The document discusses the various routes of drug administration including local and systemic routes. Local routes deliver drugs to specific localized areas without systemic absorption, including topical, deeper tissues, and arterial supply routes. Systemic routes deliver drugs via absorption into blood circulation to achieve widespread distribution throughout the body, including oral, sublingual/buccal, rectal, inhalation, nasal, cutaneous, and parenteral routes. Parenteral routes involve injection directly into tissues or bloodstream, such as intramuscular, subcutaneous, intravenous, and intradermal injections. Factors such as drug properties, site of action, absorption rate, first-pass metabolism, desired speed of effect, dosage accuracy, and patient condition determine
Dosage forms and routes of drug administrationFatenAlsadek
this presentation give an over review about Routes of drug administrations and dosage forms
Done by: Faten Al-Sadek , Pharmacy student at Mohammed Al-Mana college for Health Sciences -MACHS
This ppt is for pharmacology students of MBBS UG&PG and other healthcare persons who needs basic science like BDS, Nursing Ayurveda unani homeopathy etc.
Dosage forms and routes of drug administrationFatenAlsadek
this presentation give an over review about Routes of drug administrations and dosage forms
Done by: Faten Al-Sadek , Pharmacy student at Mohammed Al-Mana college for Health Sciences -MACHS
This ppt is for pharmacology students of MBBS UG&PG and other healthcare persons who needs basic science like BDS, Nursing Ayurveda unani homeopathy etc.
Know About Your Drug ,,, Part - II ( Route of Drug Administration) for study purpose pharmaceutical professional such as students and other specialized field. Presentation for "LEARN & EARN KNOWLEDGE" based.
Thanks all of you for your support...Part-I success and your comments.
Drugs may be administered by various routes. The choice of the route in a given patient depends on the tissue or organ to be treated, the characteristics of the drug and urgency of the situation, etc. Knowledge of the advantages and disadvantages of the different routes of administration is essential. The routes can be broadly divided into Enteral, Parenteral, and Local.
Corticosteroids in dentistry and endodonticsDr. Ritu Gupta
this seminar provides information about the corticosteroids ,history,uses, functional anatomy of adrenal glands, it's drawbacks, cushing's habitus, dental implications, mineralocorticoids, glucocorticoids
this is the essay about " is it important that students learn about the principles and life of gandhi today?" written for the occasion of 150th birth anniversary of mahatma gandhi. include various quotes, references from history and current scenarios too.
this study is a questionnaire survey among the school teachers regarding awareness about the tooth avulsion trauma and it's management. formal training about first aid in school. coconut water, milk, hbss should be given in schools.training programmes should be done frequently.
Part 2 biocompatibilty of dental materialsDr. Ritu Gupta
this is the second part od seminar which includes biocompatibilty of various dental materials which are used in daily clinical practice including routine suture materials, rootcanal , restorative materials along with pateint photographs and case reports
Part 1 biological properties and biocompatibility of dmDr. Ritu Gupta
this is the part 1 of biocompatibility of dental materials, the various tests to measure biocompatibilty, its significance, allergy, toxicity, iso 10993, ansi/ada specifications, diagnostic tests on patients
Paralleling and bisecting radiographic techniquesDr. Ritu Gupta
this is the seminar for Undergraduate students consisting of initial paralellelig and bisecting radiographic techniques, history, types, size, extraoral films, technical errors, radiographic examination in special children
Journal club- corona virus (COVID-19) 11th march 2020Dr. Ritu Gupta
this is the study presented on 11th march 2020, regarding corona outbreak, symptoms of corona, tests, incubation period,possible transmission routes in dental clinics, precautions, airborne spread, contact spread, control, patient evaluation, importance of hydrogen peroxide mouth rinse in covid 19 outbreak pandemic, disinfection of clinical setting,
this seminar includes information about various culture media and culture techniques with main focus on molecular diagnostic methods, recent advancements and studies to the process more quickly and correctly.
Article presentation: enamel repair with amorphous ceramicsDr. Ritu Gupta
this presentation simplifies and explains the mentioned article which describes newer technology for enamel repair, with this method regenerating enamel stronger and better than before
A look at the new toothbrush technologies seminarDr. Ritu Gupta
This seminar includes the newer technologies in toothbrushes, ADA specifications, brushing techniques, powered toothbrushes, amabrush, ufunbrush, unico smartbrush, hibrush, environment friendly brushes, genius 9000 and sonicare diamond clean smart etc.
Inflammation- General Pathology seminar PG 1st yearDr. Ritu Gupta
this seminar includes general inflammation, its etiology, acute inflammation, features, events, fate, chronic inflammation, causes, features, types, granulomatous inflammation, acute v/s chronic inflammation, inflammatory disorders of pulp and periradicular tissues
seminar briefly covers the oral findings and treatment related to hsv virus like erythema multiforme, SJS, Varicella zoster, epstein barr virus, infectious mononucleosis
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
3. • Most drugs can be administered by a variety of
routes.
• The choice of appropriate route in a given
situation depends both on drug as well as patient
related factors
• Mostly common sense considerations, feasibility
and convenience dictate the route to be used
• Routes can be broadly divided into
those for
a) local action b) systemic action
4. FACTORS GOVERNING CHOICE OF ROUTE
1. Physical and chemical properties of the drug (solid,
liquid, gas: solubility, stability, pH, irritancy)
2. Site of desired action - localized and approachable or
generalized and not approachable
3. Rate and extent of absorption of the drug from
different routes
4. Effect of digestive juices and first pass metabolism on
the drug
5. Rapidly with which the response is desired (routine
treatment or emergency)
6. Accuracy of dosage required (i.v. and inhalational can
provide fine tuning)
7. Condition of the patient (unconscious, vomiting)
7. LOCAL ROUTES
• These routes can only be used for localized
lesions at accessible sites and for drugs whose
systemic absorption from these sites is
minimal or absent
• Thus, high concentrations are attained at
desired site without exposing the rest of the
body
• Systemic side effects or toxicity are
consequently absent or minimal
8. • TOPICAL : refers to external application of the
drug to the surface for localized action
Oral cavity : as ointment or
jelly
e.g. 5% lignocaine hydrochloride
GI Tract : non absorbable drugs
given orally e.g. neomycin,
Vancomycin (for sterilization of
gut before surgery)
9. Bronchi :inhalation of
drugs e.g. salbutamol,
cromolyn sodium
Eye, ear, nose : as
drops, ointments and
sprays (for infection,
allergic conditions,
etc.) e.g. gentamicin
eye/ear drops
10. • DEEPER TISSUES
a) Certain deep areas can be
approached by using a
syringe and needle, but the
drug should be in such a
form that systemic
absorption is slow
•Infiltration around a
nerve or intrathecal
injection (lidocaine)
12. • ARTERIAL SUPPLY
1. Close intra arterial injection is used for contrast
media in angiography
2. Anti-cancer drugs can be infused in femoral or
brachial artery to localize the effect for limb
malignancies.
13. SYSTEMIC ROUTES
• The drug administered through systemic routes is
intended to be absorbed into the blood stream
and distributed all over, including the site of
action , through circulation
14. Vascular pathway of drugs absorbed from various systemic
routes of administration and sites of first pass metabolism
NOTE: Total drug absorbed
orally is subjected to first
pass metabolism in
intestinal wall and liver,
while approximately half of
that absorbed from rectum
passes through liver. Drug
entering from any systemic
route is exposed to first
pass metabolism in lungs,
but its extent is minor for
most drugs
15. 1. ORAL
• Oldest and commonest mode of drug
administration
• Safer, convenient, does not need assistance,
noninvasive , often painless and is cheaper
• Both solid dosage forms and liquid dosage forms
can be given orally
16. LIMITATIONS OF ORAL ROUTE
• Action of drugs is slower and thus not suitable for
emergencies
• Unpalatable drugs(chloramphenicol) are difficult to
administer; drug may be filled in capsules to
circumvent this
• May cause nausea and vomiting
• Cannot be used for uncooperative/ unconscious /
vomiting patient
• Absorption of the drug may not be variable and
erratic; certain drugs are not absorbed
(streptomycin)
• Others are destroyed by digestive juices (penicillin
G, insulin)or in liver (GTN, Testosterone, lidocaine)
17. 2. SUBLINGUAL / BUCCAL
• The tablet/pellet containing the drug is placed
under the tongue(sublingual) or between the gums
and cheek region (buccal mucosa).
• The drug absorbed through the sublingual/buccal
mucous membrane and enters the systemic
circulation directly through internal jugular veins(
systemic veins) rather than the portal veins thus
bypassing first pass metabolism
• Absorption is relatively rapid- action can be
produced within minutes
• Though, it is somewhat inconvenient, one can spit
the drug after the desired effect has been obtained
18.
19. • Liver is bypassed and drugs with
high first pass metabolism can be
absorbed directly into systemic
circulation
• Drug stability maintained because
the pH of saliva is relatively neutral
Advantages
• Only lipid soluble and non
irritating drugs can be so
administered
• May lose part of drug dose if
swallowed
Disadvantages
20. • Drugs given sublingually are GTN,
buprenorphine, desamino-oxytocin
21. 2010
Available for
Montelukast sodium to
treat asthms, alleric
conditions
Dodou K. Research and Development in buccal and sublingual drug delivery systems. The
Pharmaceutical Journal Apr 2018 : Vol 288 ; p446
2010
22. Dodou K. Research and Development in buccal and sublingual drug delivery systems. The
Pharmaceutical Journal Apr 2018 : Vol 288 ; p446
BEMA ( Bio-Erodible Mucoadhesive)
23. 3. RECTAL
• Certain irritant and unpleasant drugs
can be put into rectum as suppositories
or retention enema for systemic effect
• As an enema (administration of rectum
on liquid form)
- Evacuant enema (for evacuation of
bowel)
- Retention enema (for e.g. ,
methylprednisolone in ulcerative
colitis)
• As a suppository (administration of the
drug in a solid form into the rectum)
E.g. Glycerin for constipation
24. • ADVANTAGES:
1. Ideal if patient is having recurrent vomiting or is
unconscious
2. Partially bypasses first pass effect
3. Bypasses destruction by stomach acid
• DISADVANTAGES:
1. Inconvenient and embarrassing
2. Absorption is slower, irregular and often
unpredictable, though diazepam solution and
paracetamol suppository are rapidly and
dependably absorbed from the rectum in children
3. Rectal inflammation can result from irritant drugs
25. 4. INHALATION
• Volatile liquids and gases are given by inhalation for
systemic action e.g. general anesthesia
• Absorption takes place from the vast surface of
alveoli- action is very rapid
• When administration is discontinued the drug
diffuses back and is rapidly eliminated in expired air
• Thus, controlled administration is possible with
moment adjustment
• Disadvantage: irritant vapors (ether) cause
inflammation of respiratory tract and increase
secretion
26. GENERAL ANESTHESIA
METERED DOSE INHALER
Ibrahim M et al. Inhalation drug delivery devices : Technology Update. Med devices
(Auckl) 2015; 8: 131-139
27. 5. NASAL
• The mucous membrane of the nose can readily
absorb many drugs; digestive juices and liver are
bypassed
• However, only certain drugs like GnRH agonists,
calcitonin and desmopressin applied as a spray or
nebulized solution have been used by this route
• This route was tried for some other peptide drugs
like insulin, as well as to bypass the blood- brain
barrier
28. FDA APPROVED June 2014
Rapid acting inhaled insulin
Should be used prior to meals or within 20 min of starting meals
Not substitute for long acting insulin , has to be taken along with it for type 1 diabetes
29.
30. • eFlow®rapid Nebuliser System
• Modern inhalation therapy –
twice as fast 1
• eFlow®rapid Nebuliser System is an efficient device for the treatment of
respiratory diseases. During development, special care was taken to develop an
efficient, safe and fast inhalation treatment with the following characteristics:
• Short inhalation times
• Silent operation for discreet use
• Light, small, mobile – with mains or battery operation
• Easy to clean, can be disinfected – offers a high degree of hygienic safety
• Display provides feedback during inhalation
31. 6. CUTANEOUS
• Highly, lipid soluble drugs can be applied over the
skin for slow and prolonged absorption
• The liver is also bypassed
• The drug can be incorporated in an ointment and
applied over specified area of skin
• Absorption of the drug can be enhanced by rubbing
the preparation , by using an oily base and by an
occlusive dressing
32. TRANSDERMAL THERAPEUTIC SYSTEMS (TTS)
• These are devices in the form of adhesive
patches of various shapes and sizes (5-20 sq
cm)which deliver the contained drug at a
constant rate into systemic circulation via the
stratum corneum
• Sites of application : chest, abdomen, upper arm,
lower arm, buttock or mastoid region
(if mild local irritation, erythema occurs; can b
minimized by changing the site of application each
time by rotation)
• For different drugs, TTS have been designed to
last for 1-3 days
33.
34. • Transdermal patches of GTN, fentanyl, nicotine ,
estradiol are available in India
• Isosorbide dinitrate, hyoscine and clonidine are
marketed elsewhere
• Advantages :
1. TTS provide smooth plasma concentrations of the
drug without fluctuations
2. Minimize inter-individual variations (drug is
subjected to little first pass metabolism) and side
effects
3. More convenient
4. Patient compliance is better
• Disadvantage : expensive
35. Special Drug –Delivery Systems
• Intraoral lignocaine patch : patch containing
lignocaine is used to anaesthetize the oral
mucosa (DentiPatch®)
Hersh EV, Houpt MI, Cooper SA, Feldman RS, Wolff MS, Levin LM. Analgesic efficacy and
safety of an intraoral lidocaine patch. J Am Dent Assoc 1996;127:1626-34.
36. 7. PARENTERAL
(Par- beyond, enteral- intestinal)
• Refers to administration by injection which takes the
drug directly into tissue fluid or blood without having
to cross the enteral mucosa
• Advantages:
1. Faster and surer drug action(valuable in
emergencies)
2. Gastric irritation and vomiting are not provoked
3. Can be employed even in unconscious ,
uncooperative or vomiting patient
4. No chances of interference by food or digestive
juices
5. Liver is bypassed
37. • Disadvantages :
1. The preparation has to be sterilized and is
costlier
2. Technique is invasive and painful
3. Assistance of another person is mostly needed
(though self injection is possible, e.g. insulin by
diabetics)
4. Chances of local tissue injury
5. In general, parenteral route more risky than oral
38.
39. i) Intramuscular (i.m.)
• Drug is injected in one of the large skelatal
muscles- deltoid ,triceps, gluteus maximus, rectus
femoris, etc.
• Muscle is less richly supplied with sensory nerves
(mild irritants can be injected) and is more
vascular (absorption of drugs in aqueous solution
is faster)
• Less painful
• Depot preparations (oily solutions,
aqueous suspensions ) can be
injected by this route.
41. ii) Subcutaneous (s.c.)
• Drug is deposited in the loose subcutaneous
tissue which is richly supplied by nerves (irritant
drugs cannot be injected) but is less vascular
(absorption is slower than i.m.)
• Only small volumes can be injected
• Self injection is possible
• Repository(depot) preparations that are aqueous
suspensions can be injected for prolonged action
This route should be avoided in shock patients
who are vasoconstricted – absorption will be
delayed
42. Special forms of s.c. route
DERMOJET :
• Needle not used
• High velocity jet of drug solution
is projected from microfine
orifice using a gun like
implement
• Painless
• Suited for mass inoculations
PELLET IMPLANTATION :
• Drug in form of solid pellet is
introduced with a trochar and
canula
• Provides sustained release of
drug over weeks and months
• e.g. DOCA(Deoxy corticosterone
acetate), testosterone
43.
44. SIALISTIC (NON-BIODEGRADABLE)
AND BIO-DEGRADABLE IMPLANTS
• Crystalline drug is packed in
tubes or capsules made of
suitable materials and
implanted under the skin
• Slow and uniform leeching of
drug over months providing
constant blood levels
• Tried for hormones and
contraceptives ( e.g.
NORPLANT)
45. iii) Intravenous (i.v.)
• Drug is injected as bolus or infused slowly over
hours in one of the superficial veins
• Advantages :
1. Drug reaches directly into the blood stream and
effects are produced immediately (great value in
emergency)
2. Intima of veins is insensitive and drug gets
diluted with blood, therefore, even highly
irritant drugs can be injected
3. Dose of drug required is smallest (bioavailability
is 100%) and even large volumes can be infused
46. • Disadvantages:
1. Thrombophlebitis of injected vein and necrosis
of adjoining tissues if extravasation occurs
[these complications can be minimized by
diluting the drug or injecting it into a running i.v.
line]
2. Chances of causing air embolism
3. Most risky route, vital organs like
heart, brain, etc. get exposed
to high concentrations
of the drug
48. iv) Intradermal injection
• Drug is injected into the skin raising a bleb
(e.g. BCG vaccine , sensitivity testing) or
scarring/ multiple puncture of the epidermis
through a drop of drug is done.
• This route is employed for specific purposes
only
49.
50. REFERENCES
• Rang et al . Pharmacology. 5th edition . Noida (India) : Elsevier Science
Limited ; 2005
• Tripathi KD. Essentials of Medical Pharmacology. 8/e. New Delhi
(India) : Jaypee Brothers Medical Publishers (P) Ltd; 2019
• Dhikav V et al. Pharmacology for Dental Students. 1st edition. Delhi :
AITBS Publishers and Distributors (Regd) ; 2003
• Dodou K. Research and Development in buccal and sublingual drug
delivery systems. The Pharmaceutical Journal Apr 2018 : Vol 288 ;
p446
• Ibrahim M et al. Inhalation drug delivery devices : Technology Update.
Med devices (Auckl) 2015; 8: 131-139
• Hersh EV, Houpt MI, Cooper SA, Feldman RS, Wolff MS, Levin LM.
Analgesic efficacy and safety of an intraoral lidocaine patch. J Am Dent
Assoc 1996;127:1626-34.