Preparation & IM IV.ppt

8/10/2019 Preparation & IM IV.ppt

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Preparation &Administration IM, IV, Subcutaneous

Drugs


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Factors Deciding Choice of

Route

Type of described effect, systemic or local Physiochemical properties, solid or insoluble

Rapidity of effect

Quality of effect

Condition of patient, conscious or unconscious,vomiting


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Drug Administration

Topical/Local

AdministrationSystemic

Administration

Mucus

MembraneSkin

Enteral ParenteralInhalation


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Systemic Routes

Enteral through GIT

Orally

Buccal or sublingual

Rectal

Parental

Intravenous (IV)

Intramuscular (IM)

Subcutaneous (SC)


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Enteral Route


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Oral Administration

Via mouth

Tablets, capsules, powder, syrup, mixture

suspension or emulsion


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Advantages of oral route

Convenience and patient comfort

Safety, since medication can be retrieved in case

of error or intentional overdose

Economy, since there are few equipment cost


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Disadvantages of oral route

Slower onset of absorption and action

Rate and degree of absorption vary with

gastrointestinal contents and motility

Some drugs destroyed by digestive fluids andmust be administered by injection

Cannot be used with nausea or vomiting

Dangerous to use if patient has dysphagia, due to

the possibility of aspiration Cannot be used for unconscious patients

Cannot be use for patients who should keep nil

by oral


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Absorption from stomach and

upper intestine is affected by:-

Surface area Blood flow to site of absorption

Physical state: solid, solution, suspension

Water solubility

Concentration at the site of absorption

Rate of dissolution

Rate of disintegration

Particle size


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Via Nasogastric tube/Gastric tube

For the patients unable to swallow

Advantages : ability to bypass mouth and pharynx

when necessary , elimination of numerous

injections

Disadvantages: discomfort specially for the

conscious patients


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Buccal or sublingual Route

Buccal

medication placed in the pouch betweenthe cheek and the gum

Sublingual under the tongue

Advantages: directly absorb to the circulation and

rapid action

Disadvantage: misunderstanding of the way of

use


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Rectal Route

For the patients having nausea and vomiting orpatients who are unable to swallow

Advantages: bypassing the action of digestive

enzymes

Avoidance of irritation to the upper GI tract


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Disadvantages of Rectal route

Many medications are unavailable in suppositoryform

Prolonged use of rectal suppositories can cause

rectal irritation

Absorption may be irregular or incomplete if feces

are present

Inconvenient & embarrassing

Rectal inflammation occurs


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Disadvantages of Intravenous

Route Not suitable for oily solutions & insoluble

substances

Drug administered cannot be withdrawn

Thrombophlebitis occurs at injection site

Lack of sterility may cause viral hepatitisor AIDS

Increased risk of adverse drug reactions

Time and skill required for venipuncture

Difficulty of maintaining IV line

Complications of IV therapy bleeding, infection

and fluid overload


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Intramuscular Route ( IM)

Injections of drugs into certain muscles

Usually doses 3ml or less

IM injection

Depot preparationAbsorption depends upon rate of blood flow to the

injection site

Rapid action compared to SC route

Slow releasing compared to IV route


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Advantages : can be use to administer solutions orsuspensions

Slow, sustained effect from depot preparation

Disadvantages: incorrect placement of the needlemay damage blood vessels or nerves

PainAbscess formation

Avoid during anticoagulant therapy


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Subcutaneous Route (SC)

Injection of drugs under the skin

Use for highly soluble, non irritating, small volume

of drug about 1ml or less

Absorption is slower and the drug action is

generally longer with SC injections than with IV or

IM injections

Advantages :Slow absorption and distribution


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Disadvantages: tissue damage, tissue necrosis and

sterile abscess formation

Only nonirritant drugs

Not suitable for large volume


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Intraarterial Route

Direct injection into artery

Localization of effect in particular tissue or organ

Advantages: Diagnostics agents

Disadvantages: Reserved route for experts


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Intradermal Route

Injection into skin layers

Uses: BCG, Small pox vaccination

Testing drug sensitivity- Penicillin's

Tuberculin test


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Intraarticular Route

Drug administration directly to the joint

Usually local effect

Uses: Rheumatology disorders


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Topical Application- Mucous

Membrane

Conjunctiva, nasopharynx, oropharynx, vagina,urethra, urinary bladder, ear, nose, anal canal for

local effects

Ointment, cream, drops, jelly, powder, tablet,

suppository, pessary, sprays, gargles


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Topical Application- Skin

Absorption depends on surface area ofapplication, lipid solubility

Few drugs readily penetrate skin

Burned, denuded, abraded, inflammation

increase systemic absorption

Controlled- release topical patches


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Advantages: Absorption rapid

Only local effect Disadvantages: Toxicity by highly lipid soluble

substances


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Inhalation


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Inhalation

Via inhaler Via nebulizer

Medication directly to the respiratory system


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Advantages of Inhalation

Rapid action of the drug, with local effects with inthe respiratory tract

Potent drugs may be given in small amounts,

minimizing the side effects

Convenience and comfort of the patient


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Disadvantages of Inhalation

Requires cooperation of the patient in proper

breathing techniques for effectiveness

Adverse systemic side effects may result rapidly

because of extensive absorption capacity of thelungs

Improperly administered or too frequently

administered, inhalation can lead to irritation of the

trachea or bronchi or bronchospasm If not clean properly nebulizers can be a source of

infection

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Preparation & IM IV.ppt