Routes of drug administration

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  • Drug administratio-n
    • Oral
      • most frequently used route of drug administration
      • solid dose forms
        • tablet or capsules
          • high degree of stability
          • accurate dosage
      • most problematic
        • unpredictable nature of gastro-intestinal drug absorption
      • extent to which patients can tolerate forms varies
        • many drugs not stable in liquid formation
      • difficulties frequently arise with modified-release preparations
        • must not be crushed or broken at point of administration
          • may cause toxicity or sub optimal treatment
    • Sublinqual (under tongue)
      • sublingual mucosa offers a rich supply of blood vessels which drugs can be absorbed through
      • not a common administration route
      • offers rapid absorption into systemic circulation
      • most common is GTN spray for acute angina
      • 'wafer' tablets that dissolve rapidly
      • aimed at markets where taking tablets may be problematic
        • migraine (rizatriptan)
          • nausea may deter patients from taking tablets
      • given where compliance with prescribed drug regimens may be problematic e.g. olanzapine to treat schizophrenia
    • Rectal
      • considerable disadvantages in terms of patient acceptability in UK
      • unpredictable drug absorption
      • localised drug delivery into large bowel
        • rectal steroids
          • enemas
          • suppositories
        • treatment of inflammatory bowel disease
      • antiemetics for nausea and vomiting
      • paracetamol given to treat patients with pyrexia whoa re unable to swallow
    • Topical
      • applied directly to intended site of action
      • systemic circulation not reached in great concentration
        • risk of systemic side-effects reduced
      • eye drops to treat glaucoma
      • topical steroids in management of dermatitis
      • inhaled bronchodilator-s in treatment of asthma
      • insertion of pessaries to treat vaginal thrush
      • introducing drugs into systemic circulation
        • transdermal patches
      • creams / ointments
      • sprays / inhalers
    • Parenteral
      • injection
        • intramuscular
        • subcutaneous
        • intraveinously
      • drugs that are ineffective when given orally can be given this way
      • needs trained staff to administer
      • aseptic technique required
      • Intraveinousl-y
        • greatest risk
        • directly into systemic circulation
          • immediate onset
        • administration frequently complex
          • requires calculations
        • may need programmable infusion devices
        • preparation requires aseptic technique
        • quickest way of administering drugs
        • hardest to rectify if mistakes are made
      • Intramuscula-r or subcutaneou-s
        • allows gradual release
        • can alter formulation of drug to influence period of which it is released over
    • Self administratio-n
      • if patient is capable of opening medication and reading advice on how to take it, they should be encouraged to do so
      • in a hospital - playing a central part in their drug treatment
        • staff can monitor if education is needed

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