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Routes of drug administration

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Dr ABOOBECKER SIDDIQUE P.A
Dr ABOOBECKER SIDDIQUE P.A

www.linkedin.com/in/dr-aboobecker-siddique-p-a-200783a0 \ Routes of drug administration: A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body.[1] Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration. Routes can also be classified based on where the target of action is. Action may be topical (local), enteral (system-wide effect, but delivered through the gastrointestinal tract), or parenteral (systemic action, but delivered by routes other than the GI tract)

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Routes of Drug Administration Aboobecker Siddique. P.A Assistant Prof. Pharmacology 9995924412
Three easy steps for understanding pharmacology ! Study and Chew Study and Chew Study and Chew
ī‚—Pharmaceutical process ī‚—Drug reaches the patient ī‚—Pharmacokinetic process ī‚—What body does to the drug ī‚—Pharmacodynamic process ī‚—What drug does to the body ī‚—Pharmacotherapeutic process ī‚—Therapeutic effect on the patient
Routes of Drug Administration ī‚—Route of administration is the path by which a drug, is brought into contact with the body
Factors deciding the choice of route ī‚— Physical & chemical properties- Solid/Liquid/Gas, Irritancy, p H ī‚— Site of desired action- Local or systemic ī‚— Rate of absorption from a route ī‚— Effect digestive juice and first pass metabolism ī‚— Routine or emergency ī‚— Accuracy of dosage ī‚— Condition of Pt.-Unconscious, vomiting
Routes of drug administration Parentral Enteral --Oral --Rectal Sublingual Injection - i.m, i.v, s.c etc Topical inhalational
Oral or Enteral route ī‚— Advantages: ī‚— Safer ī‚— More convenient ī‚— Economical ī‚— Painless ī‚— Self administration possible ī‚— Complications of parenteral therapy avoided ī‚— Disadvantages: ī‚— Slow onset ī‚— Irritant & unpalatable drugs can not be given ī‚— Vomiting, unconscious pts.- not useful ī‚— Drugs which are destroyed by digestive juices -- not useful Tab, Cap, Syp, Enteric coated pills / tablets, Controlled release
Enteric-coated Tablet Tablet Extended-release tablets Capsules Mixtures
Enteric coated tablets ī‚— Coated with cellulose-acetate, phthalate, gluten etc ī‚— Not digested by gastric juice; get disintegrated in alkaline juices of intestine ī‚— Prevents gastric irritation ī‚— Avoids destruction of drug by the stomach ī‚— Provide higher conc in small intestine ī‚— Slows absorption; prolongs duration of
Enteric coated tablets Advantages Disadvantages ī‚— Reduced frequency of administration ī‚— Therapeutic conc is maintained specially when nocturnal symptoms are to be treated ī‚— Release of entire amount of drug in a short time → toxicity ī‚— More expensive
Controlled release or time release preparations ī‚— Release the active drug over an extended period of time ī‚— Drug coatings which dissolve at different time intervals ī‚— Coating which dissolves early releases an amount which establishes its action quickly ī‚— Coating which dissolves more slowly ensures slow release of remainder drug
Hydrophilic polymers, forms a viscous gelling layers which retard water penetration & act as a barrier to drug release..drug release is accomplished by diffusion through and erosion of this barrier
Rectal ī‚— Rich blood supply; easily absorbed for systemic action ī‚— Drugs absorbed from upper part → superior haemorrhoidal vein → portal circulation (can undergo first pass metabolism) ī‚— Absorbed from lower part→ middle & inferior haemorrhoidal veins → systemic circulation ī‚— E.g. Indomethacin, chlorpromazine,
Rectal route Advantages: Disadvantages: ī‚— Gastric irritation is avoided ī‚— Can be administered by unskilled persons ī‚— Useful in geriatric patients; others with vomiting & those unable to swallow ī‚— Rectal irritation ī‚— Irregular & unpredictable absorption
Rectal enemas ī‚— Administration of a drug in liquid form into rectum īļEvacuant enema: soap water enema (600ml) ī‚— For evacuation of bowel before surgeries, obstetric procedures & radiological examinations ī‚— In selected cases of constipation ī‚— Aim is to remove faecal matter & flatus ī‚— Water: stimulates rectum; soap water: lubricates īļRetention enema: drug is administered
PARENTERAL ROUTE (s.c, i.m, i.v., intradermal) ADVANTAGES DISADVANTAGES īļ Unconscious & un- cooperative pt. īļ Vomiting & diarrhoea īļ Emergencies. īļ Irritant drugs (I.V.route) īļ Drugs which are destroyed by G.I. enzymes - given safely. ī‚— Less safe ī‚— More expensive ī‚— Inconvenient ī‚— Self medication is difficult ī‚— Painful ī‚— Chances of local tissue injury,& injury to nerves ī‚— Requires sterilization of instruments & skill
Intravenous route ī‚— Drug is injected into a superficial vein→ directly reaches circulation → immediately available for action ī‚— Drugs can be given IV as ī‚— Bolus e.g. heparin ī‚— Slowly e.g. aminophylline ī‚— Slow infusion e.g. oxytocin, dextrose, saline ī‚— Employed ī‚— To slow administration to avoid toxicity e.g. morphine
Intravenous route īļAdvantages: ī‚— Most useful during emergency ī‚— Provides predictable blood conc with 100% bioavailability ī‚— Larger volumes can be given ī‚— Irritants can be given īļDisadvantages: ī‚— Once injected, cannot be withdrawn ī‚— Thrombophlebitis ī‚— Extravasation → severe irritation/sloughing ī‚— Only aqueous solutions can be given ī‚— Self administration
Administration of IV solutions ī‚— Maintain strict asepsis ī‚— IV line should be flushed with saline before starting infusion ī‚— Watch for extravasation/thrombophlebitis ī‚— No air bubbles ī‚— Carry sterile container
Intramuscular route ī‚— Aqueous soln is injected into deltoid, triceps, gluteus or rectus femoris ī‚— Absorption into plasma occurs by simple diffusion ī‚— Larger molecules enter through lymphatic channels ī‚— Rapid & uniform absorption ī‚— Volume should not exceed 10ml ī‚— In infants, rectus femoris is used instead of gluteus ī‚— Soluble solutions, mild irritants, depot
Intramuscular route īļAdvantages: ī‚— Reliable absorption ī‚— Rapid absorption īļDisadvantages: ī‚— Painful; abscess formation ī‚— Damage to nerves with irritant solutions
Intra articular: e.g. hydrocortisone in rheumatoid arthritis
Intra cardiac The procedure is performed by inserting a long spinal needle into the ventricular chamber. The needle is inserted in the fourth intercostal space between the ribs.
Intraperitoneal injection or IP injection ī‚— Into the peritoneum (body cavity). ī‚— It is more often applied to animals than to humans. ī‚— Preferred when large amounts of blood replacement fluids are needed or when low blood pressure or other problems prevent the use of a suitable blood vessel for intravenous injection ī‚— In humans, the method is widely used to administer chemotherapy drugs to treat ovarian cancer :- Fluids are injected intraperitoneally in infants, also used for peritonial dialysis.
Intra-arterial(i.a.): directly into arteries ī‚— Requires great care & experts. ī‚— Injections are used to localise effects of a drug to a particular tissue or organ e.g. in the treatment of renal tumours or head/neck cancers, drugs can be injected into the renal artery or carotid artery,
Intrathecal: into the cerebral spinal fluid ī‚— It is Used with local anaesthetics to give spinal/regional anaesthesia, often prior to perform operations on low limbs. ī‚— Opioid Âĩ-receptors mediate pain are in the spinal cord. Drugs that are administered to the cerebral spinal fluid are being delivered to this site of pain mediation. Thus, the intrathecal route of administration can be used with the opioid agonist morphine to give good pain relief.
Epidural route: ī‚— An epidural is an injection into the epidural, which is the area above the dura mater, the layer before the cerebral spinal fluid. ī‚— With local anaesthetics during childbirth prevent the pain associated with childbirth.
Alveolar Blocks
Intradermal ī‚— Drug is injected into layers of skin ī‚— Raising a bleb e.g. BCG vaccine, allergy tests ī‚— By multiple punctures of epidermis e.g. small pox vaccine ī‚— Only small quantities ī‚— May be painful
Subcutaneous injection Advantages Disadvantagesī‚— Tissue is less vascular; slow & uniform absorption; long-acting ī‚— Reliable & patients can be trained for self administration ī‚— Absorption can be enhanced by addition of ī‚— Richly supplied with nerves; irritant drugs cannot be given ī‚— Not dependable in shock due to vasoconstriction ī‚— Repeated injections → Drug is deposited in subcutaneous tissue e.g. insulin, heparin
Subcutaneous injection Hypodermoclysis: interstitial/S.C.infusion –is the s.c administration of fluids to the body. - saline/glucose sol.(1ml/min)-when slow rate of infusion required compared to i.v infusion
Subcutaneous injection Dermojet: High velocity jet of drug solution is projected from a fine orifice using a gun ī‚—Gets deposited in SC tissue → absorbed ī‚—Painless; does not require needles ī‚—Suitable for vaccines Pellet implantation: pellets packed with drugs implanted SC E.g. testosterone, des- oxy corticosterone acetate ī‚—Slow release to provide constant blood levels
Subcutaneous route Sialistic implants ī‚— Biodegradable & non biodegradable ī‚— Crystalline drug is packed in tubes & implanted under the skin ī‚— Slow & uniform leaching → constant blood levels ī‚— E.g. Norplant
Sublingual placed under the tongue e.g. glyceryl trinitrate (nitroglycerin) – Buprenorphine īąAdvantages: īąRapid onset of action īąFirst pass metabolism is avoided īąAvoids degradation of drug in stomach īąTermination of drug action is immediate ī‚§ Disadvantage: Buccal ulceration can occur
Inhalation Hydrofluoroalkane inhalers(HFAs) formerly called- metered dose inhalers ī‚— e.g. salbutamol & beclomethasone in bronchial asthma ī‚— Spacer: can help kids or people with trouble
Inhalation Dry powders inhalers (DPIs): require you to breathe in quickly and deeply e.g. salbutamol ī‚— Hard to use in Asthma attack when you can’t fully catch a deep breath. Nebuliser : through a mouth piece or mask ,Oxygen or compressed air driven ī‚— Easier to use, good for children and ī‚— Severe asthma – who may not use DPI,HFA e.g. salbutamol in bronchial asthma Gases: e.g. general anesthetics
Inhalation route Advantages: Disadvantages : ī‚— Instant absorption ī‚— Local route in pulmonary diseases ī‚— Avoids first pass metabolism in liver ī‚— Blood levels of volatile anesthetics ī‚— Irritant gases can increase pulmonary secretions ī‚— Drugs go directly to the left side of the heart through pulmonary veins → cardiac toxicity
â€ĸTo prevent dry mouth and hoarseness, rinse mouth after each use. â€ĸIt is important to practice good oral hygiene to prevent mouth infections â€ĸTooth decay ? NebulizerMetered dose inhaler
Nasal : ī‚— Local and systemic effects ī‚— Oxytocin spray for systemic absorption ī‚— Oxymetazoline nasal drops for local decongestant action ī‚— Budesonide nasal spray for allergic rhinitis
Transcutaneous route ī‚— Highly lipid soluble drugs applied over skin for slow & prolonged absorption e.g. nitroglycerine ointment in angina pectoris ī‚— Iontophoresis : ionic medicinal compounds driven into the body through the skin by a local electric current.Eg: iontophoresis of Acetylcholine, pilcocarpine iontophoresis used to stimulate sweat secreation.
Transdermal therapeutic systems
Transdermal therapeutic systems ī‚— Drug is delivered at skin surface by diffusion for percutaneous absorption ī‚— Applied on chest, abdomen, upper arm, lower back, buttock and mastoid region ī‚— E.g. Nitroglycerine, fentanyl, nicotine, estradiol, isosorbide dinitrate, hyoscine, clonidine ī‚— Last for 1-7 days
Transdermal therapeutic system Advantages: Disadvantages: ī‚— Smooth plasma conc without fluctuations ī‚— Minimize inter individual variations ī‚— Less side effects ī‚— More convenient; patient compliance ī‚— Local irritation, erythema
Local Route Topical: Local action ī‚—Skin: ointment, cream, lotion, paste, powder, dressing, spray ī‚—Inunction: rubbing on the skin ī‚—Mucous membrane: paints, lozenges, mouth washes, gargles, drops, ointment, nasal spray, jelly, irrigating solutions
Local Route Vaginal ī‚— Suppository-shaped medications are available for vaginal administration, known as pessaries- are designed to obtain a local effect. ī‚— clotrimazole, an anti-fungal drug for the treatment of vaginal candidiasis (thrush).
Eye ī‚— liquid/drop form: it is placed on the conjunctiva- drug dissolves in the tears, and following blinking, is distributed to the site of absorption, the cornea. ī‚— Local effects usually require absorption of the drug through the cornea. ī‚— It can lead to systemic effects as the drug is drained from the eye through the nasolacrimal canal. ī‚— Eg: β-blocker timolol -glaucoma ī‚— Ointment : A small amount of ointment is put along the inside of the lower eyelid. Then, blinking will spread the ointment over the cornea, and the drug will be absorbed. This provides a more prolonged contact time with
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Routes of drug administration

  • 1. Routes of Drug Administration Aboobecker Siddique. P.A Assistant Prof. Pharmacology 9995924412
  • 2. Three easy steps for understanding pharmacology ! Study and Chew Study and Chew Study and Chew
  • 3. ī‚—Pharmaceutical process ī‚—Drug reaches the patient ī‚—Pharmacokinetic process ī‚—What body does to the drug ī‚—Pharmacodynamic process ī‚—What drug does to the body ī‚—Pharmacotherapeutic process ī‚—Therapeutic effect on the patient
  • 4. Routes of Drug Administration ī‚—Route of administration is the path by which a drug, is brought into contact with the body
  • 5. Factors deciding the choice of route ī‚— Physical & chemical properties- Solid/Liquid/Gas, Irritancy, p H ī‚— Site of desired action- Local or systemic ī‚— Rate of absorption from a route ī‚— Effect digestive juice and first pass metabolism ī‚— Routine or emergency ī‚— Accuracy of dosage ī‚— Condition of Pt.-Unconscious, vomiting
  • 6. Routes of drug administration Parentral Enteral --Oral --Rectal Sublingual Injection - i.m, i.v, s.c etc Topical inhalational
  • 7.
  • 8. Oral or Enteral route ī‚— Advantages: ī‚— Safer ī‚— More convenient ī‚— Economical ī‚— Painless ī‚— Self administration possible ī‚— Complications of parenteral therapy avoided ī‚— Disadvantages: ī‚— Slow onset ī‚— Irritant & unpalatable drugs can not be given ī‚— Vomiting, unconscious pts.- not useful ī‚— Drugs which are destroyed by digestive juices -- not useful Tab, Cap, Syp, Enteric coated pills / tablets, Controlled release
  • 10. Enteric coated tablets ī‚— Coated with cellulose-acetate, phthalate, gluten etc ī‚— Not digested by gastric juice; get disintegrated in alkaline juices of intestine ī‚— Prevents gastric irritation ī‚— Avoids destruction of drug by the stomach ī‚— Provide higher conc in small intestine ī‚— Slows absorption; prolongs duration of
  • 11. Enteric coated tablets Advantages Disadvantages ī‚— Reduced frequency of administration ī‚— Therapeutic conc is maintained specially when nocturnal symptoms are to be treated ī‚— Release of entire amount of drug in a short time → toxicity ī‚— More expensive
  • 12. Controlled release or time release preparations ī‚— Release the active drug over an extended period of time ī‚— Drug coatings which dissolve at different time intervals ī‚— Coating which dissolves early releases an amount which establishes its action quickly ī‚— Coating which dissolves more slowly ensures slow release of remainder drug
  • 13. Hydrophilic polymers, forms a viscous gelling layers which retard water penetration & act as a barrier to drug release..drug release is accomplished by diffusion through and erosion of this barrier
  • 14. Rectal ī‚— Rich blood supply; easily absorbed for systemic action ī‚— Drugs absorbed from upper part → superior haemorrhoidal vein → portal circulation (can undergo first pass metabolism) ī‚— Absorbed from lower part→ middle & inferior haemorrhoidal veins → systemic circulation ī‚— E.g. Indomethacin, chlorpromazine,
  • 15. Rectal route Advantages: Disadvantages: ī‚— Gastric irritation is avoided ī‚— Can be administered by unskilled persons ī‚— Useful in geriatric patients; others with vomiting & those unable to swallow ī‚— Rectal irritation ī‚— Irregular & unpredictable absorption
  • 16. Rectal enemas ī‚— Administration of a drug in liquid form into rectum īļEvacuant enema: soap water enema (600ml) ī‚— For evacuation of bowel before surgeries, obstetric procedures & radiological examinations ī‚— In selected cases of constipation ī‚— Aim is to remove faecal matter & flatus ī‚— Water: stimulates rectum; soap water: lubricates īļRetention enema: drug is administered
  • 17. PARENTERAL ROUTE (s.c, i.m, i.v., intradermal) ADVANTAGES DISADVANTAGES īļ Unconscious & un- cooperative pt. īļ Vomiting & diarrhoea īļ Emergencies. īļ Irritant drugs (I.V.route) īļ Drugs which are destroyed by G.I. enzymes - given safely. ī‚— Less safe ī‚— More expensive ī‚— Inconvenient ī‚— Self medication is difficult ī‚— Painful ī‚— Chances of local tissue injury,& injury to nerves ī‚— Requires sterilization of instruments & skill
  • 18. Intravenous route ī‚— Drug is injected into a superficial vein→ directly reaches circulation → immediately available for action ī‚— Drugs can be given IV as ī‚— Bolus e.g. heparin ī‚— Slowly e.g. aminophylline ī‚— Slow infusion e.g. oxytocin, dextrose, saline ī‚— Employed ī‚— To slow administration to avoid toxicity e.g. morphine
  • 19. Intravenous route īļAdvantages: ī‚— Most useful during emergency ī‚— Provides predictable blood conc with 100% bioavailability ī‚— Larger volumes can be given ī‚— Irritants can be given īļDisadvantages: ī‚— Once injected, cannot be withdrawn ī‚— Thrombophlebitis ī‚— Extravasation → severe irritation/sloughing ī‚— Only aqueous solutions can be given ī‚— Self administration
  • 20. Administration of IV solutions ī‚— Maintain strict asepsis ī‚— IV line should be flushed with saline before starting infusion ī‚— Watch for extravasation/thrombophlebitis ī‚— No air bubbles ī‚— Carry sterile container
  • 21. Intramuscular route ī‚— Aqueous soln is injected into deltoid, triceps, gluteus or rectus femoris ī‚— Absorption into plasma occurs by simple diffusion ī‚— Larger molecules enter through lymphatic channels ī‚— Rapid & uniform absorption ī‚— Volume should not exceed 10ml ī‚— In infants, rectus femoris is used instead of gluteus ī‚— Soluble solutions, mild irritants, depot
  • 22.
  • 23. Intramuscular route īļAdvantages: ī‚— Reliable absorption ī‚— Rapid absorption īļDisadvantages: ī‚— Painful; abscess formation ī‚— Damage to nerves with irritant solutions
  • 24. Intra articular: e.g. hydrocortisone in rheumatoid arthritis
  • 25. Intra cardiac The procedure is performed by inserting a long spinal needle into the ventricular chamber. The needle is inserted in the fourth intercostal space between the ribs.
  • 26. Intraperitoneal injection or IP injection ī‚— Into the peritoneum (body cavity). ī‚— It is more often applied to animals than to humans. ī‚— Preferred when large amounts of blood replacement fluids are needed or when low blood pressure or other problems prevent the use of a suitable blood vessel for intravenous injection ī‚— In humans, the method is widely used to administer chemotherapy drugs to treat ovarian cancer :- Fluids are injected intraperitoneally in infants, also used for peritonial dialysis.
  • 27. Intra-arterial(i.a.): directly into arteries ī‚— Requires great care & experts. ī‚— Injections are used to localise effects of a drug to a particular tissue or organ e.g. in the treatment of renal tumours or head/neck cancers, drugs can be injected into the renal artery or carotid artery,
  • 28. Intrathecal: into the cerebral spinal fluid ī‚— It is Used with local anaesthetics to give spinal/regional anaesthesia, often prior to perform operations on low limbs. ī‚— Opioid Âĩ-receptors mediate pain are in the spinal cord. Drugs that are administered to the cerebral spinal fluid are being delivered to this site of pain mediation. Thus, the intrathecal route of administration can be used with the opioid agonist morphine to give good pain relief.
  • 29. Epidural route: ī‚— An epidural is an injection into the epidural, which is the area above the dura mater, the layer before the cerebral spinal fluid. ī‚— With local anaesthetics during childbirth prevent the pain associated with childbirth.
  • 31. Intradermal ī‚— Drug is injected into layers of skin ī‚— Raising a bleb e.g. BCG vaccine, allergy tests ī‚— By multiple punctures of epidermis e.g. small pox vaccine ī‚— Only small quantities ī‚— May be painful
  • 32. Subcutaneous injection Advantages Disadvantagesī‚— Tissue is less vascular; slow & uniform absorption; long-acting ī‚— Reliable & patients can be trained for self administration ī‚— Absorption can be enhanced by addition of ī‚— Richly supplied with nerves; irritant drugs cannot be given ī‚— Not dependable in shock due to vasoconstriction ī‚— Repeated injections → Drug is deposited in subcutaneous tissue e.g. insulin, heparin
  • 33. Subcutaneous injection Hypodermoclysis: interstitial/S.C.infusion –is the s.c administration of fluids to the body. - saline/glucose sol.(1ml/min)-when slow rate of infusion required compared to i.v infusion
  • 34. Subcutaneous injection Dermojet: High velocity jet of drug solution is projected from a fine orifice using a gun ī‚—Gets deposited in SC tissue → absorbed ī‚—Painless; does not require needles ī‚—Suitable for vaccines Pellet implantation: pellets packed with drugs implanted SC E.g. testosterone, des- oxy corticosterone acetate ī‚—Slow release to provide constant blood levels
  • 35. Subcutaneous route Sialistic implants ī‚— Biodegradable & non biodegradable ī‚— Crystalline drug is packed in tubes & implanted under the skin ī‚— Slow & uniform leaching → constant blood levels ī‚— E.g. Norplant
  • 36. Sublingual placed under the tongue e.g. glyceryl trinitrate (nitroglycerin) – Buprenorphine īąAdvantages: īąRapid onset of action īąFirst pass metabolism is avoided īąAvoids degradation of drug in stomach īąTermination of drug action is immediate ī‚§ Disadvantage: Buccal ulceration can occur
  • 37. Inhalation Hydrofluoroalkane inhalers(HFAs) formerly called- metered dose inhalers ī‚— e.g. salbutamol & beclomethasone in bronchial asthma ī‚— Spacer: can help kids or people with trouble
  • 38. Inhalation Dry powders inhalers (DPIs): require you to breathe in quickly and deeply e.g. salbutamol ī‚— Hard to use in Asthma attack when you can’t fully catch a deep breath. Nebuliser : through a mouth piece or mask ,Oxygen or compressed air driven ī‚— Easier to use, good for children and ī‚— Severe asthma – who may not use DPI,HFA e.g. salbutamol in bronchial asthma Gases: e.g. general anesthetics
  • 39. Inhalation route Advantages: Disadvantages : ī‚— Instant absorption ī‚— Local route in pulmonary diseases ī‚— Avoids first pass metabolism in liver ī‚— Blood levels of volatile anesthetics ī‚— Irritant gases can increase pulmonary secretions ī‚— Drugs go directly to the left side of the heart through pulmonary veins → cardiac toxicity
  • 40. â€ĸTo prevent dry mouth and hoarseness, rinse mouth after each use. â€ĸIt is important to practice good oral hygiene to prevent mouth infections â€ĸTooth decay ? NebulizerMetered dose inhaler
  • 41. Nasal : ī‚— Local and systemic effects ī‚— Oxytocin spray for systemic absorption ī‚— Oxymetazoline nasal drops for local decongestant action ī‚— Budesonide nasal spray for allergic rhinitis
  • 42. Transcutaneous route ī‚— Highly lipid soluble drugs applied over skin for slow & prolonged absorption e.g. nitroglycerine ointment in angina pectoris ī‚— Iontophoresis : ionic medicinal compounds driven into the body through the skin by a local electric current.Eg: iontophoresis of Acetylcholine, pilcocarpine iontophoresis used to stimulate sweat secreation.
  • 44. Transdermal therapeutic systems ī‚— Drug is delivered at skin surface by diffusion for percutaneous absorption ī‚— Applied on chest, abdomen, upper arm, lower back, buttock and mastoid region ī‚— E.g. Nitroglycerine, fentanyl, nicotine, estradiol, isosorbide dinitrate, hyoscine, clonidine ī‚— Last for 1-7 days
  • 45. Transdermal therapeutic system Advantages: Disadvantages: ī‚— Smooth plasma conc without fluctuations ī‚— Minimize inter individual variations ī‚— Less side effects ī‚— More convenient; patient compliance ī‚— Local irritation, erythema
  • 46. Local Route Topical: Local action ī‚—Skin: ointment, cream, lotion, paste, powder, dressing, spray ī‚—Inunction: rubbing on the skin ī‚—Mucous membrane: paints, lozenges, mouth washes, gargles, drops, ointment, nasal spray, jelly, irrigating solutions
  • 47. Local Route Vaginal ī‚— Suppository-shaped medications are available for vaginal administration, known as pessaries- are designed to obtain a local effect. ī‚— clotrimazole, an anti-fungal drug for the treatment of vaginal candidiasis (thrush).
  • 48. Eye ī‚— liquid/drop form: it is placed on the conjunctiva- drug dissolves in the tears, and following blinking, is distributed to the site of absorption, the cornea. ī‚— Local effects usually require absorption of the drug through the cornea. ī‚— It can lead to systemic effects as the drug is drained from the eye through the nasolacrimal canal. ī‚— Eg: β-blocker timolol -glaucoma ī‚— Ointment : A small amount of ointment is put along the inside of the lower eyelid. Then, blinking will spread the ointment over the cornea, and the drug will be absorbed. This provides a more prolonged contact time with

Editor's Notes

  1. enteral, which means into the gastrointestinal tract, or parenteral (not into the gastrointestinal tract) Routes that are enteral (into the gastrointestinal tract) are oral and rectal.  Routes that are parenteral include sublingual (under the tongue) and injection, which can be to a variety of sites e.g. into the vein (intravenous), into the muscle (intramuscular), under the skin (subcutaneous).  Other parenteral routes include topical, which is to a body surface, such as the skin, nose, eyes etc. and pulmonary, which is delivery to the lungs.  These routes of drug administration are considered in sequence.  The route of administration used for a drug may also depend on whether a systemic (around the body) effect is required.  Local administration is a way of trying to limit the effects of a drug to a local area.
  2. Reduce the viscocity of hyaluronan*constituents of extracellularmatrix**^permeabiltity
  3. Reduce the viscocity of hyaluronan*constituents of extracellularmatrix**^permeabiltity