2 Drug Administration

8/16/2019 2 Drug Administration

1/93


2/93

I. ROUTE OF ADMINISTRATION

II. INTERVAL OF ADMINISTRATION

III. TIME OF ADMINISTRATION

IV. DURATION OF THERAPHY

V. TECHNIQUE OF ADMINISTRATION


3/93

The reasons :

1. Most Convenience (oral)

2. To maximize concentration at the site of action3. Minimize it else where (topical)

4. To prolong the !ration of r!g a"sorption

#. $voi the first % pass % effect

&. 'conomical

. afest


4/93

Dose of Drug in Blood Drug in General

Drug at site of Circulation Absorption

Drug at sites of Action

Pharmacologic Effect

Clinical Effect

Toxicity Efficacy

Utility

*

+,

-

T

/

0*T *-T*/ +


5/93


6/93

- Enteral route : Oral Route

Sul!n"ual Route

#u$$al Route

Re$tal Route

- Parenteral route : Intra%enou& olu& 'I.V.(

Intra%enou& In)u&!on 'I.V.!n)(

Intra*u&$ular 'I.M.(

Su$utaneou& 'S.C.(- Ot+er route : Tran&,er*al

In+alat!on

et$

Cla&&!)!$at!on O) Route Dru" A,*!n!&trat!on


7/93

Enteral Route

Oral route

Dru" a,*!n!&tere, orall a&& t+rou"+ %ar!ou& art o) /IT0oral $a%!t- E&o+a"u&

- Sto*a$+

- Duo,enu*

- 1e2unu*

- Illeu*

- Collon

S*all !nte&t!ne : tran&!t t!*e 3 4 5 +our& A&ort!on !& not $o*lete t+e t!*e T+e ,ru"

lea%e &*all !nte&t!ne

De&tru$t!on ,!"e&t!%e 2u!$e0,!"e&t!%e en6!*

Oral $a%!t : &al!%a7 *u$!n !ntera$t 8!t+ ,ru"


8/93

E&o+a"u& : H 9 4 ;

Talet or $a&ule& *a lo,"e !n t+!& area

lo$al !rr!tat!onDru" ,!&&olut!on !& %er l!ttle

Sto*a$+ : T+e )a&t!n" H 9 < 4 ;

In t+e re&en$e o) )oo, H 9 =. 4 <

#a&!$ ,ru" &olu!l!6e, !n$rea&e

Duo,enu* : H 9 ; 4 ;.

#!$aronat neutral!6e, t+e a$!,!$ $+*e

T+e $o*le> )lu!, to ,!&&ol%e, ,ru"& 8!t+ l!*!te,

a?ueou& &olu!l!t

1e2unu* : Fe8er $ontra$t!on re)erre, !n %!%o ,ru" a&ort!on


9/93

Illeu* : H 9 @ ',!&tal art B(

#!$aronat &e$ret!on a$!, ,ru" 8!ll ,!&&ol%e,

#!le &e$ret!on to ,!&&ol%e, )at& an, +,ro+o!$ ,ru"

Collon : H 9 . 4

Lu*en $ontent *ore %!&$ou& &e*!&ol!, l!*!te, ,ru"

a&ort!on

T+eo+ll!n an, *etorolol a&ore, ↑

Le%o ,oa an, la$tulo&e *etaol!6e, enter!$ a$ter!a'aero!$ *!$ro or"an!&*(

A&ort!on o) $l!n,a*$!n an, roanolol


10/93

Parenteral Route

Intra%enou& 'I.V.(

- A)ter !n2e$t!on ,!&tr!u&e, %!a t+e $!r$ulat!on to all art o) o,

- A?ueou& &olut!on

- #!oa%a!la!l!t !& $o*lete an, ra!,

- Dru" ,el!%er !& $ontrolle, an, a$+!e%e, 8!t+ an a$$ura$ an,

!**e,!atel

- Certa!n !rr!tat!n" &olut!on o) ,ru" $an e "!%en

- Un)a)orale rea$t!on '+!"+ $on$entrat!on o) ,ru" !n la&*a an,

t!&&ue&(

D!&a,%anta"e& : - on$e !n2e$te, no retreat

- Dru" !n o!l %e+!$le7 re$!!tate loo, $on&t!tuent7

+e*ol!6e, ert+ro$te '&+oul, not e "!%en(


11/93

Intra%enou& In)u&!on 'I.V.!n)( a ,ru" &lo8l !n)u&!on

Intra*u&$ular 'I.M.(

- A)ter Intra*u&$ular !n2e$t!on ,!))u&e& )ro* *u&$le !nto t+e

&urron,!n" t!&&ue )lu!, t+e loo, ,!&tr!ute, %!a t+e $!r$ulat!on

- D!))erent *u&$le t!&&ue +a%e ,!))erent loo, )lo8- A?uaeou& &olut!on 0 &u&en&!on

Su$utaneou& 'S.C.(

- In2e$t!on un,er t+e &!n

- T+e e))e$t I.V. an, I.M.


12/93

Ot+er Route

Tran&,er*al Route=. Mu$ou&e *e*rane

- A ,ru" al!e, to *u$ou&e *e*rane& o) t+e $on2un$t!%ena&o+ar!n>7 aro+ar!n>7 %a"!na7 $ollon7 uret+ra7 an, ur!nar la,,er

- Pr!*ar )or t+e lo$al e))e$t

- A&ort!on rea,!l


13/93

ROUTE #IOAVAILA#ILITY ADVANTA/ES DISADVANTA/ES

Enteral Route&Oral 'PO(

A&ort!on *a %ar./enerall7 &lo8era&ort!on rate$o*are, to IV olu& or IM !n2e$t!on.

Sa)e&t an, ea&!e&troute o) ,ru"a,*!n!&trat!on. Ma u&e !**e,!ate- relea&e an,*o,!)!e,-relea&e

,ru" ro,u$t&.

So*e ,ru"& *a +a%eerrat!$ a&ort!on7 eun&tale !n t+e "a&to!nte&t!nal tra$t7 or e*etaol!6e, l!%err!or to &&te*!$

a&ort!on.

#u$$al or &ul!n"ual 'SL(

Ra!, a&ort!on)ro* l!!,-&olule,ru"&.

No G)!r&t-a&& e))e$t. So*e ,ru"& *a e

&8allo8e,.Not )or *o&t ,ru"& or

,ru"& 8!t+ +!"+ ,o&e&

Re$tal 'PR( A&ort!on *a %ar)ro* &uo&!tor.

More rel!alea&ort!on )ro*ene*a '&olut!on(.

U&e)ul 8+en at!ent$an not &8allo8*e,!$at!on.

U&e, )or lo$al an,&&te*!$ e))e$t&.

A&ort!on *a eerrat!$.Suo&!tor *a *!"rate,!))erent o&!t!on.

So*e at!ent ,!&$o*)ort.

ome Cracteristics of Common o!tes of 0r!gome Cracteristics of Common o!tes of 0r!g

$ministration$ministration


14/93

ROUTE BIOAVAILABILITY ADVANTAGES DISADVANTAGES

ParenteralRoutesIntravenous(IV)

Comlete (!""#)s$stem%&

'ru asort%on* Rate o+%oava%la%l%t$ &ons%'ere'%nstantaneous*

Dru %s %ven +or%mme'%ate

e,e&t*

In&rease &-an&e +ora'verse

rea&t%on*Poss%leana-$la.%s*

Intravenous

%n+us%on (IV%n+)

Comlete (!""#)

s$stem%& 'ruasort%on*Rate o+ 'ruasort%on&ontrolle' $%n+us%on um*

Plasma 'ru levels more re&%sel$ &ontrolle'*

/a$ %n0e&t lare 1u%' volumes* /a$ use 'rus 2%t-oor l%%' solu%l%t$an'3or %rr%tat%n

'ru*

Re4u%res s5%ll %n%nsert%on o+%n+us%on set* T%ssue 'amae ats%te o+

%n0e&t%on(%n6ltrat%on7ne&ros%s7

or ster%le As&ess)*

Intramus&ular %n0e&t%on(I/)

Ra%' +rom a4ueoussolut%on* Slo2 asort%on+rom

nona4ueous (o%l)solut%on*

Eas%er to %n0e&tt-an %ntravenous%n0e&t%on*

Lare volumes ma$ e use'

Irr%tat%n 'rus ma$e ver$ a%n+ul*D%,erent rates o+

asort%on'een'%n uon


15/93

ROUTE #IOAVAILA#ILITY ADVANTA/ES DISADVANTA/ES

Other RoutesTran&,er*al. Slo8 a&ort!on7

rate *a %ar.

In$rea&e,a&ort!on 8!t+o$$lu&!%e ,re&&!n".

Tran&,er*al,el!%er &&te*

'at$+( !& ea& tou&e. U&e, )or l!!,-&olule ,ru"& 8!t+lo8 ,o&e.

So*e !rr!tat!on at$+ o) ,ru".

Per*ea!l!t o) &!n%ar!ale 8!t+ $on,!t!on7anato*!$ &!te7 a"e7an,"en,er.Te o) $rea* oro!nt*ent a&e a))e$t&,ru"-relea&e an,

a&ort!on.

In+alat!on Ra!, a&ort!on.

Total ,o&ea&ore, !& %ar!ale.

Ma e u&e, )orLo$al or &&te*!$e))e$t&.

Part!$le &!6e o) ,ru",eter*!ne& anato*!$la$e*ent !n

re&!rator tra$t.Ma &t!*ulate $ou"+re)le>.

So*e ,ru" *a e&8allo8e,.


16/93

/0$ *T'

/ral ,eroral (per os) !"ling!al

,arenteral *ntraveno!s *ntraarterial *ntracariac *ntraspinal5intrathecal

*ntraosseo!s *ntraartic!lar

*ntras6novial *ntraco!tane!s5*ntraermal

!"c!taneo!s

*ntram!sc!lar 'pic!taneo!s (Topical) Transermal Con7!nctival *ntraocc!lar *ntranasal

$!ral *ntrarespirator6

Mo!th 8* tract s6stem via mo!th -ner the tong!e /ther sites than 8* tract ("6 in7ection) *nto vena *nto arter6 *nto the heart *nto spine

*nto "one *nto 7oint 6novial fl!i cavit6 *nto s9in -ner s9in *nto m!scle

9in s!rface 9in s!rface Con7!nctiva '6e glo"e +ose 'ar

!ng

SITE OF ROUTE ADMINISTRATION


17/93

THE USAGE OF DOSAGE FORMSTHE USAGE OF DOSAGE FORMS

Route O) Dru" A,*!n!&trat!on Do&a"e For*

OralSul!n"ualParenteralE!$utaneou&0Tran&,er*al

Re$talCon2un$t!%alIntrao$$ular0IntraauralIntrana&alIntrare&!rator

Va"!nal

Uret+ral

Sol!, an, L!?u!, ,o&a"e )or*Talet7 tro$+!t!on an, lo6en"e&Solut!on7 &u&en&!onO!nt*ent7 Crea*7 Pa&te7 Po8,er7 Aero&ol7Lot!on7Tran&,er*al7 D!&$7 an, Solut!on

Atta$+*entSolut!on7 O!nt*ent7 Suo&!tor!aO!nt*entSolut!on7 O!nt*entSolut!on7 Sra7 In+alant7 O!nt*ent

Aero&ol

Solut!on7 O!nt*ent7 E*ul&!)!e, )oa*7Talet7 In&ert7 Suo&!tor!a7 Son"eSolut!on7 Suo&!tor!a


18/93

DRUGS T9AT ARE USED SPECI8ICALLYDRUGS T9AT ARE USED SPECI8ICALLY

=. SU#LIN/UAL TA#LET

For $ar,!a$ ,!&ea&e& : an"!na0a&t+*a 'n!tro"l$er!n7 !&orenal!n(


19/93

;. DRU/S THAT ARE ITHOUT EKCESSIVE DRIN

Ant! "a&tr!t!& ,ru"0anta$!, &u&en&!on

. DRU/S THAT ARE TAEN ITHOUT MIL

- V!ta*!n C Ferrou&

- Ant!enteret!&

- Enter!$ $oate, talet

- Tetra$$l!ne

B. PEDIATRIC DRU/ ADMINISTRATION

Talet 0 o8,er ,!&&ol%e, !nto :

- Hone

- Su"ar 8ater - 1ell

- Corn o!l


20/93

0etermaine "6: alf % life time ( t ; ) of r!gs

a. -ltra fast $moxicillin< Cloxacillin< =l!rosemie<

,enicillin

". =ast ,aracetamol< $mpicillin< 6rocortison

c. low 0oxicillin< 8riseo fl!vine< ,roctolal. >er6 slow ar"it!rate< 0iazepam< 0igitoxin

,henil"!tazon


21/93


22/93


23/93

4. 0r!gs that s6nchronize with ch6me (foo)0r!gs that s6nchronize with ch6me (foo)

'xp :'xp : 0ox6c6cline< 0ox6c6cline h6clate< 'rthrom6cin< eth6ls!ccinate<

8riseof!lvin. (sho!l "e ta9en with meals)

#. tomachirritating r!gstomachirritating r!gs

'xp :'xp : $minoph6lline< $cet6l salicilic aci< Coein< ,hen6l"!tazon

E!A"P#E $% AD"&'&(T)AT&$' T&"E $% T*E &'TE)ACT&+E

D)UG(

R0 A*!$!ll!n *" $a No. KV

S 3. ,,.$a.I '=( +a$ ------- = +our e)ore *ealR0 Anta$!, ta No.KK

S3.,,.ta.I '=( +$ ------- = +our a)ter *eal

(t d d d i i t ti ti(t d d d i i t ti ti


24/93

Abbreviation Administration times

D !a!e ie D each a6 -s!all6 accepte to mean 1A:AA $M

"i D "is in ie D twice a a6 1A:AA $M< 2:AA ,M

ti D ter in ie D three times a a6 1A:AA $M< 2:AA ,M< an &:AA ,M

i D !ater in ie D fo!r times a a6 1A:AA $M< 2:AA ,M< &:AA ,M< an 1A:AA ,M

hs D hora somni D at "e time -s!all6 accepte to mean 1A:AA ,M

12h D !a!e !oecin hora D each twice ho!rs 1A:AA $M an 1A:AA ,M

Bh D !a!e octo hora D each eight ho!rs &:AA $M< 2:AA ,M< an 1A:AA ,M

&h D !a!e six D each six ho!rs &:AA $M< 12:AA $M< &:AA ,M< an 12:AA ,M

4h D !a!e !atto!r D each fo!r ho!rs &:AA $M< 1A:AA $M< 2:AA ,M< &:AA ,M< 1A:AA ,M<

an 2:AA $M3h D !a!e tres D each three ho!rs 3:AA $M< &:AA $M< E:AA $M< 12:AA $M< 3:AA ,M<

&:AA ,M< E:AA ,M< an 12:AA ,M

ac D ante ci"os "efore meals (approximatel6 3A % 4# min!tes)

pc D past ci"os after meals (approximatel6 1 ho!r)

'xceptions:

1. terois perhaps sho!l "e aministere near :AA or B:AA $M when on a sche!le.

2. /ral h6pogl6cemic agents an ins!lin (:AA $M an5or 4:3A ,M) when orere "i.

3. $nti"iotics sho!l "e sprea evenl6 over 24 ho!rs. $n approximate sche!le to avoi meals might "e 4:$M< 1A:AA $M< 4:AA ,M< an 1A:AA ,M.

4. $ntih6pertensive agents sho!l "e sprea over the 24 ho!r perio

#. $nticoag!lants sho!l "e sche!le so as to follow meas!rement of the patientFs clotting time.

(tandard administration times(tandard administration times


25/93

=*G T*M' /= $0M*+*T$T*/+

*n the morning : teroi

0i!retic!m

$ntih6pertensi

*n the night : Contraceptive agent

6pnotic agent

0!ring meal : 0r!g irritating stomach

0r!g that sensitive to gastric p

0r!g a"sorption increase

0!ring episoe : $ntiasthmatic r!g

0r!g for migraine

$ngina pectoris r!gs

'mpt6 stomach : 1 ho!r "efore meal 1h.a.c

2 ho!r after meal 2h.p.c


26/93

S*to*at!$ t+era : t+ree ,a&

Cau&at!%e t+era : &+oul, e enou"+


27/93

= DRUG DOSAGE 8OR/S

= ROUTE O8 AD/INISTRATION

= SPECI8IC> DRUG /EDICATION= PARENTERAL DRUG /EDICATION


28/93

!* T-e -an' -ol's t-e o%ntment a+ter 2as-e' 6rst to e

&lean

?* Oen t-e tue@s &a t-en '%s&ar' t-e 6rst !3 %n&-

lent- o+ t-e o%ntment7 e&ause t-%s ort%on %s o+ten 'r$*

*


29/93


30/93

!* Cou- out t-e sutum as mu&- as oss%le*Aerosol %s s-a5e' e+ore use

?* Pla&e %t as t-e re&ommen'at%on o+ t-emanu+a&terer* It %s usuall$ set us%'e 'o2n*

* Pla&e t-e oral e'e o+ tue %ns%'e t-e mout-7 +a&eu2ar' $ mov%n -ea' oster%orl$*

* Breat- out slo2l$7 emt$ t-e lun volume as mu&-as oss%le*

* Press t-e tue &ontent %n or'er to sra$ mean2-%le%mme'%atel$ %n-alate %t 'eel$ 2%t- touneos%t%on rema%ns st%ll elo2*

* 9ol' t-e reat- 2%t-%n !" > ! se&on's*

* T-en7 e.%re t-e a%r t-rou- nares*


31/93


32/93

!* Cou- out t-e sutum as mu&- as oss%le*

?* Pla&e t-e &asule %nto t-e %n-aler &onta%ner as t-e

manu+a&turer@s re&ommen'at%on

* Breat- out slo2l$7 emt$ t-e lun volume as mu&- as

oss%le*

* Pla&e t-e oral t% o+ tue %ns%'e t-e mout-*

* 8a&e u2ar' $ mov%n -ea' oster%orl$*

* Bret- %n 'eel$ t-rou- %n-aler* 9ol' t-e reat- +or !" >! se&on's

F* E.-ale t-e reat- t-rou- nares*


33/93


34/93

!*S%t 2%t- $our -ea' +a&%n u2ar'7 or a'

$our s-oul'er 2%t- a %llo2 un'er*

?*Insert t-e t% o+ 'roer as'ee as !&m %nto

t-e nares**Dr% some 'ros o+ t-e 'rus as

re&ommen'e'*

*No' 'o2n2ar' $our -ea' so t-at t-e -ea' %s

over t-e 5nee*

*S%t u reet%t%vel$ +or several t%mes so t-at

t-e 'ro &an enter t-e -ar$n.*


35/93


36/93

No' 'o2n t-e -ea' sl%-tl$*

T-e ot-er nose %s &lose' $ ress%n t-e

na&res 2%t- $our 6ner*

T-e sra$er %s %nserte' %nto t-e oene'

na&res $ ress%n t-e v%al7 so t-at %ts&ontent 2%ll e out an' %n-ale entl$7 t-en'o t-e same as t-e aovement%one'*


37/93

T-e est %s t-e -ea' %n slant%n os%t%on

Gentl$ t-e uer art o+ t-e ear loe %s sl%-tl$attra&te' u2ar' (%n a'ult) an' t-e m%''le one%n &-%l'ren %n or'er to let t-e oen%n %s seen&learl$*

Dr% some ear 'ros an' 2a%t +or aro.%matel$ m%nutes e+ore 'o%n t-e same %nto anot-er

one*

In some ro'u&ts7 %t %s re&ommen'e' to &loset-e ear oen%n 2%t- &otton all*


38/93


39/93

Suos%tor%a %s reare' to e out o+ t-e&onta%ner*


40/93

INTRAVAGINALINTRAVAGINAL


41/93

INTRAVAGINALINTRAVAGINAL

MEDICATIONMEDICATION

In eneral7 %ntrava%nal me'%&at%on %s l%m%te' tot-e lo&al%He' al%&at%on +or 2-%&- o%ntments ortalets are ava%lale to %nsert %nto va%na an'usuall$ $ t-e t%me o+ o%n to e'7 su&- as

metron%'aHole an' r%mar%&%n +or va%n%t%s&ause' $ tr%&-omonas an' &an'%'a*

T-e 'rus ma$ e use' %n t-e +orm o+ s2a%n

l%4u%'7 ot-ers %n t-e +orms o+ sermat%&%'e (to 5%llsermato&$te)7 +oam talet7an' &ream*


42/93


43/93

THE TOPICAL DRUGS USED FOR SKIN IN GENERAL

INCLUDE :

!*


44/93


45/93

Vesicles, edema, er!"remaCr#s!, i!c"i$% i$&ec!i'$(a!er )s'l#!i'$* + e! c'm-ressi'$P'der, l'!i'$, s-ras Cream )'.*Cream ).'* a$d a$d 'i$!me$!

Des/#ama!i'$, er!"rema!'#s, i!c"i$%,dri$%


46/93

T9E ADVANTAGES O8 PARENTERAL /EDICATION :

!* T-e 'ru a&t%on &an e rea&-e' ra%'l$7 stron7 an'

&omlete

?* No %rr%tat%on or not 'estro$e' $ astr%& a&%'

* &an e a'm%n%stere' to t-e at%ents 2%t-

un&ons&%ousness or s2allo2%n una%l%t$

Pare$!eral medica!i'$ ca$ 0e #$der!a1e$ :

!* B$ %n0e&t%on 2%t- s$r%ne

?* T-rou- %n+us%on l%4u%' (more t-an !" ml

volume)

!* In eneral7 %t %s e.ens%ve an' %mra&t%&al

?* Eas$ to &ontam%nate

* Ale to 'amae loo' vessel7 t%ssue7 an' nerve

* T-e a'm%n%strat%on met-o's s-oul' e a'0uste'7 e&ause

o+ e%n slo2 an' ra%'

T9E DISADVANTAGES O8 PARENTERAL /EDICATION :


47/93

Con&lus%vel$7 arenteral me'%&at%on are ase' on ?ma%n &ons%'erat%ons :

!* E.e&tat%on o+ ra%' 'ru a&t%on

?* t-e re4u%re' 'rus are %n t-e +orm o+ arenteral

'osae +orms

Intravenous a'm%n%strat%on %s one o+ t-e most%mortant &l%n%&al treatment &omare' to t-e ot-erarenteral a'm%n%strat%ons7 e&ause :

!* In0e&te' '%re&tl$ to2ar' t-e loo' vessel

?* Ra%' an' %mme'%ate onset

* Inversel$7 %v%n 'aner su&- as ana-$la&t%&

s-o&5 or severe ana-$la&t%& rea&t%ons*

Intravenous a'm%n%strat%on nee's t-e s5%ll+ulness7 reat


48/93

Intravenous a'm%n%strat%on nee's t-e s5%ll+ulness7 reatattent%on7 an' re&at%ousl$ 2%t- ant%set%& te&-n%4uesan' also nee' &lose mon%tor%n o+ 'ru a&t%on*

P-$s%&%ans 0u'e t-e 'e&%s%on o+ %ntravenous me'%&at%onase' on as +ollo2s :

!* 2-enever ot-er routes o+ a'm%n%strat%on are &ons%'ere%moss%le 2-ereas t-e tera$ manaement must e%mlemente' romtl$* 8or e.amle :

; /et-%&%ll%n %n stoma&- 2%ll e ro5en 'o2n $ a&%'72-ereas v%a %ntramus&ular met-o' %s %moss%lee&ause o+ lare volume re4u%re'7 t-en t-e &-osenaror%ate met-o' %s %ntraveous route*

; T-e mult%le 'ru me'%&at%on %n lare volume %s%moss%le to %ve %ntramus&ularl$ rear'%n to%v%n r%se a%n+ulness s%m%larl$7 su&utaneousmet-o' 2%ll result %n 2%'er %n1ammat%on*

; In ver$ %rr%tat%ve 'ru $ %ntramus&ular an'su&utaneous met-o'7 %t &an e '%lute' %nto %n+uss%on*


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In t-e se&%6& &l%n%&al sett%ns7 t-e ra%'a'm%n%strat%on %s re4u%re' +or at%ents 2%t-ser%ous &on'%t%on*

In at%ents 2%t- -%- ten'en&$ to e -emorr-a%&(t-romo&$toen%a or -emo-%l%a an'ant%&oaulant a'm%n%strat%on)7 %ntramus&ular an'su&utaneous me'%&at%on 2%ll &ause +ormat%on

o+ -ematoma 2-%&- %s a%n+ul an' e.tens%ve orlee'%n*

8or sulementar$ nutr%t%on7 %n at%ents 2%t-GI '%sturan&es7 eroral %nta5e %s not a'e4uate7

an' so 'oes at%ent 2%t- astro%ntest%nal ost>oerat%ve &on'%t%on*

; Pat%ents 2%t- vom%t%n an' nausea at &erta%nlevel7 su&- as severe -$eremes%s rav%'arum7un&ons&%ousness7 or s2allo2%n una%l%t$*

INTRODUCTION TO IN2ECTION DRUGSINTRODUCTION TO IN2ECTION DRUGS


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INTRODUCTION TO IN2ECTION DRUGSINTRODUCTION TO IN2ECTION DRUGS

In0e&t%on 'ru %s a ster%l%He' rearat%on %n t-e +orms o+ :

!*L%4u%'7 &ons%st%n o+ :

Solut%on7 t-e a&t%ve %nre'%ent '%solves %n %t an' t-eava%lale a&5a%n %s %n amule or v%al*

Susens%on7 unsolule a&t%ve %nre'%ent7 %s susen'e't-orou-l$ %n t-e susens%on us%n susens%on aent*

Emuls%on7 t-e l%4u%' &onta%n%n t-e m%.ture o+ 2ater an' o%l*


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e, 8!t+ &ol%ent e)ore u&e7 t+!&!n"re,!ent !& not lon"-&tan,!n" t+at rea& ,o8n !n t+e

&olut!on.

In&olule In"re,!ent7 *!>e, 8!t+ l!?u!, 8+en !t 8!ll e u&e,7

e$au&e !t !& not lon"-&tan,!n" !n &olut!on7 ut roen ,o8n.

Dela$%n t-e 'ru asort%on %nto t-e loo'vessels7 %n t-e reason to lent-en t-e 'ru a&t%on7

susens%on or solut%on %n ean o%l or sesame o%l %s+re4uentl$ use'7 +or e.amles7 en%&%ll%n an'se.ual -ormone susens%on7 %ven %ntramus&ularl$*


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THE CONTAINER OF IN2ECTIONDRUGS

34 AMPULES

It %s ma'e +rom lass or last%&s 2%t-var%ous s%Hes7 +rom ! ml (a'renal%n) u to

!" ml (am%no-$l%ne) enerall$ +or on&eusae*


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!ass!assP!asti"P!asti"


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THE PREPARATION TO USE :


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54 VIAL

It %s ma'e +rom lass 2%t- ruer &a 6.e' 2%t- 6lmmetal surroun'%n t-e ottle l%7 enerall$ &an euse' reet%t%vel$*

T-e 6ll%n o+ 'ru solut%on %nto s$r%ne %s as +ollo2s :Solut%on :

Su&5 t-e a%r as mu&- as nee'e' /a5e t-e v%al ruer &lean us%n ster%l%He' al&o-ol &otton Pr%&5 t-e s$r%ne %nto t-e v%al 2-%le t-e us%'e>'o2n

os%t%on o+ t-e v%al * Press t-e a%r %nto t-e v%al t-en '%re&tl$ um>%n t-e

solut%on as mu&- as nee'e'7 t-e nee'le s-oul' e

al2a$s %n t-e solut%on or'er* /a5e t-e s$r%ne +ree +rom a%r an' &lean %t7 2as- t-e

-an's*


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H6PODERMIC E7UIPMENTS

S6RINGE %s an e4u%ment to et 2ater or solut%on %ntot-e o'$ or o'$ &av%t%es*

H6PODERMIC S6RINGE %s s$r%ne to use +orsu&utanous7 %ntramus&ular7 an' %ntravenous met-o's* It

%s a su&5%n t$e an' &-ara&ter%He' $ t-e ma%n&omonents %n&lu'%n a metal %ston an' a tue ma'e+rom lass 2%t- var%ous s%Hes*

!* Tuer&ul%n s$r%ne : small s%He 2%t- &aa&%t$ no moret-an ! ml *

"*! > "*""! ml*

9$o'erm%& S$r%ne : Larer s%He 2%t- &aa&%t$ ? > " ml*


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DISPOSA8LE S6RINGE :DISPOSA8LE S6RINGE :

/a'e +rom last%&s 2%t- larer s%He t-an Tuer&ul%n s$r%ne ( ml) +or on&e useonl$7 a&5e' 2%t- ster%le state an'searate' nee'le*

In eneral7 %t %s use' t-e a'm%n%strat%on o+ant%%ot%&s7 ant%-%stam%ne7 -ear%n7tran4u%l%Her7 v%tam%n7 et&*


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H6PODERMIC NEEDLESH6PODERMIC NEEDLES

T-%s nee'le t$%&all$ %s ma'e +rom sta%nless steel7

-$er&-rome' steel7 &aron steel7 &-rom%um7

lat%num7 s%lver or ol'*

T"e &'rm '& "-'dermic $eedles 0ased '$ :!* Lent-

?* T-%&5ness nee'le

* Se&t%on%n: s-ar>anle se&t%one' nee'le


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N dl SiN dl Si


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Needle Si9eNeedle Si9e

T"e c"''si$% '& $eedle si9e '$ !"e 0asis '&

!* Sa+et$?* 8lo2 volume

* Pat%ent@s &onven%en&e

* Penetrat%on 'et-

T-e un%t o+ nee'le s%He %s GAUGE re+err%n to t-e outer'%ameter o+ &anula or nee'le s-a+t*

In eneral t-e s%He %s ! > ? aue7 2%t- t-e lent- notless t-an !3 %n&- an' more t-an * %n&-es*

8or several %os%es an' s%nal tran+us%on7 t-e nee'les

are ! > !K aue %n s%He an' "* > * %n&-es %n lent- 8or lo&al anest-es%a7 t-e nee'les are +rom ? aue2%t- !3? %n&- to ?" aue 2%t- %n&-es*

8or %ntravenous trans+us%on7 t-e nee'les are +rom !Kaue 2%t- !*? %n&-es to ! aue 2%t- ?* %n&-es*


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T"ere are als' ma$ '!"er #!ili!ies :T"ere are als' ma$ '!"er #!ili!ies :

!* Cau'al nee'le

?* E%'ural nee'le

* Intravenousl$ anest-et%& nee'le

* Bloo' trans+us%on nee'le

* S%nal nee'le

* B%os$ nee'le

* Cereral an%ora-%& nee'le


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5 SU8CUTANEOUS OR H6PODERMAL IN2ECTION


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54 SU8CUTANEOUS OR H6PODERMAL IN2ECTION

Dosae +orm : Solut%on or o%l

Volume : No more t-an ? ml

T-e %n0e&t%on un'er s5%n s-oul' e &on'u&te' 2%t- non>

%rr%tant 'rus 2-%&- are solule e%t-er %n 2ater or o%l7 ut t-e

e,e&t %s not as ra%' as I/ or IV met-o'* It %s eas$ to 'o $

at%ents t-emselves7 su&- as %nsul%n a'm%n%strat%on*

4 I$ 8CG admi$is!ra!i'$ &'r i$&a$!s, i$;ec!i'$


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T"is me!"'d is als' #sed i$ !"e

admi$is!ra!i'$ '& "e-ari$ a$d

e-i$e-"ri$e s#s-e$si'$s4

S5%n -as oor loo' vas&ulature7 t-ere$ t-e

'rus t-at 2%ll e asore' $ loo' vessels an'

t-e nonsolule 'rus '%,use %nto l$m-at%&

vessels*

IN2ECTION TECHNI7UESIN2ECTION TECHNI7UES


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IN2ECTION TECHNI7UESIN2ECTION TECHNI7UES

!*


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4 INTRAMUSCULAR IN2ECTION4 INTRAMUSCULAR IN2ECTION

D'sa%e &'rm : Solut%on7 susens%on %n 2ateror o%l

V'l#me : No more t-an ml

In %n0e&t%on %nto mus&les7 t-e solule 'ruresort%on 2%ll last 2%t-%n !" > " m%nutes*

T"e ad


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72/93

#estus Latera!is $#estus Latera!is $


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Middle as-ec! '& !"i%" :

ver$ oor nerve 6ers an' loo' vas&ulature*

P'si!i'$ : su%ne7 or s%tt%n

V'l#me : ?* > ml

Del!'id m#scle :Eas$7 2%t- os%t%on o+ +a&%n laterall$7 s%tt%n7or stan'%n7 nee's attent%on t-at t-e area %sver$ l%m%te' an' t-e e.%sten&e o+ lare one7loo' vessels7 an' nerve 6ers*

#estus Latera!is $#estus Latera!is $

Dru% #o!ume $Dru% #o!ume $


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!* No more t-an ? ml*?*


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ADMINISTRATIONADMINISTRATIONMa!erials :

S$r%ne 6lle' 2%t- a%r>+ree 'ru l%4u%'7

Nee'le o+ ?" aue7 lon an' mo'erate t-%&5ness

Disi$&ec!a$!

Cotton7 lasters7 an' tourn%4uet

I$;ec!i'$ Pr'ced#re :!*


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I$;ec!i'$ Pr'ced#re :

* Ve%n %s sta%l%He' $ rela&%n t-e ress%n -an' to t-es5%n %n l%ne 2%t- t-e ve%n lon%tu'%nal a.%s7 us%n t-e ot-er-an'*

* D%re&t &ar'%all$ t-e nee'le to ve%n 2%t- 'eree o+ anle7s-oot t-e nee'le slo2l$ %nto > mm 'et- o+ ve%n

F* Do as%rat%on7 %+ t-ere %s loo' %ns%'e t-e s$r%ne7 %t meanst-at t-e nee'le -as a%me' to t-e ve%n7 %nstea'7 tr$ aa%n*

K* Tourn%4uet t-en %s remove'!"* In0e&t t-e 'ru slo2l$7 oserve t-e a%n sensat%on7 s2ell%n

or -ematoma %+ t-e nee'le %s st%ll %n ve%n7 tr$ to su&5 aa%n*

!!* T-e nee'le t-en s-oul' e remove' %mme'%atel$ 2-%le t-e%n0e&t%on s%te %s ress 2%t- &otton an' suse4uentl$ &over

%t 2%t- laster*!?* Oserve t-e at%ent@s rea&t%on7 mean2-%le 2as- $our

-an's an' &lean t-e use' e4u%ments


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INTRAVENOUS ADMINISTRATION OFFLUID


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FLUID Intravenous 1u%'s re+ers to 1u%' t-at %s

a'm%n%stere' %ntravenousl$ %n lare amount

t-rou- %n+us%on*

It %s est%mate' t-at aout "# o+ t-e 'rua'm%n%strat%on at -os%tals 2ere &on'u&te' $

%n0e&t%on an' %t %s l%5el$ %n&reas%n re&entl$*THE CONTAINER OF INFUSION FLUID

34 I! is made &r'm %lass, c'$sis!i$% '& 5 !-es0ased '$ !"e di>ere$ce i$ air


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80/93


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5 T"e c'$!ai$er is made &r'm &el?i0le -las!ics


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54 T"e c'$!ai$er is made &r'm &el?i0le -las!ics-'l


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admi$s!ra!i'$ i$ s'me cli$ical se!!i$%sis :

= To &orre&t t-e %malan&e' o'$ 1u%' (as rela&ement)= To &orre&t t-e %malan&e' o'$ ele&trol$tes

= To rov%'e as%& nutr%t%onal elements

= Volum%nous arenteral -$eral%mentat%on t-at

over2-elm%n t-e normal nutr%t%on

= As t-e &arr%er o+ ot-er 'ru a'm%n%strat%on

NAME!* Am%noA&%'s (s$nt-et%&)

CONCENTRATIONF#

PURPOSE


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Am%nos$n

Ve%nam%ne

?* De.trose (Glu&ose7D3

* R%ner@s

NaCl

Cl

CaCl?

* Natr%um La&tate

*>F#

F#

?* > "#

>?"#

NaCl "*!! > !*K#

"*"#

"*"#

"*"?#

"*"

# &ase%nM6r%n

"*F#

"*"#

"*"#

!3/

8lu%' Mnutr%t%on

8lu%' M Nutr%t%on

Nutr%t%on M Ele&trol$tes

S$stem%& al5al%Her M

nutr%ent sulement

8lu%' M nutr%ent

sulement

8lu%' M nutr%ent

sulement

THE INTERMITTEN ADMINISTRATION OFTHE INTERMITTEN ADMINISTRATION OF


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THE INTERMITTEN ADMINISTRATION OFTHE INTERMITTEN ADMINISTRATION OF

ANTI8IOTICS AND OTHERSANTI8IOTICS AND OTHERS

Su&- me'%&at%on ma$ e er+orme' $ one o+ t-e t-ree+ollo2%n met-o's :

A4 Direc!l I$!ra ml2%t-%n ! > m%nutes*

Or %n0e&t t-e %n0e&tor o+ t-e -an%n %n+us%on ottle %nto t-e

%n0e&t%on s%te* T-%s met-o' %s aror%ate +or l%m%te'amount o+ 'ru an' t-e 'ru 2-%&- en'aner %+ %ven %nmult%le met-o'*

84 V'l#me C'$!r'l Me!"'d : %t re+ers to t-e %n+us%ona'm%nstrat%on 2%t- a&&urate 'osae %n e.e&te' 1o2t-rou- volume &ontrol set &ons%st%n o+ a &al%rate'last%& &-amer elo2 t-e ma%n %n+us%on ottle 2-%&- %s+re4uentl$ alon 2%t- +ree l%4u%' a'm%n%strat%on*


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THE PROCEDURE OF INTERMITTENT


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ADMINISTRATION OF INTRAVENOUS LI7UID (ITHVOLUME CONTROL SET

!* Us%n aset%& te&-n%4ue7 t-e s%5e o+ VC set %s %nserte'%nto t-e ma%n %n+us%on ottle or searate' ottle*?* T-e tue l%ne %s emt%e' +rom a%r $ oen%n t-e uer

&lam so t-at t-e l%4u%' 1o2s** Oen t-e &lam over t-e &al%rate' &-amer to let ? >

" ml o+ l%4u%' enter %nto %t +rom t-e ottle** Close t-e uer &lam** In0e&t t-e 'ru t-rou- t-e &onne&t%n -ole %nt-eruer &a o+ t-e VC set*

* Re>oen t-e uer &lam to let t-e 1o2 u to " > !"ml7 t-en &lose %t*

* Oen t-e lo2er &lam to ma5e l%4u%' 1o2s


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89/93

T"e admi$is!ra!i'$ '& !"is i$si'$ dri- is rela!ed !'!"e sec'$d li/#id4 T"r'#%"


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,a mai$ 0'!!le a$d a mi$i 0'!!le1 & l d i & i


91/93

Pe%% 8ac1 '& 5B ml, a$d i$si'$se!4 T"e mi$i Pe%% 8ac10'!!le

#s#all c'$!ai$s a$!i0i'!ics, "ils!mai$ 0'!!le is similar !' !"eclassical i$si'$ se! i!" a r#00er 6 + s"a-e c"a$$el a--ara!#s 0el'!"e clam- '& !"e mai$ 0'!!le4

T"e sec'$d 0'!!le is als' -r'


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r!"er !"e c"am0er c'$$ec!ed !' !"e !i- '& $eedle!"r'#%" 34 + m '& !#0e li$e4 8el' !"e dri- c"am0er, aclam- re%#la!es !"e e?-ec!ed dr'-s4 T"e Pr'ced#res '&Pre-ara!i'$ a$d Admi$is!ra!i'$ O& I$!ra


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2 Drug Administration

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