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Associate Professor Department of Pharmacology Kasturba Medical College, Mangalore www.scribd.com 03 August 2013
Route of administration is the path by which a drug, is brought into contact with the body
Routes of administration
Oral Enteral Route Sublingual [Systemic/ Local] Rectal Inhalation Topical -Application to
Injection
Intradermal Subcutaneous Intramuscular Intravenous Intra arterial Intrathecal Intravitreal.
other epithelial surfaces (e.g. skin, cornea, vagina and nasal mucosa)
Transdermal Nasal
Intrarticular
Mostly systemic action Rarely for local action. Eg. Peptic ulcer, ulcerative colitis
First-pass metabolism
[Metabolism before the drug reaches systemic circulation]
Injections
Portal circulation
Oral
Sub-lingual
[Tablet placed under tongue/spray]
Advantages Absorption is rapid-action can be produced in minutes. One can spit the drug after the desired effect [Convenient??] Liver is by passed[Nitrates] Eg. GTN, buprenorphine, desaminooxytocin
Rectal
Rectal
[Enema, suppositories]
Enema Evacuant enema[Liquid] Eg: Soap & water enema , AIM:-to remove fecal matter & flatus Retention Enema [Suppositories] Local action:- Eg: Prednisolone enema in ulcerative colitis.
Systemic action [Transrectal] [Suppositories] MgSO4 to ICT. Diazepam in epilepsy Indomethacin, Ergotamine
Rectal
[Enema, suppositories]
Advantages Irritant and unpleasant drugs When the patient is having recurrent vomiting Unconscious Children 50% bypasses liver
Disadvantages Inconvenient Embarrassing; Absorption is slower, irregular, unpredictable [Diazepam fast] Local irritation
Cutaneous/mucus membrane
Topical: Local action Ointments, powders, eye drops, nasal drops, paints, lozenges, unabsorbable drugs, Inhalers for asthma
Occlusive backing film Drug reservoir Rate controlling micropore membrane Adhesive impregnated with priming dose of the drug Protective film
TTS
Drug is released slowly without fluctuations Chest, abdomen/ upper arm, lower back, buttock or mastoid region are utilized. GTN, fentanyl, nicotine and estradiol are available in India, [isosorbide dinitrate, hyoscine, and clonidine -other countries.]
TTS
Advantages Convenient Better compliance Long duration No fluctuations in plasma cocn. Minimizes inter-individual variations By passes of liver Disadvantages Expensive Only lipid soluble drugs Local irritation May fall off
Inhalation
Systemic action [GA, oxygen] Local action [Bronchial asthma.Eg??] Absorption takes place from the vast surface of alveoli Controlled administration is possible with moment to moment adjustment Irritant vapors (ether) cause inflammation of respiratory tract and increase secretion Require special equipment
Nasal
Local action[decongestants] Systemic [GnRH agonists, desmopressin]