9.7 Pharmacology 4

Question 1

routes of administration: categories

Answer 1

• enteral (alimentary canal)

- parenteral (nonalimentary)

Question 2

first-pass effect

Answer 2

a significant amount of the drug is metabolized and destroyed prior to reaching the site of action

Question 3

Drug is transported to the liver via

Answer 3

portal vein

Question 4

Dosage of an oral drug and first-pass effect

Answer 4

must be strong enough to survive hepatic degradation

Question 5

Reasons why some drugs can’t be given orally

Answer 5

• first-pass effect

- unpredictable rate of absorption into the bloodstream

Question 6

What are the modes of enteral administration?

Answer 6

• sublingual
• buccal
• rectal

Question 7

sublingual

Answer 7

under the tongue

Question 8

buccal

Answer 8

between cheek and gum

Question 9

How do sublingual and buccal drugs enter the bloodstream?

Answer 9

• mouth venous drainage system
• goes to superior vena cava and heart

NO FIRST PASS

Question 10

What are sublingual and buccal drugs good for?

Answer 10

• fast-acting drugs like nitroglycerine

- must be able to be absorbed through oral mucosa and into venous drainage

Question 11

benefit to rectal administration

Answer 11

used when oral isn’t possible, such as with anti-vomiting or hemmorhoids

Question 12

drawback to rectal administration

Answer 12

many are absorbed poorly through rectal mucosa

Question 13

Which drugs are not usually subject to first-pass effect?

Answer 13

parenteral

Question 14

methods of parenteral administration

Answer 14

• inhalation
• injection
• IV
• intra-arterial
• subcutaneous
• intramuscular
• intrathecal
• topical
• transdermal

Question 15

drawbacks to inhalation drugs

Answer 15

• may irritate alveoli or nasal passages

- can get trapped by cilia and mucus

Question 16

What types of drugs are often inhaled?

Answer 16

• anesthetics
• specific pulmonary treatments
• nonlipid-soluble agents
• DNA

Question 17

example of larger nonlipid-soluble agents that are inhaled

Answer 17

• peptides

- small proteins (insulin)

Question 18

Drugs can be introduced systemically or locally via

Answer 18

injection

Question 19

benefit of an IV bolus

Answer 19

• accurate, known quantity of drug over short period

- peak level occurs almost instantly

Question 20

IV infusion delivered via

Answer 20

indwelling IV cannula

Question 21

IV infusion allow for

Answer 21

prolonged, steady infusion

Question 22

IV infusions prevent

Answer 22

large plasma fluctuation of a bolus

Question 23

function of intra-arterial drug delivery

Answer 23

puts large amts of drug into specific target site

Question 24

intra-arterial deliver is usually reserved for

Answer 24

• chemotherapy

- radiopaque dyes for dx procedures

Question 25

subcutaneous drug delivery for

Answer 25

• local procedures (lidocaine, insulin)

- hormonal implants (slow release, ex. birth control)

Question 26

What adverse effect may subcutaneous drug delivery cause?

Answer 26

local tissue irritation

Question 27

intramuscular administration used for

Answer 27

• local tx (Botox)

- relatively steady, prolonged release into systemic circulation

Question 28

effect of intramuscular administration (speed)

Answer 28

• relatively rapid effect

- doesn’t cause the sudden increase in plasma levels

Question 29

What is intrathecal administration?

Answer 29

meds released in a sheath, such as spinal subarachnoid space

Question 30

What might be used to bypass the BBB and reach the CNS?

Answer 30

• narcotic analgesics & anesthetics
• can be delivered adjacent to SC

**antibiotics, anti-cancer drugs

Question 31

topical medications absorbed through

Answer 31

• skin

- mucous membranes

Question 32

What are topical meds usually used for?

Answer 32

• skin

- absorption through systemic circulation is relatively small

Question 33

transdermal meds must be able to

Answer 33

• penetrate the skin

- not be degraded by drug-metabolizing enzymes in the skin

Question 34

What are transdermal meds usually mixed with?

Answer 34

oily or other soluble base

usually in patch form

Question 35

Benefit to transdermal meds

Answer 35

slow, controlled release at a relatively constant level for prolonged periods of time

Question 36

ionto and phonophoresis delivers meds to

Answer 36

• subcutaneous muscle
• tendon
• bursa

Question 37

common transdermal meds

Answer 37

• scopolamine
• nicotine
• hormonal agents
• lidocaine
• fentanyl

Question 38

nasal sprays are considered

Answer 38

topical agents