logging in or signing up routes of Drug Administration rushikesh drrushikesh Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 759 Category: Education License: All Rights Reserved Like it (5) Dislike it (0) Added: January 19, 2011 This Presentation is Public Favorites: 5 Presentation Description No description available. Comments Posting comment... By: anum3 (3 month(s) ago) please send it to me anumkhawaja@hotmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: anum3 (3 month(s) ago) anumkhawaja@hotmail.com -- please send it to me Saving..... Post Reply Close Saving..... Edit Comment Close By: hamsavardhini (7 month(s) ago) please make downloading as simpler as possibile Saving..... Post Reply Close Saving..... Edit Comment Close By: drsgoyal (8 month(s) ago) PLEASE ALLOW ME TO DOWNLOAD THIS FILE........... Saving..... Post Reply Close By: drrushikesh (7 month(s) ago) send me ur id... Saving..... Edit Comment Close By: gpurna (8 month(s) ago) A very good presentation.allow me to down load Saving..... Post Reply Close By: drrushikesh (7 month(s) ago) send me ur id... Saving..... Edit Comment Close loading.... See all Premium member Presentation Transcript Slide 1: Routes Of Drug Administration Guided by Presented by Dr V M Motgahre Dr Rushikesh Deshpande Prof & Head JR I 1 Dr Rushikesh Deshpande, Dr V M Motghare DEPT. OF PHARMACOLOGYS R T R MEDICAL COLLEGE, AMBAJOGAI. : DEPT. OF PHARMACOLOGYS R T R MEDICAL COLLEGE, AMBAJOGAI. Dr Rushikesh Deshpande, Dr V M Motghare 2 Slide 3: 3 Dr Rushikesh Deshpande, Dr V M Motghare Factors Deciding Routes of Administration. : Factors Deciding Routes of Administration. Onset of action Action of drug Convenience Cost Physical and chemical properties of drug. Site where the action of the drug is required, local, general or non approachable. Patient related factors, unconscious, uncooperative, vomiting. Dr Rushikesh Deshpande, Dr V M Motghare 4 Enteral routes : Enteral routes Oral Sublingual Rectal 5 Dr Rushikesh Deshpande, Dr V M Motghare Oral route : Oral route Most common route of drug administration. Majority of drugs produce systemic effects , excepting a few which are administered for local effect e.g. antacids and antidiarrhoeal drugs like norfloxacin, streptomycin, phthlyl-sulfathiazole, pectin and kaolin. 6 Dr Rushikesh Deshpande, Dr V M Motghare Oral Route : Oral Route Safe – its possible to remove it from stomach Convenient Economical No complications of parenteral therapy Easy to adjust doses. Advantages 7 Dr Rushikesh Deshpande, Dr V M Motghare Slide 8: Slower onset of actions. Highly polar drugs like Aminoglycosides- streptomycin or quaternary salts like d-tubocurarine and suxamethonium : not absorbed. Drugs like Penicillin-G, insulin, oxytocin and testesterone are destroyed by gastric juices. Drugs with high first pass effect e.g. morphine, isoprenaline. Palatibility of drugs is essential. Oral Route Disadvantages 8 Dr Rushikesh Deshpande, Dr V M Motghare Slide 9: Sublingual Route 9 Dr Rushikesh Deshpande, Dr V M Motghare Slide 10: Examples Isosorbide dinitrate, nitroglycerine : angina Isoprenaline : asthma Nifedipine : hypertension 10 Dr Rushikesh Deshpande, Dr V M Motghare Slide 11: Rectal Route 11 Dr Rushikesh Deshpande, Dr V M Motghare Slide 12: 12 Dr Rushikesh Deshpande, Dr V M Motghare Slide 13: Parenteral routes Intradermal Subcutaneous Intramuscular Intravenous Intra-arterial Intraperitoneal Intrathecal Intramedullary Intra-articular Inhalational 13 Dr Rushikesh Deshpande, Dr V M Motghare Slide 14: Dr Rushikesh Deshpande, Dr V M Motghare 14 Slide 15: Dr Rushikesh Deshpande, Dr V M Motghare 15 Intra-dermal Route Site: drug is injected into the dermal layers of the skin Demerits Only small amount of drug can be given. 0.1ml-adult 0.05ml-infants Absorption is slow. Examples BCG vaccine Penicillin sensitivity testing Slide 16: Dr Rushikesh Deshpande, Dr V M Motghare 16 Subcutaneous Route Site: injection into the subcutaneous tissue Merits Demerits Examples Smooth but slower absorption over longer period Only small volume can be given (max 2-3 ml) Not suitable in shock as reduced peripheral circulation decreases rate of absorption. Vaccines Local anaesthetics for local action Insulin for systemic action. Slide 17: Dr Rushikesh Deshpande, Dr V M Motghare 17 Hypodermoclysis It is a form of subcutaneous injection in which large amounts of (500 to 1000 ml in adults) of fluids such as normal saline or 5 % dextrose is slowly administered in the patients Extremely beneficial for infants and children to treat dehydration. Precaution: prevent too rapid injections- circulatory overload. e.g. normal saline, hyalluronidase in treatment of ganglions. c : c Site : deltoid muscle or gluteal mass of right or left buttock, vastus muscle over lateral side of thigh. e.g. depot preparation of testosterone and neuroleptics like haloperidol. Intramuscular Route 18 Dr Rushikesh Deshpande, Dr V M Motghare Slide 19: Demerits Merits Absorption is more predictable Depot injections can be given. Aseptic conditions are required Abscess formation Nerve damage Large volume can not be administered. (max 5-10 ml) 19 Dr Rushikesh Deshpande, Dr V M Motghare Slide 20: Site : through the lumen of the vein, mainly the antecubital vein. Procedures Bolus injection: initial large dose is given E.g. corticosteroids Rapid i.v. injection E.g. adenosine Slow i.v. injections: over 10-15 min E.g. aminophylline I.V. infusions: 1-8 hrs or more Dopamine, dobutamine. Intravenous Route 20 Dr Rushikesh Deshpande, Dr V M Motghare Slide 21: Intravenous administration Merits 21 Dr Rushikesh Deshpande, Dr V M Motghare Slide 22: Demerits 22 Dr Rushikesh Deshpande, Dr V M Motghare Intravenous administration Slide 23: Site : into the peritoneal space. Intraperitoneal Route Merits Demerits 23 Dr Rushikesh Deshpande, Dr V M Motghare Rapid absorption due to larger surface area Risky – chances of adhesions and infections (peritonitis) Examples Anti- rabies serum Peritoneal dialysis Slide 24: Site : into the Subarachnoid space(L3-L4). Dr Rushikesh Deshpande, Dr V M Motghare 24 Intrathecal (intraspinal) Route Bypasses Blood-brain and blood-CSF barrier Merits Demerits Strict aseptic conditions required Radiopaque contrast media for myelography Xylocaine injection for spinal anasthesia Examples Chances of infection: Meningitis Post-spinal headache, nausea ,vomitting C/I Raised ICT Slide 25: Dr Rushikesh Deshpande, Dr V M Motghare 25 Intramedullary Route Site : injection into the tibial or sternal bone marrow Merits Demerits Examples Very fast onset of action Very painful Bone marrow transplantation Blood transfusion in children Slide 26: Dr Rushikesh Deshpande, Dr V M Motghare 26 Intra-arterial Route Merits Demerits Examples Site : into the lumen of desired artery Greater concentration of drug can be administered Radiopaque contrast media for contrast angiography & cerebral angiography Anticancer drugs like nitrogen mustard can be perfused to treat the malignancy involving limbs Strict aseptic conditions required Chances of spread of infection directly into bloodstream. Slide 27: Dr Rushikesh Deshpande, Dr V M Motghare 27 Intra-articular Route Site: injection directly into the joint space Merits Demerits Ensures higher concentration of drug into localized area Damage to joint due to repeated injections Examples Rheumatoid arthritis : Hydrocortisone and gold chloride Slide 28: Dr Rushikesh Deshpande, Dr V M Motghare 28 Inhalatational Route Site: inspiration through nose or mouth Merits Demerits Examples Larger surface area of alveoli Faster absorption quick onset of action Self administration possible. Bronchial irritation increased bronchial and salivary secretion Metered aerosol preparation of salbutamol: treatment Bronchial asthma Sodium chromoglycate : prophylaxis of Bronchial asthma (local effect) Oxygen and general anesthetics ( systemic effect) INHALATION : INHALATION Salbutamol in bronchial asthma Compressed air driven solutions e.g. salbutamol in bronchial asthma Salbutamol General anaesthetic Slide 30: Dr Rushikesh Deshpande, Dr V M Motghare 30 Intra-cardiac Route The injection is given by a long needle into the heart through the left 4th ICS in midclavicular line. Adrenaline : in cardiac arrest Slide 31: Dr Rushikesh Deshpande, Dr V M Motghare 31 Epidural Route Site: through a vertebral interspace between the dura of the spinal cord and the lining of the spinal canal. Xylocaine : epidural nerve block Slide 32: Dr Rushikesh Deshpande, Dr V M Motghare 32 Topical Routes Transdermal patches Conjunctival Vaginal & Urethral Inunction Slide 33: Dr Rushikesh Deshpande, Dr V M Motghare 33 Trans-dermal Route Site: adhesive matrix (patch) containing the drug applied to chest, upper abdomen or mastoid region. Merits Slow but sustained release of drug over a period of days Examples Nitroglycerine : angina Scopolamine : motion sickness Clonidine: hypertension Estradiol: menopausal syndrome Slide 34: Dr Rushikesh Deshpande, Dr V M Motghare 34 Conjunctival Route Site: drugs are instilled onto the conjunctiva. Examples Sulfacetamide Chloramphenicol Gentamicin Ciprofloxacin Occuserts Lacriserts Slide 35: Dr Rushikesh Deshpande, Dr V M Motghare 35 Vaginal & Urethral Route Solutions, ointments,emulsion,foams,tablets, suppositories and pessaries are used for this route Examples Antifungal drugs Metronidazole Pessary Solid medicated preparation designed for insertion into the vagina. Solid medicated preparation designed for insertion into the rectum. Suppository Bougie Solid medicated preparation designed for insertion into the urethra. ENDOTRACHEAL SPRAY : ENDOTRACHEAL SPRAY Adrenaline Atropine Diazepam Naloxone Lignocaine To be diluted in 5-10 ml saline before administration. Slide 37: Dr Rushikesh Deshpande, Dr V M Motghare 37 Inunction (Rubbing) Site: rubbing the drug preparation onto the surface of skin. Merits Demerits Safe and convenient Difficulty in ascertaining the amount of drug given Systemic absorption can take place Examples Turpentine liniment LOCAL APPLICATION : LOCAL APPLICATION Slide 39: ENEMA : ENEMA EVACUANT ENEMA For evacuation of large bowel. Warm water, soap solutions, glycerin can be given. Amount ~ 600 ml. Used for Constipation Pre-op preperation Before radiological examination. RETENTION ENEMA Local action Steroids in ulcerative colitis. Systemic action Diazepam in status epilepticus Indomethacin in RA. Amount ~ 100-120 ml. Causes evacuation Should be retained for action Slide 41: Same drug different route different actiondifferent therapeutic indications. E.g magnesium sulphate, N acetyl cysteine, absolute alcohol. Action of Magnesium Sulphate. Slide 42: Dr Rushikesh Deshpande, Dr V M Motghare 42 Newer Drug Delivery System Slide 43: http://www.ianblumer.com/insulin_pump_therapy.htm Pump therapy uses rapid acting insulin and gives the insulin in tiny doses around the clock Insulin Pump Slide 44: The Medi-Jector VISION uses pressure to create a micro-thin stream of insulin that penetrates the skin The insulin is deposited into the subcutaneous (fatty) tissue in a fraction of a second Currently FDA approved for insulin delivery http://www.antarespharma.com/content/products/vision/presentation.html#product2 Slide 45: http://www.boston.com/news/nation/washington/articles/2006/01/28/inhaled_insulin_for_diabetics_wins_fdas_ok/?rss_id=Boston+Globe+--+Front+Page Exubera Inhaled Insulin Slide 46: Atropine (nerve agents) Diazepam (antiseizure) http://www.domesticpreparedness.com/onlineexhibits/meridian/meridian1.html Autoinjectors Slide 47: http://www.jetinjector.com/pages/specifications.html New no-needle way of delivering SC drugs Can deliver liquid or powdered drugs Uses compressed gas to force drug through the skin Currently used to deliver smallpox vaccine PenJet Slide 48: http://www.vyteris.com/technology.html non-invasive technique that uses a mild electric current to deliver drugs through the skin e.g. Salicylates cortisol, methacholine, lidocaine Iontophoresis Slide 49: Dr Rushikesh Deshpande, Dr V M Motghare 49 Phonophoresis “ Phonophoresis is defined as the movement of drug molecules through the skin under the influence of ultrasound.” Slide 50: a small, semi-soft disc that adheres to the mucosa, and delivers the drug as the film bioerodes Useful for systemic or local delivery Increases drug residence time which increase absorption http://www.atrixlabs.com/ourtech/bema.cfm Transmucosal delivery film Slide 51: http://www.popcouncil.org/images/mediaroom/norplant.jpg http://www.bbc.co.uk/health/sex/pop_up_contraceptive_implants.html Levonorgestrol subdermally implanted in upper arm Provides contraceptive protection for ~5yrs. Norplant Contraceptive implants : Contraceptive implants Dr Rushikesh Deshpande, Dr V M Motghare 52 Slide 53: A miniature cylinder made from a titanium alloy, which protects & stabilizes the drug inside Water enters through a semipermeable membrane; the drug is delivered from a port at the other end of the cylinder at a controlled rate for up to one year http://www.alza.com/alza/duros Viadur (leuprolide acetate implant), the first marketed product to incorporate DUROS, is indicated for the palliative treatment of advanced prostate cancer DUROS implant Slide 54: http://www.alza.com/alza/oros Osmotic drug delivery Drugs such as Procardia XL for hypertension & angina Concerta for ADHD, & Ditropan XL for bladder control They utilize this technology for once a day delivery Provides controlled drug release for up to 24 hours Slide 55: Dr Rushikesh Deshpande, Dr V M Motghare 55 Contributors Slide 56: Dr Rushikesh Deshpande, Dr V M Motghare 56 References Study notes – Dr V M Motghare, Prof & Head, Dept Of Pharmacology, S R T R Medical College, Ambajogai. Principles of Pharmacology : Sharma and sharma Dr Purohit – Routes of Drug administration presentation. Various internet sites. Slide 57: Dr Rushikesh Deshpande, Dr V M Motghare 57 THANK YOU ! You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
routes of Drug Administration rushikesh drrushikesh Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 759 Category: Education License: All Rights Reserved Like it (5) Dislike it (0) Added: January 19, 2011 This Presentation is Public Favorites: 5 Presentation Description No description available. Comments Posting comment... By: anum3 (3 month(s) ago) please send it to me anumkhawaja@hotmail.com Saving..... Post Reply Close Saving..... Edit Comment Close By: anum3 (3 month(s) ago) anumkhawaja@hotmail.com -- please send it to me Saving..... Post Reply Close Saving..... Edit Comment Close By: hamsavardhini (7 month(s) ago) please make downloading as simpler as possibile Saving..... Post Reply Close Saving..... Edit Comment Close By: drsgoyal (8 month(s) ago) PLEASE ALLOW ME TO DOWNLOAD THIS FILE........... Saving..... Post Reply Close By: drrushikesh (7 month(s) ago) send me ur id... Saving..... Edit Comment Close By: gpurna (8 month(s) ago) A very good presentation.allow me to down load Saving..... Post Reply Close By: drrushikesh (7 month(s) ago) send me ur id... Saving..... Edit Comment Close loading.... See all Premium member Presentation Transcript Slide 1: Routes Of Drug Administration Guided by Presented by Dr V M Motgahre Dr Rushikesh Deshpande Prof & Head JR I 1 Dr Rushikesh Deshpande, Dr V M Motghare DEPT. OF PHARMACOLOGYS R T R MEDICAL COLLEGE, AMBAJOGAI. : DEPT. OF PHARMACOLOGYS R T R MEDICAL COLLEGE, AMBAJOGAI. Dr Rushikesh Deshpande, Dr V M Motghare 2 Slide 3: 3 Dr Rushikesh Deshpande, Dr V M Motghare Factors Deciding Routes of Administration. : Factors Deciding Routes of Administration. Onset of action Action of drug Convenience Cost Physical and chemical properties of drug. Site where the action of the drug is required, local, general or non approachable. Patient related factors, unconscious, uncooperative, vomiting. Dr Rushikesh Deshpande, Dr V M Motghare 4 Enteral routes : Enteral routes Oral Sublingual Rectal 5 Dr Rushikesh Deshpande, Dr V M Motghare Oral route : Oral route Most common route of drug administration. Majority of drugs produce systemic effects , excepting a few which are administered for local effect e.g. antacids and antidiarrhoeal drugs like norfloxacin, streptomycin, phthlyl-sulfathiazole, pectin and kaolin. 6 Dr Rushikesh Deshpande, Dr V M Motghare Oral Route : Oral Route Safe – its possible to remove it from stomach Convenient Economical No complications of parenteral therapy Easy to adjust doses. Advantages 7 Dr Rushikesh Deshpande, Dr V M Motghare Slide 8: Slower onset of actions. Highly polar drugs like Aminoglycosides- streptomycin or quaternary salts like d-tubocurarine and suxamethonium : not absorbed. Drugs like Penicillin-G, insulin, oxytocin and testesterone are destroyed by gastric juices. Drugs with high first pass effect e.g. morphine, isoprenaline. Palatibility of drugs is essential. Oral Route Disadvantages 8 Dr Rushikesh Deshpande, Dr V M Motghare Slide 9: Sublingual Route 9 Dr Rushikesh Deshpande, Dr V M Motghare Slide 10: Examples Isosorbide dinitrate, nitroglycerine : angina Isoprenaline : asthma Nifedipine : hypertension 10 Dr Rushikesh Deshpande, Dr V M Motghare Slide 11: Rectal Route 11 Dr Rushikesh Deshpande, Dr V M Motghare Slide 12: 12 Dr Rushikesh Deshpande, Dr V M Motghare Slide 13: Parenteral routes Intradermal Subcutaneous Intramuscular Intravenous Intra-arterial Intraperitoneal Intrathecal Intramedullary Intra-articular Inhalational 13 Dr Rushikesh Deshpande, Dr V M Motghare Slide 14: Dr Rushikesh Deshpande, Dr V M Motghare 14 Slide 15: Dr Rushikesh Deshpande, Dr V M Motghare 15 Intra-dermal Route Site: drug is injected into the dermal layers of the skin Demerits Only small amount of drug can be given. 0.1ml-adult 0.05ml-infants Absorption is slow. Examples BCG vaccine Penicillin sensitivity testing Slide 16: Dr Rushikesh Deshpande, Dr V M Motghare 16 Subcutaneous Route Site: injection into the subcutaneous tissue Merits Demerits Examples Smooth but slower absorption over longer period Only small volume can be given (max 2-3 ml) Not suitable in shock as reduced peripheral circulation decreases rate of absorption. Vaccines Local anaesthetics for local action Insulin for systemic action. Slide 17: Dr Rushikesh Deshpande, Dr V M Motghare 17 Hypodermoclysis It is a form of subcutaneous injection in which large amounts of (500 to 1000 ml in adults) of fluids such as normal saline or 5 % dextrose is slowly administered in the patients Extremely beneficial for infants and children to treat dehydration. Precaution: prevent too rapid injections- circulatory overload. e.g. normal saline, hyalluronidase in treatment of ganglions. c : c Site : deltoid muscle or gluteal mass of right or left buttock, vastus muscle over lateral side of thigh. e.g. depot preparation of testosterone and neuroleptics like haloperidol. Intramuscular Route 18 Dr Rushikesh Deshpande, Dr V M Motghare Slide 19: Demerits Merits Absorption is more predictable Depot injections can be given. Aseptic conditions are required Abscess formation Nerve damage Large volume can not be administered. (max 5-10 ml) 19 Dr Rushikesh Deshpande, Dr V M Motghare Slide 20: Site : through the lumen of the vein, mainly the antecubital vein. Procedures Bolus injection: initial large dose is given E.g. corticosteroids Rapid i.v. injection E.g. adenosine Slow i.v. injections: over 10-15 min E.g. aminophylline I.V. infusions: 1-8 hrs or more Dopamine, dobutamine. Intravenous Route 20 Dr Rushikesh Deshpande, Dr V M Motghare Slide 21: Intravenous administration Merits 21 Dr Rushikesh Deshpande, Dr V M Motghare Slide 22: Demerits 22 Dr Rushikesh Deshpande, Dr V M Motghare Intravenous administration Slide 23: Site : into the peritoneal space. Intraperitoneal Route Merits Demerits 23 Dr Rushikesh Deshpande, Dr V M Motghare Rapid absorption due to larger surface area Risky – chances of adhesions and infections (peritonitis) Examples Anti- rabies serum Peritoneal dialysis Slide 24: Site : into the Subarachnoid space(L3-L4). Dr Rushikesh Deshpande, Dr V M Motghare 24 Intrathecal (intraspinal) Route Bypasses Blood-brain and blood-CSF barrier Merits Demerits Strict aseptic conditions required Radiopaque contrast media for myelography Xylocaine injection for spinal anasthesia Examples Chances of infection: Meningitis Post-spinal headache, nausea ,vomitting C/I Raised ICT Slide 25: Dr Rushikesh Deshpande, Dr V M Motghare 25 Intramedullary Route Site : injection into the tibial or sternal bone marrow Merits Demerits Examples Very fast onset of action Very painful Bone marrow transplantation Blood transfusion in children Slide 26: Dr Rushikesh Deshpande, Dr V M Motghare 26 Intra-arterial Route Merits Demerits Examples Site : into the lumen of desired artery Greater concentration of drug can be administered Radiopaque contrast media for contrast angiography & cerebral angiography Anticancer drugs like nitrogen mustard can be perfused to treat the malignancy involving limbs Strict aseptic conditions required Chances of spread of infection directly into bloodstream. Slide 27: Dr Rushikesh Deshpande, Dr V M Motghare 27 Intra-articular Route Site: injection directly into the joint space Merits Demerits Ensures higher concentration of drug into localized area Damage to joint due to repeated injections Examples Rheumatoid arthritis : Hydrocortisone and gold chloride Slide 28: Dr Rushikesh Deshpande, Dr V M Motghare 28 Inhalatational Route Site: inspiration through nose or mouth Merits Demerits Examples Larger surface area of alveoli Faster absorption quick onset of action Self administration possible. Bronchial irritation increased bronchial and salivary secretion Metered aerosol preparation of salbutamol: treatment Bronchial asthma Sodium chromoglycate : prophylaxis of Bronchial asthma (local effect) Oxygen and general anesthetics ( systemic effect) INHALATION : INHALATION Salbutamol in bronchial asthma Compressed air driven solutions e.g. salbutamol in bronchial asthma Salbutamol General anaesthetic Slide 30: Dr Rushikesh Deshpande, Dr V M Motghare 30 Intra-cardiac Route The injection is given by a long needle into the heart through the left 4th ICS in midclavicular line. Adrenaline : in cardiac arrest Slide 31: Dr Rushikesh Deshpande, Dr V M Motghare 31 Epidural Route Site: through a vertebral interspace between the dura of the spinal cord and the lining of the spinal canal. Xylocaine : epidural nerve block Slide 32: Dr Rushikesh Deshpande, Dr V M Motghare 32 Topical Routes Transdermal patches Conjunctival Vaginal & Urethral Inunction Slide 33: Dr Rushikesh Deshpande, Dr V M Motghare 33 Trans-dermal Route Site: adhesive matrix (patch) containing the drug applied to chest, upper abdomen or mastoid region. Merits Slow but sustained release of drug over a period of days Examples Nitroglycerine : angina Scopolamine : motion sickness Clonidine: hypertension Estradiol: menopausal syndrome Slide 34: Dr Rushikesh Deshpande, Dr V M Motghare 34 Conjunctival Route Site: drugs are instilled onto the conjunctiva. Examples Sulfacetamide Chloramphenicol Gentamicin Ciprofloxacin Occuserts Lacriserts Slide 35: Dr Rushikesh Deshpande, Dr V M Motghare 35 Vaginal & Urethral Route Solutions, ointments,emulsion,foams,tablets, suppositories and pessaries are used for this route Examples Antifungal drugs Metronidazole Pessary Solid medicated preparation designed for insertion into the vagina. Solid medicated preparation designed for insertion into the rectum. Suppository Bougie Solid medicated preparation designed for insertion into the urethra. ENDOTRACHEAL SPRAY : ENDOTRACHEAL SPRAY Adrenaline Atropine Diazepam Naloxone Lignocaine To be diluted in 5-10 ml saline before administration. Slide 37: Dr Rushikesh Deshpande, Dr V M Motghare 37 Inunction (Rubbing) Site: rubbing the drug preparation onto the surface of skin. Merits Demerits Safe and convenient Difficulty in ascertaining the amount of drug given Systemic absorption can take place Examples Turpentine liniment LOCAL APPLICATION : LOCAL APPLICATION Slide 39: ENEMA : ENEMA EVACUANT ENEMA For evacuation of large bowel. Warm water, soap solutions, glycerin can be given. Amount ~ 600 ml. Used for Constipation Pre-op preperation Before radiological examination. RETENTION ENEMA Local action Steroids in ulcerative colitis. Systemic action Diazepam in status epilepticus Indomethacin in RA. Amount ~ 100-120 ml. Causes evacuation Should be retained for action Slide 41: Same drug different route different actiondifferent therapeutic indications. E.g magnesium sulphate, N acetyl cysteine, absolute alcohol. Action of Magnesium Sulphate. Slide 42: Dr Rushikesh Deshpande, Dr V M Motghare 42 Newer Drug Delivery System Slide 43: http://www.ianblumer.com/insulin_pump_therapy.htm Pump therapy uses rapid acting insulin and gives the insulin in tiny doses around the clock Insulin Pump Slide 44: The Medi-Jector VISION uses pressure to create a micro-thin stream of insulin that penetrates the skin The insulin is deposited into the subcutaneous (fatty) tissue in a fraction of a second Currently FDA approved for insulin delivery http://www.antarespharma.com/content/products/vision/presentation.html#product2 Slide 45: http://www.boston.com/news/nation/washington/articles/2006/01/28/inhaled_insulin_for_diabetics_wins_fdas_ok/?rss_id=Boston+Globe+--+Front+Page Exubera Inhaled Insulin Slide 46: Atropine (nerve agents) Diazepam (antiseizure) http://www.domesticpreparedness.com/onlineexhibits/meridian/meridian1.html Autoinjectors Slide 47: http://www.jetinjector.com/pages/specifications.html New no-needle way of delivering SC drugs Can deliver liquid or powdered drugs Uses compressed gas to force drug through the skin Currently used to deliver smallpox vaccine PenJet Slide 48: http://www.vyteris.com/technology.html non-invasive technique that uses a mild electric current to deliver drugs through the skin e.g. Salicylates cortisol, methacholine, lidocaine Iontophoresis Slide 49: Dr Rushikesh Deshpande, Dr V M Motghare 49 Phonophoresis “ Phonophoresis is defined as the movement of drug molecules through the skin under the influence of ultrasound.” Slide 50: a small, semi-soft disc that adheres to the mucosa, and delivers the drug as the film bioerodes Useful for systemic or local delivery Increases drug residence time which increase absorption http://www.atrixlabs.com/ourtech/bema.cfm Transmucosal delivery film Slide 51: http://www.popcouncil.org/images/mediaroom/norplant.jpg http://www.bbc.co.uk/health/sex/pop_up_contraceptive_implants.html Levonorgestrol subdermally implanted in upper arm Provides contraceptive protection for ~5yrs. Norplant Contraceptive implants : Contraceptive implants Dr Rushikesh Deshpande, Dr V M Motghare 52 Slide 53: A miniature cylinder made from a titanium alloy, which protects & stabilizes the drug inside Water enters through a semipermeable membrane; the drug is delivered from a port at the other end of the cylinder at a controlled rate for up to one year http://www.alza.com/alza/duros Viadur (leuprolide acetate implant), the first marketed product to incorporate DUROS, is indicated for the palliative treatment of advanced prostate cancer DUROS implant Slide 54: http://www.alza.com/alza/oros Osmotic drug delivery Drugs such as Procardia XL for hypertension & angina Concerta for ADHD, & Ditropan XL for bladder control They utilize this technology for once a day delivery Provides controlled drug release for up to 24 hours Slide 55: Dr Rushikesh Deshpande, Dr V M Motghare 55 Contributors Slide 56: Dr Rushikesh Deshpande, Dr V M Motghare 56 References Study notes – Dr V M Motghare, Prof & Head, Dept Of Pharmacology, S R T R Medical College, Ambajogai. Principles of Pharmacology : Sharma and sharma Dr Purohit – Routes of Drug administration presentation. Various internet sites. Slide 57: Dr Rushikesh Deshpande, Dr V M Motghare 57 THANK YOU !