Enteral Dosage Forms with Inhalation (1st Year 2024) PDF

Dosage forms of Drugs and Routes of Administration Dr /Esraa Mostafa Elnahas Dr/ Taqwa Mohammed Abdulsalam Lecturers in Clinical Pharmacology Department Faculty of Medicine Ain- Shams University  Routes of Administration Enteral Parenteral I...

Dosage forms of Drugs and Routes of Administration Dr /Esraa Mostafa Elnahas Dr/ Taqwa Mohammed Abdulsalam Lecturers in Clinical Pharmacology Department Faculty of Medicine Ain- Shams University  Routes of Administration Enteral Parenteral Inhalation Topical Liquid Solid  ENTERAL DOSAGE FORMS & ROUTES ENTERAL DOSAGE ROUTES 1. Oral 2. Sublingual 3. Buccal 4. Rectal 5. Other : Gavage  I) Oral Dosage Forms Drugs taken by the mouth & swallowed for local or systemic effect. Liquid Solid  Solution Suspension A. Solution (Aqueous or Alcoholic): Syrup: Sweetened Aqueous solution Elixir: Sweetened Hydroalcoholic solution Tincture: Hydroalcoholic solutions of (10-20% alcohol), e.g: Orange Tincture  Solution Suspension A. Solution (Aqueous or Alcoholic): Syrup: Sweetened Aqueous solution Elixir: Sweetened Hydroalcoholic solution Tincture: Hydroalcoholic solutions of (10-20% alcohol), e.g: Orange Tincture. B. Suspension: Insoluble solids suspended in water (should be shaked), ex: Antibiotics B) Solid oral dosage form Tablets Capsules Powders II. Oral Solid form: 1)Tablets Solid dosage form of varying shape, size & weight in which the drug is compressed with inert substance (excipients).  Tablets 1-Ordinary 2-Coated (Sugar)  3- Controlled-release = Sustained-release = Slow-release = Extended-release = Retard Different coats with different disintegration time (Rabid onset, Long duration   Frequency,  Patient Compliance)  4- Enteric-coated tablet Tablets coated with substances which resist dissolution in the acid juice of the stomach but dissolve in the alkaline juices of the intestine Remain intact in the stomach But dissolve in the intestine. Advantage: Protect the stomach (Na Salicylate) Resist destruction by HCL  5- Effervescent tablet Mixtures of acids and sodium bicarbonate 6-Chewable tablet  2)Capsule: Drug in a gelatin container to provide accurate medication in a tasteless form  Hard Soft Spansules (Slow Release) Enteric coated capsules pH 2.5= pH of stomach pH 6.5 = pH of Intestine 3) Powder May be dispensed in small paper packets and may be formulated as effervescent granules (Mg2+ sulfate)  2) Sublingual Route Drug is absorbed through mucosa under the tongue to reach directly to systemic circulation Sublingual tablets are small and friable to be placed under tongue for easy absorption (e.g. nitroglycerine).  3)Buccal Route Administration of a drug between the gums and cheek In the buccal pouch e.g, lozenges. Transbuccal patch e.g, fentanyl  3)Buccal Route Administration of a drug between the gums and cheek In the buccal pouch e.g, lozenges. Transbuccal patch e.g, fentanyl ❖ Advantages of Oral route: Easy & safe More convenient No need for sterilization ❖ Advantages of Sublingual route: Rapid onset → used in Emergency Easy administration No first pass metabolism Tablet can be removed when effect occur ❖ Disadvantages of Oral route: Delayed onset (emergency??) Variable bioavailability Not suitable for some drugs: Drugs destroyed in GIT: insulin & catecholamines) Hydrophilic drugs, e.g. gentamycin Drugs irritant to stomach Drugs could be affected by diet Drugs with extensive 1st pass metabolism (e.g. lidocaine) ❖ Contraindications: Emergency, Convulsions, Vomiting or Coma ❑Gavage: Introduction Of Food Or Drugs Into Stomach By Flexible Tube. USED IN COMA.  2.rectal dosage forms 1- Solid (suppository( 2- Liquid (enema)  2.rectal dosage forms 1- Solid (suppository( 2- Liquid (enema)  1-Solid (suppository): Drug is incorporated in a waxy base ▪ Glycerine suppositories, ▪ Medicated suppositories (Theophylline, NSAIDs)  2-Liquid Enema Types: Evacuation enema: Used in Constipation & colon surgery to evacuate the rectum Retention enema: Used to administer drug e.g. corticosteroids in ulcerative colitis Advantages of rectal route: Less 1st pass metabolism by GIT & Liver enzymes Suitable for: Children and adult Vomiting or coma Irritant drug to gastric mucosa or destroyed by GIT enzymes ❖Disadvantages: Disagreeable Proctitis (chronic use) Irregular bioavailability  Oral Sublingual Rectal - -Rapid action. Less 1st pass metabolism Convenient Suitable for: - Safe, -Easy administration. - Patients: Advantages - Easy - Unconscious -Bypass 1st pass -Uncooperative metabolism (children) - Vomiting -Can control the dose by - Drugs spitting out the - Moderately irritant. tablets - Large volume - Unpalatable  Oral Sublingual Rectal Not suitable for: - Inconvenient - Disagreeable if - Rectal inflammation Patients: frequent. (Proctitis) up to anal - Unconscious polypi Disadvantage - Uncooperative - Excessive - Excessive vomiting or diarrhea salivation - Irreliable absorption Emergencies which induce especially if the Drugs swallowing rectum is full of -Drugs destroyed in GIT: insulin & feaces catecholamines) Hydrophilic drugs, e.g. gentamycin Drugs irritant to stomach Drugs could be affected by diet Drugs with extensive 1st pass metabolism (e.g. lidocaine)  inhalation route ❖Inhalation route: Can be used for local and systemic effects Drug may be given by inhalation in the following dosage forms: Gas e.g. oxygen, and nitrous oxide (general anesthetic) Volatile-liquid (vapour) e.g, halothane (general anesthetic) Powders: administered through dry-powder inhalers (DPI) Aerosols: Suspensions of a liquid or solid in a gas  Solution administered as Aerosols ❖ Salbutamol (bronchodilator). Aerosols provide high local concentration for action on bronchi, minimizing systemic effects. I. Nebulizers: Nebulizer (turns liquid medicine into a mist) Jet of air (or O2) to spray the drug. II. METERED-DOSE INHALERS (MDI): Propellent gas and drug in a canister under pressure ❖Disadvantages of MDI: Needs coordination Not suitable for children Presence of a propellant substance (gas). II. METERED-DOSE INHALERS (MDI): Propellent gas and drug in a canister under pressure II. METERED-DOSE INHALERS (MDI): Propellent gas and drug in a canister under pressure  Solid: Dry powder inhaler: as a micronized powder finely e.g. disodium cromoglycate (Intal) used in prophylaxis of bronchial asthma given by a special inhaling device called "SPINHALER".  Dry powder inhalation : ❖Advantages Suitable for patients failed to use metered dose inhaler ❖ Disadvantages: Not suitable for children