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The Oral Route
- Drug absorption may take place at any point along the alimentary canal
- Oral cavity
- Stomach
- Small intestine
- Large intestine
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Advantages of Oral Route
- Simple
- Patients are accustomed to it
- Manufacture is relatively low tech
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Disadvantages of Oral Route
- Drugs subjected to digestive enzymes, pH, first pass metabolism
- Limited to conscious compliant patients
- Taste may be limiting
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Examples of Oral Route Dosage Forms
- Solutions
- Suspensions
- Emulsions
- Lozenges
- Pastilles
- Tablets
- Capsules
- Pills
- Powders
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The Topical Route
Application to the skin for local effects (antiseptics, anesthetic) or for systemic absorption (nicotine, dramamine, nitroglycerin)
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Advantages of Topical Route
- Simple to use
- Can be used in conscious or non cooperative patients
- No first pass effect
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Disadvantages of Topical Route
- May be difficult to ensure dosage uniformity
- Pathological state of skin may be limiting
- Some preparations may be "messy" and result in poor patient compliance
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Examples of Topical Route Dosage Forms
- Topical solutions
- Lotions
- Creams
- Ointments
- Transdermal patches
- powders
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The Topical Route - Oral
- Use in the oral cavity for local or systemic effect
- General oral solution for local effect (cleansing, refreshing, disinfecting)
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Buccal
- Cheek Pouch - Oral Topical Route
- Mucoadhesive for slow release of drug
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Sublingual
- Below the tongue - Oral Topical Route
- For quick dissolution
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Advantages of Topical Route - Oral
- Rapid onset
- Ease of administration
- No first pass effect
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Disadvantages of Topical Route - Oral
- Limited by taste and mouth feel
- May not be suitable for children or non cooperative patients
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Examples of Topical Route Dosage Forms - Oral
- Sprays
- Gargles
- Washes
- Tablets
- Oral gels
- Lozenges
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The Topical Route - Otic/Aural
Insertion into the ear canal largely for local effect (cleansing, disinfecting)
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Examples of Topical Route Dosage Forms - Otic/Aural
Solutions
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The Topical Route - Nasal and Inhalation
- For local or systemic absorption along the airway
- Nasal mucosa or alveolae
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Advantages of Topical Route - Nasal and Inhalation
- Rapid effect in some conditions
- No first pass effect
- Repeated administration
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Disadvantages of Topical Route - Nasal and Inhalation
- Odor
- Risk of infection
- Critical need for patient education and compliance
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Examples of Topical Route Dosage Forms - Nasal and Inhalation
- Nasal sprays (liquid or powder)
- Inhalers
- Aerosols
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The Topical Route - Ocular, conjunctive
For local effects in the eye (cleansing, disinfecting, reduction of IOP, pupil stimulation)
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Advantages of Topical Route - Ocular, conjunctive
- Overcomes poor vascularization
- Delivery to the site of action
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Disadvantages of Topical Route - Ocular, conjunctive
- Need for patient training
- Not useful for non cooperative patients
- Disease conditions limiting to self administration
- Particle size, pH and need for sterility can be limiting
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Examples of Topical Route Dosage Forms - Ocular, conjunctive
- Solutions
- Gels
- Ointments
- Lenses
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The Topical Route - Vaginal and Urethral
Primarily for local effects (anti infective, cleansing)
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Advantages of Topical Route - Vaginal and Urethral
Direct delivery without need for systemic delivery
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Disadvantages of Topical Route - Vaginal and Urethral
- Patient compliance and training might be necessary
- Risk of infection or complications
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Examples of Topical Route Dosage Forms - Vaginal and Urethral
- Douches
- Pessaries
- Vaginal suppositories
- Creams
- Gels
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The Topical Route - Rectal
Insertion into lower GIT for local and systemic effect
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Advantages of Topical Route - Rectal
- Reduced first pass effect
- Quick onset
- Can be used in unconscious patients
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Disadvantages of Topical Route - Rectal
- Self administration may be difficult
- Infection or complications from over/improper use
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Examples of Topical Route Dosage Forms - Rectal
- Enema solutions
- Emulsions
- Suspensions
- Suppositories
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The Parenteral (outside GIT) Routes
- Injection using a needle or needle free device for some local but largely systemic effect
- Intravenous
- Intraarterial
- Intracardiac
- Intrathecal
- Intraperitoneal
- Subcutaneous
- Intradermal
- Intramuscular
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Advantages of Parenteral (outside GIT) Routes
- Almost instant response
- Sustained response
- Suitable for non cooperative patients
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Disadvantages of Parenteral (outside GIT) Routes
- Manufacturing cost
- Specialized administration
- Volume limitations
- *Painful
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