Routes of Drug Administration Flashcards
Routes of Drug Administration:
- Systemic Acting
- Local Acting
- Inhalation
- Transdermal
- Controlled/time/extended release system
- Implanted Drug Delivery system
route which drugs reaches the blood/general circulation
Systemic Acting routes
passes the GI organs & liver for drug metabolism,
OPD
Alimentary Routes
kinds of Alimentary Routes:
- Oral
- Buccal
- Sublingual
- Rectal (suppository)
swallowed (deglutition) & subject to first pass effect of liver metabolism Ex. tab, cap, liquid
Oral route
drugs are in pouch between gums & cheek (chew/mastication) to permit direct drug absorption bypassing liver metabolism or first pass
Ex. Bonamine, Flintstone
Buccal Route
drug placed under the tongue
Ex. ER meds
Sublingual Route
drug inserted at anus/rectal or vaginal suppository
Rectal Route
Advantages of Alimentary Routes:
- Safest Route
- easy and convenient dosage form of drug
- does not require sterile technique
- does not require well trained personnel (OPD) → home meds.
Disadvantages of Alimentary Routes:
- bioavailability is variable
- patient compliance is not ensured
- irritability at site of absorption (stomach → GI irritation → hyperacidity → PUD
- extensive liver metabolism
bypass the first pass effect of liver metabolism,
med. given injection → med given in hospital setting
Parenteral Routes
kinds of Parenteral routes:
- Intra-dermal ID
- Subcutaneous SubQ
- Intra-muscular IM
- Intra-Venous IV
- Intra-Arterial IA
- Intra-Cardiac IC
- Intra-Peritoneal IP
usually used for skin testing of drugs;
Site of injection: volar aspect of forearm
Intra-Dermal
Intra-Dermal angle of needle:
10degrees
given into the fat layer between the skin and muscle.
Subcutaneous
Subcutaneous angle of needle:
45 degrees
Sites of injection of Intra-Muscular Route:
Intra-Muscular
a. deltoid area → deltoid muscle (Vax)
b. thigh – lateral part → vastus lateralis muscles
c. gluteal area – upper outer quadrant → gluteal muscles
Intramuscular (IM) – angle of needle:
90 degrees
direct route bypassed the process of absorption;
Intra-Venous
Intra-Arterial
Intra-Cardiac
Intra-Venous angle of needle:
45 degrees
Intra-arterial angle of needle:
45 degrees
site of injection of Intra-cardiac:
LEFT 5th ICSMCL
I**nter - _**C**_ostal - _**S**_pace _**M**_id**Clavicular Line
Site of Injection of Epinephrine/Adrenalin:
Intra-Cardiac
Intra-Cardiac angle of needle:
45 degrees
site of Injection of Intra-peritoneal route:
1 inch below the umbilicus
either in sitting or erect position
Intra-peritoneal (IP) – angle of needle:
90 degrees
_______ are special routes of drug administration:
Intra-Arterial
Intra-Cardiac
Intra-Peritoneal
Advantages of parenteral route:
- Rapid Response - used in ER cases
- dose can be accurate delivered
- alternative route if alimentary is not feasible (unconscious, comatose, uncooperative, extensive vomiting)
Conditions when using Parenteral route if alimentary is not feasible:
- unconscious → can not swallow the meds
- comatose → CVA hgg
- uncooperative
- extensive vomiting (emesis)
Disadvantages of Parenteral Route:
- rapid absorption leads to toxic effect → wrong med, overdose meds → Hemodialysis
- need well trained personnel
- requires sterile technique
- irritation at site of injection → infiltration of Vaccine med
use for treatment of local conditions w/ little systemic absorption
will NOT produced toxic effect
Local-acting
2 routes for Local-acting:
- Topical
- Injectables
route–apply on skin (lotion, cream, ointment) or mucous membrane (drop/solution or ointment)
Topical
Topical Routes:
- Eyes
- Nose
- Throat (spray)
- Airways (spray/nebulize) → salbutamol
- Ears
- Vagina (irrigation or suppository)
Injectable Routes (anesthetic):
- local infiltration → Lidocaine
- peripheral nerve block → Lidocaine
- regional/field nerve block (mandibular nerve block) → Lidocaine
- intrathecal
Intrathecal routes:
a. epidural– Ex. Morphine, Fentanyl, Sufentanyl (narcotic analgesic → prohibited med→ Rx med)
b. subarachnoid (spinal anesthesia) – Thiopental
route– uses for volatile agents
Inhalation
Inhalation routes:
- systemic-acting – gaseous anesthesia (nitrous oxide – laughing gas)
- local-acting – salbutamol (inhaler or nebulizer) → tremor, tachycardia
apply on skin in the form of patch, bypass first pass effect
Transdermal
Transdermal routes:
- systemic–acting – drug reached the general circulation and produced systemic effects Ex. Nitroglycerin (Transdermal-Nitro patch) for angina pectoris – coronary artery vasodilator Nicotine patch Contraceptive pills patch
- local acting – Ex. methylsalycylates (Salompas)
permits slower and prolonged drug absorption from the site of administration
Controlled/Time/Extended release system
drug reservoir is implanted surgically within the body which is slowly released
Implanted Drug Delivery system