MODULE 4

Route Bioavailability Advantages Disadvantages Notes

Intravenous bolus (IV push)
Intravenous infusion
(IV drip)
PARENTERAL
100% Immediate effect
Minimal or no discomfort
Alternative to oral route
More accurate dose
100% Plasma drug levels controlled
Inject large fluid volumes
Poor lipid solubility and irritatingMuscle stiffness
drugs
Dehydration, Infections,
Chemotherapy, Chronic Conditions
Cannot be retrieved
Chance of adverse reactions
High risk infusion reactions
Extravasation
Phlebitis
Skill of insertion
Tissue damage at site of injection bloodstream
20 mL
Emergent concerns
Very slowly over 1 min
Ex.
Ampicillin (3-5 mins)
Diazepam (NLT 1 min)
Furosemide (1-2 min)
Controlled administration into
Pump Infusion (machine)
Drip Infusion (manual)

Intramuscular (IM)
Rapid for Aqueous
Slow for Non-aqueous
IA
Easier to inject than IV Irritating drugs painful API: Corn oil, Cottonseed oil, Peanut
Larger volume used compared to SC Muscle atrophy oil, Sesame oil
Injury to bone Ex.
Cellulitis Ventrogluteal (3 mL)
Sterile abscesses Vastus lateralis (3 mL)

Subcutaneous (SC)
GE
Pain and nerve injury Deltoid muscle (1 mL)
Prompt aqueous Slow, sustained absorption Depends on blood flow and NMT (1 mL)
Slow absorption repository injection volume Ex.
Lipohypertrophy or lipoatrophy Insulin Injection
Opioids
Heparin

Y
Epinephrine
Allergy Medication
Intradermal (ID) Longest absorption time of all Sensitivity allergy and local Skin holds limited volume 0.5mL
parenteral
aH
anesthesia tests Skill and time Inner surface forearm, upper back,
Reaction is easy to visualize Injection site reactions scapula
Degree of reaction assessed
ENTERAL
Buccal or Sublingual Rapid absorption lipid soluble No “FIRST PASS EFFECT” Not for drugs with higher doses Ex.
drugs Irritation of gums and inner cheek Fentanyl (buccal and sublingual)
k
Hydrocortisone (buccal) Lorazepam
(sublingual) Zolpidem (sublingual)
Oral (PO) Absorption vary Safest and easiest Some have erratic absorption
be

Slower absorption compared to IV “FIRST PASS EFFECT”

Rectal Absorption vary Patient cannot swallow Suppository have erratic Mesalazine (suppository)
absorption Budesonide (rectal foam)
Migrate different position Saline Laxatives (enema)
Discomfort
Re

Transdermal Slow absorption Easy to use Irritation Nitroglycerin (NTG) Nicotine Patch
Increased absorption with Lipid-soluble drugs with low dose Permeability vary
occlusive and low molecular weight Cream or ointment
Inhalation and intranasal Rapid absorption Local or systemic effects Anatomic placement Oro-pharyngeal region (10-30 um)
Cough reflex Trachea (1.7 cm)
Bronchi (2-8 mm) Bronchioles (0.5-2
mm) Terminal bronchioles (0.6 mm)
@

Respiratory bronchioles (0.5 mm)

Alveolar sacs (250-300 um)

VOLUMES OF DISTRIBUTION (L/70 KG ADULT)

Warfarin 7 Small volume
Gentamicin 16 Mainly plasma little tissues
Theophylline 35 Medium volume
Cimetidine 140 Similar in plasma and issues
Digoxin 510 Large volume
Mianserin 910 Mainly tissues little plasma
Quinacrine 50,000

PAGE 1 OUT OF 11 PAGES

BIOPHARMACEUTICS-PHARMACOKINETICS AND PHARMACOLOGY