Pharmaceutical Preparations2003 Drug Information Center Ministry Of Health-Khartoum State Directorate of Pharmacy i DRUG INFORMATION CENTER MINISTRY OF HEALTH KHARTOUM STATE DIRECTORATE OF PHARMACY TEL: 00249-11-793200 00249-11-793201 FAX: 00249-11-793200 EMAIL:[email protected] WEBSITE: www.dickhartoum.com Printed by Sudan currency printing press ii CONTENTS Preface Introduction General Notices Creams Ear drops Lotions Ointments Paints Pastes Solutions References Subject Index 1 2 3 9 13 14 18 25 27 30 34 35 iii Preface It was apparent at the time that opportunities for pharmacists in primary care to promote the rational use of medicines were occurring with increasing frequency, a trend that has continued unabated. More pharmacists are working as medical practioners in hospitals, running specific pharmacies, or rationalizing the range of medicines prescribed by the practice, and striving to improve the repeat prescribing process. Against this background , the administration of pharmacy in the ministry of health – Khartoum state has continued to advocate that pharmacist should be a more integral part of the primary care team and become fully utilized as a source of advice to all members of the health care team and patients. This booklet will continue to be a source of information for those pharmacists undertaking these developing rules. Our thanks go to Hassan Ali Hassan (B. Pharm ) for helping us bring information and sharing with us his expertise . Hashim Ibrahim Awad BSc.Pharm Drug Information Center Ministry Of Health Khartoum State 1 During the 1950's and 60's. and/or to changed the flavor to make it more palatable. the practice of compounding greatly declined. approximately half of all medications were compounded. Industrialization had an impact on every aspect of the activity of the pharmacist. such as a sublingual lozenge. Although the mass-marketed and mass-produced drugs meet the needs of most patients.Introduction Over the last 50 years pharmaceutical manufacturers have played a significant role in advancing health care. This practice of individualizing or customizing medication is called "compounding". The practice of preparing medications dates back to the origins of pharmacy. there are still a number of patients who require pharmacists to customize medication to meet their unique medical needs. and that a compounded medication may be more appropriate. Many patients are allergic to preservatives or dyes. by industry. it led to the creation of new drugs. and in superior quality. with the advent of the pharmaceutical manufacturers. drugs that the individual pharmacist’s own resources could not produce. Physicians also prescribe compounded medications to change the strength. Third. Second. or transdermal gel. or are sensitive to standard drug therapies. alter its form to make it easier for the patient to use. today there is still a compelling and vital need for compounded medications. Many of prescribed proprietary drugs do not meet the true medical needs of the patient. One of the most important reasons to use a compounded medication is patient non-tolerance of a manufacture product. Many pharmacists and physicians are rediscovering the benefits of compounding to improve patient care. industry assumed responsibility traditionally vested in the pharmacist for the quality of the medication. a lollipop. 2 . yet the pharmacy profession has changed over the years. However. Thus compounding can substantially improve patient compliance by allowing the physician to prescribe a custom-tailored medication to meet the patient's need. First. As late as the 1930's. many drugs that the individual pharmacist was able to produce could be manufactured more economically. The pharmacist can also prepare the medication using several unique delivery systems. In general when choosing a vehicle the following dermatological and pharmaceutical factors should be considered. watery. whereas greasy bases do not. the pharmaceutical factors to be considered are: Stability: The hydrocarbon bases (paraffins) are the most stable vehicles. which reduces the amount of medicament needed. Natural bases should be used to avoid incompatibilities with active ingredients and skin secretion. (f) Water soluble substances are most readily absorbed when in aqueous bases. as these mixes readily with aqueous skin secretions. (c) Wool fats (lanolin) do penetrate the skin. it should have emulsion properties. so the active ingredients are more rapidly and completely released. Wool fat bases and wool alcohol bases do not turn rancid. Absorption and penetration (a) Paraffin's do not readily penetrate the skin. The vehicle should be also be free from irritant or sensitizing effects. Skin preparations are supplied in powder.General Notices Rules for prescribing drugs for skin diseases The prescriber should remember that drugs that act on the skin consist of a vehicle. which is sometimes chemically inert. (e) Substance soluble both in oil and in water are most readily absorbed. Animal fat bases become rancid on exposure to moisture. and it should be easy and convenient to apply as well as easy to remove. but emulsions made with 3 . or greasy forms. Effect on skin function: When a cooling effect is required oil in water emulsion or other water miscible bases are preferable. Miscibility with skin secretion and serum: Oil in water emulsions mix readily with both aqueous and fatty secretions of the skin. The vehicle To obtain the best results from active ingredients much attention should be given to the choice of vehicle. As well the dermatological factors. (d) Absorption is required of the active ingredient. (g) Oil in water emulsions bases release their active ingredients more readily than greasy bases or water in oil emulsion bases. and air. light. The greasy form is the one most commonly used. and active ingredients. (b) Animal and vegetable fats and oils do penetrate the skin. Its activity is greatly reduced in the presence of serum. Ointments of emulsion type should be freshly prepared and long storage avoided. Other factors influencing the choice of vehicle are its solvent properties. 4 . Ammoniated mercury Used topically in the treatment of skin infections and psoriasis but the use of such mercurial preparations is generally deprecated. INGREDIENTS USED FOR TOPICAL APPLICATIONS Aluminium Aluminium powder alone and in paste form with zinc oxide has been used as a dressing. The consistency of ointments in foreign pharmacopoeias is intended for cooler climate. Aluminium acetate Used in dermatology as astringent lotions for irritating skin conditions.them are liable to surface discoloration. Their antimicrobial activity is due to undissociated benzoic acid and is therefore pH dependent. Boric acid Boric acid possesses weak bacteriostatic and fungistatic properties. so in the Sudan it is advisable to increase the amount of hard paraffin or beeswax to harden the ointment. Frequent or prolonged application to large areas or to broken skin or mucous membranes can cause mercury poisoning and use on infants has produced acrodynia. Brilliant green Is a triphenylmethane antiseptic dye with actions similar to those of crystal violet. Benzoic acid (Benzoate): Benzoate has antibacterial and anti fungal properties. The hot climate in the Sudan tends to break emulsions down and cause discoloration. and site of intended application. emulsifying properties. Local availability of vehicles and the cost may well be included as important factors. Benzyl benzoate Is an acaricide used in the treatment of scabies. They are relatively Inactive above a pH of about 5. and framycetin are marketed. Corticosteroid and antibiotic preparations Mixtures with gentamicin. cream. Also used in topical preparations in the treatment of painful skin conditions. and as oral gels and mouthwashes for mouth infections including candidiasis and to reduce dental plaque accumulation. chlortetracycline. or ointment in a variety of skin conditions. lotion. polymixin B. It is also used with other volatile agents in preparations for the relief of respiratory congestion.Calamine Calamine has mild astringent and antipruritic actions and is used as a dustingpowder. neomycin. Copper sulphate Have an astringent action on mucous surfaces and in strong solutions they are corrosive. oxytetracycline. 5 . Capsicum oleoresin Has a carminative action used as a counterirritant . choramphenicol. against some Gram-negative. Cetrimide Cetrimide is a quaternary ammonium antiseptic with actions and uses typical of cationic surfactants. Use for cleansing skin and wounds. Chlorhexidine inhibits some viruses and is active against some fungi. Coconut oil Coconut oil forms a readily absorbable ointment basis. Have bactericidal activity against Gram-positive and at higher concentration. Cajuput oil Has been applied externally as stimulant and mild rubefacient in rheumatism. The last two are especially likely to cause sensitivity. gramicidin. Chlorhexidine Chlorhexidine is abisbiguanide antiseptic and disinfectant . viruses. causing a sensation of coldness followed by an analgesic effect. a cream containing 1-5%. disinfectant and deodorant. Its solutions are used to clean wounds and ulcers in concentrations of up to 6%. When applied to the skin menthol dilates the blood vessels. Gentian violet In 1 or 2 per cent aqueous solution this is an inexpensive antibacterial. lotions. sinusitis. but the effect lasts only as long as the oxygen is being released and is of short duration. Eucalyptus oil Has been taken by mouth for catarrh and coughs. In small doses by mouth menthol has a carminative action. irrigations. or ointments in pruritis and urticaria . Menthol Menthol is chiefly used to relieve symptoms of bronchitis. in addition the anti microbial effect of the liberated oxygen is reduced in the presence of organic matter. fungicidal. It owes its antiseptic action to its ready release of oxygen when applied to tissues. It relieves itching and is used in creams. Has been applied as a rubefacient and is used as a flavour. Lactic acid: Its action similar to those of acetic acid and has been used similarly in the treatment of infective skin. Iodine Iodine has a powerful bactericidal action. Magnesium sulphate Used an application to inflammatory skin conditions such as boils and carbuncles. Hydrogen peroxide: It's an oxidizing agent used as an antiseptic. It is used as an antifungal and antiprotozoal in vaginal gel and douches. and spores.Dithranol Dithranol is used in the treatment of sub acute and chronic psoriasis. and topical preparations for the skin and nails. and antimonilial preparation. It is also active against fungi. Iodine is used as an antiseptic and disinfectant. protozoa. and similar conditions. 6 . cysts. Its also an astringent. increased to about 6% if necessary. Potassium permanganate: It posses oxidizing properties explain their disinfectant properties. It is also active against certin viruses. mycobacteria and some fungi . . and in poison ivy dermatitis. It is often prepared as 0.Methyl salicylate Is a salicylic acid derivative that is irritant to the skin and is used topically in rubefacient preparations for the relief of pain in musculoskeletal. and soft tissue disorders. psoriasis and acne. joint. Nicotinic acid: Topical nicotinamide may be used in the treatment of inflammatory acne Panthinol: Has been used topically as an ointment . through a wider range of 7 . Phenol Phenol is an antiseptic and disinfectant effective against vegetative Grampositive and Gram-negative bacteria. cream or solution usually in strength of 2% for the treatment of various minor skin disorders ( to relive itching and to aid healing. Solutions are used as cleansing applications to wounds. ulcers or abscesses and as wet dressing and in baths in eczematous conditions and acute dermatomes especially where there is secondary infection.1% solution in water. Initially a concentration of about 2% is used. Resorcinol Resorcinol has keratolytic properties and has been used in topical preparations for the treatment of acne and seborrhoeic skin Sodium thiosulphate Has been used for its antifungal properties. Solutions have also been used in bromhydrosis in mycotic infections such as athletes' foot. ichthyosis. Salicylic Acid Has keratolytic properties and is applied topically in the treatment of hyperkeratotic and scalling skin conditions such as dandruff and seborrhoeic dermatitis. seborrhoeic conditions. It is mainly applied topically in the treatment of ichthyosis and hyper keratotic skin disorders it has hydrating and keratolytic properties. It also possesses fungicidal properties and is used topically in the treatment of dermatophytes skin infections. a mild antifungal. and psoriasis. It is applied in cream or lotions containing 10. corns. Sodium bicarbonate Can be administered as ear drops to soften and remove ear wax. Zinc oxide reflects ultraviolet Zinc sulphate Is used topically in a variety of skin conditions mainly for its astringent properties. Zinc oxide This Is midly astringent and is used topically as asoothing and protective application in eczema and slight excoriations. and superficial fungal infections. a mild antiseptic. It is often used in conjunction with other drugs. 8 . Preparations containing up to 60% salicylic acid have been used as a caustic for the removal of plantar warts. and parasticide.A preparation of 40% may be used for nail destruction.. The keratogenic action can be augmented by combination with salicylic acid. Tar Coal tar preparations are used for their keratogenic properties and antipruritic effect in atopic dermatitis. scabies. notably coal tar. Tannic acid Has been used as an astringent for the mucous membranes of the mouth and throat. chronic eczema. in wounds. dandruff. it is an osmotic agent. and for haemorrhoids.concentration has been used. or calluses. Use in treatment of acne. Urea: Emollient. Sulphur This is a keratolytic.25 % urea . Formers uses of tannic acid include its application to burns. Creams. particularly tinea pedis. (c) dexamethasone and betamethasone and methyl. In order to reduce the risk of such infections. such as prednisolone. Preparation of creams. the number of micro – organisms in anti – inflammatory creams and creams likely to be applied to broken skin or burns should be reduced to the lowest possible level. Incompatibilities may also arise if two creams are mixed. the choice depending on the site and nature of the lesion. if the cream is applied to broken or inflamed skin .. Freshly 9 . Topical corticosteroids There is Avery wide range of products. Emulsifying agents for aqueous creams include emulsifying anionic . If heavy microbial contamination develops in a cream. The apparatus used in the preparation of creams and the final containers should. beeswax .prednisolone. For prolonged use over large areas or in children a corticosteroid preparation must be diluted or weakened. particularly in aqueous creams . ointments. some of corticosteroids with antibiotics or chemotherapeutic or other agents. The choice of ointment base is important. polysorbates and sodium . and finally dried. (b) intermediate corticosteroids. lotions. then rinsed with purified water which has freshly boiled and cooled. Sensitivity to added ingredients can occur. it may cause either deterioration of the preparation or. In pharmaceutical practice the term (cream) should be restrictor to preparations for external use. some consist of corticosteroids alone. potassium . an infection in the patient. The various chemical formulations include: (a) hydrocortisone and hydrocortisone acetate. The possibility of incompatibility between the emulsifying agent and the other ingredients or preservatives must be considered when choosing the emulsifying agent for a particular preparation. ammonium and triethanolamine soaps .Zinc undecenoate Zinc undecenoate applied topically in the prophylaxis and treatment of superficial dermatophytoses. be thoroughly cleansed. care must be taken to avoid contamination by observing the highest standards of cleanliness during preparation and by selecting a suitable final container. wool alcohols . or sprays can be made up. oily creams are normally prepar0ed with emulsifying agents such as wool fat . cationic and non. Even if a preservative is present. (d) fluorinated compounds. before use. calcium soaps and certain sorbitan esters. if no preservative is include . CREAMS Creams are viscous emulsions of semi – solid consistency . Moulds or micro – organisms may grow. which may be of an oil – in – water type (aqueous creams) or water .ionic waxes .in – oil type (oily creams). Stir gently until cool. Dilution of creams. Creams should be stored and supplied in well – closed containers which prevent evaporation and contamination . Hygienic precautions must again be taken. Aluminum tubes are not suitable for creams preserved with an organic mercury compound. 300 g 10 g 1000 g 10 . The container should be labelled ( For external use only). and the diluted cream must be freshly prepared. when a cream of strength lower than any available from a manufacturer is prescribed. add sufficient of the Purified Water to produce 1000 g and mix.02 per cent of sodium dihydrogen phosphate (dihydrate) may be included . if this is specified in the individual monograph . sufficient to produce Method: Aqueous Cream may be prepared in the following manner. (2) BETAMETHASONE VALERATE CREAM. a phosphate buffer such as that provided by a mixture of 0. betamethasone valerate with chlorocresol in a water – miscible base. Labelling. add the phenoxyethanol solution when both are at about 60° and mix. For certain specified creams. freshly boiled and cooled. (1) AQUEOUS CREAM Emulsifying Ointment Phenoxyethanol Purified Water. The label on the container of a diluted cream should also state that the contents should not be used later than one month after issue for use. and hygienic precautions should be taken throughout the preparation and subsequent filling into containers. a stronger cream should be diluted to the required strength with the diluent(s) suggested in the individual monograph. Dissolve the Phenoxyethanol in sufficient Purified Water at about 60° to produce a total weight of about 700 g. Containers and storage. Collapsible tubes of metal or suitable plastics should be used whenever possible . Melt the Emulsifying Ointment.boiled and cooled purified water should be used in the preparation of all creams. If aluminum tubes are used.1 per cent of disodium hydrogen phosphate (anhydrous) and 0. and kept in a cool place . It is inadvisable to dilute creams for which information on a suitable diluent is not available. in order to inhibit corrosion of the aluminum and reduce the possibility of evolution of hydrogen gas. add the sodium phosphate . and incorporate in the cream. Triturate the calamine and the zinc oxide with the remainder of the water. freshly boiled and cooled Arachis Oil Emulsifying Wax Calamine Zinc Oxide 570g 300g 60g 40g 30g Method: Melt the emulsifying wax with the aid of gentle heat. for use as a diluent as specified in the individual monographs: Formula A Cetomacrogol Emulsifying Ointment Chlorocresol Purified Water .5g 0. and warm.(3) BUFFERED CREAM Purified Water . freshly boiled and cooled Formula B Cetomacrogol Emulsifying Ointment Methyl Hydroxybenzoate Propyl Hydroxybenzoate Thiomersal Purified Water . and stir gently until cold. previously dissolved in the water at the same temperature . freshly boiled and cooled Emulsifying Ointment Sodium phosphate Citric Acid Chlorocresol 669g 300g 25g 5g 1g Method: Melt the emulsifying ointment with the aid of gentle heat .8g 0. and stir until cold. freshly boiled and cooled 300g 1g 699g 300 g 1. add 400 g of the water at the same temperature. add the arachis oil. AQUEOUS Formula A Purified water . (4) CALAMINE CREAM.02g 697.68 g 11 . (5) CETOMACROGOL CREAM Cetomacrogol Cream may be prepared according to one of the following formulate . the citric acid and the chlorocresol . freshly boiled and cooled Cetostearyl Alcohol Cetrimide 500g 445g 50g 5g Method: Melt the cetostearyl alcohol with the aid of gentle heat. to the chlorhexidine gluconate solution. add sufficient of the water to produce the required weight. melt the cetomacrogol emulsifying ointment on a water – bath . (8) OILY CREAM (Hydrous Ointment) Wool alcohol ointment Purified water (9) SALICYLIC ACID AND SULPHUR CREAM Salicylic acid . It must be freshly prepared . at the same temperature. add the liquid paraffin. with rapid stirring. finely sifted Aqueous cream 2g 2g 96 g 50 g 50 g 12 . dissolve the cetrimide in the water at the same temperature . and add. and add to the warm mixture . (7) CHLORHEXIDINE CREAM Cetomacrogol Emulsifying Wax Liquid Paraffin Chorhexidine Gluconate Solution Purified Water. and stir until cold. previously diluted to 500 ml with the water. (6) CETRIMIDE CREAM Liquid Paraffin Purified Water . finely sifted Precipitated sulphur . stirring gently until cold. and warm . and mix. add the solution containing the preservatives at the same temperature . Cool.Method: Dissolve the preservatives in the water with the aid of gentle heat . freshly boiled and cooled to 250 g 100 g 50 ml 1000 g Method: Melt the cetomacrogol emulsifying wax in the liquid paraffin at 60. triturate the mixture with 800 g of Zinc Cream until smooth. The container should be labelled (for external use only ). if desired. (1) HYDROGEN PEROXIDE EAR. Labelling. the preparation may be diluted with glycerin. Containers. EAR-DROPS Ear-drops are solutions or suspensions of medicaments in water . incorporate the Ichthammol.5 ml 32 g 8g 45 mg 100 g Method: Melt together the Wool Fat and the Cetostearyl Alcohol with the aid of gentle heat. and are intended for instillation into the ear.(10) ZINC CREAM Zinc oxide Oleic acid Arachis oil (or any locally available vegetable oil) Wool fat Calcium hydroxide Water to (11) ZINC AND ICHTHAMMOL CREAM Ichthammol Cetostearyl Alcohol Wool Fat Zinc Cream sufficient to produce 50 g 30 g 100 g 1000 g 32 g 0. propylene glycol or other suitable solvent . glycerin . diluted alcohol . Dilution with water renders phenol Ear – drops caustic. add sufficient Zinc Cream to produce 1000 g and mix.DROPS Hydrogen Peroxide Solution Water 25 ml to 100 ml (2) PHENOL EAR-DROPS Phenol Glycerin Glycerin 40 ml to 100 ml Caution. Ear – drops should be dispensed in coloured fluted bottles with a dropper or in suitable plastics containers. 13 . Lotions may contain suitable antimicrobial preservatives. provided that the law and the statutory regulations governing the use of industrial methylated spirit are observed. unless the active ingredients or vehicles have sufficient intrinsic antibacterial and antifungal activity. and mix. 5 ml 100 ml 14 . (2) that the lotion is intended for external use only. The ear – drops should be recently prepared. (5) the conditions under which the lotion should be stored. (4) the date after which the Lotion is not intended to be used . LOTIONS Lotions are liquid or semi-liquid preparations containing one or more active ingredients in suitable vehicles. (1) ALUMINIUM ACETATE LOTION Aluminum acetate solution Purified water to It must be freshly prepared and used undiluted. add the glycerin and sufficient of the water to produce the required volume . Labelling: The label states (1) the names and concentrations of the active ingredients. (3) that the contents should be shaken before use . They are intended to be applied to the unbroken skin without friction. Storage Lotions should be kept in well-closed containers.(3) SODIUM BICARBONATE EAR – DROPS Sodium Bicarbonate Glycerin Purified Water 5g 30 ml to 100 ml Method: Dissolve the sodium bicarbonate in about 60 ml of the water . They may contain other suitable auxiliary substances such as stabilizers. (4) SPIRIT EAR – DROPS Alcohol (95 per cent) Water 50 ml to 100 ml In making this preparation the alcohol (95 per cent) may be replaced by Industrial Methylated Spirit. Finally add the remaining purified water. the Glycerol and sufficient Purified Water to produce 1000 ml. add the Benzyl benzoate. and shake the mixture thoroughly.(2) ALUMINIUM CHLORIDE 10 per cent solution in water. (3 ) BENZYL BENZOATE LOTION Benzyl benzoate Triethanolamine Oleic acid Purified water 250 ml 5g 20 g 750 ml Method: Mix the Triethanolamine with the Oleic acid. and mix. and again shake thoroughly. 15 . the Zinc Oxide and the Bentonite with a solution of the Sodium Citrate in about 700 ml of the Purified Water and add the Liquefied Phenol. add 250 ml of purified water. Transfer the mixture to a suitable container of about 2000 ml capacity. freshly boiled and cooled Sufficient to produce 150 g 50 g 30 g 5g 5 ml 50 ml 1000 ml Method: Triturate the Calamine. (4) CALAMINE COMPOUND LOTION Prepared calamine Strong solution of lead acetate Glycerin Lime water (0.1 per cent solution) (5) CALAMINE AND SULPHUR LOTION Precipitated sulphur Calamine Lotion 4g 100 g 10 g 1 ml 5 ml 100 ml to (6) CALAMINE LOTION Calamine Zinc Oxide Bentonite Sodium Citrate Liquefied Phenol Glycerol Purified Water. in the warm basis. (11) SALICYLIC ACID LOTION Salicylic acid Castor oil Alcohol (95 %) 20 g 10 ml 1000 ml 40 g 10 g 0. stirring until cold.25 g 100 ml (9) COPPER AND ZINC SULPHATE LOTION Copper sulphate Zinc sulphate Camphor water 10 g 15 g 1000 ml to (10 ) HYDROCORTISONE LOTION Self-emulsifying Monostearin Hydrocortisone in ultra-fine powder Chlorocresol Glycerin Purified water. add the self-emulsifying monostearin. incorporate . heat to 60. freshly boiled and cooled to Method: Dissolve the Chlorocresol in 850 ml of the water with the aid of gentle heat.25 g 1. with constant stirring . allow to cool slowly.5 g 63 g 1000 g to 16 . Triturate the hydrocortisone with the glycerin.(7) CALAMINE LOTION OILY (Liniment of calamine) Calamine Wool fat Oleic acid Arachis oil (or any locally Available vegetable oil) Calcium hydroxide solution to 5g 1g 0. and stir until completely dispersed.5 ml 50 ml 100 ml (8) CHLORINATED LIME WITH BORIC ACID LOTION (Eusol) Chlorinated lime Boric acid Purified water to 1. and mix. Hydrocortisone Lotion may be prepared using any other suitable basis. and sufficient of the water to produce the required weight. Method: Dissolve the salicylic acid in a portion of the alcohol . (12) SULPHUR COMPOUND LOTION Precipitated sulphur Alcohol (95 %) Glycerin Quillaia tincture Calcium hydroxide solution Method: Disperse the precipitated sulphur in the alcohol and the glycerin previously mixed.01 g 2g 100 ml 40 g 60 ml 20 ml 5 ml 1000 ml to NOTE: resorcinol is likely to change the colour of the hair temporarily (14) SODIUM THIOSULPHATE 20 per cent solution in water. add the castor oil and sufficient of the alcohol to produce the required volume. and mix.5 g 2 ml 100 ml 17 . (13) SCALP LOTION Resorcinol Salicylic acid Sodium metabisulphite Glycerin Alcohol 50% to 2g 2g 0. and mix. (15) TRIAMCINOLONE LOTION Triamcinolone Lotion is a dispersion of Triamcinolone Acetonide in a suitable lotion basis. (16) ZINC SULPHATE LOTION Formula A Zinc sulphate Amaranth solution Purified water to Formula B Zinc sulphate Compound tincture of lavender Purified water to 10 g 10 ml 1000 ml 0. add the quillaia tincture and sufficient of the calcium hydroxide solution to produce the required volume. particularly polystyrene. should state the name and concentration of the preservative present. Oil – in – water emulsifying agents such as Emulsifying Wax. but the amounts of active ingredients must in all cases be maintained. oils. Ointments should be stored in a cool place. A mildly antiseptic or astringent powder such as zinc oxide may be added. synthetic esters of fatty acids or wool fat. fats and waxes may be varied in ointments intended to be used in tropical or subtropical climates to meet extremes of temperature. Labeling: When a preservative is included. Cetrimide Emulsifying Wax or Cetomacrogol Emulsifying Wax may be incorporated into anhydrous bases in order to render them miscible with exudates and more easily removable from the skin by washing. except one issued on a medical prescription for an individual patient. The proportions of paraffins. together with inert bases such as soft paraffin. a stronger ointment should be diluted to the required strength with the suggested in the individual monograph. Dilution of ointments. Containers made of certain plastics. phthalate esters and similar substances. In addition. when strength of ointment not available from a manufacturer is prescribed. Water – miscible ointments may be prepared with a basis consisting of a mixture of macrogols.(17) WHITE LOTION Zinc sulphate Talc powder Glycerin Lime water to 25 g 25 g 25 g 100 ml OINTMENTS Ointments are semisolid preparations consisting usually of a medicament or mixture of medicaments dissolved or dispersed in a suitable basis which nowadays is often anhydrous. Suitable preservatives may be including when permitted in the monographs. ointments containing water or other volatile ingredients should be stored and supplied in well – closed containers which prevent evaporation. 18 . For certain specific ointments. They are used as emollients. the label on the container. Containers and storage: Ointments should be stored and supplied in containers made of materials which do not allow absorption or diffusion of the contents. are unsuitable for ointments containing methyl salicylate. as protective preparations on the skin or as a means for the local application of medicaments. Emollient and protective ointments may contain vegetable oils. Such preparations are particularly suitable for application to the scalp. 5 g (2)AMMONIATED MERCURY AND COAL TAR OINTMENT Yellow Soft Paraffin 950 g Ammoniated Mercury 25 g Strong Coal tar Solution 25 g Method: Triturate the ammoniated mercury with a portion of the yellow soft paraffin until smooth. and gradually incorporate the remainder Of the ointment. finely sifted 850 g 150 g 19 . COAL TAR AND SALICYLIC ACID OINTMENT Ammoniated Mercury and Coal Tar Ointment Salicylic Acid. mix with the remainder of the yellow soft paraffin. in fine powder Salicylic Acid. in fine powder 980 g 20 g Method: Triturate the salicylic acid with a portion of the ammoniated mercury and coal tar ointment until smooth. (3)AMMONIATED MERCURY. in fine powder 910 g 60 g 30 g Method: Triturate the benzoic acid and the salicylic acid with a portion of the emulsifying ointment until smooth. and incorporate the strong coal tar solution.(1)AMMONIATED MERCURY OINTMENT Ammoniated Mercury Ointment Simple ointment 2. (5) CALAMINE OINTMENT WHITE Soft Paraffin Calamine. (4) BENZOIC ACID OINTMENT.5 g 97. and gradually incorporate the remainder of the ointment. COMPOUND (Whitfield's Ointment) Emulsifying ointment Benzoic acid. (8)CETOMACROGOL EMULSIFIYIG OINTMENT White Soft Paraffin Cetomacrogol Emulsifying Wax Liquid Paraffin Method: Melt together and stir until cold.finely sifted Zinc Oxide. (6) CALAMINE AND COAL TAR OINTMENT White Soft Paraffin Hydrous Wool Fat Calamine . add the Cetrimide and stir until cold. incorporate the capsicum oleoresin. 20 .Method: Triturate the calamine with a portion of the white soft paraffin until smooth. and stir until cold. Cetostearyl Alcohol and Liquid Paraffin. finely sifted Strong Coal tar Solution 475 g 250 g 125 g 125 g 25 g Method: Melt together the hydrous wool fat and the white soft paraffin. the zinc oxide and the strong coal tar solution .and stir until cold. (7) CAPSICUM OINTMENT Simple Ointment 935 g Emulsifying Wax 50 g Capsicum Oleoresin 15 g Method: Melt together the simple ointment and the emulsifying wax. and gradually incorporate the remainder of the paraffin. incorporate the calamine. 500 g 300 g 200 g ( 9 )CETRIMIDE EMULSIFYING OINTMENT White Soft Paraffin Cetostearyl Alcohol Liquid Paraffin Cetrimide 500 g 270 g 200 g 30 g Method : Melt together the White Soft Paraffin. (12) EMULSIFYING OINTMENT Emulsifying wax White Soft Paraffin Liquid Paraffin Method: Melt together and stir until cold. triturate with a portion of the yellow soft paraffin until smooth .(10)COAL TAR AND SALICYLIC ACID OINTMENT Coconut Oil Emulsifying Wax Hard Paraffin Yellow Soft Paraffin Strong Coal Tar Solution Salicylic Acid 500 g 180 g 100 g 100 g 100 g 20 g Method: Melt together the hard paraffin. and gradually incorporate the remainder of the paraffin . and the strong coal tar solution . the emulsifying wax. finely sifted Strong Coal tar Solution 600 g 300 g 100 g Method: Mix the zinc oxide with the strong coal tar solution . It should be recently prepared. the yellow soft paraffin and the coconut oil.and stir until cold. (14) HYDROUS OINTMENT (Oily Cream) Wool Alcohols ointment Phenoxymethanol 500 g 10 g 500 g 500 g 300 g 500 g 200 g 21 . (13) HYDROUS WOOL FAT OINTMENT Hydrous Wool Fat Yellow soft Paraffin Method: Melt together and stir until cold. Cool to about 40° . (11)COAL TAR AND ZINC OINTMENT Yellow Soft Paraffin Zinc Oxide. and dissolve the salicylic acid in the melted basis. NON-STAINING. stirring constantly . add the aqueous solution gradually while still warm . to the remainder of the solution add sufficient of the yellow soft paraffin .to produce an ointment of the required strength. (16) IODINE OINTMENT.mix vigorously until smooth cream is obtained and stir until cold. add the methyl salicylate. (15) ICHTHAMMOL OINTMENT Wool Fat Yellow Soft Paraffin Ichthammol 450 g 450 g 100 g Method: Melt together the wool fat and the yellow soft paraffin. with occasional stirring. accurately weighed.staining Iodine Ointment to 50 ml 1000 g Method: Melt the non-staining iodine ointment at a low temperature. incorporate the ichthammol. until the brown colour disappears. (17) IODINE OINTMENT. and stir until cold. WITH METHYL SALICYLATE Methyl Salicylate Non. Melt the Wool Alcohols ointment .using about 0.1 g.Dried Magnesium Sulphate Purified Water. Determine the concentration of iodine present in the solution by the method given below . and stir until cold. NON-STAINING Iodine Arachis oil Yellow soft Paraffin 50 g 150 ml a sufficient quantity Method: Shake the iodine with the arachis oil at room temperature until dissolved.previously heated to 40° . (18) METHYL SALICYLATE OINTMENT Methyl Salicylate 500 g White Beeswax 250 g Hydrous Wool Fat 250 g 22 . and maintain the solution at 50°. and mix. freshly boiled and cooled 5g 485 g Method: Dissolve the Phenoxymethanol and the Dried Magnesium Sulphate in the Purified Water with the aid of gentle heat. Method: Melt together the beeswax and the hydrous wool fat. and stir until cold. gradually add the salicylic Acid and stir until cold. (20) PARAFFIN OINTMENT White Beeswax Hard Paraffin Cestostearyl alcohol White soft Paraffin 20 g 30 g 50 g 900 g Method: Mix the ingredients. (22) SALICYLIC ACID AND SULPHUR OINTMENT Oily Cream Salicylic acid. finely sifted Precipitated sulphur. finely sifted 940 g 30 g 30 g 23 . (21) SALICYLIC ACID OINTMENT Salicylic Acid.COMPOUD Methyl Salicylate White Beeswax Wool Fat Menthol Water Cajuput oil Eucalyptol 500 g 200 g 105 g 100 g 45 g 25 g 25 g Method: Melt together the beeswax and the wool fat. heat gently with stirring until homogenous and stir until cold. the eucalyptol and the cajuput oil. finely sifted Wool Alcohols ointment 20 g 980 g Method: Melt the Wool Alcohols Ointment. and add the menthol previously dissolved in the methyl salicylate . Incorporate the water at the same temperature. (19) METHYL SALICYLATE OINTMENT . and stir until cold. add the methyl salicylate. (23)SIMPLE OINTMENT Wool Fat 50 g Hard Paraffin 50 g Cetostearyl Alcohol 50 g White Soft Paraffin or Yellow Soft Paraffin 850 g Method: Mix the ingredients. (26)ZINC UNDECENOATE OINTMENT Zinc undecenoate Emulsifying ointment Undecenoic acid 20 g 75 g 5g (27)ZINC AND CASTOR OIL OINTMENT ( zinc and castor oil cream) Zinc Oxide. gradually add the remainder of the simple ointment and mix thoroughly. heat gently with stirring until homogenous and stir until cold.Method: Triturate the salicylic acid and the precipitated sulphur with a portion of the oily cream until smooth. and gradually incorporate the remainder of the cream. (24)SULPHUR OINTMENT Precipitated sulphur Simple ointment prepared with white Soft paraffin (25) ZINC OINTMENT Zinc oxide Simple ointment 15 g 85 g 10 g 90 g Method: Triturate the Zinc Oxide with a portion of the Simple ointment until smooth. finely sifted 75 g Castor Oil 500 g Cetostearyl Alcohol 20 g White Beeswax 100 g Arachis Oil 305 g 24 . prepared storax or tolu balsam in ethereal solution are employed as bases of medicated varnishes. When Wool Alcohols Ointment is used in a white ointment. when used in a coloured ointment it should be prepared with Yellow Soft Paraffin.Method : Triturate the Zinc Oxide with a portion of the Castor Oil until smooth and add the mixture to the remainder of the ingredients previously melted together. Resinous substances such as benzoin. it should be prepared with White Soft Paraffin. Stir while cooling until the temperature is about 40°. caustic or analgesic properties. the proportions of Hard Paraffin. (1) BRILLIANT GREEN PAINT Brilliant green Alcohol ( 70 %) 1g 100 ml to (2) BRILLIANT GREEN AND CRYSTAL VIOLET PAINT Brilliant green Crystal violet (gentian violet ) Alcohol (90% ) Water to 0. PAINTS Paints are liquid preparations intended for application to the skin or mucous surfaces. Containers.5 g 0. astringent. (28)WOOL ALCOHOL OINTMENT Wool Alcohols 60 g Hard Paraffin 240 g White Soft Paraffin or Yellow Soft Paraffin 100 g Liquid Paraffin 600 g In preparing Wool Alcohols Ointment.5 g 50 ml 100 ml 25 . Method : Melt together with the aid of gentle heat and stir until cold. They are usually medicated with substances possessing antiseptic. They should be dispensed in coloured fluted bottles. Soft Paraffin and Liquid Paraffin may be varied to produce Wool Alcohols Ointment having suitable properties. add the alcoholic magenta solution and sufficient water to produce the required volume.4 g 4g 0. Dissolve the boric acid in a portion of water. dissolve the phenol and the resorcinol in this solution . (6)PHENOL GLYCERIN Glycerin Phenol 840 g 160 g 0.Method: Dissolve the brilliant green and the crystal violet in the alcohol. and add sufficient water to produce the required volume. and mix. (3) GENTIAN VIOLET PAINT Formula A Gentian Violet Water to 5g 1000 ml Formula B Gentian Violet Water (4)ICHTHAMMOL GLYCERIN Glycerin Ichthammol (5) MAGENTA PAINT (Castellant's paint) Magenta Phenol Boric acid Acetone Resorcinol Industrial methylated spirit or alcohol (90 %) Water Method: Dissolve the magenta in the alcohol and the acetone. previously mixed.5 ml to 100 ml 900 g 100 g to 1g 100 ml 26 .8 g 4 ml 8g 8. (1) COMPOUND ALUMINIUM PASTE(Baltimore paste) Aluminum Powder Zinc Oxide Liquid Paraffin 200 g 400 g 400 g Method: Mix the Aluminum Powder and the Zinc Oxide with the Liquid Paraffin until smooth. They are used principally as antiseptic. Containers and storage: Pastes should be stored and supplied in containers made of materials which do not allow absorption or diffusion of the contents. 850 g 150 g PASTES Pastes are semisolid preparations intended for external application. In addition . and warm gently until solution is effected. with the aid of gentle heat if necessary. (2) COAL TAR PASTE Strong Coal Tar Solution Compound Zinc Paste 75 g 925 g 27 . protective or soothing dressings which are often spread on lint before being applied. They usually consist of a high proportion of finely powdered medicaments mixed with soft or liquid paraffin or with a non-greasy basis made with glycerin. mucilage or soap. (7) TANNIC ACID GLYCERIN Glycerin Tannic acid Method: Triturate the tannic acid with the glycerin.Method: Dissolve the phenol in the glycerin. pastes containing water or other volatile ingredients should be stored and supplied in well closed containers which prevent evaporation. Mix 45 g of the dried material in a warm mortar with the Phenol dissolved in the Glycerol.5 hours or at 130° for 4 hours and allow to cool in a desiccators. incorporate the Zinc Oxide and the Starch and stir until cold. previously heated at 120° for 1 hour and cooled 55 g Method: Dry about 70 g of Dried Magnesium Sulphate at 150° for 1. even dispersion is obtained and gradually incorporates the remainder of the Zinc and Salicylic Acid Paste.Method: Triturate the Strong Coal Tar Solution with a portion of the Compound Zinc Paste until smooth and gradually incorporate the remainder of the Compound Zinc Paste. or a sufficient quantity sufficient to produce 1000 g Method: Mix the Dithranol with a portion of the Zinc and Salicylic Acid Paste until a smooth. 28 . (3) COMPOUND ZINC PASTE Zinc Oxide. finely sifted White Soft Paraffin 250 g 250 g 500 g Method: Melt the White Soft Paraffin. finely sifted Starch. (4) DITHRANOL PASTE Dithranol Zinc and Salicylic Acid Paste 1 g.5 g Glycerol. (5) MAGNESIUM SULPHATE PASTE(Morison's paste) Dried Magnesium Sulphate a sufficient quantity Phenol 0. finely sifted Methyl Salicylate Thymol Peppermint Oil Glycerol Method: Mix the Heavy Kaolin.5 ml 425 g 29 . (8) KAOLIN POULTICE Heavy Kaolin. and stir until cold. incorporate the Zinc Oxide. add the Zinc Oxide and the Starch. finely sifted Salicylic Acid. finely sifted Boric Acid. finely sifted Starch Yellow Soft Paraffin 50 g 60 g 60 g 380 g 450 g Method: Melt the Emulsifying Wax at 70°. and add the remainder of the Yellow Soft Paraffin. and the Boric Acid with the Glycerol. stirring occasionally. dissolve the Thymol in the Methyl Salicylate. stir at 70° until completely melted. The heating step may be omitted if some other satisfactory means of mixing the solid ingredients with the Glycerol is used but in this case Heavy Kaolin that has been sterilized is used. stirring constantly. heat at 120° for 1 hour. Separately. and allows cooling. add to the cooled mixture.(6) ZINC AND COAL TAR PASTE Emulsifying Wax Coal Tar Zinc Oxide. (7) ZINC AND SALICYLIC ACID PASTE Zinc Oxide. cool to 30°. finely sifted Starch. finely sifted White Soft Paraffin 240 g 20 g 240 g 500 g Method: Melt the White Soft Paraffin. 527 g 45 g 2 ml 500 mg 0. add the Peppermint Oil and mix thoroughly. the Salicylic Acid and the Starch and stir until cold. previously dried at 100°. add the Coal Tar and 225 g of the Yellow Soft Paraffin. transferred to the final co containers. freshly boiled and cooled sufficient to produce 50 g 750 ml 1000 ml 30 . Labelling: The label on the sealed container states: (1) The name and strength of the solution. The apparatus used in the preparation of sterile solutions and the containers should be thoroughly cleansed before use. A readily breakable seal should cover the closure.a braided surfaces. They are issued sterile or unsterilised. anticoagulant solutions. Sterile solutions comply with the tests for sterility. Alternatively. and the solution clarified by filtration. bladder irrigations. They are intended for internal or external use or for instillation into body cavities. Precautions should be taken to minimize any microbial contamination during preparation. (2) The words ( Sterile Solution) and (Not for Injection) and (3) That any portion of the solution not used when the seal is first broken should be discarded. Unsterilised Solutions: These include solutions for internal administration. Preparation of sterile solutions. which are then closed. which are then closed to exclude micro – organisms. (1) BORIC ACID SOLUTION Dissolve 5 g of boric acid in a mixture of 20 ml of water and 20 ml of absolute ethanol and dilute to 250 ml with absolute ethanol. The medicament is dissolved in the solvent. the solution is sterilized by filtration (see Appendix) . and heamodialysis solutions. solutions for external application to non. either alone or as ingredients of other preparations. and transferred by means of an aseptic technique to the final sterile containers . and concentrated solutions for the preparation of injections.SOLUTIONS Solutions are liquid preparations containing one or more soluble ingredients usually dissolved in water. Standard Sterility. Containers: Containers should be readily distinguishable from containers used for intravenous fluids and should be closed so as to exclude microorganisms. depending on the purpose for which they are intended. Sterile Solutions These include solutions for external application to abraded surfaces. (2) BENZOIC ACID SOLUTION Benzoic Acid Propylene Glycol Purified Water. intraperitoneal dialysis solutions. and sterilized by autoclaving or by heating with a bactericide (see Appendix 27 ) . and Limit of preservative (not more than 0. Contains. pour this mixture in a thin stream into 800 ml of Ethanol (96 per cent) in a closed vessel fitted with an agitator.5 grams and not more than 3. Meets the requirements for Identification.Method: Dissolve the Benzoic Acid in the Propylene Glycol and add sufficient Purified Water. Barium. Contains not more than 0. (3) COAL TAR SOLUTION Coal Tar Polysorbate 80 Ethanol (96 per cent) 200 g 50 g sufficient to produce 1000 ml In making Coal Tar Solution. Allow the mixture to stand for not less than 24 hours. (4) HYDROGEN PEROXIDE TOPICAL SOLUTION USP Preserve in tight. combine the filtrate and washings and add sufficient Ethanol (96 per cent) to produce 1000 ml. in small quantities and with constant stirring. not less than 2. Heavy metals (not more than 5 ppm) Limit of nonvolatile residue. Acidity. (6) POTASSIUM PERMANGANATE SOLUTION Potassium permanganate Water 0.5 grams of Hydrogen Peroxide. warmed if necessary to render it fluid. to produce 1000 ml. decant and filter the supernatant liquid.05%). wash the vessel and filter with Ethanol (96 per cent). with the Polysorbate 80. continue agitation throughout the addition of the mixture and for 1 hour thereafter. in each 100 ml. light – resistant containers at controlled room temperature.1g to 100 ml 31 . Method: Mix the Coal Tar.05% of a suitable preservative or preservatives. the Ethanol (96 per cent) may be replaced by Industrial Methylated Spirit. (5) IODINE TINCTURE USP Iodine Tincture may be prepared by dissolving 20 grams of iodine and 24 grams of Sodium Iodide in 500 ml of Alcohol and then adding Purified Water to make the product measure 1000 ml. warmed if necessary to render it fluid. The diluted solution contains potassium permanganate about 1/8000 Directions for use. decant and filter the supernatant liquid. Method: Mix the Coal Tar. (7) POTASSIUM PERMANGANATE SOLUTION. STRONG Potassium permanganate Water 4g to 100 ml It must be freshly prepared. (9) STRONG COAL TAR SOLUTION Coal Tar Polysorbate 80 Ethanol (96 per cent) 400 g 50 g sufficient to produce 1000 ml 9g to 1000 ml In making Strong Coal Tar Solution the Ethanol (96 per cent) may be replaced by Industrial Methylated Spirit1. wash the vessel and filter with Ethanol (96 per cent). Allow the mixture to stand for not less than 24 hours. one part to be diluted with seven parts of water or as directed. with the Polysorbate 80. 32 .Method: It must be freshly prepared. (8) SODIUM CHLORIDE SOLUTION (Normal Saline) Sodium Chloride Purified Water Method: Dissolve. pour this mixture in a thin stream into 700 ml of Ethanol (96 per cent) in a closed vessel fitted with an agitator. combine the filtrate and washings and add sufficient Ethanol (96 per cent) to produce 1000 ml. continue agitation throughout the addition of the mixture and for 1 hour thereafter. and filter. The diluted solution contains potassium permanganate about 1/2500 Directions for use: 5 ml to be diluted to 600 ml with water or as directed. with mixing. Allow to stand for a few hours before use.3 g 0. Add 250 ml of the Ethanol (96 per cent). Vanillin and Cinnamon Oil in the remaining 100 ml of Ethanol (96 per cent).02 ml 500 g 350 ml 1000 ml Method: Dissolve the Sucrose in 320 ml of Water. and agitating until solution is effected . (12) WEAK IODINE SOLUTION (Iodine Tincture) B. and then adding Alcohol to make the product measure 1000 ml. adding 70 grams of Iodine . add this solution to the sucrose solution with mixing. Benzoic Acid. Dissolve the Cinnamic Acid.0 g 2. (11) TOLU-FLAVOUR SOLUTION Cinnamic Acid Benzoic Acid Ethyl Cinnamate Vanillin Cinnamon Oil Sucrose Ethanol (96 per cent) Water sufficient to produce 5.1 g 0.p Iodine Potassium Iodide Purified water Ethanol (90 per cent) Sufficient to produce 25 g 25 g 25 ml 1000 ml Method: Dissolve the Potassium Iodide and the iodine in the purified water and add sufficient Ethanol 990 per cent) to produce 1000 ml.5 g 0.(10) STRONG IODINE TINCTURE USP May be prepared by dissolving 50 grams of Potassium Iodide in 50 ml of Purified Water . 33 . dilute to 1000 ml with Water and mix. Ethyl Cinnamate. British Pharmacopoeia 1988 volume 2. 3. Approved Drug Products and Legal Requirements. 20 th edition. British Pharmacopoeia 1988 volume 1. volume 3. British Pharmaceutical Codex 1968. 2000. 34 . British Pharmacopoeia 2000 CD 4. 2. 6. 5.References 1. Sudan National Formular0y 1979. AQUEOUS. 11 CALAMINE LOTION OILY. 26 HYDROCORTISONE LOTION. 20 CALAMINE AND SULPHUR LOTION. 14 ALUMINIUM CHLORIDE. 21 GENTIAN VIOLET PAINT.DROPS. 19 CAPSICUM OINTMENT. 15 AMMONIATED MERCURY AND COAL TAR OINTMENT. 12 CETRIMIDE EMULSIFYING OINTMENT. 13 HYDROGEN PEROXIDE TOPICAL SOLUTION USP. 20 CETOMACROGOL CREAM. 20 CETRIMIDE CREAM. 31 35 . 28 EMULSIFYING OINTMENT. 10 BENZOIC ACID OINTMENT. 11 CETOMACROGOL EMULSIFIYIG OINTMENT. 15 BETAMETHASONE VALERATE CREAM. COMPOUND(Whitfield's Ointment). 25 BRILLIANT GREEN PAINT. 27 COMPOUND ZINC PASTE. 20 CHLORHEXIDINE CREAM. 21 COAL TAR PASTE. 19 BENZOIC ACID SOLUTION.Subject Index ALUMINIUM ACETATE LOTION. 15 CALAMINE COMPOUND LOTION. COAL TAR AND SALICYLIC ACID OINTMENT. 30 BRILLIANT GREEN AND CRYSTAL VIOLET PAINT. 19 AMMONIATED MERCURY OINTMENT. 21 COAL TAR AND ZINC OINTMENT. 31 COMPOUND ALUMINIUM PASTE (Baltimore paste). 12 CHLORINATED LIME WITH BORIC ACID LOTION (Eusol). 10 BORIC ACID SOLUTION. 16 COAL TAR AND SALICYLIC ACID OINTMENT. 15 CALAMINE OINTMENT. 16 DITHRANOL PASTE. 19 AMMONIATED MERCURY. 16 CALAMINE LOTION. 27 COAL TAR SOLUTION. 30 BENZYL BENZOATE LOTION. 19 AQUEOUS CREAM. 11 CALAMINE AND COAL TAR OINTMENT. 28 COPPER AND ZINC SULPHATE LOTION. 15 CALAMINE CREAM. 25 BUFFERED CREAM. 16 HYDROGEN PEROXIDE EAR. 31 POTASSIUM PERMANGANATE SOLUTION. 22 IODINE OINTMENT. 31 KAOLIN POULTICE. 21 HYDROUS WOOL FAT OINTMENT. 33 SULPHUR COMPOUND LOTION. 24 36 . 22 IODINE OINTMENT. NON-STAINING. 22 IODINE TINCTURE USP. 12 SALICYLIC ACID AND SULPHUR OINTMENT. 28 METHYL SALICYLATE OINTMENT. 17 WEAK IODINE SOLUTION (Iodine Tincture). 33 WHITE LOTION. 25 ZINC AND CASTOR OIL OINTMENT. 27 TOLU-FLAVOUR SOLUTION. 21 ICHTHAMMOL GLYCERIN. 29 ZINC CREAM. 24 TANNIC ACID GLYCERIN. 23 OILY CREAM. 24 ZINC SULPHATE LOTION. 13 PHENOL GLYCERIN. 23 SALICYLIC ACID LOTION. 14 STRONG COAL TAR SOLUTION. 23 PHENOL EAR-DROPS. 29 ZINC AND ICHTHAMMOL CREAM. 16 SALICYLIC ACID OINTMENT. 26 MAGNESIUM SULPHATE PASTE (Morison's paste). 17 SULPHUR OINTMENT.HYDROUS OINTMENT (Oily Cream). 32 SODIUM THIOSULPHATE. NON-STAINING. 33 TRIAMCINOLONE LOTION. 12 PARAFFIN OINTMENT. 14 SODIUM CHLORIDE SOLUTION (Normal Saline). 22 METHYL SALICYLATE OINTMENT. 24 SODIUM BICARBONATE EAR – DROPS. 29 MAGENTA PAINT. 17 SIMPLE OINTMENT. 13 ZINC AND SALICYLIC ACID PASTE. 26 POTASSIUM PERMANGANATE SOLUTION. 23 SCALP LOTION. 13 ZINC OINTMENT.WITH METHYL SALICYLATE. 26 ICHTHAMMOL OINTMENT. COMPOUD. 24 ZINC AND COAL TAR PASTE. 32 SALICYLIC ACID AND SULPHUR CREAM. 32 STRONG IODINE TINCTURE USP. 18 WOOL ALCOHOL OINTMENT. 17 SPIRIT EAR – DROPS. STRONG. 17 ZINC UNDECENOATE OINTMENT. 37 .