Education may be required forpharmacy technicians and students,who may not be aware of the differencebetween a solution and a suspension. Visually check that the suspensionis uniformly dispersed before it istransferred from its original container. Pharmacists involved in the finalcheck of a suspension should verifywith the individual who prepared itthat this important step was performedbefore allowing the suspensionto be dispensed.
Consider making auxiliary labels asreminders for pharmacy staff members thatread "Shake well before dispensing," and addthem to appropriate pharmacy stock bottles. Inaddition, attention could be drawn to suspensionsby highlighting or circling the word "suspension" on product labels.
Make sure thatpatients receiving suspension preparations arecounseled so that they fully understand theneed to shake the medication well before eachuse. The "Shake Well" auxiliary label, whichcommonly accompanies the pharmacy label onsuspension preparations being dispensed, couldeasily be overlooked. It should not be used asthe only means of communicating this importantinformation, but rather it should serve as areminder for patients.
ISMP is a nonprofit organizationwhose mission is to understand the causes ofmedication errors and to provide time-criticalerror-reduction strategies to the health carecommunity, policy makers, and the public.
On shaking the bottle, the heavier particles get properly dispersed into the solution which will add to the medicinal properties of the medicine. Since the particles of a suspension are larger than those of solutions and are insoluble, they settle to the bottom of the container over time. Therefore, suspensions need to be shaken to ensure that the solute particles are evenly distributed throughout the mixture.
In such a mixture, a solute is a substance dissolved in another substance, known as a solvent. In short, the eye drop in the form of solution contains miscible constituents and does not need shaking before use.
Prednisolone acetate, the most commonly used eye steroid, is a suspension that requires vigorous shaking at least 20 times to thoroughly mix the bottle contents.
It just means there are some parts in the drink that tend to settle to the bottom of the bottle, due to gravity pulling denser things down more. So you shake it before drinking to give it a good re-mix. The well-shaken and poorly shaken bottles in the patient simulation phase exhibited no differences in concentrations whereas the unshaken bottle had differences throughout the study period.
Problems thought to be associated with PHY-S may be related to compliance and inaccurate measuring devices. Abstract Phenytoin suspension PHY-S is reported to settle, resulting in uneven drug distribution and variable patient dosing.
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