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CONTINUING PROFESSIONAL DEVELOPMENT
KEY LEARNING POINTS
• Pharmacists can reduce the potential
exposure of healthcare workers or
carers to the teratogenic effects
of thalidomide, by providing an
oral suspension for those patients
who are unable to swallow
• Pharmacists are able to formulate a
suspension to contain appropriate
excipients to ensure the optimum
stability and accurate dosing of
• Pharmacists are able to prepare
an oral suspension containing
thalidomide using personal
protective equipment in a protective
environment (e.g. class II cytotoxic
drug safety cabinet).
14. US Pharmacopeia - National Formulary (USP 37-NF
32) Online. NF monographs: Vehicle for Oral Solution,
Vehicle for Oral Solution Sugar Free and Vehicle for Oral
Suspension. Rockville, MD: United States Pharmacopeial
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handbook. 23rd edn. Canberra: Pharmaceutical Society of
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respiratory infections in exotic pets. Aus Pharm.
17. Haywood A, Glass B. Liquid dosage forms
extemporaneously prepared from commercially available
products – Considering new evidence on stability. J Pharm
Pharm Sci. 2013;16(3):441–55 .
18. Pharmaceutical Society of Australia. Professional Practice
Standards. Version 4, 2010. Standard 10: Compounding.
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Adelaide: Australian Medicines Handbook Pty Ltd; 2015.
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Handbook. 1st Ed. Collingwood, VIC: Society of Hospital
Pharmacists of Australia; 2011.
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(electronic resource). London: Pharmaceutical Press; 2015.
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on prescription medicines. At: www.tga.gov.au/
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8. Eriksson T, Bjorkman S, Roth B, et al. Stereospecific
determination, chiral inversion in vitro and
pharmacokinetics in humans of the enantiomers of
thalidomide. Chirality. 1995;7(1):44–52 .
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forced degradation and stability indicating studies of
drugs–A review. J Pharm Anal. 2014;4(3):159–65.
10. Reist M, Carrupt PA, Francotte E, et al. Chiral inversion
and hydrolysis of thalidomide: mechanisms and
catalysis by bases and serum albumin, and chiral
stability of teratogenic metabolites. Chem Res Toxicol.
11. Kraft S, Johnson CE, Tyler RP. Stability of an
extemporaneously prepared thalidomide suspension. Am
J Health Syst Pharm. 2012;69(1):56–8 .
12. Hopkins AM, Sharley NA, Tang CD. Stability Study
of a Thalidomide Suspension. J Pharm Prac Res.
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pharmacokinetics of thalidomide. Clin Pharmacokinet.
SOLUTIONS THROUGH COMPOUNDING
1. Which of the following statements
about thalidomide is FALSE?
a) Thalidomide has anti-inflammatory
activity and in addition to treating skin
systems associated with leprosy, it is
also used to treat multiple myeloma,
according to a treatment protocol.
b) Thalidomide, due it is structural
similarity to the barbiturates, was
originally introduced onto the market as
c) Thalidomide, a chiral molecule, is always
administered as the pure S-enantiomer.
2. The % w/v of thalidomide in the oral
3. Which of the following statements
about the stability of thalidomide is
a) Chiral conversion from the S- to R-
enantiomer is only possible in vitro.
b) Thalidomide is not susceptible to light
c) Thalidomide is capable of undergoing
d) Acid catalysed hydrolysis results in the
formation of a primary amide.
4. Vehicle for Oral Solution NF contains
__ ____ ____ a s sweetening agents
d) Glycerin and sorbitol.
5. Thalidomide compounded oral
suspension by Hopkins et al9 is
a) Methyl paraben.
b) Propyl paraben.
c) Benzoic acid.
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