Routes of administration (VK)


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  • Routes Of Drug Administration - דרך מתן התרופה
    Enteral - דרך מערכת העיכול
    Parenteral - שלא דרך מערכת העיכול
    Rectal - דרך פי הטבעת (ה-rectum) למשל ע”י נרות
    Respiratory - של מערכת הנשימה למשל אינלציה
    Topical -מקומי (דרך העור או הרירית) למשל משחת עור או טיפות עיניים
    oral - הצורה הכי נפוצה
  • Routes of administration (VK)

    1. 1. Routes of Drug Administration
    4. 4. PARENTERAL ROUTE  INTRAVENOUS-Ex.-Glucose, N.S., Dextrose, Heparin.  INTRAMUSCULAR- Ex. –oily solution, antibiotics, vaccines, neuroleptics.  INTRAPERITONEAL- Ex- Antirabies, peritoneal dialysis.  INTRATHECAL-Ex –Xylocaine inj. INTRATHECAL
    5. 5.  INTRAMEDULLARY-Ex. Bone marrow transplantations, blood transfusion in child.  INTRAATERIAL –Ex. Anticancer drugs, for coronary angiography.  INTRA-ARTICULAR- Ex. Hydrocortisone, gold inj.  SUBCUTANEOUS- Ex. L.A., insulin,vaccine.
    6. 6.  INHALATION- Ex.-Oxygen, salbutamol.  INTRADERMAL – Ex. Test sensitivity, BCG vaccine.
    7. 7. TOPICAL/LOCAL ROUTE  TRASDERMAL-Ex. Patchnitroglycerin, scopalamine, clonidine.  CONJUNTIVAL – ex. Oint, drop, eg-gentamycin,ciprofloxacin.  VAGINA, URETHRA- Ex. Solu, oint, jelly, pessaries, suppository. 
    8. 8.  INNCTION(Rubbing)-Ex. Antifungal oint , powder, liniment.  MUCOUS MEMBRANE – Ex. Gargals, lozenges, mouth wash.
    9. 9. Routes of Drug Administration Important Info The route of administration (ROA) that is chosen may have a profound effect upon the speed and efficiency with which the drug acts
    10. 10. Factors affecting choice of route        Physical and chemical properties of drugs. Site of desired action Rate and extent of absorption of drug from different routes. Effect of digestive juices and first pass metabolism. Rapidity with which response is desired. Condition of patient. Accuracy of dosage required.
    11. 11. Routes Of Administration Local Topical Systemic Enteral parenteral Skin mucous membrane Deeper tissues intraarticular, intrathecal, retrobulbar Arterial anticancerous drugs, angiography
    12. 12. Routes Of Administration Systemic routes Of Drug Administration Parenteral Injection Cutaneous Enteral Respiratory Rectal Oral
    13. 13.  The possible routes of drug entry into the body may be divided into two classes: Enteral Parenteral
    14. 14. Enteral Routes  Enteral - drug placed directly in the GI tract: sublingual - placed under the tongue oral - swallowing (p.o., per os) rectum - Absorption through the rectum
    15. 15. Sublingual/Buccal Some drugs are taken as smaller tablets which are held in the mouth or under the tongue.  Advantages  rapid absorption  drug stability  avoid first-pass effect
    16. 16. Sublingual/Buccal  Disadvantages    inconvenient small doses unpleasant taste of some drug  Examples 1. Nitroglycerine Isoprenaline clonidine 2. 3.
    17. 17. Oral  Advantages  Convenient - can be self- administered, pain free, easy to take  Absorption - takes place along the whole length of the GI tract  Cheap - compared to most other parenteral routes
    18. 18. Oral  Disadvantages  Sometimes inefficient - only part of the drug may be absorbed  First-pass effect - drugs absorbed orally are initially transported to the liver via the portal vein  irritation to gastric mucosa nausea and vomiting
    19. 19. Oral  Disadvantages cont.  destruction of drugs by gastric acid and digestive juices  effect too slow for emergencies  unpleasant taste of some drugs  unable to use in unconscious patient
    20. 20. First-pass Effect  The first-pass effect is the term used for the hepatic metabolism of a pharmacological agent when it is absorbed from the gut and delivered to the liver via the portal circulation. The greater the first-pass effect, the less the agent will reach the systemic circulation when the agent is administered orally
    21. 21. First-pass Effect
    22. 22. Rectal 1. unconscious patients and children 2. if patient is nauseous or vomiting 3. easy to terminate exposure 4. absorption may be variable 5. good for drugs affecting the bowel such as laxatives 6. irritating drugs contraindicated
    23. 23. Parenteral Routes  Intravascular (IV, IA)- placing a drug directly into the blood stream  Intramuscular (IM) - drug injected into skeletal muscle  Subcutaneous - Absorption of drugs from the subcutaneous tissues  Inhalation - Absorption through the lungs
    24. 24. Routes of Drug Administration common abbreviations… PO = per os = oral IV = intravenous = into the vein IM = intramuscular = into the muscle SC = subcutaneous = between the skin and muscle IP = intraperitoneal = within the peritoneal cavity icv = intracerebroventricular = directly into the ventricle of the brain
    25. 25. Intravenous Administration Oral Administration Metabolism Liver Intestines
    26. 26. Intravascular Absorption phase is bypassed (100% bioavailability) 1.precise, accurate and almost immediate onset of action, 2. large quantities can be given, fairly pain free 3. greater risk of adverse effects a. high concentration attained rapidly b. risk of embolism c. OOPS factor or !@#$%
    27. 27. Intramuscular 1. very rapid absorption of drugs in aqueous solution 2.repository and slow release preparations 3.pain at injection sites for certain drugs
    28. 28. Subcutaneous 1. slow and constant absorption 2. absorption is limited by blood flow, affected if circulatory problems exist 3. concurrent administration of vasoconstrictor will slow absorption
    29. 29. Peridural Anesthesia  This is accomplished by injecting a local anesthetic into the peridural space, a covering of the spinal cord
    30. 30. Spinal anesthesia  Here, the local anesthetic is injected into the subarachnoid space of the spinal cord
    31. 31. Inhalation 1.gaseous and volatile agents and aerosols 2.rapid onset of action due to rapid access to circulation a.large surface area b.thin membranes separates alveoli from circulation c.high blood flow Particles larger than 20 micron and the particles impact in the mouth and throat. Smaller than 0.5 micron and they aren't retained.
    32. 32. Inhalation cont.  Respiratory system. Except for IN, risk hypoxia.  Intranasal (snorting) Snuff, cocaine may be partly oral via postnasal dripping.  Smoke (Solids in air suspension, vapors) absorbed across lung alveoli: Nicotine, opium  Volatile gases: Some anaesthetics (nitrous oxide, ether) petroleum distillates. Diffusion and exhalation (alcohol).  Lung-based transfer may get drug to brain in as little as five seconds.
    33. 33. Topical Skin a. Dermal-rubbing in of oil or ointment (local action), paste, powder, cream, dressing, spray, etc b. Transdermal - absorption of drug through skin (systemic action) i. stable blood levels ii. no first pass metabolism iii. drug must be potent or patch becomes to large
    34. 34. Mucosal membranes  Mouth and pharynx- paints, lozynges, mouthwash, gargles.  Eyes, ear, nose- drops, ointments, irrigation, spray.  Git- nonabsorable drugs given orally.  Bronchi and lungs- inhalations,aerosols.  Urethra- jellys  vagina- Peseries, vaginal tablets,cream,powder.  Anal canal- ointments. `
    35. 35. Route for administration -Time until effect          intravenous 30-60 seconds intraosseous 30-60 seconds endotracheal 2-3 minutes inhalation 2-3 minutes sublingual 3-5 minutes intramuscular 10-20 minutes subcutaneous 15-30 minutes rectal 5-30 minutes ingestion 30-90 minutes transdermal (topical) variable (minutes to hours)
    36. 36. Time-release preparations  Oral - controlled-release, timedrelease, sustained-release  designed to produce slow,uniform absorption for 8 hours or longer  better compliance, maintain effect over night, eliminate extreme peaks and troughs
    37. 37. Time-release preparations  Depot or reservoir preparations - parental administration (except IV), may be prolonged by using insoluble salts or suspensions in non-aqueous vehicles.
    38. 38. Important Info The ROA is determined by the physical characteristics of the drug, the speed which the drug is absorbed and/ or released, as well as the need to bypass hepatic metabolism and achieve high conc. at particular sites
    39. 39. r t an t Impo V e r y fo ! In No single method of drug administration is ideal for all drugs in all circumstances