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Monday, May 29, 2017

Routes of Drug Administration

Table of Contents

INTRODUCTION.
DEFINITION.
FACTORS OF DRUG ADMINISTRATION.
ADVANTAGES AND DISADVANTAGES.
CONCLUSION.

Routes of medication administration
To start, let’s talk about the different ways drugs can be
administered. You’re probably familiar with injections and
pills that you swallow, but medications can be given in
many other ways as well.
Routes of medication administration are described in the as follows…

DEFINITION

These are Routes of Medications that are used to diagnose, treat, or prevent illness.
They come in lots of different forms and they are taken in many different ways. 
 Drugs can be taken by oneself or a healthcare provider may give it to you.
Drugs can be dangerous, though, even when they are  meant to improve our health.
Taking them correctly and understanding the right way to administer them can reduce the risks.

FACTORS CONSIDERED IN DRUGS ADMINISTRATION

The routes used to give a drug depends on three main factors:
1. The part of the body being treated.
2. The way the drug works within the body.
3. The formula of the drug.
For instance, some drugs are destroyed by stomach acid if they are taken by mouth. So, they may have to be given by injection instead.

THE ROUTES:

 Enteral:  Placement of drug directly into any part of the GIT is called an 'enteral' mode of administration.
 a) Oral : Swallowing a drug through mouth.
  Advantages:
Most commonly used method as it is safe, convenient & a painless procedure
Economical as sterilization of drug products is not
essential
No need of any assistant.

Disadvantages:

Onset of action is slower.
Polar drugs can't be given as they are not absorbed (e.g: Streptomycin).
Drugs are destroyed by the digestive juices (Eg: Penicillin-G, Insulin, Oxytocin)
Bad taste, Bad smell & irritant drugs cannot  be given.
Drugs can't be given to unconscious & uncooperative patients.
Drugs cannot be given during emesis.

 b). SUBLINGUAL/ BUCCAL: The drug is place beneath the tongue (sublingual) or crushed
 in mouth and spread over the buccal mucosa (Buccal).
Advantages:
Quick onset of action because of rapid absorption due to more blood supply in that region.
Bypasses the portal circulation

Drug action can be terminated at any time when side effects are observed.

 Disadvantages:
Distasteful, irritant drugs cannot be given.
Higher molecular weight drugs can't be absorbed (e.g: insulin)

Examples include: Isosorbide dinitrate tablets & Nitroglycerin tablets (for Angina), Isopranline sulfate tablets (for Bronchial Asthma), Nifedipine in powder form (in Hypertension)

c) Rectal: Through Rectum (Suppositories, Enema).
Advantages:
   Useful in patients with nausea and vomiting
   Useful for gastric irritant drugs
Disadvantages:
Chances of rectal inflammation
Absorption is irregular
Inconvenient and embarrassing to the patient.

Parenteral Routes

These are routes other than "Enteral“. Administration of drugs by injection, by topical application to skin or by inhalation through the lungs are all parenteral.

a) Intravenous: This is through injection into a vein or into an IV line.

Advantages:
Directly enters into the systemic circulation & no 1st pass effect & quicker onset of action
 Less dose is needed to achieve greater therapeutic effects.
Valuable in emergency
 Can be given to unconscious, uncooperative
patients  and those  having nausea, vomiting & diarrhea
In addition: 
Hypertonic solutions & GIT irritant drugs can be infused.
 Large volume of fluids can be infused at a uniform rate.
 Amount of the drug can be controlled with an accuracy.

Disadvantages:
 Strict aseptic conditions are needed
 Patient has to depend upon other person for
administration of drug
 Painful
Risky because once it is injected, it can't be recalled
Introduction of any air or particulate matter produce embolism which is fatal.
Drugs in suspensions & Oily drugs can't be given
Depot injections can's be given
 Venous thrombosis & Thrombophlebitis of the vein injected
 Necrosis around the site of action
  Examples: Glucose, Glucose normal saline, Dopamine & Norepinephrine drips.

b) Intramuscular: Deltoid muscle or gluteal mass of left or right buttock. Vastus muscle underlying the lateral surface of the thigh.
Advantages:
Absorption is more predictable, less variable & rapid compared to Oral route
 Depot injections can be given.

Disadvantages:
 Perfect aseptic conditions are needed.
Chances of abscess at the site of injection
 Chances of nerve damage leading to paresis of muscle supplied by it.
 Large volumes can't be given (maximum 5 – 10 ml)
Examples: Depot injection of Testosterone, Antibiotics e.t.c

c) Intraperitoneal: Injected Into the peritoneal space
 Rapid absorption due to large surface area
Disadvantage
Painful, risky

d) Intrathecal (Intraspinal): Applied Into the  subarachnoid space. They cross BBB & Blood CSF barrier. E.g Xylocaine injection for providing Spinal Anesthesia.
e) Intramedullary: Injection into the tibial or sternal bone marrow.
f) Intra-arterial : Into the lumen of the desired artery.
g) Intra-articular: injection directly into the joint space
















 TIMING AND DOSAGE OF DRUG ADMINISTRATION


 Dosage should be followed strictly as described in the prescription label or other instructions.
Dosage is carefully determined by the doctor.
It can be affected by age, weight, kidney and liver function, and other health conditions.

For some medications, dosage must be determined by trial and error. For these drugs, the effects are  monitored when you first start treatment. 
   For instance, if your doctor prescribes thyroid medications or blood thinners, you would likely need to have several blood tests over time to show if the dosage is too high or too low.

The results from these tests would help the Physician adjust the dosage to fit the person’s body system.
Drugs need to be given at specific times, such as every morning, to keep that amount of drug in body system. Taking a dose too soon could lead to high drug levels.

 Missing a dose or waiting too long between doses could lower the amount of drug in the
    body and keep it from working properly.


CONCLUSION

Not all types of medications can be administered at home
Or by someone without special training. Doctors, nurses,
And other healthcare providers are trained in how to give
You medication safely. Administration of medication
Requires thorough understanding the drug, including:
How it moves through your body
When it needs to be administered
Possible side effects and dangerous reactions

storage proper, handling, and disposal
Healthcare providers are trained in all of these issues. In
fact, many healthcare providers keep in mind the “five
rights” when they administer drugs:
the right patient.
the right drug.
the right time.
the right dose.
the right route.


Have a nice time.

This article was written and compiled by Mrs Nancy FWANGTER.

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