Home' Australian Pharmacist : Australian Pharmacist July 2014 Contents Australian Pharmacist July 2014 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
1. A glass mortar and pestle should
be used in preference to a ceramic
mortar and pestle in the preparation
of the oral suspension since:
a) The glass mortar allows more effective
grinding with the pestle of the
ingredients to achieve a smaller particle
b) The API, tramadol, will interact with a
c) A ceramic mortar is porous and will
absorb the tuna flavour.
d) A glass mortar allows for more accurate
2. The strength (in % w/v) of tramadol
in the oral suspension is:
3. Cap-lock, making opening of a
medicine bottle very difficult can
be avoided by excluding ________
from the formulation.
e) Propylene glycol.
4. The commercially available tramadol
oral drops are not appropriate to be
used to compound an oral liquid due
5. Nonpharmacological measures for
managing OA in cats include:
a) Modifying the environment to decrease
the level of moist heat.
b) Decreasing all exercise to show
improved mobility and to decrease pain.
c) Avoiding supplementation with
omega-3 fatty acids and oral
d) Maintaining a healthy weight for the cat.
SOLUTIONS THROUGH COMPOUNDING
• Other – low level laser and
acupuncture are other treatments
which may assist in improving quality
Directions for use
• SHAKE WELL BEFORE EACH USE to
ensure an accurate dose.
• Use the measuring device supplied to
accurately measure the required dose.
• Wash your hands after administering
• Ask your veterinarian to demonstrate
how best to administer the
suspension to your cat. Liquid
medications are usually gently
squirted into the pouch between the
teeth and cheek, taking care that the
liquid is not inhaled (i.e. do not tilt the
cat’s head backward). Talking softly
and stroking your cat, or giving a food
treat afterwards, will assist in ensuring
a positive experience.
• Store the preparation in a cool place
(below 25 °C), protected from light
and away from children and pets.
KEY LEARNING POINTS
• Tramadol, a synthetic opioid, is
useful for the treatment of pain in
companion animals including dogs
and cats, especially where NSAIDs are
• Pharmacists are able to counsel
cat owners on important
nonpharmacological measures for
• Pharmacists are able to prepare a
product extemporaneously, which is
appropriately flavoured and suitable
for cats for the delivery of tramadol.
1. Rychel JK. Diagnosis and treatment of osteoarthritis. Top
Companion Anim Med. Feb 2010;25(1):20–25.
2. Kerwin SC. Osteoarthritis in cats. Top Companion Anim
Med. Nov 2010;25(4):218–23.
3. Slingerland LI, Hazewinkel HA, Meij BP, Picavet P,
Voorhout G. Cross-sectional study of the prevalence and
clinical features of osteoarthritis in 100 cats. Vet J. Mar
4. Ray J, Jordan D, Pinelli C, Fackler B, Boggess D, Clark J. Case
studies of compounded tramadol use in cats. International
Journal of Pharmaceutical Compounding. 2012;16(1):44–9 .
5. Tramal® oral drops, Tramal SR tablets, Tramal capsules. At:
6. Australian Medicines Handbook online. Adelaide:
Australian Medicines Handbook. 2014.
7. Beatty JA, Swift N, Foster DJ, Barrs VR. Suspected
clindamycin-associated oesophageal injury in cats: five
cases. J Feline Med Surg. Dec 2006;8(6):412–9 .
8. German AJ, Cannon MJ, Dye C, et al. Oesophageal
strictures in cats associated with doxycycline therapy. J
Feline Med Surg. Feb 2005;7(1):33–41 .
9. Wagner DS, Johnson CE, Cichon-Hensley BK, DeLoach
SL. Stability of oral liquid preparations of tramadol in
strawberry syrup and a sugar-free vehicle. Am J Health
Syst Pharm. 2003;60(12):1268–70.
10. Johnson CE, Wagner DS, DeLoach SL, Cichon-Hensley
BK. Stability of tramadol hydrochloride - acetaminophen
(Ultracet) in strawberry syrup and in a sugar-free vehicle.
Am J Health Syst Pharm. 2004;61(1):54–7 .
11. Martindale: The complete drug reference (electronic
resource). London: Pharmaceutical Press; 2014.
12. US Pharmacopeia - National Formulary (USP 36-NF
31) Online. NF monographs: Vehicle for Oral Solution,
Vehicle for Oral Solution Sugar Free and Vehicle for Oral
Suspension. Rockville, MD: United States Pharmacopeial
13. Australian Pharmaceutical Formulary and Handbook. 22nd
Ed. Canberra: Pharmaceutical Society of Australia; 2012.
14. Haywood A, Glass B. Voriconazole suspension for
respiratory infections in exotic pets. Aus Pharm.
15. 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 .
16. PSA. Pharmaceutical Society of Australia. Professional
Practice Standards. Version 4, 2010. Standard 10:
Compounding. At: www.psa.org.au/download/standards/
Links Archive Australian Pharmacist June 2014 Australian Pharmacist August 2014 Navigation Previous Page Next Page