PTCB Study Guide: ROA

<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihIDjhl0sfNoQARktDgcJ9DYsUXknoTC-pN0rkvkH24cFHCaVI1HJLuBtazuWXVrTcS-heLgeF9viNszMUm2zVDabn-4dX32z9KBAj09l3PbxCWfsqrPIeA1EPIa5LbRh2v0W2DPwG0QUI/s1600/c3cs60436e-f2_hi-res.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihIDjhl0sfNoQARktDgcJ9DYsUXknoTC-pN0rkvkH24cFHCaVI1HJLuBtazuWXVrTcS-heLgeF9viNszMUm2zVDabn-4dX32z9KBAj09l3PbxCWfsqrPIeA1EPIa5LbRh2v0W2DPwG0QUI/s320/c3cs60436e-f2_hi-res.gif" width="291" /></a></div>
<table style="width: 100%;"><tbody>
<tr>
    <td colspan="2"><b>Route of Administration</b></td> 
  </tr>
<tr>
    <td>OD</td>
    <td>Right Eye</td>  
  </tr>
<tr>
    <td>OS</td>
    <td>Left Eye</td>  
  </tr>
<tr>
    <td>OU</td>
    <td>Both Eyes</td>  
  </tr>
<tr>
    <td>AD</td>
    <td>Right Ear</td>  
  </tr>
<tr>
    <td>AS</td>
    <td>Left Ear </td>  
  </tr>
<tr>
    <td>AU</td>
    <td>Both Ears </td>  
  </tr>
<tr>
    <td>PO</td>
    <td>By Mouth </td>  
  </tr>
<tr>
    <td>SL</td>
    <td>Sublingual</td>  
  </tr>
<tr>
    <td>NG  or NGT</td>
    <td>Feeding Tube through the nose into stomach</td>  
  </tr>
<tr>
    <td>IEN or NAS</td>
    <td>by Nostril</td>  
  </tr>
<tr>
    <td>Bucc</td>
    <td>Held Inside the Cheek</td>  
  </tr>
<tr>
    <td>S&S</td>
    <td>Swish & Swallow </td>  
  </tr>
<tr>
    <td>HHN</td>
    <td>Hand Held Nebulizer </td>  
  </tr>
<tr>
    <td>PR</td>
    <td>Into the Rectum </td>  
  </tr>
<tr>
    <td>PV</td>
    <td>Into the Vagina</td>  
  </tr>
<tr>
    <td>SubQ, SC, SQ</td>
    <td>Immediately under the skin</td>  
  </tr>
<tr>
    <td>Top</td>
    <td>Topical</td>  
  </tr>
<tr>
    <td>GT or PGT</td>
    <td>Feeding Tube through the abdominal wall into stomach</td>  
  </tr>
<tr>
    <td>JT</td>
    <td>Feeding Tube through the small Intestine</td>  
  </tr>
<tr>
    <td>IA</td>
    <td>Into a(n) artery or joint</td>  
  </tr>
<tr>
    <td>IC</td>
    <td>Into the heart muscle</td>  
  </tr>
<tr>
    <td>ID</td>
    <td>Into the top layer of the skin</td>  
  </tr>
<tr>
    <td>IT</td>
    <td>Into the Trachea</td>  
  </tr>
<tr>
    <td>IM</td>
    <td>Into a muscle</td>  
  </tr>
<tr>
    <td>IV</td>
    <td>Into a vein</td>  
  </tr>
<tr>
    <td>INH</td>
    <td>Inhalant</td>  
  </tr>
</tbody></table>

The most difficult pharmacy abbreviations to remember are the eyes and ears. They are very easy to mix up. Try this: When you see the O, think of "OCULAR". For the A, remember it as "AUDIO". For the letter U, think of "UNITED" - all parts.

Route of Administration Abbreviations

Route of Administration OD Right Eye OS Left Eye OU Both Eyes AD Rig...

<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...