PCOL 2 LAB - Exercise 5

route of administration

It is the path by which a drug, poison or other similar substances is taken into the body

Desired effect or Site of Administration

Methods of drug administration could be classified by ________ or __________

Systemic or local

Desired effects can be either ________ or _________

Enteral, parenteral, or topical

Three sites of administration

Peroral, Sublingual, Buccal, Rectal, Nasogastric

Enteral routes of administration (5)

PERORAL

the most common route of drug administration

PERORAL

drug is given through the oral cavity (PO)

PERORAL

Dosage forms of this route of administration include tablets, capsules, powders, granules, syrup, solution, emulsion, suspension, elixir

slow absorption; irritable and non-palatable drugs; not suitable for uncooperative patients; some drugs are destroyed when orally administered; some drugs cannot be absorbed orally; first pass effect; food-drug or drug-drug interactions

Disadvantages of Peroral administration (just read nalang po)

generally regarded as safe; convenient; economical; usually good absorption; no need for sterilization

Advantages of Peroral administration (just read nalang po)

Sublingual

tablet or pellet containing the drug is placed under the tongue

Buccal

tablet or pellet containing the drug is crushed in mouth and spread over the buccal mucosa

drug absorption is quick; quick termination; first-pass effect avoided; self-administered; economical

Advantages of sublingual/buccal administration (read nalang po)

unpalatable & bitter-tasting drugs; irritation of oral mucosa; large quantities are not given this method; few drugs are absorbed

Disadvantages of sublingual/buccal administration (read nalang po)

Rectal

drugs administered rectally; inserted into the rectum

Rectal

Dosage forms include suppositories and enemas

suitable for children; little or no first-pass effect (ex hemorrhoidal vein); used in vomiting or unconscious patients; higher concentrations are rapidly achieved

Rectal administration advantages (read nalangs pi)

inconvenient; absorption is slow and erratic; irritation or inflammation of rectal mucosa may occur

Disadvantages of Rectal Administration (read nalang po)

Nasogastric

This route provides access to the stomach for diagnostic and therapeutic purposes

Nasogastric

Tube is inserted via the nasal passage

used for diagnostic, gastric decompression feeding and bowel irrigation process; suitable for unconscious patients

Advantages of Nasogastric Route

invasive; may cause irritation or trauma to nasal passage; requires direct attention from a professional

Nasogastric route disadvantages

Parenteral route

A site of administration wherein the desired effect could be local or systemic achieved through injection of the drug to the specific site

high bioavailability; rapid action (emergency); no first pass effect; suitable for vomiting and unconscious patients, and unpalatable drugs; no gastric irritation; no food-drug interaction

Advantages of Parenteral administration

infection; needs sterilization techniques; invasive - assistance required; painful; needs skill to do; anaphylaxis; expensive

Disadvantages of Parenteral Administration

Intravenous

A parenteral route into the vein (direct into the bloodstream)

Intravenous

most common parenteral route for drugs not absorbed orally

avoids first-pass effect; rapid effect and maximal degree of control large quantities can be given; 100% bioavailability

IV Administration Advantages

cannot be recalled; may induce hemolysis or other side-effects by too rapid delivery of high concentrations of drug; thrombophlebitis and tissue necrosis in extravasation

IV Administration Disadvantages

False (slow absorption)

True or False: Peroral Administration has fast absorption

Peroral

[Route of Administration] not suitable for uncooperative patients

True

True or False: Peroral administration undergoes first-pass effect

True

True or False: Peroral dosage forms have no need for sterilization

False (first-pass effect avoided)

True or False: Buccal and Sublingual routes undergo first-pass effect

True

True or False: Drug absorption and even termination in Buccal and Sublingual routes are quick

False

True or False: Large quantities are given in Buccal and Sublingual routes

Rectal

[Route of Administration] suitable for children and is used in vomiting or unconscious patients; has little or no first-pass effect

False (absorption is slow and erratic)

True or False: Rectal administration has fast and consistent drug absorption

Nasogastric

[Route of Administration] Enteral route suitable for unconscious patients

True

True or False: Parenteral routes of administration has no food-drug interaction

100% bioavailability

IV Administration has _______% bioavailability

Intravenous

[Route of Administration] may induce hemolysis or other side-effects by too rapid delivery of high concentrations of drug

Intravenous

[Route of Administration] thrombophlebitis and tissue necrosis in extravasation

deltoid, triceps, gluteus maximus, rectus femoris

In what muscle groups do IM Injections are commonly administered? (4)

Intramuscular

Parenteral route into the muscle

Z-track method

IM Administration utilizes __________ method

10mL

IM Injection can only be administered up to _________ mL of drug only

Intramuscular

[Route of Administration] local hematoma for anticoagulant patients

absorption is reasonably uniform; rapid onset of action; mild irritants can be given o avoids first-pass effect; avoids gastric factors

Advantages of IM Administration

only up to 10mL of drug only; local pain and nerve damage may occur; expensive; infection; local hematoma for anticoagulant patients

Disadvantages of IM Administration

Subcutaneous

common routes for insulin and some contraceptive drugs

Subcutaneous

Parenteral route that provides rich nerve supply minimizes risks associated with IV

False (Slower absorption than IM)

True or False: SC has faster absorption than IM due to less vasculature

Intradermal

Parenteral route into the skin raising a small bleb

Intradermal

best route for skin sensitivity testing and the BCG vaccine

Intrathecal

Parenteral route into the spinal cord specifically the cerebrospinal fluid

Intrathecal

best route for amphotericin B used for Cryptococcus meningitis infection

Intraarterial

Parenteral route into the arteries; this method is more painful

Intraarterial

suitable for vasodilators and thrombolytic drugs

Intracardiac

Parenteral route into the heart; only used to provide emergency drugs to patient if IV or other routes are not possible or ineffective

False (intracardiac is OBSOLETE)

True or False: Intracardiac remains as one of the most effective parenteral administration of today

Intraosseous

Parenteral route into the bone marrow

Intraosseous

recommended for children after two failed attempts at IV access or circulatory collapse

Intraarticular

Parenteral route into the joints specifically the synovial fluid

Intraarticular

Parenteral route usually used for corticosteroids to relieve painful, inflamed arthritic joint

Peritoneum

serous membrane that forms the lining of the abdominal cavity

Intraperitoneal

Parenteral route into the peritoneum

Intraperitoneal

Parenteral route suitable for dialysis

Intraperitoneal

the most common method of drug administration for animal testing (i.e. mice)

Intravitreal

Parenteral route into the eyes specifically into the vitreous humor

Vitreous humor

clear gel-like substance that fills the anterior chamber of the eye

Intravitreal

Used for the treatment of macular degeneration and other various retinal vascular disorders

Epidural

Parenteral route into the epidural space; used for epidural anesthesia

Epidural

This route can be injected anywhere in the spinal column, while IT is only on the second lumbar region

Infiltrative

method used to administered local anesthetics used in dental procedures

Topical

Administration site wherein the desired effect is local

Topical

Site of administration that includes percutaneous, mucous membrane of the respiratory tract, eye and ear drops and intranasal sprays

Percutaneous

application into the skin

Percutaneous

usually for dermal application of drugs

Percutaneous

Dosage forms include ointments, creams, lotions, powders, embrocations

Inhalational

provides the rapid delivery of drug across the large surface area of the respiratory tract

Inhalational

effective and convenient for patients with respiratory problem

False (Provides local action)

True or false: inhalational route provides systemic action

True

True or False: inhalational route avoids first-pass effect

Inhalational

Dosage forms include aerosol, nebulizer, insulin inhalations (Afrezza Pfizer rapid-acting insulin)

rapid absorption because of the large surface area; provide local action; minor systemic affect; lesser side effects; avoids first-pass effect

Inhalational route advantages

only few drugs can be used; dosage forms: aerosol, nebulizer, insulin inhalations (Afrezza Pfizer rapid-acting insulin)

Inhalational route disadvantages

Intranasal

involves administration of drugs directly into the nose

Intranasal

includes nasal decongestants

Desmopressin

This particular drug is administered intranasally for diabetes insipidus

external ear

In otic administration, solution is directly dropped into the ____________

Conjunctiva

In ophthalmic administration, solution is directly dropped into the __________

Conjunctivitis

Ophthalmic drops / ointments are commonly used in ___________

otitis externa

Otic drops are commonly used in ____________

Intravaginal

Topical route into the vagina; the drug is inserted into the vaginal canal

Intravaginal

used for contraceptive drugs and for the treatment of vaginal infection

Intravaginal

Vaginal rings, pessaries, vaginal tablets are the common dosage forms of this route of administration

Intraurethral

Topical administration into the urethra

erectile dysfunction

Drugs delivered through intraurethral route is used for the treatment of _____________

alprostadil

MUSE (medicated urethral suppository for erection) which is __________, is the only urethral suppository approved by US FDA