CHAPTER 5

Oral

Mouth

Peroral (per os)

Gastrointestinal tract via mouth

Sublingual

under the tongue

Parenteral

other than the gastrointestinal tract (by injection)

Intravenous

vein

Intra-arterial

artery

intracardiac

heart

intraspinal or intrathecal

spine

intraosseous

bone

intra-articular

joint

intrasynovial

joint fluid area

Intracutaneous, Intradermal

skin

Subcutaneous

beneath the skin

Intramuscular

muscle

epicutaneous

skin surface (topical)

transdermal

skin surface

conjunctival

conjunctiva

intraocular

eye

intranasal

nose

aural

ear

intrarespiratory

lung

rectal

rectum

vaginal

vagina

Oral

what is its route of administration?

• Tablets

• Capsules

• Solutions

• Syrups

• Elixirs

• Suspensions

• Magmas

• Gels

• Powders

Sublingual

what is its route of administration?

• Tablets

• Troches

• Lozenges

• Drops (Solutions)

Parenteral

what is its route of administration?

• Solutions

• Suspensions

Epicutaneous, Transdermal

what is its route of administration?

• Ointments

• Gels

• Creams

• Intusion pumps

• Pastes

• Plasters

• Powders

• Aerosols

• Lotions

• Transdermal Patches, Disks, Solutions

Conjunctival

what is its route of administration?

• Contact lens inserts

• Ointments

Intraocular

what is its route of administration?

• Solution

Intraaural

what is its route of administration?

• Suspensions

Intranasal

what is its route of administration?

• Solutions

• Sprays

• Inhalants

• Ointments

Intrarespiratory

what is its route of administration?

• Aerosol

Rectal

what is its route of administration?

• Solutions

• Ointments

• Suppositories

• Gels

Vaginal

what is its route of administration?

• Solutions

• Ointments

• Emulsion foams

• Gels

• Tablets

• Inserts, suppositories, sponge

Urethral

what is its route of administration?

• Solutions

• Suppositories

Local Effects

achieved by direct application of the drug to the desired site of action

eye, nose, or skin

example of local effects

Systemic Effects

result from the entrance of the drug into the circulatory system and transport to the cellular site of its action

intravenous injection

example of systemic effects

sublingual, intravenous, buccal

example of rapid onset

oral (swallowed), topical ointment/patch

example of slower onset, longer duration

oral

has first-pass effect absorption

intravenous, intramuscular, sublingual

example of a no first-pass effect absorption

Inactive Metabolites

larger oral dose required to attain desired therapeutic effect

Active Metabolites

tailored to the desired therapeutic effect

first-pass effect

oral administration of a drug: once absorbed through the lumen of the gastrointestinal tract into the portal vein, the drug may pass directly to the liver and undergo the ____________ wherein some or all of the drug may be metabolized by the liver, consequently, its bioavailability is decreased

Oral Route

drugs are most frequently taken by this administration; most are taken for the systemic drug effects that result after absorption from the various surfaces along the gastrointestinal tract; a few drugs are taken for their local action in the gastrointestinal tract

natural, uncomplicated, convenient, and safe

Advantage of the Oral Route:

• considered the most _________________________________ means of administering drugs

slow

Disadvantages of Oral Route:

• a._______ drug response (compared with parenterally administered drugs)

• chance of b.___________ absorption of drugs, depending upon such factors as constitutional makeup and the amount or type of food in the gastrointestinal tract

• c.__________ of certain drugs by the acid reaction of the stomach or by gastrointestinal enzymes

a = ?

irregular

Disadvantages of Oral Route:

• a._______ drug response (compared with parenterally administered drugs)

• chance of b.___________ absorption of drugs, depending upon such factors as constitutional makeup and the amount or type of food in the gastrointestinal tract

• c.__________ of certain drugs by the acid reaction of the stomach or by gastrointestinal enzymes

b = ?

destruction

Disadvantages of Oral Route:

• a._______ drug response (compared with parenterally administered drugs)

• chance of b.___________ absorption of drugs, depending upon such factors as constitutional makeup and the amount or type of food in the gastrointestinal tract

• c.__________ of certain drugs by the acid reaction of the stomach or by gastrointestinal enzymes

c = ?

Rectal Route

some drugs are administered like this for their local effects and others for their systemic effect; may be administered as solutions, suppositories, or ointments; may be preferred for drugs destroyed or inactivated by the environments of the stomach and intestines

subcutaneous, intramuscular, and intravenous

3 primary parenteral routes

Parenteral Route

administered when drugs destroyed or inactivated in the gastrointestinal tract or too poorly absorbed to provide satisfactory response; preferred when rapid absorption is essential, as in emergencies; faster than after oral administration but also the blood levels of drug that result are far more predictable; generally permits the administration of smaller doses

no retreat

Disadvantage of Parenteral Administration

• once the drug is injected, there is _______________

Subcutaneous (Hypodermic)

entails injection through the skin into the loose subcutaneous tissue; prepared as aqueous solutions or as suspensions and are administered in relatively small volumes, 2 mL or less

Intramuscular

performed deep into the skeletal muscles, generally the gluteal or lumbar muscles; drugs that are irritating to subcutaneous tissue are often administered; greater volumes (2 to 5 mL) may be administered

Intravenous

an aqueous solution is injected directly into the vein at a rate commensurate with efficiency, safety, comfort to the patient, and the desired duration of drug response; drugs may be administered as a single, small-volume injection or as a large-volume slow drip infusion

Epicutaneous Route

drugs are administered topically, or applied to the skin, for their action at the site of application or for systemic drug effects; drug absorption is enhanced if the drug substance is in solution, if it has a favorable lipid–water partition coefficient, and if it is not an electrolyte

Ocular, Otic, and Nasal Routes

drugs are frequently applied topically to the eye, ear, and mucous membranes of the nose, usually as ointments, suspensions, and solutions