Enteral Medication Administration
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Questions and Answers

In the context of medication administration, what is the primary characteristic of enteral routes?

  • Application of medication directly onto the skin for localized effects.
  • Administration of medication through the respiratory system for rapid absorption.
  • Delivery of medication directly into the bloodstream, bypassing the digestive system.
  • Introduction of medication into the body via the gastrointestinal tract. (correct)

Which of the following is an example of medication administered via an enteral route?

  • Sublingual nitroglycerin tablet
  • Intravenous antibiotic injection
  • Transdermal nicotine patch
  • Oral paracetamol tablet (correct)

A patient has difficulty swallowing pills. Which alternative formulation would still allow for enteral administration?

  • A medication given via subcutaneous route.
  • A liquid suspension given orally. (correct)
  • An intravenous injection.
  • A topical cream.

Compared to intravenous administration, what is a key disadvantage of the enteral route?

<p>Slower and more variable absorption rates. (D)</p> Signup and view all the answers

A medication's first-pass metabolism primarily affects drugs administered via which route?

<p>Enteral (A)</p> Signup and view all the answers

How would severe vomiting and diarrhea most likely affect the absorption of an enterally administered drug?

<p>Decrease drug absorption by reducing the time for drug dissolution and contact with the intestinal lining. (D)</p> Signup and view all the answers

An elderly patient with reduced gastric acid production is prescribed an enteric-coated tablet. What potential issue might arise?

<p>Delayed or incomplete dissolution of the coating, leading to reduced drug absorption. (A)</p> Signup and view all the answers

Which of the following scenarios would most likely necessitate avoiding the enteral route of drug administration?

<p>A patient experiencing a bowel obstruction. (B)</p> Signup and view all the answers

A patient requires immediate pain relief. Considering the bioavailability and onset time, which parenteral route is MOST suitable?

<p>Intravenous (IV) (B)</p> Signup and view all the answers

A new drug needs to be administered in a hospital setting due to the necessity for continuous monitoring and immediate response to potential adverse reactions. Which route is MOST appropriate?

<p>Intravenous (IV) (B)</p> Signup and view all the answers

Which parenteral route involves injecting a drug directly into a vein?

<p>Intravenous (IV) (D)</p> Signup and view all the answers

Which of these is generally considered an advantage of the intramuscular (IM) route compared to the intravenous (IV) route?

<p>Avoidance of the gastrointestinal tract (D)</p> Signup and view all the answers

What is a key disadvantage of the intravenous (IV) route compared to other parenteral routes?

<p>Increased risk of infection (B)</p> Signup and view all the answers

A patient requires a vaccine. Considering the need for a sustained release, which parenteral route is MOST suitable?

<p>Intramuscular (IM) (D)</p> Signup and view all the answers

In which scenario would the risk of nerve damage be MOST concerning when selecting a parenteral route?

<p>Giving a flu shot via the intramuscular route (A)</p> Signup and view all the answers

For a medication that is significantly affected by first-pass metabolism, which parenteral route would be the LEAST affected?

<p>Intravenous (C)</p> Signup and view all the answers

A patient requires a medication that needs to bypass the gastrointestinal tract for direct absorption. Which route of administration would be MOST appropriate?

<p>Intravenous (B)</p> Signup and view all the answers

A new drug is developed that is significantly degraded by stomach acid. Which route of administration would be LEAST suitable for this drug?

<p>Oral (A)</p> Signup and view all the answers

A patient experiencing severe nausea is unable to swallow medications. Which route of administration might be considered as an alternative to oral?

<p>Rectal (C)</p> Signup and view all the answers

A drug is designed to target the respiratory system directly. Which route of administration would be MOST effective in delivering the drug?

<p>Inhalation (C)</p> Signup and view all the answers

For a drug administered topically, what is the primary site of action?

<p>Skin or mucous membranes (C)</p> Signup and view all the answers

Which of the following routes of administration provides the MOST rapid onset of action?

<p>Intravenous (B)</p> Signup and view all the answers

A patient needs a medication that provides a sustained release over an extended period. Which route of administration is LEAST likely to be suitable?

<p>Intravenous bolus injection (D)</p> Signup and view all the answers

A drug is administered via the enteral route. Consequently, through which system will the drug FIRST pass after absorption?

<p>Hepatic portal system (B)</p> Signup and view all the answers

A patient is having difficulty swallowing oral medications. Which of the following enteral routes would be LEAST appropriate, considering their swallowing difficulties?

<p>Oral (D)</p> Signup and view all the answers

Why do drugs administered via the sublingual route often have a quicker onset of action compared to the oral route?

<p>Sublingual administration is directly absorbed into the bloodstream and avoids first-pass metabolism. (C)</p> Signup and view all the answers

A medication is known to cause significant gastrointestinal irritation when taken orally. Which alternative enteral route might be considered to minimize this side effect, while still achieving systemic drug effects?

<p>Rectal (B)</p> Signup and view all the answers

A patient requires a medication quickly, but they are currently experiencing severe nausea and vomiting. Which enteral route would be the MOST suitable to administer the drug?

<p>Rectal (A)</p> Signup and view all the answers

Why do some drugs have limited bioavailability when taken orally?

<p>They are subject to first-pass metabolism in the liver. (B)</p> Signup and view all the answers

Which of the following is a primary disadvantage of the buccal route of drug administration compared to the sublingual route?

<p>The buccal route has a slower absorption rate due to less permeability. (D)</p> Signup and view all the answers

A drug is most effective when delivered in high concentrations but is only available in limited quantities. Which enteral route would be MOST appropriate to maximise the amount of drug absorbed?

<p>Rectal Route. (C)</p> Signup and view all the answers

Which of the following dosage forms is LEAST suitable for sublingual administration?

<p>Enteric-coated capsules. (D)</p> Signup and view all the answers

A patient requires a medication that needs to be absorbed slowly and consistently over time. Considering the advantages of different administration routes, which would be MOST suitable?

<p>Subcutaneous (SC) (C)</p> Signup and view all the answers

A physician needs to perform a diagnostic test that requires minimal systemic absorption of the administered drug. Which route of adiminstration is MOST appropriate?

<p>Intradermal (A)</p> Signup and view all the answers

A patient is prescribed a medication for hemorrhoids. Which topical route of adminstration is MOST suitable?

<p>Rectal (D)</p> Signup and view all the answers

A new drug is developed that needs to act locally with minimal impact on the rest of the body. Which route of administration would be MOST appropriate for this drug?

<p>Topical (C)</p> Signup and view all the answers

Which of the following is an advantage of topical drug administration?

<p>Localized action and reduced systemic side effects. (C)</p> Signup and view all the answers

A patient is experiencing seasonal allergies with nasal congestion. Which topical route of administration would be MOST appropriate to deliver a decongestant?

<p>Nasal (B)</p> Signup and view all the answers

When would the intradermal route be the PREFERRED method of drug administration?

<p>Performing allergy tests with minimal systemic absorption. (A)</p> Signup and view all the answers

A patient needs an artificial tear solution. Which topical route of administration is MOST appropriate?

<p>Ophthalmic (B)</p> Signup and view all the answers

What is a primary benefit of administering a drug through a transdermal patch compared to oral administration?

<p>It allows the drug to bypass initial liver metabolism. (D)</p> Signup and view all the answers

A patient reports skin irritation at the site of a transdermal patch. Which characteristic of transdermal drug delivery is most likely the cause?

<p>Direct application to the skin (D)</p> Signup and view all the answers

A doctor prescribes a fentanyl patch for a patient's chronic pain management. What aspect of transdermal fentanyl administration is most beneficial in this scenario?

<p>The sustained release of the medication. (A)</p> Signup and view all the answers

Which of the following is a disadvantage of using transdermal drug delivery systems?

<p>They can cause localized skin reactions in some individuals. (C)</p> Signup and view all the answers

How does the non-invasive nature of transdermal patches primarily benefit patients?

<p>By improving patient compliance and comfort. (A)</p> Signup and view all the answers

Why might a medication be formulated into a transdermal patch rather than an oral tablet?

<p>To minimize potential gastrointestinal side effects and liver metabolism. (B)</p> Signup and view all the answers

If a patient needs a medication that requires consistent blood levels over several days, which route of administration is most suitable?

<p>Transdermal patch (D)</p> Signup and view all the answers

A patient using a nicotine patch to quit smoking continues to smoke cigarettes. What is a potential risk associated with this?

<p>Excessive nicotine levels leading to toxicity. (D)</p> Signup and view all the answers

Flashcards

Enteral Route

Refers to the delivery of nutrients directly into the gastrointestinal (GI) tract.

Route of Drug Administration

The method by which a drug is introduced into the body to achieve a therapeutic effect.

Examples of Enteral Routes

Oral and rectal administrations.

Parenteral Route

Administration bypassing the gastrointestinal tract.

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Examples of Parenteral Routes

Intravenous (IV) and intramuscular (IM) injections.

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Topical Route

Direct application to the skin or mucosal membranes.

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Examples of Topical Routes

Transdermal patches and ophthalmic drops.

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Inhalational Route

Drugs delivered to the lungs through inhalation.

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Oral Route

Drug taken by mouth and absorbed through the GI tract.

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Oral Route Advantages

Convenient, non-invasive, and cost-effective administration.

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Oral Route Disadvantages

Slow onset, first-pass metabolism, GI irritation possible.

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Sublingual/Buccal Route

Drug placed under the tongue (sublingual) or between gum and cheek (buccal).

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Sublingual/Buccal Advantages

Rapid onset, bypasses first-pass metabolism.

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Sublingual/Buccal Disadvantages

Limited to small doses and not suitable for all drugs.

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Rectal Route

Drug introduced into the rectum.

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Rectal Route Advantages

Useful in vomiting or unconscious patients; partial bypass of first-pass metabolism.

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Intravenous (IV)

Direct injection into a vein.

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IV Examples

Antibiotics, chemotherapy, anesthetics.

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IV Advantages

Rapid onset, precise dosing, 100% bioavailability.

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IV Disadvantages

Invasive, infection risk, requires trained personnel.

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Intramuscular (IM)

Injection into a muscle (e.g., deltoid, gluteus).

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IM Examples

Vaccines, hormones.

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IM Advantages

Sustained release possible, avoids GI tract.

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Subcutaneous (SC) Route

Injection into the subcutaneous tissue, beneath the skin.

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SC Route Examples

Examples include insulin and heparin, offering slow, sustained absorption and self-administration.

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SC Route Disadvantages

Limited to small volumes; may cause irritation.

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Intradermal (ID) Route

Injection into the dermis layer of the skin.

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ID Route Examples

Examples include tuberculin and allergy tests; useful for diagnostics with minimal systemic absorption.

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ID Route Disadvantages

Requires precise technique; only small volumes can be administered.

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Topical Route Definition

Direct application to the skin or mucosal membranes.

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Topical Route Examples

Includes creams, ointments, eye drops, nasal sprays, vaginal pessaries and rectal creams.

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Transdermal Route

Drug administration via skin for systemic absorption.

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Transdermal Examples

Nicotine patches, fentanyl patches.

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Transdermal Advantages

Prolonged drug release, non-invasive, bypasses first-pass metabolism.

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Transdermal Disadvantages

Slow onset, potential skin irritation.

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Enteral Route Definition

Administration directly into the gastrointestinal (GI) tract.

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Parenteral Route Definition

Administration that bypasses the gastrointestinal (GI) tract.

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Inhalational Route Definition

Delivered to the lungs through inhalation.

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Study Notes

  • The method by which a drug is introduced into the body affects a therapeutic outcome.
  • Route selection impacts drug efficacy and patient compliance.

Classification of Drug Administration Routes

  • Enteral routes utilize the gastrointestinal tract, like oral or rectal administrations.
  • Parenteral routes bypass the gastrointestinal tract, including intravenous and intramuscular.
  • Topical routes involve direct application to the skin or mucosal membranes, such as transdermal or ophthalmic applications.
  • Inhalational routes deliver drugs to the lungs.

Enteral Routes

  • Oral: Drugs are taken by mouth and absorbed through the GI tract, examples include tablets, capsules, and syrups.
    • Advantages: Convenient, non-invasive, and cost-effective.
    • Disadvantages: Characterized by a slow onset, it is subject to first-pass metabolism, and may cause GI irritation.
  • Sublingual and Buccal: Drugs are placed under the tongue (sublingual) or between the gums and cheek (buccal), examples include nitroglycerin and buprenorphine.
    • Advantages: Offer a rapid onset and bypass first-pass metabolism.
    • Disadvantages: Limited to small doses and are not suitable for all drugs.
  • Rectal: Drugs are introduced into the rectum via suppositories or enemas.
    • Advantages: Useful for patients who are vomiting or unconscious and partially bypasses first-pass metabolism.
    • Disadvantages: It is inconvenient and exhibits variable absorption.

Parenteral Routes

  • Drugs are administered via injection or infusion, bypassing the GI tract.
  • Intravenous (IV): Directly into a vein.
    • Examples: Antibiotics, chemotherapy and anesthetics.
    • Advantages: Characterized by rapid onset, precise dosing, and 100% bioavailability.
    • Disadvantages: Invasive, carries a risk of infection, and requires trained personnel.
  • Intramuscular (IM): Injected into a muscle, like the deltoid or gluteus.
    • Examples: Vaccines and hormones.
    • Advantages: Sustained release and avoids the GI tract.
    • Disadvantages: Includes pain at the injection site and the potential risk of nerve or tissue damage.
  • Subcutaneous (SC): Injected into the subcutaneous tissue.
    • Examples: Insulin and heparin.
    • Advantages: They can be self-administered and exhibits slow and sustained absorption.
    • Disadvantages: It is limited to small volumes, and irritation can occur.
  • Intradermal (ID): Injected into the dermis layer of the skin.
    • Examples: Tuberculin tests and allergy tests.
    • Advantages: Minimal systemic absorption and diagnostic utility.
    • Disadvantages: Characterized by the need for precise technique and is limited to small volumes.

Topical Routes

  • Applied directly to the skin or mucosal membranes.
  • Dermal: Creams, ointments (e.g., hydrocortisone).
  • Ophthalmic: Eye drops (e.g., artificial tears).
  • Nasal: Sprays (e.g., decongestants).
  • Vaginal: Pessaries (e.g., antifungals).
  • Rectal: Creams (e.g., hemorrhoid treatments).
    • Advantages: Localized action and reduced systemic side effects.
    • Disadvantages: Limited absorption for systemic effects and possible irritation.

Transdermal Route

  • Drugs applied to the skin for systemic absorption, examples are Nicotine and fentanyl patches.
    • Advantages: Prolonged drug release, non-invasive and bypasses first-pass metabolism.
    • Disadvantages: Exhibits slow onset and can cause potential skin irritation.

Inhalational Route

  • Drugs delivered to the lungs via aerosols or inhalers.
    • Examples: Bronchodilators (e.g., salbutamol) and anesthetics (e.g., isoflurane).
    • Advantages: Rapid absorption and localized action in respiratory diseases.
    • Disadvantages: Technique-dependent and may irritate airways.

Factors Influencing Route Selection

  • Drug Properties: Consider solubility, stability, and bioavailability.
  • Patient Factors: Consider age, consciousness, and compliance.
  • Therapeutic Goal: Rapid action (IV), sustained effect (transdermal), local effect (topical).
  • Type of Condition: Chronic (oral) vs. acute (IV).

Comparison of Routes:

  • Oral: Slow onset, variable bioavailability, systemic action, and examples include paracetamol and asprin.
  • IV: Immediate onset, 100% bioavailability, systemic action, and examples include antibiotics and anesthetics.
  • Inhalational: Fast onset, high bioavailability, local/systemic action, and examples include salbutamol and isoflurane.
  • Transdermal: Slow onset, high bioavailability, systemic action, and examples include nicotine patches.

Key Takeaways

  • Route selection influences a drug's onset, duration, and effect.
  • Understanding patient needs and drug properties is essential before choosing a route.
  • Each route has unique advantages and limitations.

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Description

Explore enteral routes of medication administration, their characteristics, and potential challenges. Compare enteral routes to parenteral routes, considering factors like first-pass metabolism and bioavailability. Examine the impact of conditions like vomiting or reduced gastric acid on drug absorption.

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