tablet daily.

E. SUPPOSITORIES (Suppositoria) - FM and FO both methods!, specialty

- solid drug forms designes for application in body openings

Types: According to place of administration)

- anal (Suppositoria analia)
- vaginal
- medicinal (for other body openings)

- exhibit local or systemic action

- conically or egg shaped, weight 2-3 g
- contain specific vehicle – Cacao butter (Cacao oleum) – which is solid at room temperature, but at
body temperature (36-37ºC) it starts melting to liquid condition! Beside principle medicinal agent (s)
suppositories can also contain: water, jelly, balm, etc. Macrogolum: glycerine-gelatin substrate, mono
and diglycerid mixture.

E.1. Suppositories with LOCAL action: know MD

- act in rectum (treatment of haemorrhoids, anal fissures, proctitis; laxatives)
- therapeutic concentration (TC, %)

E.2. Suppositories with SYSTEMIC action: must know MSD

- active substances are absorbed from the rectal mucosa
- advantages: bypass of portal vein and “first pass effect”, faster reaching the site of action, useful for
drugs that irritate stomach, in patient who can not swallow
- when oral administration is not possible (young children, surgical procedures in alimentary tract),

a. When prescribing suppositoria analia, to know:

- STD (single therapeutic dose) or TC (therapeutic concentration) expressed in g or %
- number of the doses (n),

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- weight/mass (M) of one suppository (2-3 g)
- have shape of sharpened cylinder or cone, with weight of 2-3 g for grown, and 1 g for children.
- prepared with melting and effusion in mould.

EXAMPLE 4.

Benzocaine (Aethylis aminobenzoas) is local anesthetic. As anal suppository it is used for local,
symptomatic therapy of anal fissures and painful haemorrhoids. Therapeutic concentration is 10% (in 1
supp. of 2,0 g STD is 0,2 g of benzocaine). Prescribe 10 suppositories, using division method.

Rp./ Aethylis aminobenzoatis 2,0

Cacao olei ad 20,0
Misce fiat suppositoria analia.
Divide in doses aequales No X (decem)
S. Take out casing and put one suppository anally.

EXAMPLE 5.

Glyceroli suppositoria is officinal pharmaceutical form of alcohol glycerol, which is used as a laxative.
STD for children is 1,0 g, and for adults 3,0 g. It is suitable laxative for the elderly, children and
pregnant women.

Rp./ Glyceroli suppositoriorum 1,0

Da tales doses No V (quinque).
S. Take out casing and put one suppository anally.

EXAMPLE 6.

Morphini chloridum is opiate analgesic, and it is used in the therapy of severe pains (postoperative
pains, politraumas, pains in terminal carcinoma stadium). It belongs to group of drugs with very strong
action so because of that its prescription is strictly controlled. MSD is 0,01 g, highest MSD is 0,03 g,
maximum allowed daily quantity is 0,1 g. Prescribed in the form of suppositories it is adequate for use
in patients who can’t take it orally or parenteraly. Prescribe 10 doses, with dispension method.

Rp./ Morphini chloridi 0,02

Cacao olei q.s.
Misce fiat suppositorium anale.
Da talia suppositoria No X (decem)
S. Take off cover and place 1 suppository in the anal opening.

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b. Vaginal suppositories: Specialty mainly, all 3
- are pharmaceutical forms with spheric (Globuli vaginales) egg (Ovuli vaginales) or conic (Vagitoria)
shape, designed for application and local action in the vagina.
- prepared in the weight of 3-5 g
- for base it is used most frequently cacao butter, macrogoli or mixture gelatin, glycerol and water
- before administration they shouldn’t be sprinkled (put water), because they are melting naturally on
the body temperature.

EXAMPLE 7.

Estriol, derivate of estrogen, is administering local in the form of vaginal suppositories, in the treatment
of menopausal atrophic vulvovaginitis.

Rp./ Ovestin ovule

Da scatulam orignalem No I
S. 1 suppository put in the vagina 1 time daily.

c. Medical suppositories (Bacilli medicati)

- cylindrical medicinal preparations (1-3 cm long, 3-5 mm diameter).
Intended for use in body openings: nose (Bacilli nasales), external ear canal (Bacilli otales), urethra
(Bacilli urethrales), dental (Bacilli dentales), as well as wounds (Cereoli) and fistulas (Styli).
- Styli caustici are special form of medicinal suppositories with a caustic effect with destruction of
pathological changes in the skin and mucous membranes. Mainly Specialty , but all 3.

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 4. LIQUID PREPARATIONS – SOLUTIONS
Solutiones medicinales

- undivided l.preparations which contain therapeutic substance dissolved in appropriate solvent

Solvents:
- water ( Aqua purificata, Aqua ad iniectabilia)
- alcohol (Aethanoli dilutum)
- glycerol (Glycerolum)
- herbal oil (Olivae oleum) or mineral oil
- acetone
- chloroform
- methanol

- therapeutic substance can be liquid or solid substance, soluble in appropriate solvent

- liquid preparations can be delivered in glass bottle (vitrum → FM, FO), dark-glass bottle (vitrum
nigrum), if the substance is photosensitive or in plastic bottle/flask (lagena → Specialty), usually in
pharmaceutical package

Following approximate conversions are useful:

1 teaspoon(tsp) = 5 ml (g) water = 3g oil
1 tablespoon(tbsp) = 15 mL(g) water = 10g oil
1 glass ~ 150-200 mL 1.5-2dL water

- in Signa. Always label : For topical use.

A. Solutions for external use ( Solutiones medicinales as usum externum)

- meant for external, topical use on skin ( Liquida as usum dermicum) and mucous membranes, as well
as cleaning, disinfection
- Local and strong action
- amount of active substances in solution is expressed in %
- often prescribed in higher c than they are applies, so the instruction how to dilute must be followed

EXAMPLE 1.

Prescribe by FM the 3% water solution of boric acid (Acidi boricum) in the total amout of 100ml. Boric
acid is weak acid, white crystaline powder, soluble in water up to 4%. It is antiseptic for dermal use
( litus) un therapy of skin irritaions , or as adjuvant during fungal indections. It can also be used for
rinsing the eyes ( collyria) .
NOTE! 1Ml of water = 1g

Rp./ Acidi borici 3.0

Aquae purificatae ad 100.0
Misce fiat solutio.
Da ad vitrum.
Signa. For external use only, apply on skin several times a day.

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EXAMPLE 2.

Prescribe by FO a 100ml of diluted hydrogen peroxide solution (Hydrogenii peroxydi solutio diluta) for
application in dentistry. It is an official preparation as 3% solution. It is used as antiseptic in wound
treatment. In dentistry it is used 10 times diluted (0.3%) for mouth rinsing during e.g. gingivitis.
Genitive: solutio → solutionis (o → onis)

Rp./ Hydrogenii peroxidi solutionis dilutae 100.0

Da ad vitrum.
Signa. For external use only ,one tbsp of solution
dilute in one glass of water, for mouth rinsing, do not swallow!

A. Solutions for internal use ( Solutiones medicinales as usum internum)

- intended for per os use ( Liquida peroralia)

- are usually drugs with large therapeutic width, weak action, so the patient can measure doses by
himself by tsp or tbsp
- therapeutic substance can be liquid or easy soluble powder in solvents like:
- water (Aqua purificata) – water solution
- oil (Olivae oleum) – oil solution
- this pharmaceutical form is convenient for perdiatric patients, elderly or patients with swallowing
difficulties
- prescribed in amount of 20-30 doses (100-300 ml) ,which should be used in the following 3-5 days
due to its unstability – perishable pharmaceutical form.

- due to possible unpleasant taste or smell of solutions, it is desirable to add corrective(R. Corrigens)
- for taste correction, in concentratin of 10-20%: Sirupus simplex
Aurantii sirupus
Citri sirupus
Althaeae sirupus
- for smell correction: Menthae piperitae aqua c up to 20%
Menthae piperitae aetheroleum essential oils 2-4 drops/150ml sol
Citri aetheroleum
Foeniculi aetheroleum
Anisi aetheroleum

A. 1. Syrup: FM
- liquid officinal prep. for oral use containing at least 45% saccharose+flavor+corrective

A.2. Syrup: Specialty

- final, pharmaceutical(industrial) liquid prep.(solution,suspension) for oral use

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FM:
Rp./ R.cardinalis STDxn IMPORTNANT!
R.corrigens 10-20% nxV 1 dosing device ( tsp/tbsm) = 1 STD
R.constituens ad nxV
Misce fiat solutio. For FM need to know:
Da ad vitrum(nigrum). STD, volume/mass(V) of doing device
Signa. ….. n of doses

EXAMPLE 3.
Kalii iodidum is expectorant. STD= 0.3 g
Prescribe 20 doses, as water solution for oral use. To be used 3 times/day, by teaspoon.

Rp./ Kalii iodidum 6.0 (0.3x20)

Aquae purificatae ad 100.0 (5x20)
Misce fiat solutio.
Da ad vitrum.
Signa. Take one teaspoon of solution 3 times a day.
Dissove one tesaspoon of solution in one glass of water.

EXAMPLE 4.

Fish oil or cod-liver oil (Jecoris oleum) contains vitamin A&D. It is used in prevention and therapy of
rickets. Daily need for vit. D = 300-600 IU, prophylactic dose is about 800 IU and therapeutic dose is
1200-1500 IU – per day.
1 g contains about 85 IU according to pharmacopoeia.
Prescribe fish oil for prophylactic use in chidren , ofr 1 month therapy.

Rp./ Jecoris oleum 28.23 (800x30 IU=2400:85=28.23g )

Sirupus simplex 20.0
Olivae oleum ad 100.0 ?
Misce fiat solutio.
Da ad vitrum nigrum.
Signa. Take x tablespoon x times a day.

EXAMPLE 5.

Bromhexine hydrochloride is used in conditions with thick secretions or mucus in airways (productive
cough). For children it is convenient to be prescribed as syrup. It can be dosed 2-3x4 mg per day ,
depending on the age of the patient.

Rp./ Bisolvon syrup 200.0

Da lagenam originalem No.I (uno)
Signa. Take one teaspoon of solution with lots of water, 3 times a day.

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EXAMPLE 6.

Prescribe using FM 100ml solution of procaine-chloride (Procaini Chloridum) 0.5% for local
anaesthesia by infiltration. In order to have isotonic solution add soldium chloride (0.9%) in the same
concentration (Sodii chloridum, 0.5%). As a vehicle use Aqua ad iniectabilia – sterile water.

Rp./ Procaini chloridi

Sodii chloridi āā 0.5
Aquae ad iniectabiliae ad 100.0
Misce fiat solutio.
Da as vitrum collo amplo, sterilisa!
Signa. Signa suo nomine.

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 5. LIQUID PREPARATIONS – DROPS

DROPS – Guttae FM, FO, Specialty

- liquid prep. which allow precise dosing or specific way of use

- according to the way of use: Internal & External

1. Drops for internal use

- drugs with strong or very strong action

- can be precisely dosed by counting specific n of drops with STD
- Solvents: water, ethanol, oil
- drop is strictly defined by the size of the pipette (radius) and the density (temp) of the liquid
- according to the practice , standard pipette on room t(20 C) in 1 g liquid, contains:
- 20 d water solution
- 60-50 d ethanol solution
- 40 d oil solution
- Number of drops with STD should be more than 5 and less or = 20.
- prescribed in amount of 10-30 g
- can be delivered in botthles with a pipette (vitrum cum pipetta) or in a bottle with a dropper ( vitrum
guttatorium)
- can be taken directly or solved in a teaspoon of water/juice, or on a sugar cube

EXAMPLE 1.

Codeine phosphate (Codeini phosphas) is an opioid cough suppressant – drug with a very strong action
for a treatment of dry or painful cough. STD = 30mg, take 3times daily. Can be prescribed as water
solution . Priscribe 20 doses.
If the STD is in 10 drops → STD = 0.5 g water solution.

Rp./ Codeini phosphatis 0.6 (0.03x20)

Aquae purificatae ad 10.0 (20x0.5)
Misce fiat solutio.
Da ad vitrum cum pipetta/ vitrum guttatorium.
Signa. Take 10 drops 3 times a day.

- for industrially produced drops the producer gives instructions about the number of drops with 1ml of
solution, also about dosage

19
EXAMPLE 2.

Prescribe Digoxin drops using Specialty. Digoxin is used for the treatment of heart failure and has a
small therapeutic width. Precise dosage is possible by prescribing the drug in the form of drops or
tablets. Dose : 0.5 mg/day.
NOTE: it is a water solution.

Rp./ Dilakor drops

Da scatulam originalem No. I.
Signa. Take 13 drops per day.

2. Drops for external use

- amount of active substance is expressed as average concentration in %.

- prescribed in total amount of 5-10 g
- delivered in a bottle with a pipette (vitrum cum pipetta)
- in Signa. Always label : For topical use only!
- for eyes, nose, ears.

2.a. Eye drops (Oculoguttae) - FM, FO, Specialty

- MUST be sterile, isotonic ( or mild hypertonic) – related to tears, pH 7,5
- sterile solvent : Aqua ad iniectabilia

EXAMPLE 3.

Pilocarpine (pilocarpini chloridum) is a miotic, ised in the management of raised intra-ocular pressure
– glaucoma, as a 2% of water solution. Prescribe in amount of 10 ml using FM. Also physostigmine
(physostigmini salicylas) is used in treatment of glaucoma as a 0.2 % of water solution.

Rp./ Pilocarpini chloridi 0.2 Rp./ Physostigmini Salicylatis 0.2

Aquae ad iniectabiliae ad 10.0
Misce fiat solutio.
Da ad vitrum guttatorium, sterilisa!
S. For external use only! Apply 1
drop 2 times/day into each eye.
Aquae ad iniectabiliae ad 10.0
Misce fiat solutio.
Da ad vitrum guttatorium, sterilisa!
S. For external use only! Apply 1
drop 2 times/day into each eye.

20
EXAMPLE 4.

Eye drops of atropine sulphate ( Atropini sulfas), as a 0.3-1% of solution , are used as mydriatics and
cyclopegics (paralyse the ciliary muscle) in opthalmology for the eyamination of the fundus of the eye,
refraction procedure in children, but also for the treatment of anterior uveitis.
Prescribe using FO 10ml 1% of solution, for the use in the hospital (used by the doctor).

Rp./ Atropini sulfatis oculogittatarum 1% 10.0

Da at vitum cum pipetta, sterilisa!
Signa suo nomine.

NOTE: May precipitate acute glaucoma!

EXAMPLE 5.

Gentamicin is an aminoglycosides antibacterial for systemic and topical administration (eye drops and
eye oinments) In a form of eyes drops it is used for the treatment of bacterial eye infections.

Rp./ Gentamicin eye drops 10.0

Da lagenam originalem No.I.
Signa. For external use only. Apply
1 drop several times daily into each eye.

2.b. Ear drops (Otoguttae) - FM, FO, Specialty

- insert into ear canal (meatus)
- solvents: water, ethanol, oil
- before use warm the ear drops till body temperature.

2.c. Tooth drops (Guttae dentales) - FM, FO, Specialty

- used in dentistry

2.d. Nose drops (Rhinoguttae) - FM, FO, Specialty

- applied into each nostril to act on oral mucosa
- solvent can be: water (doesn't have to be streile), glycerine, oil

EXAMPLE 6.

Prescribe FM 3% water solution (10 ml) of ephedrine (Ephedrini chlorium) in a form of nose drops,
used for the treatment of rhinitis in adults.

21
 Rp./ Ephedrini chloridi 0.3
Aquae purificatae ad 10.0
Misce fiat solutio.
Da ad vitrum cum pipetta.
Signa. For external use only. Apply 1 drop
4 times daily into each nostrils.

EXAMPLE 7.

Tincture (Tincturae) are colored ethanol-water extracts of drugs or solutions of drug extracts. They can
be weak but also with strong action when they have to be measured by drops.

Tinctura amara – has weak action, with an unpleasant (bitter) taste. It improves appetite and digestion.
It should be taken before a meal. Prescribe 20 ml using FO.

Rp./ Tincturae amarae 20.0

Da ad vitrum guttatorium.
S. Take1 0-15 drops ½ hour before meal.

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 6. LIQUID PREPARATIONS - MIXTURES

Mixturae agitandae - FM, FO, FG

- undivided liquid preparations which contain therapeutic substance mixed with solvent (NOT
dissolved) .

Types:
A. mixture between solid and liquid phase = Suspensions (Suspensiones medinales)
B. mixture between two liquid phases (usually water and oil) = Emulsions (Emulsiones).

- After a certain time period the phases begin to separate (solid phase subsides; oily phase goes to the
top). In order to prevent such changes it is necessary to add stabilizers / emulsifiers in the amount of
10-20% (mucous Gummi arabicum, Gummi arabicum mucilago; genitiv: mucilago - mucilaginis).

- They are packed in bottles with wide neck (vitrum collo amplo).
- In label (Signa) it must be noted to SHAKE WELL BEFORE USE!

A.1. Suspensions for internal use (Suspensiones ad usum internum)

- intended for (per)oral use of insoluble solid drugs in the form of liquid preparations.
- drugs with large therapeutic width, weak action, so, patient can measure doses by himself by
teaspoon or tablespoon, which contains 1 STD
- prescribed in amount of 20-30 doses (100-300 mL) which should be used in next 3-5 days because
this is rather unstable - perishable pharmaceutical form.

EXAMPLE 1.

Prescribe in the form of suspensio for oral use:

10 doses of Bismuth subcarbonate (Bismuti subcarbonas) which can be used in the therapy of peptic
ulcers. STD is 0.5 g. Due to unpleasant taste, corrective should be added, as well as stabilizer, both in
the amount of 20%. Instruction for use: 1 tbs 3-4 times per day.

Rp./ Bismuti subcarbonatis 5,0

Sirupi simplicis 30,0 20%
Gummi arabici 30,0 20%
Aquae purificatae ad 150,0
Misce fiat suspensio.
Da ad vitrum collo amplo.
S. Shake well before use, take one table spoon of suspensio 3 times a day.

EXAMPLE 2.

Mebendazole is drug against threadworms, roundworms etc, usually present in childhood. It is

insoluble in water.
Prescribe it as syrup (suspension) with appropriate dosing, for children.

23
 Rp./ Soltrik syrup
Da lagenam originalem No I.
S. Shake well before use, take one tea spoon of suspension.

A.2. Suspensions for external use (Suspensiones ad usum externum, Pastae aquosae)

- Intended for application on skin and wounds, by cotton tissue pad, gauze swabs or cotton wool balls
- have better adherence on skin than powders

- Basic masse is consisted of:

+Solid phase – zinc oxide & talc,
+Liquid phase – water & glycerol. Ratio: 1 : 1 : 1 : 1

- The amount of therapeutic substance reduce the same phase!

EXAMPLE 3.

Basic suspension for external use in the amount of 100 g.

Rp./ Zinci oxydi

Talci
Glyceroli
Aquae purificatae āā 25.0 =ana partes aequales each ing. should be used in the same am.
Misce fiat suspensio.
Da ad vitrum collo amplo.
S. For topical use. Shake before use….

B.1. Emulsions for oral use (Emulsiones)

- intended for (per)oral use of insoluble/unmixable liquid preparations.

- usually drugs with large therapeutic width, weak action, so, patient can measure doses by himself
using teaspoon or tablespoon, which contains 1 STD
- after mixing the preparation look like milky liquid.

EXAMPLE 4.

Castor oil (Ricini oleum) is powerful stimulant laxative. STD is 20 g (about 2 tbs). It has unpleasant
taste, so it is easier to be used in the form of emulsion (with stabilizer).
Prescribe one bottle (100 mL) of this emulsion.

Rp./ Ricini olei 20,0

Gummi arabici 20,0
Aquae purificatae ad 100,0
Misce fiat emulsio.
Da ad vitrum collo amplo.
S. Shake well before use, drink the content of one bottle.

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B.2. Emulsions for external use (Linimenta)

- liquid or semi liquid preparations which comprise two insoluble liquid phases.
- water and oil, alcohols or other volatile liquids.
They can be put only on UNDAMAGED skin!!!
- Therapeutic substance is usually liquid mixable with other components of emulsion or solid substance
soluble in one fractions of emulsion. The amount is expressed in %.

EXAMPLE 5.

Benzylis benzoatis linimentum is 25% emulsion of benzyl benzoate, which is used against scabies
(parasiticidal preparation). It in applied on whole body, except face, left overnight and washed in the
morning. All members of collectivity should be treated at the same time!
The whole procedure should be repeated after 3 and 5 days. Prescribe by FO in the amount of 200-300
mL.

Rp. / Benzylis benzoatis linimenti 200,0

Da ad vitrum collo amplo.
S. For topical use only, shake well before use, apply the emulsion on skin.

STDx n of doses
0.5x10
Total volume= volume of dose x n of dose
1 tbsp=15ml=15g

25
 7. DRUGS FOR PARENETERAL USE (I.V., I.M., S.C.)

Parenteral preparations (Parenteralia)

– sterile preparations used in a form of injection, I.V. solution or by implanting in human body
– simple way of drug administration into the tissue/blood which results in faster drug effect,
higher concentrations of drug in the human body.

Types :
- injection (Iniectiones – pl.; iniectio,-onis – sg.),
- I.V. solution (Infundibilia – pl.; infundibile,-is –sg.),
- concentrated preparations for injections and I.V. solutions
- powders for injections and I.V. solutions,
- implants, preparations for gradual (slow) release of active substance

A. INJECTIONS (Iniectiones) Specialty or F.O.

- sterile preparations
- in the form of solution/mixture/emulsion prepared by dissolving, emulsifying, mixing active
substance with appropriate vehiculum which has to be sterile
- in form of sterile powder for injection which are mixed with appropriate amount of sterile
vehiculum (water - Aqua ad iniectabilia)
- in form of concentrate for injection → dilute before administration

- Injection can be in form of single dose or multiple dose preparation

- Injection is delivered in ampule or small bottle.
Ampules (sing. Ampulla, pl. -e) :small hermetically sealed containers made of glass, contain couple
of ml of liquid (1 therapeutic dose = STD).
Small bottle for injection (sing. Lagena, pl. -e, ) : bottle with a volume ~ 20 ml, and can contain 1<
STD
- Injection must be sterile, pH 5-8 and must not contain any pyretic or hypotensive substances.
- Pyretic substances increase body temperature and cause shivering. Usually those substances are
remains of destroyed bacterial cells and are composed of protein.
- Hypotensive substances decrease blood pressure, which can in some situations be fatal.

Indications:
- When drug is destroyed in alimentary tract, liver (first-pass effect);
- When drug is not enough absorbed from the alimentary tract;
- When drug causes any kind of alimentary tract disease;
- When there is stasis in system of v. portae;
- When a patient cannot swallow;
- When a fast drug effect is needed;

Route of administration
intradermal, s.c., submucous, i.m., i.v., injection for serous cavities (joint, pleura, peritoneum), for
scull, for heart, injection for administration around nerve (perineural) etc.

26
EXAMPLE 1.

Prescribe using F.M. 100 ml Procaini chloridum solution with a therapeutic concentration of 0,5%,
for infilitrative anesthesia. To make this solution approximately isotonic, add some Natrii chloridum;
therapeutic concentration 0.4-0.5%.

Rp./ Procain chloridi

Natrii chloridi āā 0,5
Aquae ad iniectabiliae ad 100,0
Misce fiat solutio.
Da ad vitrum collo amplo, sterilisa!
Signa suo nomine.

EXAMPLE 2.

Tramadol is an analgetic (opioid agonist) with less side effects than other opioid agonists. Therapeutic
dose when given i.v. or i.m. is 50 - 100 mg. Prescribe 3 ampoules, 100 mg (FO and specialty).

Rp./ Tramadoli ampullarum 0,1

Da tales ampullas No III (tres).
Signa suo nomine.

Rp./ Tramadol ampule 0,1

Da ampullas originales No III (tres).
Signa. Ad manum medici.

EXAMPLE 3.

Sustained released microcrystalline suspensions are long acting preparations. Duration of activity
depends on the size of crystals. I.V. administration is forbidden. They are administrated deeply i.m. or
in small amount s.c. This kind of preparation is usually used for insulin.
Ispohane insulin contains equal amounts of insulin and protamine. It’s activity begins in about 1-2
hours and lasts for about 24 hours. Prescribe as Specialty.

Rp./ Isofan-insulin HM injekcije 40 i.j

Da lagenam originalem No I
Signa. Ad manum aegroti.

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B. I.V. SOLUTIONS (Infundibilia)

- sterile water solutions prepared for i.v. administration with a total amount over 100 mL.
- can also be sterile powders for i.v. solutons as well as concentrated preparations
- must be sterile, without any piretic or hypotensive substances and usually are
(not obligatory) isotonic
- most frequently they are administrated i.v. (on rare occasions intraperitoneal).
- must be clear and without any particles

- delivered in: sterile, transparent, not painted glass bottles; bags and transparent bottles made of
plastic materials. They are enclosed with rubber corks.

Indications:
- nutrition,
- Osmotic therapy,
- Parenteral dialysis,
- I.V. administration of drugs.

- Amount of active substance is expressed in percentage (%), g/L or mol/L.

EXAMPLE 1.

IV solution is an isotonic sol. which contains 0,9% NaCl (154 mmol/L Na+ and 154 mmol/L Cl-).
It is used in patients with low levels of Na or Cl, or when it is necessary to reimburse water. It
is also used as a basic solution for administration of other electrolytes, different drugs etc.
Prescribe one bottle (500 ml) of i.v. solution of NaCl using formula for brand name drug/ specialty.

Rp./ Natrii chloridi infundibile 500,0

Da lagenam originalem No I
S. Ad manum medici.

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 8. SOFT PREPARATIONS FOR EXTERNAL USE

- undivided preparations
- intended for external use on skin and mucous membranes, for achieving:
- Local effect
- Absorption through skin
- Protection of the skin and mucous membranes
- They are: ointments, cremes, gels, pastes
- contain simple or complex bases (constituens).
- can be made by solving/emulsifying/ suspending the active substance (or 1< active substance) into the
bases.
- The amount of active substance in soft preparations is expressed as concentration – in (%).
- If they are used for wound treatment, damaged skin or on the mucous of the eye, they must be
sterile

A. OINTMENTS (Unguenta – pl; unguentum, i - sg ) FM, FO, specialty

- contain a basis with 1 phase.
- the therapeutic substance can be liquid or solid substance, dissolved in the phase.
- intended for: protecting and cooling the skin, deeper effect into the skin

BASES can be:

- natural and synthetic
- 1 or 1< phases
- hydrophilic and lypophilic
- can contain aid substances: conservants, antioxidance….

- The most commonly used simple bases are:

Adeps solidus, Adeps lanae hydrogenatus, Adeps lanae cum aqua, Olea pinguia, Cera flava, Cera alba,
Vaselinum flavum, Vaselinum album, Parrafinum liquidum, Paraffinum periliquidum, Parrafinum
solidum, Glycerolum, Macrogolum…

- Mixing simple bases according to the Ph. Jug IV we can get complex bases:
*Bases for ointments (Exipiens ad unguenta )
*Bases for ointments with antibiotics (Exipiens ad unguenta antibiotica )
*Bases for eye ointments (Exipiens ad oculenta )
*Bases for cooling (Unguentum emoliens )
*Bases with glycerol (Glyceroli unguentum )

29
- prescribed as undivided preparations, in the amount of 5-200 g, according to the site of use, the
length of the treatment and the quality of the base.
- amount of active substance is expressed as concentration - in %
- delivered in bottle/flask (olla, acc. ollam), or in original tubes.
- Signa – always label: For topical use. They can be applied on the skin with fingers or hand of the
nurse. If we use it an ointment for eyes - we can apply it into the eye using tuba or a glass stick (ollam
cum bacillo vitreo).

EXAMPLE 1.
Prescribe 20g of salycilic acid (Acidum salicylicum ) SC 10%, as a topical ointment, using FM. As a
base use Vaselinum flavum . It is used in treatment of psoriasis.

Rp/. Acidi salicyclici 2.0

Vaselini flavi ad 20.0
Misce fiat unguentum.
Da ad ollam.
S. For topical use only!
Apply oinment on affected skin.

EXAMPLE 2.
Hloramfenikol (Chloramphenicolum ) is a potent broad spectrum antibiotic with serious
hematological side effects when given systemically. However, it gives good results in treatment of
skin and eye infections. Prescribe using FO and specialty, as an eye ointment (oculenta ).

FO: Rp./ Chloramphenicoli oculentae 5.0

Da ad ollam cum balilo vitreo.
S. Signa suo nomine.

Specialty: Rp./ Hloramfenikol eye oinment 5.0

Da ad scatulam originalem No.I.
S. Ad manum originalem.

30
B. CREAMES always as specialty!
- preparations which contain an oil phase and water phase.
- This pharmaceutical form is produced only industrially.
- It is easy to remove from the skin with warm water. It is convenient for use on hairy parts of the
body.
- active powder +nonactive powder: helps absorption.

C. GELS - only specialty

- contain liquids gelled with a suitable base.
- produced only industrially
- convenient for use on hairy parts of the body, as well as on mucous membranes.
- easy to remove using water.

D. PASTES
- soft preparations, containing powders mixed with a base. 1:1 ratio.
- the powder absorbs the discharge, the base allows easier application of pastes.
- do not use on hairy skin – it is hard to remove.

Every international name has a code in the pharma index e.g. (J01BA01)

31
 9. INHALATIONS – AEROSOLS

- inhalationes are liquid and solid medical preparationes which we are applying in the respiratory tract
in form of steam, aerosol or powders.
- intended for local (therapy of respiratory tract, including lower parts) or systemic action (huge and
good resorptive surface and vascularisation, quick drug effect)
- In the form of inhalation it can be used gases also, for example anestetic gases, with device for
inhalator anesthesia.

Types:
1) Liquid preparations for inhalation
2) Liquid preparations for dispersion – nebulisation
3) Preparations for inhalation under pressure and with dozer
4) Powders for inhalation.

1. Liquid preparations for inhalation - FM, FO, FG

represent easily volatile liquid substances or water/oil solutions of medical substances, that are used
in form of steam (they are added in hot water and formed steam can be inhaled)
- termostabile substances are administering on that way (i.e. some ethereal oils - eucalyptus, anis) in
patients where jet of hot air is not contraindicated. These preparations can be prescribed as water or oil
solutions, drops

2.Liquid preparations for dispersion – nebulisation FO, Specialty (+FM)

- are water solutions, suspensions or emulsions that are administering with special disperse system
(nebulizator) which makes nebulas – fogs (mixture of liquid and air). That is possible when gas under
high pressure, US vibrations or some other mechanism acts on liquid in the machine.
- with these way of administration continued inhalation of adequate dose is possible on adequate speed,
as appropriate size of particles also (< 5 microns, achieve lower airways). The patient breaths medicine
with mask for face breathing normally.
- Nebulizators are useful for dispersion of termolabile substances and in patients that can’t use regular
sprayer (pumps), as are children to 2 years old, patients in severe asthma attack that don’t have enough
inspiratory strength, patients with danger of bleeding after use of hot steam.
- These preparations can be prescribed as solutions
- Medical substance that we put in the nebulizator is prepared in form of isotonic solution with
physiological solution (0,9% NaCl)

3. Preparations for inhalation under pressure and with dozer - Specialty

- are solutions, suspensions and emulsions that are packing in special bottles under pressure, with
appropriate valve for dozing (continuously or individually).
- are also called dispersers of fixed doses ("metered-dose inhaler" – MDI), . pumps.
- contain medical substance in particles of 2-5 microns and liquid gas under pressure (Freon or some
other gas). With activation of disperser fixed quantity of drug is delivered.

32
- Advantage: huge number of doses, appropriate dimensions and possibility of use of many drugs in the
therapy of asthma and similar diseases of respiratory system
- Disadvantage: need of harmonizing of dispersion activation and beginning of inspiration. In this way,
patient must keep his breath for ten seconds as particles from aerosol can penetrate deeper regions of
respiratory tract.
- there are also dispersers of fixed doses that are activating automatically with inspiration ("breath-
actuated inhalers" – BAI). For their activation appropriate inspiratory flow is needed.

4. Powders for inhalation Specialty

- are solid form of drugs that are administering with inhaler/disperser for dry powder ("dry powder
inhaler"-DPI).
- packed in form capsules or some other appropriate pharmaceutical forms.
- these inhalers don’t contain gas under pressure and they are simpler from MDI. They can be built for
inhalation of only one or more drug doses
- the powder particles must be very small that they can arrive to lower airways.

AEROSOLS (sprays) Specialty

- preparations packed in special packing under gas pressure that contains one or more medical
substances. The preparation from package is relieved with turning appropriate valve, in form of:
- aerosol – dispersion of solid particles or drops (liquid particles) in the gas, and size of particle is
adapted for use;
- foam

Aerosols can be emulsions, suspensions and solutions.

- are prepared for local administration on the skin, mucouse membranes of body openings or for
inhalations (as dispersers of fixed doses).
- can contain different accessory substances, solvents, emulsifiers, substances for stabilization of
suspensions, lubricants that are preventing stoppage of valve.

ENEMA (Clysmata)

- liquid drug forms for rectal administration with irrigator or syringe.

- prescibed as solutions/emulsions with specific way of administration (most frequently from medical
persons). Before administration they must be heated to body temperature (36-37ºC).

Types:
- enema for cleaning (Clysmata evacuantia), 500-1000 g;
- nutritious enemas (Clysmata nutrientia), 50-150 g;
- medical enemas (Clysmata medicata), 50-100 g, microenemas 3-5 g.
Before nutritious and medical enemas we must use enemas for cleaning always.

33
EXAMPLE 1.

In the form of medical enema it can be used chloralhydrate (Chloralhydratum; STD 1 g), hypnotic and
anticonvulsive. Because of its irritating action this enema must contain mucus substance up to 10%.
Prescribe 100 g of this enema.

Rp./ Chlorahydrati 1.0

Gummi arabici mucilaginis 10.0
Aquae purificatae ad 100.0
Misce fiat clysmata.
Da ad vitrum collo amplo.
Signa suo nomine.
or S. In the cleared bowels administer enema warmed up to body temperature.

EXAMPLE 2.

In the form of cleaning enemas it can be used solution of bitter salt (Magnesii sulfas) or Glauberg salt
(Natrii sulfas), which MSD are 10 g. Overall volume can be 500-1000 mL.

Rp./ Natrii sulfatis 10.0

Aquae purificatae ad 500.0 (1000.0)
Misce fiat solutio.
Da ad vitrum.
Signa suo nomine.
or S. Warm up solution to body temperature, and use in the form of enema.

34