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ORAL
ADVANTAGES simplest route from a patients point of view if properly used, it is the safest economical self administered
ORAL
DISADVANTAGES o slow onset of action o variable absorption o destroyed by enzymes, gastric acidity, secretions in the GIT o subject to presystemic metabolism first pass) o cause gastric irritation o needs cooperation of patient
ORAL
o drug solubility may be altered by presence of other substances in the GIT
(e.g. calcium)
General Considerations
more lipid soluble the drug, better absorbed in the gut, more widely distributed in the body weak acids = best absorbed in the stomach weak bases = best absorbed in the intestine most drug absorption = proximal duodenum
General Considerations
absorption is a dynamic process most drugs are sufficiently water soluble to be carried away by blood extremely lipid-soluble cpds enter the lymphatics
intestine
enter
liver
pass through
Systemic circulation
BUCCAL
Sites for absorption: 1. Sublingual under the tongue
fast onset of action; short duration
2. Buccal buccal sulcus (area between the upper lip and gum)
quick onset of action; longer duration
BUCCAL - advantages
relatively quick onset of action absorbed into systemic circulation; avoiding first pass may be administered to unconscious patients
RECTAL
liquids, solid, semi-solid dosage forms inserted into the rectum
middle & inferior rectal veins = systemic circulation upper rectal vein = portal system to the liver
RECTAL - advantages
oral route is unsuitable drug causes GI irritation use for local action
RECTAL - disadvantages
o irregular & unpredictable absorption = variable effect o less convenient o low patient acceptability
VAGINAL
tablet, capsule, solution, spray, cream, ointment, foam most often used for local effect not subject to first pass effect
INHALATION
through the nose or mouth delivered directly to the site of action small dose required to produce desired effect rapid drug absorption
NASAL
traditionally used for local effects recently used for systemic action due to good vascular supply avoids first pass has enzymatic activity solution, spray
TOPICAL
site of action = skin for local effects liquid, powder dosage forms may produce a systemic effect avoids first pass
PARENTERAL
Regarded in practice as dosage forms implanted, injected, infused directly into vessels, tissues, tissue spaces or body compartments
PARENTERAL
drugs given by injection drugs cannot be given orally
Intolerance Instability Poor absorption
may be given to unconscious patients produce localized or systemic effect may produce a rapid effect
PARENTERAL - routes
PARENTERAL - routes
INTRAVENOUS directly into the systemic circulation rapid absorption accurately controlled drug levels suitable for large volumes good for irritant drugs
PARENTERAL - routes
INTRAVENOUS most dangerous route drugs must be in aqueous soln performed slowly cannot be removed
PARENTERAL - routes
SUBCUTANEOUS easiest & less painful to administer injected into loose connective & adipose tissue
Abdomen Upper back Upper arms Lateral upper hips
PARENTERAL - routes
SUBCUTANEOUS slow & continuous absorption is required drug must be isotonic & at physiological pH drug distribution is affected by
Site of administration Age Degree of massaging of injection site
PARENTERAL - routes
INTRAMUSCULAR injected into muscle layers produce fairly fast onset of action when in aqueous solution slower & more prolonged action when in suspension or oily vehicle
PARENTERAL - routes
INTRAARTERIAL - artery INTRAARTICULAR joint INTRAPLEURAL - pleural cavity INTRASYNOVIAL - joint fluid area