Pills

PILLS (from Latin pila-ball, pilula-little ball), a solid medicinal form for internal use, having the appearance of small balls, the weight of which according to the VI Pharmacopoeia ranges from 0.05 g to 0.3 g each. Pills are prepared either from only active medicinal substances (basis) or, more commonly and usually, with the addition of substances that are more or less indifferent, which constitute the basis of the pill mass (massa pilularum); this is done in cases when it is not possible to prepare a proper pill mass from only active medicinal substances either because there is little of these substances or because their consistency is not suitable for forming a pill mass. The pill mass should have the consistency of a thick, easily kneadable dough, plastic, easily separating from the walls of the mortar and the pestle, not crumbling and not drying out too quickly. Most often, as a constituens for pills, a mixture in equal parts of powder and extract of licorice root (Pulv. et Extr. Rad. Glycyrrhizae, s. Liquiritiae aa) is prescribed, as well as Pulv. et Extr. Rad. Taraxaci, Calami, Gentianae, Absinthi and the like. In addition, calcined magnesia (Magnesia usta) is used as a constituens when pills contain balsams, essential oils, creosote, tar and others. If medicinal substances that decompose from combination with organic substances (e.g., argentic nitrate, sublimate, potassium permanganate salt) are prescribed in the pills, then white clay (Bolus alba) is taken as the constituens. Gum arabic (Gummi arabicum) with water and glycerin, the crumb of white bread (mica Panis albi) with water can also be used as constituens for preparing pills. In recent years, abroad, a specially prepared yeast extract-Extr. Faecis, s. Cenomassa-cenomass-has begun to be used for making pills. The amount of active medicinal substances and the number of pills in the prescription must necessarily be indicated, with the amount of basis usually being indicated in total based on all the pills, while the number of pills is better indicated in numbers that are multiples of 25 or 30, since the cutter of the pharmaceutical pill machine, when making pills, divides the pill mass into either 25 or 30 equal parts. Indifferent substances necessary for preparing the pill mass and their amounts need not be indicated in the prescription, since the pharmacist has the right, at his discretion, to introduce indifferent substances into the pill mass that give it the proper consistency, making a note of this in the prescription and the signature. If the weight of the pills is not indicated in the prescription, then the pills are prepared by the pharmacy with a weight of 0.12 g (VI Pharmacopoeia) if possible. Pills are prescribed approximately in the following variants: 1) Rp.: Acidi arsenicosi 0.03, Pulv. et Extr. Rad. Glycyrrhizae q. s., ut fiat massa pilularum, e qua formentur pilulae XXX. D. S.; 2) Rp.: Argenti nitrici 0.3, Boli albae q. s., ut f. pil. XXX. D. S.; 3) Rp.: Strychnini nitrici 0.06, Massae pilularum q. s. M. fiat pil. 60. D. S.; 4) Rp.: Extr. Belladonnae, Extr. Opii aa 0.25. P. lege artis pil. XXX. D.S. When prescribing pills without indicating the weight of the pill mass and yet wishing to obtain pills of a strictly defined weight for one reason or another, the physician can after indicating the number of pills in the prescription add the word pondere (weighing) with the indication of the desired weight of each pill, e.g., M. f. pil. XXX; pilula singularis pondere 0.25. The ingredients contained in the pills must be thoroughly mixed or triturated in a mortar beforehand, with dry substances first being turned into the finest powder, while potent substances are dissolved in water, alcohol or ether or are thoroughly triturated with them. The water or other liquid required for kneading the pill mass (a mixture of water with glycerin, syrup, alcohol and others) is added drop by drop to the mixture being triturated in the mortar. The resulting plastic mass (or all or part of it, depending on the number of prescribed pills) is rolled with a long wooden board into a cylindrical rod of uniform thickness, in length coinciding with the size of the cutter, i.e., the cutting surfaces of the pill machine. Placing the rod between these cutting surfaces, rolling it and applying uniform pressure, it is cut into individual pills, which are then finally rounded with the help of a special board-disk (the so-called roller, rotulator or fertig-macher). The pills should all be of the same size, uniformly spherical, smooth, elastic, not crumbling. In making pills, steel mortars and pill machines with steel knives are usually used. Depending on the chemical properties of the ingredients in the pills, it is sometimes necessary to resort to porcelain mortars and pill machines with horn knives. In addition to ordinary pharmaceutical pill machines, special presses (e.g., 'Aesculapius', Engler's, etc.) are also used for making pills in large quantities, and the mass preparation of pills is carried out industrially by means of special machines with manual and mechanical drives. To prevent the prepared pills from sticking together, they are dusted with spores of club moss (Lycopodium). The physician can prescribe other substances for dusting the pills, for example powder of cinnamon bark, violet root, making a note in the prescription: consperge (dust) pulvere Cort. Cinnamomi (Rad. Iridis florent. etc.). For the purpose of masking the taste and smell of medicinal substances and giving the pills a beautiful appearance, instead of dusting, they can be coated with a thin layer of gum arabic, collodion, tolu balsam, varnish (prepared from a mixture of mastic and benzoic resins), gelatin, graphite, gold, silver and others. This is indicated in the prescription as follows: obduco (coat) Collodio (Balsamo toluano, Gelatina, Auro etc.). In addition, pills prepared in large quantities industrially are often subjected to so-called candying or drageeing, i.e., coating with sugar (see Dragees). Varnishing, gelatinizing and candying of pills also serves to protect them from excessive drying, hardening, mold and other damage. Pills coated with keratin, glutol or salol have special practical medical significance. Such pills pass through the stomach unchanged and disintegrate only in the alkaline contents of the intestine. Silvering and gilding of pills, as procedures that increase the cost of production and have no practical value (only elegance of dispensing is achieved), have not found application in the practice of Soviet physicians. Pills are dispensed in boxes, in jars with ordinary or glass stoppers or with screw-on caps. Dispensing in jars is more rational, since in well-closed jars, pills are better protected from atmospheric influences. In the form of pills, it is convenient to administer medicinal substances that have an unpleasant taste and smell. The small size, portability, ease of taking pills by adults, suitability of pills in the treatment of chronic patients-positive qualities of pills. The possibility of unhygienic and irrational preparation of pills-negative side of the matter. Irrationally prepared pills may pass through the gastrointestinal tract without disintegrating and thus without exerting a therapeutic effect. Pills cannot be prescribed to small children, severely ill patients and patients with clouded consciousness, with difficult swallowing, suffering from diseases of the gastrointestinal tract, as well as in cases requiring emergency medical aid. - The main medical requirements for pills: 1) observance of thorough cleanliness in preparation, 2) rationality of preparation, ensuring their proper disintegrability, and 3) accuracy of dosage: fluctuations in the content of active principles in individual pills should not exceed 15% of the prescribed dose. Pills weighing more than 0.3 g are called boluses. They are prepared from a softer mass to facilitate swallowing (sometimes they are given an oblong shape-Boli oblongati) and their subsequent disintegration in the gastrointestinal contents. Boluses are prescribed in the same way as pills, only instead of M. (ut) f. pil. they write M. (ut) f. boli. Boluses are often used in veterinary practice. Pills weighing up to 0.05 g are called pellets or granules (granula). As a constituens for them, a mixture of 4 parts of milk sugar and 1 part of gum arabic is used, which is kneaded with a syrup containing 10% glycerin into a plastic mass. Pellets disintegrate quickly in the stomach, and the medicinal substances contained in them have the opportunity for rapid action. In the form of pellets, it is convenient to prescribe poisonous and potent substances (alkaloids and their salts). Pellets are widely used in homeopathy. There are no official pills, boluses and pellets in our pharmacopoeia (VI Pharmacopoeia). Of the official preparations according to foreign pharmacopoeias, the following prescriptions are encountered in the practice of Soviet physicians: Pilulae Blaudii (see Blaudii pilulae), Pilulae aloeticae ferratae-so-called Italian pills (containing in each pill 0.05 of senna and ferrous sulfate), Pilulae asiaticae-Asian pills (containing in each pill 0.001 of arsenic anhydride and 0.03 of black pepper). In addition, according to standard prescriptions, we prepare Pilulae nervinae (containing 0.1 of monobrom-camphor and quinine hydrobromide each), Pilulae tonicae (containing 0.001 of arsenic anhydride and strychnine nitrate and 0.3 of glycerophosphate calcium salt each), Pilulae laxantes (from preparations of cascara, rhubarb and belladonna) and others.

In former times, laxative pills were often prepared for manual sale under names such as, for example, 'archimandritic pills' (with preparations of jalap, rhubarb, yarrow, and ammonium chloride), 'Swiss pills' (with preparations of senna and cascara), 'Kvyatkovsky's pills' (with preparations of senna, jalap, senna leaf, rhubarb, myrrh, and larch fungus), and others. The so-called Marienbad pills were also popular (see Marienbad salt). Such old 'varieties' of pills as Pilulae perpetuae - perpetual pills (balls cast from metallic antimony), Pilulae Rhei tor-natae (balls turned from pieces of rhubarb root), and others, can now be mentioned only as curiosities. Pills should not be confused with those balls called globuli, which are currently used only for vaginal administration (see Vaginal balls). In former times, however, the name globuli referred to those large (weighing 10-60 g) pill-like balls, in the form of which medicinal substances were rolled for external use, for example, for baths (Globuli martiales - containing ferro-potassium tartrate, Globuli sulfurati - containing a mixture of calcium sulfide and table salt), for removing stains (Globuli emaculatorii - with soap, egg yolk, turpentine, and white clay), for fontanelles (Globuli ad fonticulos - with Spanish fly powder), and others.