Routes and Formulations

What are the four enteral route of administration?

Oral, sublingual, buccal, and rectal

At what temperature is oral suspensions at?

Room temperature

What are the routes of parenteral?

Intraocular, Intranasal, Dermal, Inhalation, Intravenous, Intradermal, Vaginal, Subcutaneous, & Intramuscular

Define this:

Occurs when the drug activity is at the site of administration

Local Effect

Define this:

Occurs when the drug is introduced into the circulatory system from the route of administration and carried by the blood to the site of activity

Systemic Effect

Define this:

Form is to be swallowed and that absorption will occur primarily from the stomach and the intestine

PO (per oral)

What is included as an oral dosage?

Solutions, suspensions, gels and emulsions

Define this:

Hard formulations in which the drug and other ingredients are machine compressed under high pressure into a shape. Sugar or film-coated

Tablets

Define this:

Contain the drug and the other ingredients packaged in gelatin shell

Capsules

Define this:

Contain active drug in small powder paper or foil envelope

Bulk Powder

Define this:

Alcoholic or hydroalcoholic solutions of volatile substances

Spirits

Define this:

Alcoholic or hydro-alcoholic solution of nonvolatile substances

Tinctures

Define this:

Can be formed into a homogenous mixture when an emulsifying agent is used. Mixture of oil and water; requires shaking

Emulsions

Define this:

Formulations in which the drug does not completely dissolve in the solvent. Particles are suspended in formulation.

Suspensions

Define this:

Concentrated or nearly saturated solution of sucrose in water

Syrups

Define this:

Clear, sweetened, hydroalcoholic liquids intended for oral use

Elixirs

Define this:

Tend to settle over time, leading to a lack of dose uniformity

Unpleasant oral texture

Disadvantageous of Suspensions

What is the best known sublingual tablet?

Nitroglycerin

Why are drugs administered via rectum?

Local effect or avoid degradation after oral administration

What are the most common administration dosage forms?

Suppositories, solutions, and ointments

Define this:

Semisolid dosage forms that dissolve or melt when inserted into the rectum

Suppositories

Why is parental route preferred?

Rapid drug response

Define this:

One is cost.

Skilled personal administration

Remove the dose if there is an adverse or toxic reaction

Disadvantages to giving Parenteral Routes

Define this:

Administered into top layer of skin at a slight angle using short needles

Intradermal

How long for intravenously administrated drugs to circulate throughout the body?

20 seconds

Define this:

The ease with which a suspension can be drawn from a container into a syringe

Syringeability

What does TPN (total parenteral nutrition) solution provide?

Triglycerides, fatty acids, and calories for patients

What are the complications that can occur from intravenous administration?

Thrombus formation, phlebitis, air emboli, and particulate material

Define this:

Used to inject formulations over a short period of time. Needle sized is based on route of administration.

Syringes

Define this:

Gradual intravenous injection of volume of fluid into a patient

Infusions

Define this:

Administration devices that are dependent upon gravity flow have a variable delivery rate

Infusion Pumps

Define this:

Useful for intermittent or very, slow continuous infusion. Balloon-like reservoirs filled with medications that is forced out of the reservoir through flow reservoir.

Elastomeric Pumps

Why are drugs given intramuscular?

Patients who are unable to take them by oral administration

Define this:

A suspension composed of particles up to a hundred times smaller than those in standard suspensions

Colloid

Define this:

A technique used for medications that stain the skin or irritate tissues.

Z-track Injection

What are the site of injections for intramuscular formulations?

Deltoid, Gluteus Medius, Ventrogluteal, Gluteus Maximus, and Vastus Lateralis

What is the most common drug routinely administrated via subcutaneous?

Insulin

Define this:

Long-term drug release is to place the drug in a delivery system or device inside the body

Implanted

Define this:

Raised, blister-like area on the skin caused by an intradermal injection

Wheal

What is the usual site of intradermal injections?

Surface of the forearm

What is the major problem of ophthalmic administration?

Immediate loss of a dose by natural spillage

What percentage is lost in the dosage during drug administration?

80%

What is the rate of tear production?

2 mL/per min

Define this:

The eyelid lining

Conjunctiva

What is the nasal cavity capacity?

20 mL

Define this:

A device that contains a drug that is vaporized by inhalation

Nasal Inhalers

What are three ways a dosage can be lost following nasal administration?

1. Enzymes that degrade some drugs

2. Mucus flow

3. Some amount of the drug is swallowed.

What are the most important drugs delivered through inhalation?

Gaseous or volatile anesthetics

What are most inhalation dosage forms?

MDI aerosols

Define this:

Devices that break up a liquid into a spray

Atomizers

Define this:

Contains an atomizing unit inside a chamber

Nebulizer

Define this:

The absorption of drugs through the skin, often for a systemic effect

Percutaneous AbsorptionW

What is the major disadvantage of dermal administration?

2 mg/hr

What are the disadvantages of vaginal administration?

Variable absorption, possible toxic shock, and expelled dosages

Define this:

A rare and potentially fatal diseases that results from a severe bacterial infection of blood.

Toxic Shock Syndrome

What are three T-shaped IUDs?

Liletta, Skyla and Mirena

What is the primary goal of modified release drugs?

Reduce the number of doses a patients must take per day

How is intramuscular injection different?

Lower but longer lasting blood concentration

Which dosage form is appropriate for a vomiting patient?

Rectal and IV

What route bypasses first-pass metabolism?

Sublingual, IV, transdermal

Which form should never be crushed?

ER, XR, SR tablets

What is not true about intranasal and inhalation administration?

Subjects the active drugs to degradation in the gastrointestinal tract

What are two reasons to use parenteral route administration?

1. A drug has extensive first pass metabolism

2. A rapid drug response is desired

3. The patient is uncooperative or unconscious

What is the fastest to slowest IM administration?

Aqueous solutions > oleaginous solution > colloids > suspensions

What is the fastest to slowest IV administration?

IV Push (emergencies) > IV Piggyback (antibiotics) > Continuous IV fusion (fluids & long-term meds)

What is the primary reason to use in vaginal applicator is to?

Place the formulation high in vaginal tract

A dissolution step would not be necessary for drug absorption from?

Oral Syrup

What do non-solutions typically contain?

Glycerin, alcohol, and propylene glycol

The average drop size from an eye dropper is _ mL?

50 uL

Define this:

Drug administered over a short period (IV)

Bolus IV or IVP

Define this:

Drug administered to the patient over hours or day by continues drip or infusion

Continuous IV infusion

Define this:

Small volume of IV medicine given in addition to an IV infusion; ‘piggybacking’ through the primary IV line

IV piggyback

Define this:

Where digestive and liver (hepatic) enzymes transform and metabolize the drug into another product, often a product that loses its original clinical utility.

First-Pass Effect