Routes of administration

Question 1

Difference between sublingual and buccal

Answer 1

Sublingual administration involves placing a drug under your tongue to dissolve and absorb into your blood through the tissue there. Buccal administration involves placing a drug between your gums and cheek, where it also dissolves and is absorbed into your blood

Question 2

What are the advantages of giving oral medication?

Answer 2

• Convenient
• non sterile
• cost
• “slow” release drugs may be available to extend duration of action.

Question 3

What are some disadvantaged with oral administration ?

Answer 3

• Hepatic first pass metabolism will affect the drugs bioavailability.
• Gastrointestinal irritation
• Potential to interact with food and other drugs.
• Effected by presence of bile acids (increase absorption)
• Variable absorption depending on the surface area of the gut.
• Rate of gastric emptying affects absorption rate
• unsuitable for patients who are uncooperative, nil by mouth, are vomiting or have an ileus.

Question 4

Positives of sublingual/buccal administered drugs

Answer 4

Avoids first pass metabolism and destruction by gastric acid

Question 5

What’s some negatives of sublingual/ buccal administered drugs

Answer 5

Few preparations suitable

Requires adherence by the patient

Question 6

Benefit of rectal ?

Answer 6

Good absorption - the haemorrhoidal veins drain directly into the inferior vena cava, avoiding first pass metabolism.

Question 7

Disadvantaged of rectal

Answer 7

May not be suitable after rectal or anal surgery
Some patients dislike suppositories
May not be culturally acceptable for the patient

Question 8

Subcutaneous/ intramuscular advantages

Answer 8

• Good absorption
• onset is rapid
• depending on the formulation can have very long duration of action eg depot contraception

Question 9

What does depot mean in terms of injection ?

Answer 9

Slow release

Question 10

Negatives of subcutaneous/intramuscular

Answer 10

• painful , risk of tissue damage
• limited to volume of the drug
• absorption may be unpredictable if peripheries are poorly perfused.
• depends of blood flow to muscle and the amount of muscle (intramuscular)
• needle stick injury

Question 11

Positives of intravenous

Answer 11

Rapid absorption
100% bio availability useful for emergency situations
Drug can be titrations against physiological response eg insulin and analgesia

Question 12

Negatives of IV administration

Answer 12

• Requires a functioning cannula
• More exspensive than other routes
• cannulation can be distressing to some patients
• cannulas are more prone to infection
• risk of sepsis due to unwanted bacteria in the body
• embolism

Question 13

Why can IVs cause an embolism

Answer 13

embolism - any time a catheter or needle is inserted into the vein the vein can become irritated and inflamed which may lead to the development for small blood clots. Furthermore presence of the IV itself can create a spot for clots to form.

Question 14

Pros or topical drugs

Answer 14

Easy
Non invasive
High level of patient satisfaction

Question 15

Negative of topical

Answer 15

• Very slow absorption

- most drugs are poorly lipid soluble struggle to pass though the skin or mucous membranes

Question 16

Positives of inhaled

Answer 16

• rapid absorption due to the huge surface area of the respiratory endothelium
• bronchodilators and inhaled steroids can be targeted to the lungs with low level of systematic absorption

Question 17

Negative of inhaled drugs

Answer 17

• can be bulky equipment

- bioavailability depends of the patients technique

Question 18

The enteral route of administration relates to what ?

Answer 18

Oral route of administration

Question 19

What is referred to as the parental route of administration

Answer 19

At route that is not enteral.

Consists of injections.