Strengths, Dosage Forms and Routes

The Pharmacy Technician Scope and Oral Solid Dosage Forms

In daily practice, pharmacy technicians prepare and package medications under pharmacist supervision, subject to state law. This role requires careful attention to detail, but technicians must recognize the strict boundaries of their duties. Pharmacists are solely responsible for clinical judgment, performing drug utilization review, and conducting final prescription verification. Technicians do not perform these clinical tasks. Furthermore, patient counseling regarding drug indications, adverse effects, and administration instructions must always be performed by a pharmacist. If a patient asks a technician about what to do for missed doses or inquires about drug substitutions, the technician must immediately refer them directly to the pharmacist.

The oral route is the most common, non-invasive, and convenient route of drug administration. Oral tablets are solid dosage forms prepared by compression or molding. Tablets come in many designs to meet patient needs. Chewable tablets are designed to be chewed and swallowed and may help some patients who cannot swallow tablets whole, but they are not automatically safe for patients with dysphagia; questions about suitability should go to the pharmacist. In contrast, orally disintegrating tablets break apart rapidly on the tongue and can usually be taken without water, offering convenience for patients on the go.

Other solid formulations are engineered for specific absorption pathways. Sublingual tablets are placed under the tongue to dissolve and absorb directly into the bloodstream, bypassing first-pass hepatic metabolism for rapid drug delivery. Buccal tablets are placed between the cheek and gum to allow absorption across the buccal mucosa. Oral solid dosage forms also include capsules. Hard gelatin capsules have two-piece shells and commonly contain powders, granules, or pellets, but some contain compatible liquids or semisolids; soft gelatin capsules have sealed shells and typically contain liquids or semisolids.

Many oral solid dosage forms feature advanced designs that alter drug release. Modified-release dosage forms include extended-release, sustained-release, controlled-release, and delayed-release formulations. Enteric-coated tablets are specially formulated to resist gastric acid and dissolve in the higher pH of the small intestine. Enteric-coated tablets generally should not be crushed, split, or chewed unless a pharmacist confirms that the specific product permits it. Similarly, crushing extended-release or controlled-release dosage forms can lead to dose dumping and potential toxicity. Damaging an extended-release coating or matrix can cause medication to be released faster than intended, potentially leading to dose dumping; the effect depends on the product.