Where does intravenous injection deliver medication?
Into systemic circulation.
Where does subcutaneous injection deliver medication?
Into the tissue beneath the skin.
Where does intramuscular injection deliver medication?
Into muscle.
How does an intravenous injection differ from an intravenous infusion in volume and delivery rate?
An injection delivers a small volume rapidly at one time; an infusion delivers a large volume slowly at a constant rate.
What bioavailability does intravenous administration provide?
100% bioavailability.
What response and bloodstream delivery result from intravenous administration?
It produces a quick response and delivers the entire dose to the bloodstream.
Where does a subcutaneous injection place aqueous solutions, oil solutions, or suspensions?
Into the loose connective and adipose tissue immediately beneath the skin.
Where does an intramuscular injection place aqueous solutions, oil solutions, or suspensions?
Directly into relaxed muscle.
What volume can an intramuscular injection accommodate?
Up to 2 ml.
What two effects can the oral route produce?
Local effects or systemic effects after gastrointestinal absorption.
What are key advantages and limitations of oral administration?
It is simple, self-administered, safe, convenient, and inexpensive, but onset is slow and absorption may be irregular or affected by gastrointestinal enzymes.
What is the first-pass effect?
Hepatic metabolism before a drug reaches general circulation can reduce its effect and may require a higher dose.
What limits the dose size in buccal administration?
Only small doses fit in the mouth.
Which metabolic process can buccal administration avoid?
First-pass metabolism.
Which patients can use buccal administration despite being unable to swallow?
Unconscious or vomiting patients.
What effects do transdermal drugs produce after crossing the skin?
Systemic effects.
Which metabolic process do transdermal drugs avoid?
First-pass metabolism.
Which digestive substances do transdermal drugs avoid?
Digestive juices.
Why are transdermal drugs generally limited to potent drugs?
Skin permeability is usually inadequate.
When can the rectal route be used instead of oral administration?
When oral administration is unsuitable, such as during vomiting or unconsciousness.
How does most rectal venous drainage affect first-pass effect?
It enters general circulation directly, reducing first-pass effect.
What limits the predictability and convenience of the rectal route?
Absorption is irregular and unpredictable, and the route is less convenient than oral administration.
What local effects are eye products used to treat?
Eye infections or allergies.
What forms are eye products available in?
Drops or ointments.
How long after opening should eye products be discarded?
Four weeks.
What preparation may injection dosage forms require before use?
Reconstitution of a powder.
What condition must injection preparations meet?
They must be sterile.
What moves fluid during an IV infusion?
Gravity moves the fluid.
What determines the pressure driving IV infusion flow?
The height of the infusion above the patient determines the pressure.
When can intravenous administration be used instead of the oral route?
When the oral route is unavailable or the patient is unconscious.
What must be available to perform intravenous administration?
Trained personnel and a suitable vein.
Which vein is preferred for administering large volumes of IV fluid?
The subclavian vein.
How does subcutaneous absorption typically proceed, and can injections be self-administered?
Absorption is slow but usually complete, and injections can be self-administered, as with insulin.
What is a typical maximum volume for a subcutaneous injection?
Typically no more than 1 ml.
Which sites are commonly used for subcutaneous injections?
The abdomen, upper back, upper arms, and lateral upper hips.
Which intramuscular site is often chosen for rapid absorption?
The deltoid muscle.
How much fluid does an intradermal injection typically place between the epidermis and dermis?
About 0.1 ml.
Why is an intradermal injection often used for allergy or immunity diagnostic tests?
It is absorbed slowly.
What limits the use of intra-arterial injection?
Rapid blood flow disperses the drug, and the route is technically difficult.
Where are emergency intracardiac injections administered?
Directly into a ventricle or cardiac muscle.
What type of solutions are used for intracardiac injections?
Aqueous solutions.
What volume is used for intraspinal injections?
Less than 20 ml.
What are the two categories of intraspinal injections?
Subarachnoid and epidural injections.
Where does an intra-articular injection place the solution or suspension?
Into the synovial fluid of a joint cavity.
Which dosage forms can be administered orally?
Solutions, suspensions, emulsions, tablets, capsules, granules, and powders.
How can calcium in antacids affect tetracycline absorption?
Calcium can chelate tetracycline and reduce its absorption.
How can food affect penicillin absorption?
Food slows penicillin absorption.
What advantages do liquid oral dosage forms have over solid forms?
They are easier to swallow and readily absorbed.
Why are enteric-coated tablets used, and what can cause premature coating breakdown?
They protect drugs degraded by gastric juice or irritating to the gastric mucosa; indigestion remedies can alter stomach pH and break down the coating prematurely.
What local effect can buccal administration produce?
Relief of a sore throat from a lozenge.
What systemic effect can buccal nitroglycerine provide?
Treatment of angina.
How does saliva support buccal drug administration?
It facilitates drug dissolution.
What facilitates drug absorption in the buccal cavity?
The highly vascular tongue and buccal cavity.
Which dosage forms are used for buccal administration?
Buccal tablets, lozenges, and pastilles.
What effects do topical preparations commonly produce?
Local effects.
Which dosage forms are topical preparations?
Lotions, liniments, ointments, pastes, creams, gels, paints, collodions, powders, and irrigation solutions.
What does a transdermal patch deliver over a specified time period?
A controlled dose of drug.
What local conditions can rectal preparations treat?
Hemorrhoids or constipation.
What systemic conditions can rectal preparations treat?
Fever or epilepsy.
Which dosage forms are used for rectal administration?
Suppositories and enemas.
What local condition can vaginal preparations treat?
Vaginal infection.
Which dosage forms are used for vaginal preparations?
Pessaries, tablets, capsules, solutions, sprays, and creams.
What local and systemic effects can inhaled drugs produce?
Local effects include bronchodilation or nasal decongestion; systemic effects include general anesthesia.
Which dosage forms are used for inhalation?
Inhalations, aerosols, and powders.
How can inhalation for local effects affect dose and side effects compared with oral administration?
It can require a much smaller dose and reduce side effects.
What lung features enable rapid systemic absorption after inhalation?
High blood flow and large surface area.
Where do inhaled particles larger than 20 microns impact?
In the mouth and throat.
How long should a user hold their breath after using an aerosol inhaler?
For 10 seconds or as comfortable.
What systemic treatment can use the nasal route for diabetes insipidus?
Desmopressin treatment.
Which dosage forms are used for the nasal route?
Nasal sprays and nasal drops.
How should the head and lower lid be positioned to instill eye drops?
Tilt the head back and pull down the lower lid to form a pocket.
How should the dropper be positioned when instilling eye drops?
Hold it close to the eye without touching it.
How should the head and cheek be positioned to apply eye ointment?
Tilt the head back and pull down the cheek to form an eyelid pouch.
How much ointment should be placed in the eyelid pouch?
A 1/4- to 1/2-inch ribbon.
When should eye drops be administered relative to eye ointment?
Administer the drops 10 minutes before the ointment.
What local conditions are ear drops used to treat?
Ear infections or earwax.
How should an ear-drop bottle be prepared before use?
Warm it in your hands and shake it.
How should an adult’s earlobe be positioned for ear drops?
Up and back.
How should a child’s earlobe be positioned for ear drops?
Down and back.
What should you do after instilling ear drops?
Keep the head tilted for several minutes.
What should you do after keeping the head tilted?
Straighten the head and wipe away excess liquid.
Why is subcutaneous absorption slower than intravenous drug entry into the blood?
The drug must cross the capillary endothelium and its basement membrane before reaching the blood.
Answer 24 questions on Drug Administration Routes.
1. Which route delivers a drug into the tissue beneath the skin rather than directly into the bloodstream or into muscle?
2. A clinic receives an injectable medication as a powder that must be prepared before administration. What preparation and product property are required?
Go over the full study guide for Drug Administration Routes.
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