Non-Oral Routes of Drug Administration
|
|
- Julian Harper
- 8 years ago
- Views:
Transcription
1 Non-Oral Routes of Drug Administration Reading: Ansel 9 th edition, p Routes of Drug Administration Over the next series of lectures, we will talk about the biopharmaceutics of several non-oral routes of drug administration and related drug delivery devices. Biopharmaceutics is defined as the study of physiological and formulation factors affecting the release and subsequent absorption of drugs from drug delivery systems as relate to the onset, duration, and intensity of drug action For each of the routes of drug administration or delivery strategy that we will discuss, it is helpful to keep in mind the following basic but important thoughts (among others). The design of the formulation/device governs or controls how the drug is released from the formulation/device at the site of administration and how the drug product is used or applied at the site of administration (brief or long exposure) When intended for systemic therapy, the drug must move from the formulation/device at the site of administration to the intended site of drug action, requiring drug absorption and drug distribution When targeted for local action, there may be unintended drug absorption causing systemic side effects 1. Parenteral Administration General types of injectable formulations: Injection: Liquid preparation that is a solution of a drug in a liquid vehicle For injection: Dry solids that upon addition of a vehicle become an injection solution PCEUT 531P Page 1
2 Injectable emulsion: Liquid preparation of a drug dissolved or dispersed in an emulsion medium (e.g., propofol) Injectable suspension: Liquid preparation of a solid drug suspended in a liquid vehicle (betamethasone sodium phosphate and betamethasone acetate, Celestone Solupan ) For injectable suspension: Dry solid that upon addition of vehicle yields a an injectable suspension (e.g., octreotide acetate, Sandostatin LAR Depot) Any of the above may contain buffers, preservatives, and other excipients. Parenteral (injection) routes (we will cover some in more detail than others) Intravenous within a vein Intra-arterial within an artery Intraosseous into the bone marrow (as an alternative to intravenous access) Intra-cardiac within one of the chambers of the heart Intra-articular within the cavity of a joint Intrasynovial within the synovial sac of a joint or a synovial tendon sheath Intra-spinal - within the vertebral canal or spinal cord Intrathecal within either the subarachnoid (middle of the three coverings of the central nervous system) or the subdural space (between the dura mater and the arachnoid mater) Epidural on (or outside) the dura mater Intracutaneous/intradermal within the substance of the skin, particularly the dermis Subcutaneous within the tissue under the skin Intramuscular within muscle Note: all parenteral routes are vulnerable to risk of infection PCEUT 531P Page 2
3 INTRAVENOUS (IV) can provide rapid action potential for significant adverse effects invasive (risk of infection) rate of injection/volume of injection: bolus in less than a minute or two; small injection volume (1 to 10 ml) short-term infusion from minutes to few hours; decrease peak concentration; larger injection volume, up to several hundred ml long-term infusion to achieve steady-state plasma drug levels; may need IV bolus loading dose to achieve therapeutic levels sooner antecubital vein (in front of elbow) is usually used; access via central vein (internal jugular, subclavian or femoral) catheter may be required for drugs that are caustic or prone to cause phlebitis 100% systemic availability of the dose not suitable for insoluble materials, unless drug particle size is sufficiently small to avoid formation of emboli microemulsions of fat-like or fat-soluble materials (e.g., propofol) and other heterogeneous formulations (e.g., Abraxane albumin-bound paclitaxel injectable suspension) are sometimes used poorly water soluble drugs may precipitate if injected too rapidly or into a vein with low blood flow; classic examples: diazepam solubility 66 mg/l or μg/ml dose 5 to 10 mg (5 mg/ml in 40% propylene glycol + 10% alcohol in water at ph 6.6) should be administered slowly (2 to 5 mg per minute) into a large lumen vessel, such as an antecubital vein rapid injection or injection into small vein carries the risk of syncope, hypotension, apnea and thrombophlebitis phenytoin solubility 32 mg/l or μg/ml dose 10 to 20 mg/kg or 700 to 1400 mg (50 mg phenytoin sodium/ml in 40% propylene glycol + 10% alcohol in water at ph 12) recommended infusion rate mg/min PCEUT 531P Page 3
4 a dose of a poorly water soluble drug can be slowly administered by using short-term infusions of the drug dissolved in a sufficient volume of vehicle and administered immediately to avoid precipitation issue INTRA-ARTICULAR injected directly into the joint space for local effect (for example, antiinflammatory corticosteroids or steroids into a painful, inflamed arthritic joint) range of injection volumes: 0.1 to 2 ml for elbow, ankle, knee, shoulder 2 to 3 ml for hip INTRA-ARTERIAL injection volume varies, usually from 10 to 50 ml over time (infused) invasive (risk of infection) used for specific access to a vascular bed, often to deliver chemotherapy to a particular organ or tumor site floxuridine (FUDR) for hepatic tumor FUDR has a high hepatic extraction ratio (94-99%) administration into the hepatic artery achieves very high hepatic levels and relatively low systemic levels degradable starch microspheres (40 μm) have been injected into the hepatic artery to retard flow of the blood through the arteriolar-capillary bed of the liver and lead to increased local drug deposition INTRADERMAL between the layers of the skin for local purpose usual injection volume up to 0.1 ml often given in the inner palm-side surface of the forearm often used for conducting skin allergy tests and testing for antibody formation PCEUT 531P Page 4
5 INTRATHECAL OR EPIDURAL ADMINISTRATION primarily used to administer analgesics and anesthetics for regional effects morphine (or other opioids) by this route intraoperative or postoperative use also for the control of chronic pain activity is through spinal opioid receptors increased duration of effect, and a lower incidence of respiratory depression and other CNS effects if respiratory depression is observed by this route, it often is observed hours after the administration of the drug as it spreads rostrally via the CSF or via systemic redistribution to supra-spinal sites SUBCUTANEOUS (SC) needle penetrates the epidermal and dermal layer to deposit drug into the loose subcutaneous fatty tissue usual injection volume of about 0.5 ml; range 0.5 to 1.5 ml, 2 ml injections may cause a feeling of painful pressure injected formulation volume produces the drug delivery site within the interstitial fluid larger volumes may be administered (over longer time) by SC infusion large number of potential injection areas on the body to choose from (see accompanying figure) readily self-administered by patient (and patient acceptance may be increased with prefilled syringe) good route for multiple dosing or continuous infusion muscle mass is not an issue in cachectic or elderly patients risk of infection is present because the needle breaks the protective barrier of the skin PCEUT 531P Page 5
6 systemic bioavailability for a given drug may be 100% or < 100%, mainly related to formulation factors and drug stability at the SC injection site bioavailability information is difficult to find for the SC route small molecule drugs are generally rapidly absorbed following SC injection; rate of absorption depends on drug dissolution if formulation is a suspension or if drug precipitates out of solution at the injection site absorption involves diffusion through interstitial fluid and tissues, and passage across vascular membranes into surrounding blood capillaries generally, it is thought that the blood supply to SC site is poorer than to muscle tissue and, consequently, small molecule drug absorption may be slower than IM absorption rate may be influenced by massage, exercise (such as running) and heat (as in a sauna or hot tub), because of the increase in blood flow vasoconstrictors are used to slow dissipation of local anesthetics; e.g., lidocaine hydrochloride and epinephrine injection for infiltration and nerve block protein drugs have the following issues stability in the sc site; proteolysis slow absorption depending on size: small proteins (insulin ~6 kd) are taken up into the interstitial capillaries larger protein >16 kd (Mabs ~150kd) are absorbed indirectly via the lymphatic system (see accompanying figure), which is a slow process occurring over some hours (tmax >24 hours) PCEUT 531P Page 6
7 INTRAMUSCULAR (IM) range of injection volumes: 0.5 to 2.0 ml for deltoid 1 to 5 ml for gluteus maximus 1 to 5 ml for vastus lateralis as with SC injection, formulation volume that is injected IM produces the drug delivery site within the interstitial fluid drugs irritating to SC tissue may be given IM risk of infection is present as the protective barrier of the skin is broken considerations of rate and extent of absorption are generally the same as for SC administration (see above) absorption rate for lipophilic small drug molecules is generally in the order of deltoid > vastus lateralis >> gluteus maximus, because of blood perfusion and amount of fatty tissue at the injection site poorly soluble small molecule drugs can precipitate on administration and actually form crystals at the site of injection can cause of pain at the injection site and at times muscle injury crystals may dissolve very slowly and apparently incompletely, possibly resulting in less than 100% bioavailability phenytoin (see solubility, solution ph and dosing details above) o IM administration of may be required by the clinical situation (but is not very common), postoperatively or in comatose patients o sufficient dose (higher dose compared to oral dose) must be administered IM to maintain the plasma level within the therapeutic range IM route for diazepam should be avoided if practicable because of precipitation absorption rate for small drug molecules can be decreased or at least compromised when the injection does not actually reach the muscle, but is instead deposited in the subcutaneous fat lower blood flow in fat more sequestration and slower release of lipid soluble drug from fat PCEUT 531P Page 7
8 muscle site, length of needle and angle of injection are important determinants of the likelihood of deposition in fat deltoid and thigh are less likely to result in this problem, more likely with injection into the buttocks absorption in infants and young children may be unpredictable due in part to insufficient muscle tone and vascularity of muscle tissue decreased muscle mass of many older adults may result in faster small drug molecule absorption; approximate 25% decline in muscle strength occurs between the ages of 20 and 60 years, and a decline in muscle strength corresponds with a decrease in muscle mass protein drugs are usually slowly absorbed (depending on size), again as with SC absorption, because of lymphatic involvement PCEUT 531P Page 8
Absorption of Drugs. Transport of a drug from the GI tract
Absorption of Drugs Absorption is the transfer of a drug from its site of administration to the bloodstream. The rate and efficiency of absorption depend on the route of administration. For IV delivery,
More informationParenteral Administration
Chapter 10 and 11 Parenteral Administration Equipment Syringes Syringe consists of a barrel, a plunger, and a tip. Outside of the barrel is calibrated in milliliters, minims, insulin units, and heparin
More informationInfluence of ph Most local anesthetics are weak bases.
Local anesthetics The agent must depress nerve conduction. The agent must have both lipophilic and hydrophilic properties to be effective by parenteral injection. Structure-activity relationships The typical
More informationAn introduction to the principles and practice of safe and effective administration of injections
An introduction to the principles and practice of safe and effective administration of injections Introduction Giving an injection safely is considered to be a routine nursing activity. However it requires
More informationINSULIN PRODUCTS. Jack DeRuiter
INSULIN PRODUCTS Jack DeRuiter The number and types of insulin preparations available in the United States is constantly changing, thus students should refer to recent drug resources for a current list
More informationIntraosseous Vascular Access and Lidocaine
Intraosseous Vascular Access and Lidocaine Intraosseous (IO) needles provide access to the medullary cavity of a bone. It is a technique primarily used in emergency situations to administer fluid and medication
More informationPHENYLEPHRINE HYDROCHLORIDE INJECTION USP
PRESCRIBING INFORMATION PHENYLEPHRINE HYDROCHLORIDE INJECTION USP 10 mg/ml Sandoz Canada Inc. Date of Preparation: September 1992 145 Jules-Léger Date of Revision : January 13, 2011 Boucherville, QC, Canada
More informationNSW Higher School Certificate Senior Science 9.2 Lifestyle Chemistry
NSW Higher School Certificate Senior Science 9.2 Lifestyle Chemistry Section 5 Drug Solubility 9.2 Lifestyle Chemistry Section 5 ::: Drug Solubility 9.2.5 The solubility of drugs has an effect on the way
More informationProcedure -8. Intraosseous Infusion Adult and Pediatric EZIO. Page 1 of 7 APPROVED:
Page 1 of 7 Intraosseous Infusion Adult and Pediatric APPROVED: EMS Medical Director EMS Administrator 1. Goals/Introduction: 1.1 Intraosseous (IO) infusion provides an effective alternative means of providing
More informationPHARMACOTHERAPY HOW TO INJECT INSULIN. Living your life as normal as possible. www.lilly-pharma.de www.lilly-diabetes.de
PHARMACOTHERAPY HOW TO INJECT INSULIN Living your life as normal as possible www.lilly-pharma.de www.lilly-diabetes.de In Germany about 1.9 million people with diabetes are being treated with insulin.
More informationV: Infusion Therapy. Alberta Licensed Practical Nurses Competency Profile 217
V: Infusion Therapy Alberta Licensed Practical Nurses Competency Profile 217 Competency: V-1 Knowledge of Intravenous Therapy V-1-1 V-1-2 V-1-3 V-1-4 V-1-5 Demonstrate knowledge and ability to apply critical
More informationBasic Pharmacology. 2009 by Paul Nicolazzo the Wilderness Medicine Training Center wildmedcenter.com
Basic Pharmacology 2009 by Paul Nicolazzo the Wilderness Medicine Training Center wildmedcenter.com Basic Pharmacology Introduction Pharmacology is the study of drugs. Drugs are defined as chemical substances
More informationMedications or therapeutic solutions may be injected directly into the bloodstream
Intravenous Therapy Medications or therapeutic solutions may be injected directly into the bloodstream for immediate circulation and use by the body. State practice acts designate which health care professionals
More informationAnimalgeiscs for Mice & Rats, 3.0 ml Vial Label: Carton Label:
Animalgeiscs for Mice & Rats, 3.0 ml Vial Label: Carton Label: Animalgesics for Mice & Rats, 1.6 ml Vial Label: Carton Label: Animalgesics for Mice & Rats (buprenorphine extended-release injectable suspension)
More informationEpidural Anesthesia. Advantages of Epidural Anesthesia
Epidural Anesthesia Epidural anesthesia involves the use of local anesthetics injected into the epidural space to produce a reversible loss of sensation and motor function. Epidural anesthesia requires
More informationCommon Regional Nerve Blocks Quick Guide developed by UWHC Acute Pain Service Jan 2011
Common Regional Nerve Blocks Quick Guide developed by UWHC Acute Pain Service Jan 2011 A single shot nerve block is the injection of local anesthetic to block a specific nerve distribution. It can be placed
More informationAdministration of Parenteral. Medications. Chapter Outline. Essential Terms
C H A P T E R 34 Administration of Parenteral Medications Chapter Outline Administration of Parenteral Medications Parenteral Equipment and Supplies Preparing Medications General Guidelines for Parenteral
More informationNIH Clinical Center Patient Education Materials Giving a subcutaneous injection
NIH Clinical Center Patient Education Materials What is a subcutaenous injection? A subcutaneous injection is given in the fatty layer of tissue just under the skin. A subcutaneous injection into the fatty
More informationParenteral Dosage of Drugs
Chapter 11 Parenteral Dosage of Drugs Parenteral Route of administration other than gastrointestinal Intramuscular (IM) Subcutaneous (SC) Intradermal (ID) IV Parenteral Most medications prepared in liquid
More informationVascular Access. Chapter 3
Vascular Access Chapter 3 Vascular Access Introduction Obtaining vascular access in infants and children can be difficult even under optimal conditions. Attempting emergent access in a hypotensive, struggling
More informationA. ADMINISTERING SUBCUTANEOUS MEDICATIONS INTERMITTENTLY/CONTINUOUSLY B. (SUBCUTANEOUS INFUSION) HYDRODERMOCLYSIS
SUBCUTANEOUS THERAPY A. ADMINISTERING SUBCUTANEOUS MEDICATIONS INTERMITTENTLY/CONTINUOUSLY B. (SUBCUTANEOUS INFUSION) HYDRODERMOCLYSIS PARTS I. Purposes II. General Information III. Responsibilities IV.
More informationHeroin. How is Heroin Abused? What Other Adverse Effects Does Heroin Have on Health? How Does Heroin Affect the Brain?
Heroin Heroin is a synthetic opiate drug that is highly addictive. It is made from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears
More informationSTANDARD OPERATING PROCEDURE. Administration of High Dose Muscular Vitamin Supplements for Undergoing Alcohol
STANDARD OPERATING PROCEDURE Administration of High Dose Muscular Vitamin Supplements for Undergoing Alcohol DOCUMENT CONTROL: Version: 2 Ratified by: Clinical Effectiveness Committee Date ratified: 03
More informationNursing 113. Pharmacology Principles
Nursing 113 Pharmacology Principles 1. The study of how drugs enter the body, reach the site of action, and are removed from the body is called a. pharmacotherapeutics b. pharmacology c. pharmacodynamics
More informationPATIENT INFORMATION. Medicine To Treat: D iabetes. What You Need to Know About. Insulin
PATIENT INFORMATION Medicine To Treat: D iabetes What You Need to Know About Insulin INTRODUCTION The insulin preparations currently available in Singapore are mostly from human origin; pork or bovine
More informationPOST-TEST Pain Resource Professional Training Program University of Wisconsin Hospital & Clinics
POST-TEST University of Wisconsin Hospital & Clinics True/False/Don't Know - Circle the correct answer T F D 1. Changes in vital signs are reliable indicators of pain severity. T F D 2. Because of an underdeveloped
More informationTop-up for Cesarean section. Dr. Moira Baeriswyl, Prof. Christian Kern
Top-up for Cesarean section Dr. Moira Baeriswyl, Prof. Christian Kern In which situations? 2 What exactly is a Top-up? 3 C-section, NOW!! Emergency C-section requires a rapid onset of sustained analgesia
More informationDRUGS FOR GLUCOSE MANAGEMENT AND DIABETES
Page 1 DRUGS FOR GLUCOSE MANAGEMENT AND DIABETES Drugs to know are: Actrapid HM Humulin R, L, U Penmix SUNALI MEHTA The three principal hormones produced by the pancreas are: Insulin: nutrient metabolism:
More informationWHY THE IMPLANTABLE INSULIN PUMP WORKS SO WELL
WHY THE IMPLANTABLE INSULIN PUMP WORKS SO WELL H ave you ever wondered why it is so very difficult to manage your diabetes? There is no lack of motivation - we know how important good control is, and we
More informationHOWS AND WHYS OF CRI ANALGESIA IN SMALL ANIMALS Luisito S. Pablo, DVM, MS, Diplomate ACVA University of Florida, Gainesville, Florida
HOWS AND WHYS OF CRI ANALGESIA IN SMALL ANIMALS Luisito S. Pablo, DVM, MS, Diplomate ACVA University of Florida, Gainesville, Florida Management of severe pain in small animals continues to be a challenge
More informationMEDICATION MANUAL Policy & Procedure
MEDICATION MANUAL Policy & Procedure TITLE: Section: Initial Management of Anaphylaxis Following Immunization Medication Specific NUMBER: MM 20-005 Date Issued: October 2009 Source: Distribution: Capital
More informationThymus Cancer. This reference summary will help you better understand what thymus cancer is and what treatment options are available.
Thymus Cancer Introduction Thymus cancer is a rare cancer. It starts in the small organ that lies in the upper chest under the breastbone. The thymus makes white blood cells that protect the body against
More informationDRUG DOSE CALCULATIONS
FINDING THE ORDERED DOSE The ordered dose is the most simple dosage calculation for the prehospital care provider. In this type of problem, the paramedic is given an order to administer to a patient. There
More informationYes This controlled document shall not be copied in part or whole without the express permission of the author or the author s representative.
Title: Patient Group Direction for the administration of lidocaine hydrochloride 1% injection as infiltration anaesthesia for insertion/removal of central venous catheters by nurses/radiographers working
More informationHED\ED:NS-BL 037-3rd
HED\ED:NS-BL 037-3rd Insulin Insulin is produced by the beta cells in the islets of Langerhans in the pancreas. When glucose enters our blood, the pancreas should automatically excrete the right amount
More informationIntroduction to Enteris BioPharma
Introduction to Enteris BioPharma Enteris BioPharma Intelligent Solutions for Oral Drug Delivery Privately held, New Jersey based biotech company Owned solely by Victory Park Capital, a large Chicago based
More informationMA 2000 Pharmacology for Medical Assistants
South Central College MA 2000 Pharmacology for Medical Assistants Course Information Description Total Credits 3.00 Total Hours 64.00 Types of Instruction In this course students will learn topics essential
More informationSports Injury Treatment
Sports Injury Treatment Participating in a variety of sports is fun and healthy for children and adults. However, it's critical that before you participate in any sport, you are aware of the precautions
More informationPERIPHERAL STEM CELL TRANSPLANT INTRODUCTION
PERIPHERAL STEM CELL TRANSPLANT INTRODUCTION This booklet was designed to help you and the important people in your life understand the treatment of high dose chemotherapy with stem cell support: a procedure
More informationUnderstanding How Existing and Emerging MS Therapies Work
Understanding How Existing and Emerging MS Therapies Work This is a promising and hopeful time in the field of multiple sclerosis (MS). Many new and different therapies are nearing the final stages of
More informationAnkle Block. Indications The ankle block is suitable for the following: Orthopedic and podiatry surgical procedures of the distal foot.
Ankle Block The ankle block is a common peripheral nerve block. It is useful for procedures of the foot and toes, as long as a tourniquet is not required above the ankle. It is a safe and effective technique.
More informationVISTARIL (hydroxyzine pamoate) Capsules and Oral Suspension
VISTARIL (hydroxyzine pamoate) Capsules and Oral Suspension DESCRIPTION Hydroxyzine pamoate is designated chemically as 1-(p-chlorobenzhydryl) 4- [2-(2-hydroxyethoxy) ethyl] diethylenediamine salt of 1,1
More informationPrior Authorization Guideline
Prior Authorization Guideline Guideline: PDP IBT Inj - Vivitrol Therapeutic Class: Central Nervous System Agents Therapeutic Sub-Class: Opiate Antagonist Client: 2007 PDP IBT Inj Approval Date: 2/20/2007
More informationALLERGENIC EXTRACT. Prescription Set of Serial Dilutions (or Maintenance Vial (s)) INSTRUCTIONS FOR USE. U.S. Government License No.
ALLERGENIC EXTRACT Prescription Set of Serial Dilutions (or Maintenance Vial (s)) INSTRUCTIONS FOR USE U.S. Government License No. 308 Revised 07/04 PO Box 800 Lenoir, NC 28645 USA DESCRIPTION This set
More informationHeroin. How Is Heroin Abused? How Does Heroin Affect the Brain? What Other Adverse Effects Does Heroin Have on Health?
Heroin Heroin is an opiate drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears as a white or brown
More informationBier Block (Intravenous Regional Anesthesia)
Bier Block (Intravenous Regional Anesthesia) History August Bier introduced this block in 1908. Early methods included the use of two separate tourniquets and procaine was the local anesthetic of choice.
More informationMedication Utilization. Understanding Potential Medication Problems of the Elderly
Medication Utilization Understanding Potential Medication Problems of the Elderly NICE - National Initiative for the Care of the Elderly WHAT ARE MEDICATION UTILIZATION PROBLEMS AMONG THE ELDERLY? A useful
More informationD( desired ) Q( quantity) X ( amount ) H( have)
Name: 3 (Pickar) Drug Dosage Calculations Chapter 10: Oral Dosage of Drugs Example 1 The physician orders Lasix 40 mg p.o. daily. You have Lasix in 20 mg, 40 mg, and 80 mg tablets. If you use the 20 mg
More informationPROCEDURE FOR THE ADMINISTRATION OF MEDICATION BY INJECTION VIA THE INTRAMUSCULAR ROUTE OR VIA THE SUBCUTANEOUS ROUTE
PROCEDURE FOR THE ADMINISTRATION OF MEDICATION BY INJECTION VIA THE INTRAMUSCULAR OR VIA THE SUBCUTANEOUS First Issued Issue Version Purpose of Issue/Description of Change Planned Review Date October 2012
More informationBlood & Marrow Transplant Glossary. Pediatric Blood and Marrow Transplant Program Patient Guide
Blood & Marrow Transplant Glossary Pediatric Blood and Marrow Transplant Program Patient Guide Glossary Absolute Neutrophil Count (ANC) -- Also called "absolute granulocyte count" amount of white blood
More informationMedical Physiology Z.H.Al-Zubaydi
Lec.13 Medical Physiology Z.H.Al-Zubaydi Functions of the Digestive System The major functions of the digestive tract include the following six processes, summarized in Figure 1: 1. Ingestion Food must
More informationHuman Body Vocabulary Words Week 1
Vocabulary Words Week 1 1. arteries Any of the blood vessels that carry blood away from the heart to all parts of the body 2. heart The muscular organ inside the chest that pumps blood through the body
More informationSELECTED OPIATES TOXICITY A MODERN DAY EPIDEMIC
SELECTED OPIATES TOXICITY A MODERN DAY EPIDEMIC Learning Objectives: 1. Identify the names and reasons/circumstances for additional toxicity of SELECTED OPIATES hydromorphone DILAUDID Methadone Fentanyl/DURAGESIC
More informationGuidelines for Education and Training
Aim These protocols aim to provide the necessary guidance to enable insulin to be initiated safely and effectively Objectives 1. To provide the suggested procedure for the initiation of insulin for people
More informationThe Ideal Local Anesthetic. Pain and Anxiety. Percent Solution. Contents cont: Contents of a dental cartridge
The Ideal Local Anesthetic Pain and Anxiety University of Minnesota Division of Oral and Maxillofacial Surgery Ma Ann C. Sabino, DDS PhD Water soluble/stable in solution Non-irritating to nerve Low systemic
More informationGentle and safe injections. Tips and tricks for injecting insulin.
Gentle and safe injections. Tips and tricks for injecting insulin. More freedom. More confidence. With mylife. Gentle and safe injections The correct injection technique The insulin is injected into the
More informationOsseous Tissue & Structure. The skeletal system includes: Storage of minerals: calcium salts
Chapter 15 Lecture The Skeletal System: Osseous Tissue & Skeletal Structure The Skeletal System The skeletal system includes: Bones, cartilages, ligaments Bone tissue = osseous tissue Includes living cells
More informationdeveloped in the 1930 s Amides had a faster onset and a longer half life so they lasted longer Amides quickly ikl replaced esters In dentistry today,
Local Anesthetics History The first local anesthetics were cocaine and procaine (Novacain) developed in lt late 1800 s They were called esters because of their chemical composition Esters had a slow onset
More informationSign up to receive ATOTW weekly - email worldanaesthesia@mac.com
PHARMACOLOGY FOR REGIONAL ANAESTHESIA ANAESTHESIA TUTORIAL OF THE WEEK 49 26 TH MARCH 2007 Dr J. Hyndman Questions 1) List the factors that determine the duration of a local anaesthetic nerve block. 2)
More informationObstetrical Emergencies
Date: July 18, 2014 Page 1 of 5 Obstetrical Emergencies Purpose: To provide the process for the assessment and management of the patient with an obstetrical related emergency. Pre-Medical Control 1. Follow
More information02 DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION REGULATIONS RELATING TO ADMINISTRATION OF INTRAVENOUS THERAPY BY LICENSED NURSES
02 DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION 380 BOARD OF NURSING Chapter 10: REGULATIONS RELATING TO ADMINISTRATION OF INTRAVENOUS THERAPY BY LICENSED NURSES SUMMARY: This chapter identifies
More informationPharmacy Technician Review. Pharmacy Technician Review. Program Disclosure. Program Disclosure. Parenteral Routes of Administration
Pharmacy Technician Review Aseptic Technique: Presented by: Presented by: Pamela Grimm, CPhT Pharmacy Pamela Grimm, Technician CPhT Manager University Pharmacy of Technician Iowa Hospitals and Clinics
More informationSOP 001: POLYCLONAL ANTIBODY PRODUCTION IN RABBITS
SOP 001: POLYCLONAL ANTIBODY PRODUCTION IN RABBITS PURPOSE: To describe the proper procedure to follow when injecting adjuvants into rabbits for the production of polyclonal antibodies. POLICY: The improper
More informationDrug Excretion. Renal Drug Clearance. Drug Clearance and Half-Life. Glomerular Filtration II. Glomerular Filtration I. Drug Excretion and Clearance
t/.drugexcretion AINTRAVENOUSDOSE 36848765430TIME(hours) t/ Drug Excretion Dr. Robert G. Lamb Professor Pharmacology & Toxicology Drug Excretion and Clearance Drug Excretion: is the movement of drug from
More informationHeroin. How Is Heroin Abused? How Does Heroin Affect the Brain? What Other Adverse Effects Does Heroin Have on Health?
Heroin Heroin is an opiate drug that is synthesized from morphine, a naturally occurring substance extracted from the seed pod of the Asian opium poppy plant. Heroin usually appears as a white or brown
More information8/6/2010. Name of medication Concentration (1:1,000 or 1mg/1ml) Expiration date
Learning Objectives: Anaphylaxis & Epinephrine Administration by the EMT Adapted with permission from the Pilot Project for the Administration of Epinephrine by Washington EMTs With successful completion
More informationTestosterone Therapy for Women
Testosterone Therapy for Women The Facts You Need Contents 2 INTRODUCTION: The Facts You Need... 3-4 CHAPTER 1: Testosterone and Women... 5-9 CHAPTER 2: Testosterone Therapy for Women... 10-14 CONCLUSION:
More informationHerniated Cervical Disc
Herniated Cervical Disc North American Spine Society Public Education Series What Is a Herniated Disc? The backbone, or spine, is composed of a series of connected bones called vertebrae. The vertebrae
More informationJeopardy Topics: THE CLOT STOPS HERE (anticoagulants) SUGAR, SUGAR, HOW D YOU GET SO HIGH (insulins)
Jeopardy Topics: THE CLOT STOPS HERE (anticoagulants) SUGAR, SUGAR, HOW D YOU GET SO HIGH (insulins) I HEAR YA KNOCKING BUT YOU CAN T COME IN (electrolytes) TAKE MY BREATH AWAY (Opiates-morphine) OUT WITH
More informationSection B: Epithelial Tissue 1. Where are epithelial tissues found within the body? 2. What are the functions of the epithelial tissues?
Tissue worksheet Name Section A: Intro to Histology Cells are the smallest units of life. In complex organisms, cells group together with one another based on similar structure and function to form tissues.
More informationLiver Transarterial Chemoembolization (TACE) Cancer treatment
Patient Education Liver Transarterial Chemoembolization (TACE) Cancer treatment This handout explains what liver transarterial chemoembolization (TACE) is and what to expect with this cancer treatment.
More informationIntrathecal Baclofen for CNS Spasticity
Intrathecal Baclofen for CNS Spasticity Last Review Date: November 13, 2015 Number: MG.MM.ME.31bC5 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or
More informationPsychology 3625 Cellular and Molecular Neuroscience. Dr Darren Hannesson
Psychology 3625 Cellular and Molecular Neuroscience Dr Darren Hannesson Lecture 6 Cells of the nervous system Neurons Glia Other cell types Blood-brain barrier Types of nervous system cells Neurons The
More informationOPTIONAL LESSON Anaphylaxis and Epinephrine Auto-Injector
OPTIONAL LESSON Anaphylaxis and Epinephrine Auto-Injector Lesson Length: 54 minutes GUIDANCE FOR THE INSTRUCTOR To complete this lesson and meet the lesson objectives, you must: Discuss all points in the
More informationDigestive System Functions
Digestive System Functions A. Gastrointestinal Processes 1. Ingestion: placing food in mouth (voluntary) 2. Propulsion: moving food through GI tract a. Peristalsis: alternating waves of contraction and
More informationFemoral Nerve Block/3-in-1 Nerve Block
Femoral Nerve Block/3-in-1 Nerve Block Femoral and/or 3-in-1 nerve blocks are used for surgical procedures on the front portion of the thigh down to the knee and postoperative analgesia. Both blocks are
More informationManagement in the pre-hospital setting
Management in the pre-hospital setting Inflammation of the joints Two main types: Osteoarthritis - cartilage loss from wear and tear Rheumatoid arthritis - autoimmune disorder Affects all age groups,
More information2161-1 - Page 1. Name: 1) Choose the disease that is most closely related to the given phrase. Questions 10 and 11 refer to the following:
Name: 2161-1 - Page 1 1) Choose the disease that is most closely related to the given phrase. a disease of the bone marrow characterized by uncontrolled production of white blood cells A) meningitis B)
More informationIV solutions may be given either as a bolus dose or infused slowly through a vein into the plasma at a constant or zero-order rate.
د.شيماء Biopharmaceutics INTRAVENOUS INFUSION: IV solutions may be given either as a bolus dose or infused slowly through a vein into the plasma at a constant or zero-order rate. The main advantage for
More informationCarla Duff, CPNP MSN CCRP Clinical Advanced Registered Nurse Practitioner University of South Florida Division of Allergy, Immunology, and
Carla Duff, CPNP MSN CCRP Clinical Advanced Registered Nurse Practitioner University of South Florida Division of Allergy, Immunology, and Rheumatology Intravenous Subcutaneous IVIg SCIg What should you
More information.org. Herniated Disk in the Lower Back. Anatomy. Description
Herniated Disk in the Lower Back Page ( 1 ) Sometimes called a slipped or ruptured disk, a herniated disk most often occurs in your lower back. It is one of the most common causes of low back pain, as
More informationPACKAGE LEAFLET: INFORMATION FOR THE USER. PARACETAMOL MACOPHARMA 10 mg/ml, solution for infusion. Paracetamol
PACKAGE LEAFLET: INFORMATION FOR THE USER PARACETAMOL MACOPHARMA 10 mg/ml, solution for infusion Paracetamol Read all of this leaflet carefully before you start using this medicine. Keep this leaflet.
More informationDesigning a Pharmacology Course for a Doctor of Physical Therapy Program
Designing a Pharmacology Course for a Doctor of Physical Therapy Program Lynn Wecker, Ph.D. Distinguished Professor University of South Florida College of Medicine Department of Psychiatry & Neurosciences
More informationPHARMACY TECHNICIAN COMPETENCY EXAMINATION PROGRAM
PHARMACY TECHNICIAN COMPETENCY EXAMINATION PROGRAM 1 PHARMACY TECHNICIAN CERTIFICATION TABLE OF CONTENTS Dosage Calculations and Math Review.3 General Pharmacology.3-5 Substance Abuse, Vitamins, Psychotropic
More informationBrain Cancer. This reference summary will help you understand how brain tumors are diagnosed and what options are available to treat them.
Brain Cancer Introduction Brain tumors are not rare. Thousands of people are diagnosed every year with tumors of the brain and the rest of the nervous system. The diagnosis and treatment of brain tumors
More informationMATERIAL SAFETY DATA SHEET
MATERIAL SAFETY DATA SHEET 1. PRODUCT AND COMPANY IDENTIFICATION Name: XYLOCAINE SOLUTIONS WITH EPINEPHRINE Address/Phone No.: DENTSPLY Pharmaceutical 3427 Concord Road York, PA 17402 Phone: 717-757-0200
More informationEliminating Infusion Confusion. Agenda
Eliminating Infusion Confusion (Drug Administrations in Facility and Non-facility Settings) Presented by Maria Rita Genovese, CPC, PCS & Maryann C. Palmeter, CPC, CENTC 1 Agenda Review of CPT codes What
More informationNaloxone Hydrochloride Injection PRODUCT INFORMATION
Naloxone Hydrochloride Injection PRODUCT INFORMATION DESCRIPTION Naloxone hydrochloride is 17-allyl-4,5α-epoxy-3,14-dihydroxymorphinan-6-one hydrochloride; C 19 H 21 NO 4.HCl. It is an off-white powder
More informationPain Management after Surgery Patient Information Booklet
Pain Management after Surgery Patient Information Booklet PATS 509-15-05 Your Health Care Be Involved Be involved in your healthcare. Speak up if you have questions or concerns about your care. Tell a
More informationHerniated Lumbar Disc
Herniated Lumbar Disc North American Spine Society Public Education Series What Is a Herniated Disc? The spine is made up of a series of connected bones called vertebrae. The disc is a combination of strong
More informationVIVITROL (EXTENDED-RELEASE INJECTABLE NALTREXONE) MEDICAL PROTOCOL AND PROCEDURES
VIVITROL (EXTENDED-RELEASE INJECTABLE NALTREXONE) MEDICAL PROTOCOL AND PROCEDURES INTRODUCTION This is the protocol and procedures to administer VIVITROL (extended-release naltrexone injection, or XR-NTX)
More informationBIO 137: CHAPTER 1 OBJECTIVES
BIO 137: CHAPTER 1 OBJECTIVES 1. Define the terms anatomy and physiology, and explain their relationship using an example of a human structure with its corresponding function. A. ANATOMY = the study of
More informationData Sheet. Paraldehyde
Data Sheet Paraldehyde Paraldehyde Injection Solution 100% Presentation Paraldehyde Injection BP is a sterile liquid containing paraldehyde BP with hydroquinone 100 micrograms/ml as an antioxidant. It
More informationPain Management for Labour & Delivery
Pain Management for Labour & Delivery Departments of Anesthesia, Obstetrics, and Obstetrical Nursing December 2008 This pamphlet has been prepared to provide you, members of your family, and others who
More informationLevel 2 Certificate in Fitness Instructing Unit 1: Anatomy and Physiology
Level 2 Certificate in Fitness Instructing Unit 1: Anatomy and Physiology These questions have been compiled based on the information available for the above qualification and unit. This mock should be
More informationSpinal Anesthesia. Contraindications Please review Chapter 2 for contraindications.
Spinal Anesthesia Spinal anesthesia involves the use of small amounts of local anesthetic injected into the subarachnoid space to produce a reversible loss of sensation and motor function. The anesthesia
More informationMaking our pets comfortable. A modern approach to pain and analgesia.
Making our pets comfortable. A modern approach to pain and analgesia. What is pain? Pain is an unpleasant sensory and emotional experience with awareness by an animal to damage or potential damage to its
More informationObjectives At the completion of this module, unlicensed assistive personnel (UAP) should be able to:
Objectives At the completion of this module, unlicensed assistive personnel (UAP) should be able to: 1. administer medications by subcutaneous injections. 2. document medication administration in the client
More informationSUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT 2 QUALITATIVE AND QUANTITATIVE COMPOSITION
SUMMARY OF PRODUCT CHARACTERISTICS 1 NAME OF THE MEDICINAL PRODUCT Methadone 10mg/ml Injection / Physeptone 10mg/ml Injection 2 QUALITATIVE AND QUANTITATIVE COMPOSITION Contains: Methadone Hydrochloride
More informationCorporate Medical Policy
File Name: anesthesia_services Origination: 8/2007 Last CAP Review: 1/2016 Next CAP Review: 1/2017 Last Review: 1/2016 Corporate Medical Policy Description of Procedure or Service There are three main
More information