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ROUTES OF ADMINISTRATION

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)

What affects GI absorption?


PHYSIOLOGICAL: volume & surface area
where is the major site of absorption?

food in the stomach transit time motility blood flow pH

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

First Pass Effect


Drug
absorption

intestine

enter

liver
pass through

hepatic portal vein

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

small volume (< 1mL)

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

SUBCUTANEOUS INJECTION SITES

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

INTRAMUSCULAR site of injection

PARENTERAL - routes
INTRAARTERIAL - artery INTRAARTICULAR joint INTRAPLEURAL - pleural cavity INTRASYNOVIAL - joint fluid area

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