Routes of Administration Tehseen

8/10/2019 Routes of Administration Tehseen

1/85

ROUTES OFADMINISTRATION

OF

DRUGSDR.LUBNA ASGHAR


2/85

THESE ARE THE POSSIBLE ROUTES OFENTRY OF DRUG INTO THE BODY

HOW THE DRUGS ARE INTRODUCEDINTO THE BODY


3/85

Drugs are given by varius ru!es "a#$inis!ra!in %Ora&' in!ravenus an#

in(a&a!in)


4/85

ROUTES OF DRUG DELIVERY

Parenteral(IV)

Inhaled

Oral

Transdermal

Rectal

Topical

Parenteral

(S! I")


5/85

CO**ENEST ROUTE OF

AD*INISTRATION IS ORAL% +,- OFTHE DRUGS ARE GI.EN THROUGH

THIS ROUTE)


6/85

DRUG DELIVERYDrugs are #e&ivere# in varie!y " #sage

"r$s' in/&u#ing0

12 Tab&e!s' Ca3su&es

42 S&u!ins' sus3ensins' #r3s52 *#i6e# re&ease !ab&e!s7/n!r&&e#

re&ease !ab&e!s %designed to produceslow, uniform absorption of the drug

for 8 hours or longer)82 En!eri/ /a!e# !ab&e!s%e.g.: Enteric

coatings is helpful for drugs such asaspirin that can cause signicant gastricirritation.)


7/85

12 In9e/!ab&e s&u!ins

42 Oin!$en!s' /rea$s

52 Su33si!ries' Ene$as

82 In(a&ers


8/85

*ODIFIED DRUG RELEASETABLETS

T re#u/e"re:uen/y "#sing

Fr #rugs ;i!(s(r!er (a&"&ives< 8 (urs

T (ave be!!er3a!ien!

/$3&ain/e.


9/85

DRUGS MUST BE IN APPROPRIATEDOSAGE FORM FOR THE PARTICULAR

ROUTE

As a s&u!in "r I2.2 in9e/!ins

Fr$u&a!ins &i=e !ab&e!s' /a3su&es'

s&u!in > sus3ensins' are #esigne#"r a#$inis!ra!in via GIT

Oin!$en!s > /rea$s "r a33&i/a!in !s=in

.&a!i&e &i:ui#s > gases "r in(a&a!inru!e

As #r3s "r ins!i&&a!in in! eye' ear >nse e!/2


10/85

T(ere are severa& reasns "r a#3!ing #i?eren!

ru!es " a#$inis!ra!in in /&ini/a& $e#i/ine

Fr /nvenien/e %eg' ra&)

T $a@i$ie /n/en!ra!in a! !(e si!e " a/!inan# $ini$ie i! e&se;(ere %eg2 In(a&a!ina&'!3i/a& ru!es)

T 3r&ng !(e #ura!in " #rug absr3!in %e2g2!rans#er$a&)' r ! avi# !(e 6rs!3asse?e/!%sub&ingua&)


11/85

THE CHOICE OF THE ROUTE OFADMINISTRATION OF DRUGS DEPENDS

UPON THE

Properties of the drug su/( as0

Wa!er r &i3i# s&ubi&i!y' #egree " inia!in' 3a " !(e

#rug e2g2 a$ing&y/si#es

Dsage "r$0 s&i#' &i:ui#' gas e!/2

S!abi&i!y " !(e #rug e2g2 e?e/! " #iges!ive 9ui/es > 6rs!

3ass $e!ab&is$ n !(e #rug e2g2 ni!rg&y/erine )


12/85

Therpeuti! o"#e!ti$es "r e@a$3&e0

Nee# " a ra3i# nse! " a/!in

%e$ergen/y si!ua!ins)

Nee# "r &ng!er$a#$inis!ra!in% Diabe!es *e&&i!us2 HTN)

Res!ri/!in ! a &/a& si!e % &ung' s=in)


13/85

Co%ditio% of the ptie%t&%un/ns/ius r v$i!ing) I2.2A#$inis!ra!in is 3re"erre#' re/!a&

ru!e es3e/ia&&y in /(iren2

'he% A!!ur!( of the dosere)uired e2g2 I2.2 > In(a&a!in ru!es3rvi#e 6ne !uning

e2g2 Cri!i/a&&y i&& 3a!ien!s


14/85

T*PES OF ROUTES OF DRUGADMINISTRATION

The possi"+e routes ofd,i%istrtio% re

di$ided "rod+( i%to three

!+sses&

-. ENTERAL

/. PARENTERAL0. TOPICAL


15/85

ENTERAL ROUTE

a) ,raL

b) Sub&ingua&7Bu//a&

/) Re/!a&


16/85

TOPICAL ROUTE

12 In(a&a!in

42 L/a& A33&i/a!in On S=in >

$u/us$e$branes

52 Ins!i&&a!in in %Ear' Nse' Eye)

82 Trans#er$a& Pa!/(


17/85

PARENTERAL ROUTES In!ravas/u&arIn!ravenus' In!ra

ar!eria&

In!ra/u!aneus7In!ra#er$a&

In!ra$us/u&ar Sub/u!aneus

In!raar!eria&

In!ra/ar#ia/ In!ra!(e/a&7 In!ra/is!erna&7E3i#ura&


18/85

PARENTERAL ROUTES

In!ra/ar#ia/ In!rasseus7In9e/!in In! T(e

Bne *arr; In!ra3&eura& In!ra3eri!nea&

In!raar!i/u&ar Sub/n9un/!iva& In!ra/u&ar In!ravi!rea&


19/85

PARETERAL ROUTES


20/85


21/85

INTRAOSSEOUS


22/85


23/85

12 Drugs en!er !(e b#y a! si!es re$!e "r$ !(e!arge! !issue r rgan2

42 T(ey are nee#e# ! be !rans3r!e# ! !(eir

in!en#e# si!e " a/!in2

52 A&& #rugs are absrbe# in! !(e b "r$ i!ssi!e " a#$inis!ra!in

%e@/e3! "r. Drugs ;(i/( are #esigne# ! a/! &/a&&y

%!3i/a&&y) ) r

. Drugs !(se #ire/!&y in9e/!e# in! !(e bs!rea$% I2.2 ru!e)


24/85

12 T(e ra!e an# e@!en! " absr3!in is#i?eren! "r #i?eren! ru!es "a#$inis!ra!in " #rugs2

42 T(e ra!e " absr3!in is #e!er$ine# by!(e si!e " a#$inis!ra!in an# !(e #rug"r$u&a!in2

52 B!( !(e ra!e an# !(e e@!en! " absr3!in/an inuen/e !(e 3&as$a /n/en!ra!in "!(e #rug i2e2 biavai&abi&i!y > /&ini/a&e?e/!iveness " a #rug2


25/85

12 Biavai&abi&i!y " !(e #rug is !(ere"rea&s n! sa$e "r !(e varius ru!es

Bio$i+"i+it( is #e6ne# as !(e"ra/!in " un/(ange# #rug rea/(ing!(e sys!e$i/ /ir/u&a!in "&&;inga#$inis!ra!in by any ru!e2

Ru!es " A#$inis!ra!in Biavai&abi&i!y an# Genera&


26/85

Route Bioavailability (%) Chaa!tei"ti!"

Intravenous (IV) 100 (by definition) Most rapid onset

Intramuscular (IM) 75 to 100 Large volumes often feasible

may be painful

!ubcutaneous (!") 75 to 100 !maller volumes t#an IM maybe painful

$ral (%$) 5 to & 100 Most convenient first'pass

effect may be significant

ectal (%) 0 to & 100 Less first'pass effect t#an oral

In#alation 5 to & 100 $ften very rapid onset

*ransdermal +0 to 100 ,sually very slo- absorption

used for lac. of first'pass

effect prolonged duration of

action

Ru!es " A#$inis!ra!in' Biavai&abi&i!y' an# Genera&C(ara/!eris!i/s2


27/85

ORAL ROUTE*s! #rugs are !a=en by $u!( an#

s;a&&;e#+,-

Li!!&e absr3!in //urs un!i& !(e #rugen!ers !(e s$a&& in!es!ine

Wea= a/i#s an# bases are ;e&&absrbe# s!rng a/i#s an# bases are

3r&y absrbe#2AD1ANTAGESo C$$nes! ' C(ea3es!

Na!ura& Ru!e


28/85

ABSORPTION %Ta=es 3&a/e a&ng !(e;(&e &eng!( " !(e GI !ra/!)

Easy an# sa"e ru!e "r se&"

a#$inis!ra!in " !(e #rug


29/85

DISAD1ANTAGES A"sorptio%2222variab&e' s&;er an#

&ess /$3&e!e as /$3are# ! !(er3aren!era& ru!es2

O%+( 345 of drug!a=en ra&&y isabsrbe# in 15 (rs2 e2g2 On&y ,- " a#se " #ig@in rea/(es !(e sys!e$i/

/ir/u&a!in2

Bio$i+"i+it( < 1,,- i2e2 J-"r !; $ain reasns


30/85

REASO#S $OR REDUCEDBIOAVAILABILITY

In/$3&e!e e@!en! " absr3!in

Firs! 3ass e?e/!


31/85

FACTORS AFFECTING DRUG ABSORPTION

Sur"a/e area "r absr3!in %4,, $e!er s:uareIn!es!ine)

B ; ! !(e si!e " absr3!in

T(e 3(ysi/a& s!a!e " !(e #rug %s&u!in' sus3ensin' rs&i# #sage "r$)

I!s ;a!er s&ubi&i!y' an# /n/en!ra!in a! !(e si!e "absr3!in2Degree " inia!in " a #rug A$ing&y/si#es% s!re3!$y/in 'ne$y/in I2*2 Pu&$nary T2B)


32/85

L/a& a/!in gu! s!eri&ia!in 3rir! gu! surgery r #iagns!i/3r/e#ures2

Su!( A$eri/an In#ians use# Arr;3isn Curare

Kuara!nery A$$niu$ /$3un#s

s!rng bases Pr&y absrbe# "r$ !(e GIT


33/85

PH*SIOLOGICAL FACTORS OFTHE GUT&

Diarr(ea De/rease Cn!a/! !i$eS(/= De/rease in S3&an/(ni/

b ;Cnges!ive Car#ia/

Fai&ure%CCF)O#e$a " gas!ri/$u/sa

*igraine ' Diabe!i/ neur3a!(yGas!ri/ s!asis


34/85

Re$erse drug tr%sporter&3g&y/3r!ein

%gu! ;a&&)

Drugs ,( "e irrit%t to gstri!,u!os2nausea >v$i!ing e2G2 Can/er/(e$!(era3y

So,e drugs 6ith o"#e!tio%"+e tste7odour e.G. 8ui%i%e

Dis!o+ortio% of teethirn $i@!ures


35/85

NOT PRACTICABLE ROA

Un/ns/ius

Un/3era!ive 3a!ien!s > E$ergen/y si!ua!in


36/85

FIRST PASS EFFECT ORFIRST PASS ELIMINATION

DRUGS ABSORBED ORALL* AREINITIALL* TRANSPORTED TO THE LI1ER

1IA THE PORTAL 1EIN

E@!ensive $e!ab&is$ " s$e #rugsre#u/e biavai&abi&i!y " !(a! #rug e2g2

Ni!rg&y/erine %,-) %a/u!e a!!a/= "angina 3e/!ris)

Is3rena&ine


37/85

FIRST PASS EFFECT ALSOINCLUDE

GUT $ACTORS GASTRIC PH M4

DESTROY PENCILLIN G

GUT ENY*E %%CYP5A8 eny$e sys!e$)

*ETABOLIE INSULIN

CO*T ENY*E CATECHOLA*INES

ADRENALINE' NORADRENALINE

Tetr!(!+i%ebin#s s!rng&y ! Ca4' an# /a&/iu$ri/( "#s%es3e/ia&&y $i&=) 3reven! i!s absr3!in2

Bi+e !id2"i%di%g resi%s su/( as !o+est(r,i%e

Trea!$en! " (y3erC(&es!er&ae$ia

Bin# severa& #rugs' "r e@a$3&e 6rfri% an# th(ro9i%e.


38/85

TO A1OID FIRST PASS EFFECT 'EHA1E TO ADOPT ANOTHER OTHER

ROA

12 Sub&ingua& Ru!e

42 Re/!a&

52 Trans#er$a&82 In(a&a!in


39/85

BUCCAL 7 SUBLINGUAL:ROUTE

Sub&ingua& absr3!in 3rvi#es #ire/!a//ess ! sys!e$i/ /ir/u&a!in !(rug(sub&ingua& veins in! !(e su3erir vena /ava

By 3asses e@3sure ! gu!%3H' eny$es) >i$$e#ia!e e@3sure ! !(e &iver !(rug(3r!a& veins2

Drug e2g2 !ab&e!' #r3s

T(is ru!e is use"u& "r #rugs !(a! are3!en!' &i3i# s&ub&e an# (ave a//e3!ab&e!as!e2

;Onl# a $e% molec&les are needed to 'e a'sor'ed toprod&ce therape&tic e$$ect


40/85

Un#er !(e !ngue

Diss&ve in sa&iva

Li3i# s&ub&e #rugs3ass !(rug(

$u/us $e$brane E@a$3&e " #rugs0 Ni!rg&y/erine'

Is3rena&ine' O@y!/in e!/2


41/85

AD1ANTAGES N! e?e/!e# by GIT eny$es

N 6rs! 3ass e?e/!

Absr3!in is very :ui/=

E@/ess " #rug /an be re$ve# Bys3i!!ing r s;a&&;ing !(e re$aining!ab&e!


42/85

DISADVA#TAGES *ay be irri!a!e $u/sa " !(e $u!(

E@/essive sa&iva!in $ay 3r$!es;a&&;ing

BUCCAL ROUTE

In !(e 3u/( be!;een !(e gu$s an#/(ee=

O?ers sa$e "ea!ures as !(e sub&ingua&ru!e


43/85

RECTAL ROUTEDrugs given 3er re/!u$

Drugs $ay be0 S&i# Su33si!ryLi:ui# Ene$a

-. For +o!+ !tio%&. T re&ieve /ns!i3a!in e2g2 G&y/erine

su33si!ries%3aran ;a@ > a/!iveingre#ien!)

. An!iina$$a!ry #rugs "r use in

u&/era!ive /&i!is-. For s(ste,i! !tio%0

A$in3(y&&ine In#$e!(a/in a/e!a$in3(in


44/85

AD1ANTAGESPar!ia& avi#an/e " 6rs! 3ass e?e/!Q

J,-

Absr3!in is s&;er !(an "r$ s$a&&in!es!ineN vi&&i > &ess sur"a/e area

I! /an be use# in0 Un/ns/ius'un/3era!ive

I" ra& ru!e /ann! be use# i2e2 3a!ien!s;( are v$i!ing%an!ie$e!i/ #rugs areusua&&y given !(rug( !(is ru!e)


45/85

ADVA#TAGESDrugs ;i!( un3&easan! !as!e are

be!!er a#$inis!ere# re/!a&&y

I! is use# ! a#$inis!er di


46/85

ADVA#TAGES Preven! !(e #es!ru/!in " !(e #rug by

in!es!ina& eny$es r by &; 3H in !(es!$a/(2

T(e re/!a& ru!e is use"u& i" !(e #rugin#u/es v$i!ing ;(en given ra&&y r i"!(e 3a!ien! is a&rea#y v$i!ing2

N!e0 T(e re/!a& ru!e a&s is /$$n&yuse# ! a#$inis!er an!ie$e!i/ agen!s2


47/85

DISAD1ANTAGES

N! a ru!ine&y use# ru!e

Irregu&ar an# in/$3&e!e absr3!in

*any #rugs $ay /ause irri!a!in " re/!a& $u/sa

Cu be e$barrassing "r !(e 3a!ien!

E@a$3&es " #rugs given P7R0

G&y/erin Su33si!ry ! re&ieve /ns!i3a!in

Ana&gesi/s 7 An!i3yre!i/s

Bariu$ Ene$a


48/85

INHALATION ROUTE T(is ru!e ?ers ra3i# > $a@i$u$ #e&ivery

" #rug ! !(e !arge! rgan i2e2 &ung

Larger sur"a/e area

Ri/( b su33&y

3r#u/ing an e?e/! a&$s! as ra3i#&y as byin!ravenus in9e/!in2

In !(e /ase " res3ira!ry #iseases0

Trea!$en! " Brn/(ia& As!($a% 4agnis! > /r!i/s!eri# in(a&ers)


49/85

In(a&a!ina& Anes!(e!i/s7Drugs use#"r genera& anes!(esia

Gases0 N 4O'

%Ni!rus @i#e' ) .&a!i&e &i:ui#s %e!(er' (a&!(ane)

O 4 "r (y3@e$ia

A$y& ni!ri!e "r /rnaryvas#i&a!a!in in angina 3e/!ris2


50/85

Nn v&a!i&e 6ne 3ar!i/&es " #rugs are3re3are# as in(a&er S3rays > Nebu&iers2

Drug 3ar!i/&es are usua&&y sus3en#e# r

#iss&ve# in ;a!er an# are in(a&e#2

Aeroso+s are "r$e# ;(en a #rug s&u!in r$i/rnie# 3;#er is /nver!e# in! a $is! r#us!' res3e/!ive&y2

In /nven!ina& s3rays %e. g.= %e"u+i


51/85

T(e sie " !(e aers& 3ar!i/&es #e!er$ines

!(e s3ee# a! ;(i/( !(ey are s;e3!

A Par!i/&es 1,, V$ in #ia$e!er are !ra33e#

in !(e r3(aryngea& /avi!y2

T(se (aving 1, an# , V$ ;i&& be #e3si!e#n !(e e3i!(e&iu$ " !(e brn/(ia& !ra/!2

Par!i/&es < 4 V$ in #ia$e!er /an rea/(

T(e a&ve&i2


52/85

AD1ANTAGES I$$e#ia!e a/!in

Ra3i# absr3!in r absr3!in in n!i$e

Larger a&ve&ar e3i!(e&iu$ sur"a/e areaRi/( b su33&y

Pr#u/e $a@i$u$ #e&ivery " #rug&/a&&y in &ung ;(ereas $ini$iing

sys!e$i/ si#e e?e/!s2


53/85

E@a$3&e0

G&u//r!i/i#s

Be/&$e!(asne #i3r3ina!e' Bu#esni#e

F&unis&i#e' an# u!i/asne #i3r3ina!e

Xagnis!s su/( as sa&bu!a$& an#

"en!er&2


54/85

FOR"S OF PUL"O*RY DELIVERY+

"etered dose inhaler

Dr# po%der inhalers

e'&li,er


55/85

METERED DOSE INHALERS A #rug $ay be #e&ivere#

"r$ a s&u!in r

3;#er 3a/=age# in a

3ressurie# /anis!er

e:ui33e# ;i!( a va&ve

!(rug( ;(i/( a $e!ere#

#se is #is/(arge#2

*s! /$$n #e&ivery

sys!e$ in !rea!$en! "

Brn/(ia& as!($a

T h i $ $ "DI d i


56/85

Techni-&es $or &se o$ "DI de.ices+

T%o $in/er%idth

$rom mo&th

Use o$ space orholdin/ cham'er

Placement o$inhaler in

mo&th

(not $or &se

%ithsteroids)

Patient m&st

coordinate

inhalation and

act&ation o$ de.ice


57/85

DRY PO0DER I1*LERS (DPI)

2reath acti.ated

"icroni,ed dr&/ particles 'lended

%ith an e3cipient (e4/4! /l&cose or lactose)

Ph#sical properties o$ dr&/ and e3cipientcritical

(i4e4! particle si,e! shape! s&r$ace morpholo/#!

etc)

E2ULI5ER


58/85

E2ULI5ER

De.ice prod&ces small droplets $rom a s&spension or sol&tion

thro&/h an air 6et or &ltrasonic atomi,ation (-&ieter! '&t moree3pensi.e)


59/85

TRANSDER*AL ROUTET(e #rug is in/r3ra!e# in a s!i/=n

3a!/( a33&ie# ! an area " !(in s=in2

T(is ru!e is $s! "!en use# "r !(esus!aine# #e&ivery " #rugs' su/( as !(ean!iangina& #rug' ni!rg&y/erin2

Avi# 3resys!e$i/ $e!ab&is$2

&i3i#s&ub&e #rugs

Re&a!ive&y e@3ensive2


60/85

E>AMPLES OF DRUGS DELI1ERTHROUGH TRANSDERMAL ROUTE

The Ni!oti%e s=in 3a!/( are n; use# !re#u/e !(e ;i!(#ra;a& sy$3!$s !(a!a//$3any s!33ing s$=ing2

T(e s!opo+,i%es=in Pa!/( "r 3reven!in" $!in si/=ness2 /(rni/ severe 3ain

T(e fe%t%(+ s=in 3a!/( "r /(rni/ severe

3ain2

Estroge%"r (r$ne re3&a/e$en! areavai&ab&e in !(is "r$2


61/85

TOPICAL ROUTE ;(en a &/a& e?e/! n !(e s=in is re:uire#

%e2g2 !3i/a&&y a33&ie# s!eri#s "r /n!a/!#er$a!i!is' /&!ri$a&e /rea$ in#er$a!3(y!sis)2)2

*s! #rugs are absrbe# very 3r&y !(rug(unbr=en s=in2

Organ3(s3(rus /$3un# 3isning in"ar$ ;r=ers2

Ni/!ine

TRANSDERMAL


62/85

TRANSDERMALROUTE:CUTANEOUS

Absr3!in " #rugs #e3en#s u3n0

Sur"a/e area ver ;(i/( !(ey are a33&ie#

Li3i# s&ubi&i!y2

Trans#er$a& absr3!in /an be en(an/e#by0

Sus3en#ing !(e #rug in an i&y ve(i/&e

Rubbing Hy#ra!in " !(e s=in ;i!( an //&usive

#ressing $ay "a/i&i!a!e absr3!in2


63/85

Parenteral Ro&tes

PARENTERAL ADMINISTRATION


64/85

IS USED FOR

Dugs !(a! are 3r&y absrbe# "r$ !(egas!rin!es!ina& %GI) !ra/!

An agen!s su/( as insu&in !(a! areuns!ab&e in !(e GI !ra/!2

Un/ns/ius7un/3era!ive 3a!ien!s

Un#er /ir/u$s!an/es !(a! re:uire ara3i# nse! " a/!in2

I! 3rvi#es !(e $s! a//ura!e /n!r&ver !(e a/!ua& #se " #rug #e&ivere#! !(e b#y2

THE THREE MA?OR


65/85

THE THREE MA?ORPARENTERAL ROUTES ARE

1) In!ravas/u&arIn!ravenus r in!raar!eria&

4) In!ra$us/u&ar5) Sub/u!aneus

E!h hs its d$%tges %d

dr6"!@s


66/85

INTRA1ASCULAR

In!ravenus %I.) $s! /$$n

12 Fr #rugs !(a! are n! absrbe# ra&&y'!(ere is "!en n !(er /(i/e2

42 Firs!3ass $e!ab&is$ by !(e &iver /anbe avi#e#2

52 I! 3er$i!s a ra3i# e?e/! an# a $a@i$aegree " /n!r& ver !(e /ir/u&a!ing

&eve&s " !(e #rug282 I! is an invasive > #angerus

3r/e#ure2


67/85

12 I! Cann! be re$ve# by %bin#ing !a/!iva!e# /(ar/a&) gas!ri/ &avage re$esis

42 S3e/ia& Te/(ni:ue is re:uire#

52 S!ri/! ase3!i/ $easure nee#e# ! avi#sys!e$i/ in"e/!in

82 I! is use# un/ns/ius' un/3era!ive >/$a!se 3a!ien!s

J2 S&; I2. in9e/!in s(u be given1,$& in9e/!in ver 1, $inu!es


68/85

12 Irri!an! #rugs /an be given

42 Larger v&u$es /an be given e2g2 0in"usins ' TPR i2e2 T!a& 3aren!era&nu!ri!in

52 B Trans"usin

82 An!ibi!i/s e2g2 Peni/i&&in2Ce3(a&s3rins a$ing&y/si#es e!/2 '

genera& Anes!(e!i/s e2g2 3r3"&'!(i3en!a& s#iu$2


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INTRAMUSCULAR ROUTE Drugs a#$inis!ere# in!ra$us/u&ar&y /an be in A:ueus s&u!ins

S3e/ia&ie# #e3! 3re3ara!ins"!en a

Sus3ensin " #rug in a nna:ueus ve(i/&e'

su/( as e!(y&ene g&y/& r 3eanu! i&2

Absr3!in " #rugs

In a:ueus s&u!in is "as!

Fr$ #e3! 3re3ara!ins is s&;2

As the $ehi!+e diuses out of the ,us!+e= thedrug pre!ipittes t the site of i%#e!tio%.


70/85

T(e #rug !(en #iss&ves s&;&y'3rvi#ing a sus!aine# #se ver ane@!en#e# 3eri# " !i$e2

An e@a$3&e is sus!aine# re&ease(a&3eri#& #e/ana!e' *e#r@y3rges!erne' 3r/aine Pen/i&&in e!/2

S&; #i?usin "r$ !(e $us/&e

3r#u/es an e@!en#e# neur&e3!i/e?e/!2

*i irri!an! #rugs /an be given2

S$a&& v&u$es 4J $&


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SUBCUTANEOUS SC T(is ru!e " a#$inis!ra!in' &i=e !(a! " I*

in9e/!in' re:uires absr3!in >s$e;(a! s&;er !(an !(e I. ru!e2

Pre"ere# Si!e0 Ar$' !(ig( arun# !(eu$b&&i/us

SC in9e/!in $ini$ies !(e ris=s

ass/ia!e# ;i!( in!ravas/u&ar in9e/!in2

Nor2p+%ts0 Si&as!i/ /a3su&es /n!aining!(e /n!ra/e3!ive &evnrges!re&


72/85

Pro2gr,,"+e ,e!h%i!+ pu,ps!(a! /an be i$3&an!e# ! #e&iver insu&inin s$e #iabe!i/s2

Drugs given0 (e3arin' insu&in' a#rena&ine


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I#TRA#ASAL ROUTE Des$3ressin is a#$inis!ere#

in!ranasa&&y in !(e !rea!$en! "#iabe!es insi3i#us

Ca&/i!nin' a 3e3!i#e (r$ne use#in !(e !rea!$en! " " s!e3rsis2

T(e abuse# #rug' //aine' isgenera&&y !a=en by sning2


74/85

INTRADERMAL ROUTE %In! !(e s=in i!se&") is use# "r s=in !es!ing

s$e a&&ergens

Drug se%siti$it( teste2g2 Pen/i&&in

,2,1,24 /2/2 ui# ;i!( 1/2/2 sriynge

M%tou9 test "r Tuber/u&sis

Di!@ test"r #i3!(eria

Shi!@ test "r s/ar&e! "ever


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OTER ROUTES I&ta've"i!alinfusion is into the urinary

bladder.

I&ta'utei&e

Therapeutic Abortion, yoectoy

!UD "for contraception is iplanted

I&ta'vai&al # tablets for the induction ofthe labour containin$ %G&' ( %G)'*

Ru!es " A#$inis!ra!in' Biavai&abi&i!y' an# Genera&C(ara/!eris!i/s


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Route Bioavailability (%) Chaa!tei"ti!"

Intravenous (IV) 100 (by definition) Most rapid onset

Intramuscular (IM) 75 to 100 Large volumes often feasible

may be painful

!ubcutaneous (!") 75 to 100 !maller volumes t#an IM maybe painful

$ral (%$) 5 to & 100 Most convenient first'pass

effect may be significant

ectal (%) 0 to & 100 Less first'pass effect t#an oral

In#alation 5 to & 100 $ften very rapid onset

*ransdermal +0 to 100 ,sually very slo- absorption

used for lac. of first'pass

effect prolonged duration of

action

C(ara/!eris!i/s2


77/85

I#TRATECAL ROUTE

In9e/!in " a #rug in! !(e subara/(ni#s3a/e via a &u$bar 3un/!ure nee#&e is use#"r s$e s3e/ia&ie# 3ur3ses2

A. Dig%osti!0 S3ina& !a37 LP /y!&gi/a& >Bi/(e$i/a& ana&ysis " CSF in varius/n#i!in $eningi!is' as a ru!ine in

/(iren ;i!( 3yre@ia " un=n;n rigin'subara/(ni# (e$rr(age'


78/85

Lube Pu&!tue Lube Pu&!tue


79/85

A. Therpeuti!&

.T by3ass !(e b brain barrier2

.S$a&&er #ses ' &esser sys!e$i/ si#e e?e/!s

.T(e 6rs! &u$bar 3un/!ure ;as #ne in 1++J

! a#$inis!er //aine "r anes!(esia2

2


80/85

For %esthesi %d !utepostoperti$e pi% ,%ge,e%t=#rugs are usua&&y a#$inis!ere# by &u$bar3un/!ure2

For !hro%i! pi% ,%ge,e%t' s3e/iaevi/es' in/&u#ing 3u$3s' are use#2

Methotre9te/(i(#&eu=ae$ias ! 3reven! re&a3se in !(eCNS2


81/85

Regina& anaes!(esia7S3ina& anes!(esia&/a& anaes!(e!i/ su/( as "upi$!i%e

Opite ana&gesi/s "r /(rni/ 3ain2

B!+ofe%%a ga$$aa$inbu!yri/ a/i#%GABA) ana&gue' is use# ! !rea! #isab&ing$us/&e s3as$s


82/85


83/85

Te/(ni:ue0

T(e 3a!ien!s 3si!in

Le"! %r rig(!) &a!era& 3si!in ;i!( (is7(er

ne/= ben! in "u&& e@in an# =nees ben! in "u&&e@in u3 ! (is7(er /(es!

A33r@i$a!ing a "e!a& 3si!in as $u/( as

3ssib&e2

T(e area arun# !(e &;er ba/= is 3re3are#using ase3!i/ !e/(ni:ue


84/85

A s3ina& nee#&e is inser!e# be!;een!(e &u$bar ver!ebrae L57L8 r L87LJ

Ps! &u$bar 3un/!ure (ea#a/(es ;i!(nausea is /$$n


85/85

EPIDURAL ROUTEDrug is in9e/!e# abve !(e #ura$a!!er in

!(e bny s3ina& /ana& i2e2 e3i#ura&

In9e/!ing $e#i/a!in in! !(e e3i#ura&s3a/e is 3ri$ari&y 3er"r$e# "r ana&gesia2

Fr %+gesi +o%e%e2g2 in /(ibir!( isun&i=e&y ! /ause &ss " $us/&e 3;er'bu! is n! usua&&y su/ien! "r surgery)2

Documents

Routes of Administration Tehseen