routes of drug administration routes of drug administration diane young, rn health science brewbaker...

Routes of Drug AdministrationRoutes of Drug Administration

Diane Young, RNHealth ScienceBrewbaker Technology Magnet High School

Drug Absorption

Absorption is the process by which a drug enters the bloodstream without being chemically altered or

The movement of a drug from its site of application into the blood or lymphatic system

Drug Absorption Factors which influence the rate of

absorption types of transport the physicochemical properties of the

drug protein binding routes of administration dosage forms circulation at the site of absorption concentration of the drug

Drug Absorption

The rate at which a drug reaches it site of action depends on:Absorption - involves the

passage of the drug from its site of administration into the blood

Distribution - involves the delivery of the drug to the tissues

Routes of Drug Administration

The route of administration (ROA) that is chosen may have a profound effect upon the speed and efficiency with which the drug acts

ImportantImportantInfoInfo

Drug Route’s Cont’d

The possible routes of drug entry into the body may be divided into two classes:

EnteralParenteral

Enteral Routes

Enteral - drug placed directly in the GI tract:sublingual - placed under the

tongueoral - swallowing (p.o., per os)rectum - Absorption through the

rectum

Sublingual/Buccal

Some drugs are taken as smaller tablets which are held in the mouth or under the tongue.

Advantages rapid absorption drug stability avoid first-pass effect

Sublingual/Buccal

Disadvantages inconvenient small doses unpleasant taste of some drugs

Oral

Advantages Convenient - can be self- administered,

pain free, easy to take Absorption - takes place along the whole

length of the GI tract Cheap - compared to most other

parenteral routes

Oral

DisadvantagesSometimes inefficient - only part

of the drug may be absorbedFirst-pass effect - drugs

absorbed orally are initially transported to the liver via the portal vein

irritation to gastric mucosa - nausea and vomiting

Oral

Disadvantages cont.destruction of drugs by gastric

acid and digestive juiceseffect too slow for emergenciesunpleasant taste of some drugsunable to use in unconscious

patient

First-pass Effect The first-pass effect is the term

used for the hepatic metabolism of a pharmacological agent when it is absorbed from the gut and delivered to the liver via the portal circulation. The greater the first-pass effect, the less the agent will reach the systemic circulation when the agent is administered orally

First-pass Effect

1. unconscious patients and children 2. if patient is nauseous or vomiting 3. easy to terminate exposure 4. absorption may be variable 5. good for drugs affecting the bowel such as laxatives6. irritating drugs contraindicated

Rectal

Parenteral Routes

Intravascular (IV, IA)- placing a drug directly into the blood stream

Intramuscular (IM) - drug injected into skeletal muscle

Subcutaneous - Absorption of drugs from the subcutaneous tissues

Inhalation - Absorption through the lungs

Intravascular

Absorption phase is bypassed (100% bioavailability)1.precise, accurate and almost immediate onset of

action, 2. large quantities can be given, fairly pain free

3. greater risk of adverse effects a. high concentration attained rapidly b. risk of embolism c. OOPS factor or !@#$%

Intramuscular

1. very rapid absorption of drugs in aqueous solution 2.repository and slow release preparations 3.pain at injection sites for certain drugs

Subcutaneous

1. slow and constant absorption 2. absorption is limited by blood flow, affected if circulatory problems exist 3. concurrent administration of

vasoconstrictor will slow absorption

1.gaseous and volatile agents and aerosols 2.rapid onset of action due to rapid access to circulation a.large surface area b.thin membranes separates alveoli from circulation c.high blood flow

Inhalation

Inhalation cont. Respiratory system. Except for IN, risk hypoxia. Intranasal (snorting) Snuff, cocaine may be partly oral via post-nasal

dripping. Fairly fast to brain, local damage to septum. Some of the volatile gases also appear to cross nasal membranes.

Smoke (Solids in air suspension, vapors) absorbed across lung alveoli: Nicotine, opium, THC, freebase and crack cocaine, crystal meth.Particles or vapors dissolve in lung fluids, then diffuse. Longer action than volatile gases. Tissue damage from particles, tars, CO.

Volatile gases: Some anaesthetics (nitrous oxide, ether) [precise control], petroleum distillates. Diffusion and exhalation (alcohol).

Lung-based transfer may get drug to brain in as little as five seconds.

Topical•Mucosal membranes (eye drops, antiseptic, sunscreen, callous removal, nasal, etc.) •Skin a. Dermal - rubbing in of oil or ointment (local action) b. Transdermal - absorption of drug through

skin (systemic action) i. stable blood levels ii. no first pass metabolism iii. drug must be potent or patch

becomes to large

intravenous 30-60 seconds intraosseous 30-60 seconds endotracheal 2-3 minutes inhalation 2-3 minutes sublingual 3-5 minutes intramuscular 10-20 minutes subcutaneous 15-30 minutes rectal 5-30 minutes ingestion 30-90 minutes transdermal (topical) variable (minutes to

hours)

Route for administration -Time until effect-

Time-release preparations

Oral - controlled-release, timed-release, sustained-release designed to produce slow,uniform

absorption for 8 hours or longerbetter compliance, maintain effect

over night, eliminate extreme peaks and troughs

The ROA is determined by the The ROA is determined by the physical characteristics of the physical characteristics of the drug, the speed which the drug is drug, the speed which the drug is absorbed and/ or released, as well absorbed and/ or released, as well as the need to bypass hepatic as the need to bypass hepatic metabolism and achieve high metabolism and achieve high conc. at particular sitesconc. at particular sites

ImportantImportantInfoInfo

No No singlesingle method of drug method of drug administration is ideal for all administration is ideal for all drugs in all circumstancesdrugs in all circumstances

Very Important

Very Important

Info!Info!

Terminology

Side effects Adverse effects Toxic effects Receptor site Agonists Antagonists Site of action Mechanism of action FDA

Terminology cont’d

Dose-response curve Time-response curve Potency Therapeutic Index Generic name Trade name Prescription drugs OTC drugs Controlled substances

Rights

List the 5 rights in administering medication.

THAT’S IT!!