13/08/2023 FORMS AND ROUTES OF DRUG ADMINISTRATION Dosage Form 1s. a system or device by which the drug is delivered to the body * Active ingredient responsible for the drug's therapeutic effect, inert ingredient ~ has litle or no therapeutic value * May also contain the following: * Additives ~ ae inert ingredients that may be needed for a successful preparation of the dosage form "Binders ~ promote adhesion of active and inactive ingredients inthe tablets *Diluents - are additives used to increase the bulk weight or vlume of a dosage form ‘+ Excipients are inactive substances used as a carrier forthe active ingredient * Preservatives ~ are substances that prevent or minimize the growth of bacteria or ‘microorganisms in the dosage form. DOSAGE FORMS, Dosage Form (cont) » Sold dosage forms “include tables, capsules, capes, lozenges/troches, pasties, powders, and granules + Advantages = increased stability + ase of packaging, storage and dispensing = Convenience tle oF no taste or smell + Allow for accurate dosing the entire dose is contained within the dosage form, which minimizes measuring eros. + May be ciffcult to swallow, have a slow onset of action, and may be degraded by the acidic content inthe stomach Dosage Form (cont'd) »Semisolid dosage forms = Have different composition from liquids and solids « Usually intended for topical application, applied to the skin, placed on mucous ‘membranes, or used in the nasa, rectal, or vaginal cavity «Examples: ointments, creams, lotions, gels, pastes, suppositories Dosage Form (cont'd)13/08/2023 > Liquid dosage forms Contain one or more active ingredients such as a solution, suspension, or emulsion + Can be administered by many routes but ae often less stable than medications in solid form + Route of administration may be oral, V, IM, cutaneous, SC ete + Advantages: + Allow easier dosage adjustments, particularly pedia patients + Easier to swallow, particulary pedia and elderly patients + Onset of action is faster than the solid dosage forms + Easier to place down a feeding tube 8 Dosage Form (cont'd) > Liquid dosage form (contd) + Disadvantages: + Loss of potency faster than with sold for. + Difficulty in masking bitter taste or odor + Need preservatives iquid doses provide an excellent medium for growth of microorganisms + There is a potential for dosing inaccuracy + Inconvenience » Classification of liquid dosage form «= Monophasic liquid phase «Biphasic ~ 2 phases: solid and liquid 10 Dosage Form (cont) > Inhalation Dosage Forms + Some patients need to have their medications delivered specifically tothe bronchial tree (asthmatic patients) + Inthe form of gases, vapors, aerosols, powders, sprays, solutions, suspensions and are intended to be inhaled via the nose or mouth = Devices used to deliver these medications to reach the lungs may include: vaporzers, humidifiers, and nebulizes 11 Inhalation Devices 12 Dosage Forms (cont'd) Transdermal Dosage Form + Transdermal patch dosage form is designed to hold a specific amount of medication to be released into the skin and absorbed into the bloodstream over time via a patch or disk «The backing is removed and the adhesive layer is attached to the skin « Patches are convenient because they can be applied easly and minimize stomach upset + Improves compliance since they eliminate the need for more frequent dosing B 14 Route of Drug Administration13/08/2023 > sa path by which a drug is taken into the body »This is determined by: +The property of the drug +g, water oF lipid solubility, ionization «Therapeutic objectives + Eg. desirability of rapid onset, need for long term treatment + Biopharmaceutical factors * Cellular components, thelr preparation and use ‘+ The absorption pattern of drugs varies between different routes of administration 15 18 Enteral Administration > This route involves the gastrointestinal tract which includes the esophagus, stomach, the small and large intestines and rectum. > Methods of administration include 1. oral drugs are swallowed 2. sublingual - under the tongue 3. buccal ~ between gums and cheeks 4, rectal ~in the rectum 17 ORAL ADMINISTRATION > Isa route of administration where a substance is taken through the mouth > 2 methods + Applying topically to the mouth + Swallowing for absorption along the GI tract into systemic circulation 'Medications are taken orally because they are intended to have a systemic effect, reaching different parts ofthe body via the bloodstream ‘The most used route ‘Absorption pattern: variable (affected by many factors); also depends on the dosage form 18 Common Oral Dosage Forms “Tablets * Capsules + Liquids * Solutions + Suspensions + Syrups * Els 19 Buccal Route 1)» The drug is placed between gums and inner lining of the cheek (buccal pouch) » Absorbed by the buccal mucosaa 2 2 2s 2 Sublingual Route > The drug is placed under the tongue and is allowed to dissolve in the mouth > The drug gets absorbed through the mucous membrane directly into circulation » Rectal Route » Administered rectally as suppository, solutions or ointments, In this form, the drug is mixed with a waxy substance that dissolves or liquefies after its inserted into the rectum, Rectal Route > Drugs are given rectally fora local effector to achieve a systemic effect >For a systemic effect, rectal route is preferred when: + The drug is destroyed in the Gl tract + Oral administration is not possible because of vomiting «The patient is unconscious or incapable of swallowing oral medications Parenteral Route 11s the injection or infusion by means of a needle or catheter inserted into the body Mypes « Intradermal (1D) ~ into skin + Subcutaneous (SC) ~ into subcutaneous tissue + Intramuscular (IM) ~ into skeletal muscle + Intravenous (I) ~nto veins « Intra-artetial (IA) ~into arteries. “Intrathecal (I) ~ cerebral fluids «Intraperitoneal (IP) - peritoneal cavity + Intra-articular (synovial fluids) ‘Types of Parenteral Routes Parenteral Route >} INTRADERMAL +A shallow or superficial injection of a medication into the dermis » > INTRAMUSCULAR A technique used to deliver medication deep into the muscles Parenteral Route SUBCUTANEOUS A technique of administering medication into the tissue layer under the skin > INTRATHECAL > Administration of medication via an injection into the spinal canal or subarachnoid space. Parenteral Route DINTRAARTICULAR > An injection placed directly into a joint to relieve pain INTRAVENOUS 13/08/202313/08/2023 } Medications are sent directly into a vein using a needle or tube 2 Percutaneous Route 1s the application ofa drug directly tothe surface ofthe skin > Includes administration of drugs to any mucous membrane tye “Nose «Ears Lungs + Vagina 29 Percutaneous (Topical) Dosage Forms 1 SKIN: Creams Ointment * Lotions "Gels ‘Transdermal patches Disks 2 + EVEOREAR + Solutions ‘Suspensions *Ointments “NOSE & LUNGS * Sprays and powders 30 Selection of Route of Administration ‘The ROA is determined by: ‘The physical characteristics ofthe drug +The speed by which the drug is absorbed and/or released ‘The need to bypass hepatic metabolism ‘Flo achieve high concentrations at particular sites ‘Accuracy of the dosage Condition of the patient a1 References: > " sh » l Ho. Shah » Basic Pharmacology for Nurses by Clayton, Stock, Harroun >