Extended-Release Medications

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUyje72-yUl-IZVcJASY30-wXItdiQMA2Em8JKZnhAM7P0mz8-hPZs42t7YO89V871mR-WhefARhSnCZBGdxFH9YTYHoCS80UBu4I9mAKyhA-5g2hacbogudvhIsOCqVkfwEhrt5BdKmya/s1600/pharmatutor-art-1733-2.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="161" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUyje72-yUl-IZVcJASY30-wXItdiQMA2Em8JKZnhAM7P0mz8-hPZs42t7YO89V871mR-WhefARhSnCZBGdxFH9YTYHoCS80UBu4I9mAKyhA-5g2hacbogudvhIsOCqVkfwEhrt5BdKmya/s320/pharmatutor-art-1733-2.png" width="320" /></a></div> These medication dosage forms are called extended-release, sustained release, long-acting, or controlled release. Although the exact meaning of these terms differ in some respects, each of these terms implies a gradual release of medication over a long period time.<br /> <br /> <table style="width: 100%;"> <tbody> <tr> <td>CD</td> <td>Controlled-diffusion</td> </tr> <tr> <td>CR</td> <td>Controlled-release, continuous-release</td> </tr> <tr> <td>CRT</td> <td>Controlled-release tablet</td> </tr> <tr> <td>LA</td> <td>Long-acting</td> </tr> <tr> <td>SA</td> <td>Sustained-action</td> </tr> <tr> <td>SR</td> <td>Sustained-release, slow-relaese</td> </tr> <tr> <td>TD</td> <td>Time-delay</td> </tr> <tr> <td>TR</td> <td>Time-release</td> </tr> <tr> <td>XL</td> <td>Extra-long</td> </tr> <tr> <td>XR</td> <td>Extended-release</td> </tr> </tbody></table>

Extended-Release Medications

These medication dosage forms are called extended-release, sustained release, long-acting, or controlled release. Although the exact meani...

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Routes of Medication Administration

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_-gZPqoCULSmZ6oPEAOzwIm2VtBkcJGegI8znnZ7IEKMFOYOeUHj6gsiWJcJ8iNCJFSVg8tfel2jAsjM4OW90w6UeZU9vMvVlq6IOT1ynx41rUkvdoTBaFAvRVZ54J1PQCBcPBNAS21qA/s1600/ncpcardio0456-f1.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="350" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_-gZPqoCULSmZ6oPEAOzwIm2VtBkcJGegI8znnZ7IEKMFOYOeUHj6gsiWJcJ8iNCJFSVg8tfel2jAsjM4OW90w6UeZU9vMvVlq6IOT1ynx41rUkvdoTBaFAvRVZ54J1PQCBcPBNAS21qA/s640/ncpcardio0456-f1.gif" width="640" /></a></div> <div style="text-align: justify;"> <br /> A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration. Routes can also be classified based on where the target of action is. Action may be topical (local), enteral (system-wide effect, but delivered through the gastrointestinal tract), or parenteral (systemic action, but delivered by routes other than the GI tract).</div> <br /> <table><tbody> <tr> <th>Route</th> <th>Methods</th> <th>Description</th> <th>Advantages</th> <th>Disadvantages</th> </tr> <tr> <td rowspan="5">Oral</td> <td>Oral</td> <td>Through the mouth </td> <td>It is convenient. It is the cheapest available route. It is easy to use. It is safe and acceptable.</td> <td>Less amount of drug reaches the target tissue.<br /> Some of the drug is destroyed by gastric juices.<br /> Absorption has to take place which is slow, so is not preferred during emergencies.<br /> It might cause gastric irritation.<br /> It might be objectionable in taste.<br /> It might cause discoloration of teeth.</td> </tr> <tr> <td>Buccal</td> <td>Inside the cheek</td> <td></td> <td></td> </tr> <tr> <td>Lingual</td> <td>On the tongue</td> <td></td> <td></td> </tr> <tr> <td>Sublingual</td> <td>Under gums</td> <td>Rapid absorption takes place.<br /> Drug is dissolved easily.<br /> Drug enters the blood directly.<br /> Less first pass effect.<br /> Spitting out of the drug removes its effect.</td> <td>This method is inconvenient.<br /> Irritation of the mucous membrane might occur.<br /> Person may swallow the drug.<br /> Might be unpleasant in taste.</td> </tr> <tr> <td>Transmucosal</td> <td>Across mucous membrane</td> <td></td> <td></td> </tr> <tr> <td rowspan="4">Enteral</td> <td>Enteral</td> <td>By way of the intestine</td> <td></td> <td></td> </tr> <tr> <td>Nasogastric (Tube)</td> <td>A feeding tube inserted through the nose into the stomach (NG or NGT)</td> <td></td> <td></td> </tr> <tr> <td>Gastrostomy (tube), percutaneous endoscopic gastrostomy (tube)</td> <td>A feeding tube inserted through the abdominal wall into the stomach (GT or PEG)</td> <td></td> <td></td> </tr> <tr> <td>Jejunostomy (tube)</td> <td>A feeding tube inserted through the jejunum (small intestine) (JT)</td> <td></td> <td></td> </tr> <tr> <td>Inhalation</td> <td>Inhalation</td> <td>Drawn through the mouth into the lungs</td> <td>Rapid absorption takes place.<br /> Rapid onset of action takes place.<br /> This route has minimum side effects.<br /> No first pass effect takes place.<br /> This method is easy.<br /> Fewer doses is required.</td> <td>Special apparatus is required.<br /> Irritation of the respiratory tract may take place.<br /> Cooperation of the patient is required.<br /> Airway must be patent.</td> </tr> <tr> <td rowspan="18">Parenteral</td> <td>Parenteral</td> <td>By passing the gastrointestinal tract. Not delivered via the intestinal tract. </td> <td>Parenteral route is rapid.<br /> It is useful for uncooperative patients.<br /> It is useful for unconscious patients.<br /> Inactivation by GIT enzymes is avoided.<br /> First pass effect is avoided*.<br /> Bioavailability is 100%.</td> <td>Skill is required.<br /> It is painful.<br /> This method is expensive.<br /> It is less safe.</td> </tr> <tr> <td>Implant</td> <td>A device inserted into or under the skin</td> <td></td> <td></td> </tr> <tr> <td>Intra-arterial</td> <td>Into an artery (AI)</td> <td></td> <td></td> </tr> <tr> <td>Intra-articular</td> <td>Into a joint (AI)</td> <td></td> <td></td> </tr> <tr> <td>Intracardiac</td> <td>Into the heart muscle (IC)</td> <td></td> <td></td> </tr> <tr> <td>Intradermal</td> <td>Into the top lay of the skin (ID)</td> <td></td> <td></td> </tr> <tr> <td>Intratracheal, endotrcheal</td> <td>Into the trachea (IT)</td> <td></td> <td></td> </tr> <tr> <td>intramuscular</td> <td>Into a muscle (IM)</td> <td>Absorption is rapid than subcutaneous route.<br /> Oily preparations can be used.<br /> Irritative substances might be given<br /> Slow releasing drugs can be given by this route.</td> <td>Using this route might cause nerve or vein damage.</td> </tr> <tr> <td>Intraosseous</td> <td>Into the marrow of a bone</td> <td></td> <td></td> </tr> <tr> <td>intraperitoneal</td> <td>Into the peritoneal (abdominal) cavity</td> <td></td> <td></td> </tr> <tr> <td>Intrapleural</td> <td>Into the pleura (sac that surround the lungs)</td> <td></td> <td></td> </tr> <tr> <td>intrathecal</td> <td>Into space around the spinal cord</td> <td></td> <td></td> </tr> <tr> <td>intrauterine</td> <td>Into the uterus</td> <td></td> <td></td> </tr> <tr> <td>intravenous</td> <td>Into a vein (IV)</td> <td>Immediate action takes place.<br /> This route is preferred in emergency situations.<br /> This route is preferred for unconscious patients.<br /> Titration of dose is possible.<br /> Large volume of fluids might be injected by this route.<br /> Diluted irritant might be injected.<br /> Absorption is not required.<br /> No first pass effect takes place.*<br /> Blood plasma or fluids might be injected.</td> <td>There is no retreat.<br /> This method is more risky.<br /> Sepsis-Infection might occur.<br /> Phlebitis(Inflammation of the blood vessel) might occur.<br /> Infiltration of surrounding tissues might result.<br /> This method is not suitable for oily preparations.<br /> This method is not suitable for insoluble preparations.</td> </tr> <tr> <td>intraventricular</td> <td>Into the ventricles, or cavities, of the brain</td> <td></td> <td></td> </tr> <tr> <td>intravesicular</td> <td>Into the urinary bladder</td> <td></td> <td></td> </tr> <tr> <td>intravitreal or intravitreous</td> <td>Into the eye</td> <td></td> <td></td> </tr> <tr> <td>Subcutaneous</td> <td>Immediately under the skin (SubQ, SC, SQ)</td> <td>Absorption is slow and constant.<br /> It is hygienic.</td> <td>It might lead to abscess formation.<br /> Absorption is limited by blood flow.</td> </tr> <tr> <td>Nasal</td> <td></td> <td>Into the nose</td> <td></td> <td></td> </tr> <tr> <td>Ophthalmic</td> <td></td> <td>Into the eye</td> <td></td> <td></td> </tr> <tr> <td>Otic, aural</td> <td></td> <td>Into the ear</td> <td></td> <td></td> </tr> <tr> <td>Percutaneous</td> <td></td> <td>Through the skin</td> <td></td> <td></td> </tr> <tr> <td>Rectal</td> <td></td> <td>Through the anus into the retum</td> <td>This route is preferred in unconscious or uncooperative patients.<br /> This route avoids nausea or vomiting.<br /> Drug cannot be destroyed by enzymes.<br /> This route is preferred if drug is irritant.</td> <td>This route is generally not acceptable by the patients.<br /> Locally acting drugs include glycerin and Bisacodyl suppository.<br /> Systemic acting drugs include Indomethacin (anti inflammatory) and aminophyllin (bronchodilator).<br /> Retention enema is diagnostic and is used for finding the pathology of lower intestines.<br /> Drugs given by rectal route have 50% first pass metabolism.*</td></tr> <tr> <td>Topical</td> <td></td> <td>Applied to the skin or mucous membranes</td> <td></td> <td></td> </tr> <tr> <td>Transdermal</td> <td></td> <td>Through the skin</td> <td></td> <td></td> </tr> <tr> <td>Vaginal</td> <td></td> <td>Into the vagina</td> <td></td> <td></td> </tr> </tbody></table> <br /> <b>*First Pass Effect</b>: First pass effect is the term used for hepatic metabolism of drug when absorbed and delivered through portal blood. Greater the first pass effect, less amounts of the drug reach the systemic circulation.<br /> <b><br /> Time of Action using Different Routes of Administration</b><br /> <table id="t01"><tbody> <tr> <th>Route of Administration</th> <th>Delay time for Action</th> </tr> <tr> <td>Intravenous route</td> <td>30-60 seconds</td> </tr> <tr> <td>Intraosseous route </td> <td>30-60 seconds</td> </tr> <tr> <td>Endotracheal inhalation</td> <td>2-3 minutes</td> </tr> <tr> <td>Sublingual route </td> <td>3-5 minutes</td> </tr> <tr> <td>Intramuscular route </td> <td>10-20 minutes</td> </tr> <tr> <td>Rectal route</td> <td>5-30 minutes</td> </tr> <tr> <td>Ingestion</td> <td>30-90 minutes</td> </tr> </tbody></table>

Routes of Medication Administration

A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into th...

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Medication Dosage Forms

<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-FGZ_y7-YuCnSgoU6Slap4gZCVyGL7ooHNOfg1fGrKYJpRuqH-Gc5F9er3uXOE4TyJJnEr-DO49gv15grdL0-59r2fzIWYCpqLuCzjmAsEoMoWGvjbLzoBCyqT_yrK9RlTzw060jGhnOk/s1600/20060822_0023.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="426" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-FGZ_y7-YuCnSgoU6Slap4gZCVyGL7ooHNOfg1fGrKYJpRuqH-Gc5F9er3uXOE4TyJJnEr-DO49gv15grdL0-59r2fzIWYCpqLuCzjmAsEoMoWGvjbLzoBCyqT_yrK9RlTzw060jGhnOk/s640/20060822_0023.jpg" width="640" /></a></div> <br /> <div style="text-align: justify;"> The term dosage form can also sometimes refer only to the chemical formulation of a drug product's constituent drug substance(s) and any blends involved, without considering matters beyond that (like how it's ultimately configured as a consumable product such as a capsule, patch, etc.). Because of the somewhat vague boundaries and unclear overlap of these terms and certain variants and qualifiers thereof within the pharmaceutical industry, caution is often advisable when conversing with someone who may be unfamiliar with another person's use of the term.</div> <div style="text-align: justify;"> <br /></div> <div style="text-align: justify;"> Depending on the method/route of administration, dosage forms come in several types. These include many kinds of liquid, solid, and semisolid dosage forms. Common dosage forms include pill, tablet, or capsule, drink or syrup, and natural or herbal form such as plant or food of sorts, among many others. Notably, <a href="http://ptcbstudy.blogspot.com/2015/05/routes-of-medication-administration.html" target="_blank">the route of administration (ROA) </a>for drug delivery is dependent on the dosage form of the substance in question. A liquid dosage form is the liquid form of a dose of a chemical compound used as a drug or medication intended for administration or consumption.</div> <br /> <a href="http://www.fda.gov/Drugs/DevelopmentApprovalProcess/FormsSubmissionRequirements/ElectronicSubmissions/DataStandardsManualmonographs/ucm071666.htm">A 1999 Food and Drug Administration Draft Guidance for Industry states:</a> "A dosage form is the way of identifying the drug in its physical form. In determining dosage form, FDA examines such factors as (1) physical appearance of the drug product, (2) physical form of the drug product prior to dispensing to the patient, (3) the way the product is administered, (4) frequency of dosing, and (5) how pharmacists and other health professionals might recognize and handle the product."<br /> <br /> <table><tbody> <tr> <th colspan="2">Liquid Medication Dosage Forms</th> </tr> <tr> <td rowspan="8">Solutions</td> <td>Aqueous (water-based)</td> </tr> <tr> <td>Gargles</td> </tr> <tr> <td>Oral Rinses</td> </tr> <tr> <td>Washes & Mouthwashes</td> </tr> <tr> <td>Douches</td> </tr> <tr> <td>Irrigants</td> </tr> <tr> <td>Enemas</td> </tr> <tr> <td>Sprays</td> </tr> <tr> <td rowspan="2">Viscous (thick) aqueous</td> <td>Syrups</td> </tr> <tr> <td>Jellies</td> </tr> <tr> <td rowspan="2">Hydroalcoholic</td> <td>Elixirs</td> </tr> <tr> <td>Spirits</td> </tr> <tr> <td rowspan="2">Alcoholic</td> <td>Collodions</td> </tr> <tr> <td>Spirits</td> </tr> <tr> <td>Glycerites</td> <td></td> </tr> <tr> <td rowspan="2">Extractives</td> <td>Extracts</td> </tr> <tr> <td>Tinctures</td> </tr> <tr> <td rowspan="2">Emulsions</td> <td>Fluidextracts</td> </tr> <tr> <td>Oil-in-Water</td> </tr> <tr> <td rowspan="3">Suspensions</td> <td>Magmas & Milks</td> </tr> <tr> <td>Gels</td> </tr> <tr> <td>Mucilages</td> </tr> </tbody></table> <br /> <table id="t01"><tbody> <tr> <th colspan="2">Solid Medication Dosage Forms</th> </tr> <tr> <td>Tablets</td> <td></td> </tr> <tr> <td rowspan="3">Compressed</td> <td>Suger-coated</td> </tr> <tr> <td>Film-coated</td> </tr> <tr> <td>Enteric-coated</td> </tr> <tr> <td>Sublingual</td> <td></td> </tr> <tr> <td>Buccal</td> </tr> <tr> <td>Effervascent</td> <td></td> </tr> <tr> <td>Chewable</td> <td></td> </tr> <tr> <td>Vaginal</td> <td></td> </tr> <tr> <td rowspan="2">Capsules</td> <td>Hard gelatin</td> </tr> <tr> <td>Soft gelatin</td> </tr> <tr> <td>Lozenges</td> <td></td> </tr> <tr> <td rowspan="3">Supporites</td> <td>Rectal</td> </tr> <tr> <td>Vaginal</td> </tr> <tr> <td>Urethral</td> </tr> <tr> <td rowspan="3">Semisolids</td> <td>Oinments</td> </tr> <tr> <td>Creams</td> </tr> <tr> <td>Pastes</td> </tr> </tbody></table> <br /> <table id="t01"><tbody> <tr> <th colspan="2">Miscellaneous Medication Dosage Forms</th> </tr> <tr> <td>Poweders</td> </tr> <tr> <td>Granules</td> </tr> <tr> <td>Inhalants</td> </tr> <tr> <td>Aerosols</td> </tr> <tr> <td>Shampoos & crème rinses</td> </tr> <tr> <td>Wipes & scrubs</td> </tr> <tr> <td>Transdermal patches</td> </tr> <tr> <td>Implants</td> </tr> </tbody></table> <br /> <table id="t01"><tbody> <tr> <th>Dosage Forms</th> <th>Description</th> </tr> <tr> <td>Capsules</td> <td>Capsules are composed of a gelatin container. Caplet dosage forms are related closely to tablets, but they are smooth sided and are therefore easier to swallow.</td> </tr> <tr> <td>Lozenges & Troche</td> <td>Lozenges and troches are other forms of tablets that are not meant to be swallowed but to dissolve in the mouth, which releases the medication more slowly. Troches are larger than normal-size tablets and are flat: they usually have a chalky consistency in order to dissolve in the mouth. </td> </tr> <tr> <td>Patches</td> <td>Patches are solid pieces of material that hold a specific amount of medication to be released into the skin over time. </td> </tr> <tr> <td rowspan="8">Liquids</td> <td>Liquids are composed of various solutions.</td> </tr> <tr> <td>Syrups are sugar-based solutions that have medication dissolved into them. </td> </tr> <tr> <td>Elixirs contain dissolved medication in an alcohol base or water and alcohol base. </td> </tr> <tr> <td>Sprays are composed of various bases such as alcohol or water in a pump dispenser. </td> </tr> <tr> <td>Inhalants and aerosols need to be able to get medication directly to the source of inflammation. </td> </tr> <tr> <td>Emulsions are a mixture of water and oil may be used with an emulsifier to bind the two together. </td> </tr> <tr> <td>Suspensions are liquids that have very small, solid particles suspended in the base solution. </td> </tr> <tr> <td>Enemas may be administered for two different reasons-retention or evacuation. </td> </tr> <tr> <td rowspan="9">Semisolids</td> <td>Semisolids contain solids and liquids, they normally are meant for topical application. </td> </tr> <tr> <td>Creams usually have medications in a base that is part oil and part water and is meant for topical or local use. </td> </tr> <tr> <td>Lotions are thinner than creams because their base contains more water. They penetrate well into the skin and do not leave an oily residue after application. </td> </tr> <tr> <td>Ointments contain medication in a glycol or oil base. Ointments can be used rectally, topically and as an ophthalmic agent. </td> </tr> <tr> <td>Gels contain medication in a viscous liquid that easily penetrates the skin and does not leave a residue. </td> </tr> <tr> <td>Pastes contain a lesser amount of liquid base than solids. They are used for topical application and are able to ab sorb skin secretions, unlike other topical agents. </td> </tr> <tr> <td>Suppositories can be used rectally and vaginally. </td> </tr> <tr> <td>Powders do not fit neatly into semisolids. Powders are solids, yet they are packaged in some forms that allow them to be sprayed similar to liquid dosage forms. </td> </tr> <tr> <td>Injectables are used for rapid response. The onset of an injectable drug only takes a few minutes as opposed to the 45 minutes that oral medications can take to work. </td> </tr> </tbody></table>

Medication Dosage Forms

The term dosage form can also sometimes refer only to the chemical formulation of a drug product's constituent drug substance(s) and...

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