What does oral administration mean? What does it mean to take medicine by mouth? Video about the method of drug administration

All routes by which drugs enter the human body, can be divided into two subgroups: parenteral and enteral.

The former include intravenous, intramuscular, subcutaneous and others. The latter ensure that the drug enters the human body through the mucous membrane of the stomach and intestines. This subgroup includes the method orally. It's like putting a pill on your tongue and swallowing it. In addition, there are rectal (through the rectum), sublingual (under the tongue), subbucal (into the space between the cheek and gums) entry of drugs into the body.

Oral administration is like swallowing a drug, which helps it enter the human body in this way, followed by absorption in the stomach, intestines.

Pharmacokinetics

The drug makes a dizzying flight through the esophagus and enters the stomach, and then the intestines, where it is slowly absorbed over thirty to forty minutes. After absorption, the active principle enters the bloodstream of the portal vein. Further, the blood flow carries the drug to the liver, and then straight to the inferior vena cava, then to the right side of the beating heart and from there to the pulmonary circulation.

Having swept through a small circle, the medicinal substance is sent through the pulmonary veins to the left side of the working heart, from where it rushes to the target organs and tissues with arterial blood.

In a similar way, which means orally, liquid and solid substances enter the human body. dosage forms.

Advantages of the method

Oral administration is simple, convenient and most physiological. The medicinal substance enters the body in a natural way.
No special training is required to use this method. Any patient can use this method independently.
Oral administration is absolutely safe.

Disadvantages of the method

The medicinal substance enters the systemic circulation very slowly, and also slowly reaches the target organ.
Inconsistent absorption rate. It depends on the presence of contents in the intestines and stomach, the degree of their fullness, motility gastrointestinal tract. With reduced motility, the rate of absorption also decreases.
Medicines enter the stomach, intestines, orally. This properly exposes them to the enzymes of the stomach, intestinal juice, and later the metabolic enzymes of the liver system. All these enzymes destroy most of the drug even before it enters the systemic circulation (for example, nitroglycerin is destroyed by ninety percent when taken orally).
You can not use those drugs that are poorly absorbed in the intestines and stomach (antibiotics aminoglycosides, for example) or are destroyed there (growth hormone, alteplase, insulin, for example).
Some drugs irritate the intestines with the stomach up to ulcerative lesions (salicylates, corticosteroids).
In this way, it will not be possible to administer the drug if the patient is unconscious (if only one resorts to intragastric administration with a probe), when the patient constantly and continuously vomits, when there is a tumor in the esophagus, there is massive edema that disrupts the absorption of the drug in the intestine.

Types of diseases for which this method is preferable

The choice of the method of drug administration depends on the ability of the latter to dissolve in water or non-polar solvents, on the severity of the disease, on the location of the pathological process.

With a disease of the respiratory system of mild / moderate severity.
With diseases of the intestines, stomach of any severity.
With diseases of the heart, blood vessels
In diseases of soft tissues, skin of moderate / mild severity.
With ailments of the endocrine system of moderate / mild severity.
In diseases of the musculoskeletal system of moderate / mild severity.
In diseases of the mouth, ears, eyes - in severe cases.
For diseases of the genitourinary system of moderate / mild severity.

Dosage forms taken by mouth

Many drugs can be given orally to the patient. These are both tablets and powders, both tinctures and decoctions.

Powders - the simplest dosage form, which is a drug crushed in a mortar (coffee grinder). When taken orally, it is better to drink the powder with the required amount of mineral or plain water. Powders are rarely used in medical practice.

Infusions and decoctions - often found dosage forms that are prepared by water extract from medicinal raw materials plant origin. Infusions and decoctions are not stored for a long time and quickly deteriorate. They need to be stored in the refrigerator for no more than two days.

Tinctures - alcohol-water, alcohol-ether and alcohol extracts, without the use of heat treatment, are prepared from medicinal raw materials. The dosage is made in drops, which can be diluted in a small amount of water before taking. Their difference from infusions and decoctions is that tinctures are able to retain their therapeutic effect for a long time.

Syrups are a dosage form convenient for children, which is a mixture of a drug and a concentrated sugar solution. Stored in glassware closed after boiling.

Tablets - oral preparations of an oval, round or other shape. Usually biconvex. They are made by pressing the drug with special machines. Easy to use, retain their properties long time, portable. The taste of the drug in them is not so noticeable.

Conclusion

The oral method is simple and convenient, easy to use and does not require special training. Allows you to easily control the intake of the drug. It is enough for the doctor to write out a prescription - and the patient will continue the treatment on his own.

Modern medicine dates back to ancient times, which is why there are so many Latin and ancient Greek words in it as a tribute. For example, most drugs are prescribed orally: how is it? Even those who are far from Latin can answer this question - the term is used too often in everyday life.

Two main routes of administration.

And what are the methods of introducing drugs into the patient's body? All options are reduced to two - enteral and paraenteral.

The first ones include:

Orally.
Sublingual.
Buccal.
Translingual.
Vaginally.
Rectally.

Inhalation. This can also include the intranasal route of administration.
Injection. All intramuscular, intravenous and subcutaneous injections.
Introduction to cavities. In such cases, drugs are sent to abdominal cavity or joint cavities.

The effectiveness of injections and inhalations

The methods described in the second column allow substances to reach the sites of exposure as quickly as possible and influence the outcome of the disease. With the same nasal congestion, it is easier to use a spray than to do intramuscular injections. Since we remembered about the injections.

What does it depend on whether they will be done in a vein, muscle or skin? From the drug to be entered.

Some substances, when administered intramuscularly, can cause acute pain and even rapidly developing tissue death. The second important factor is time of action of the drug. The fastest change in state is given by intravenous injections, a few seconds are enough. But from the muscle tissue, the drug must be absorbed into the bloodstream, and only then can it act on the body.

With skin, the situation is almost the same. Abdominal application is rather an exception to the rule. They are used during surgical interventions and after them, in case of serious damage to the joints.

What is oral?

But what about enteral methods? All of them are connected with the veins of the gastrointestinal tract. Most often drugs prescribed orally, i.e. - through the mouth. Ordinary tablets, capsules, powders, tinctures, solutions. It is enough to swallow, drink, chew and after 15-20 minutes you will feel the first changes. The sequence of penetration of the drug is quite simple:

The medicine enters the stomach, where digestion processes begin.
Absorption can begin in the stomach or intestines, in the arteries.
Active molecules are carried by the blood throughout the body.
They pass through the liver, where some of them lose their activity.
Excreted by the kidneys or liver.

Negative aspects of oral administration

The method seems extremely simple, but at the same time it not suitable for critically ill patients. Babies are also very difficult to get to chew or swallow a pill, especially if it is eerily bitter. In this case, you have to look for alternative ways of delivery.

Another significant downside is passage through the liver. As you know, this organ is our main protector against any toxic substances. The action of the drug may well be based on what is perceived as a poison. And here the liver will do us a disservice by reducing the effectiveness of the drug. The drug may become inactive as it is bound by liver proteins.

In this state, the substance will not have any effect on the body, but can be in fairly high concentrations. Negative conditions will contribute to the release of the drug from the bound state.

The effect, given the concentration, can have unfortunate consequences.

But why dramatize? The oral method of administering drugs was one of the first in medicine. And throughout history, it has shown its effectiveness and simplicity. After all, a person does not need outside help to take drugs. Even an exhausted person will quite calmly endure the reception if he is still conscious. No negative emotions and associations. You probably remember the children in the office, before the injection. If all substances were administered by injection, it would be unrealistic to drag the child to the hospital. In addition, this is the best option for influencing the esophagus, stomach and intestines.

And be sure to read the directions carefully before using. Many people decide that it is not necessary to take pills with a large amount of water. But some of the drugs, with this careless attitude, can lead to the development of stomach ulcers.

Drinking before or after meals is also an important point. No one has yet canceled the features of metabolism and blood circulation. The optimal effectiveness of the drug depends on this, which has been proven in numerous clinical studies.

Knowing how it is orally, you can always consult your grandmother or any other relative. But do not overdo it with drugs, the use of more than 5 drugs at the same time increases the risk of manifestation side effects up to 50%.

Video about the method of drug administration

Per os means through the mouth. This is how most drugs are taken. Today's recipes no longer use this phrase, the need for this has disappeared.

Why is it so

According to tradition, the doctor prescribes medication through the mouth, this method is the most common, because many drugs dissolve well under the action of gastric juice, ensuring optimal absorption by the walls of this organ, as well as the walls of the intestine. Oral administration is also indicated in the reverse situation - when drugs are poorly absorbed by the stomach. A good therapeutic effect of such treatment is achieved due to the maximum concentration of the drug in the stomach, allowing the disease of this organ to succeed.

But oral medication is not without its drawbacks. The most significant of them is the long time that passes before the onset of the swallowed action. In addition, the bioavailability of the drug, that is, the rate of absorption and absorption for each person is different and depends on age, condition of the gastrointestinal tract, food intake, and sometimes gender. Some drugs have very low bioavailability on their own. Therefore, if the instructions for the product indicate that its bioavailability is 30%, then you should look for some other drug or buy the same one, but in a different form, for example, candles.

Features of oral administration

In some cases, oral administration is simply not possible, in particular with vomiting, fainting and in infants. It is worth noting that sometimes taking drugs orally is impractical due to the creation of harmful metabolites that can cause great damage to the liver. It is most rational to take medicines inside in the morning, 20-30 minutes before breakfast. At this time, the body does not yet have time to activate the secretion of digestive juices, so it is more likely that the drug will not lose its activity due to their destructive effects.

You can reduce the irritating effect of the drug on the walls of the stomach if you drink it with plenty of water. And take it strictly as prescribed by the doctor or according to the instructions, since some drugs, for example, retard tablets and retard capsules, cannot be crushed. In this case, their properties may be lost. Some drugs, eliminating one disease, cause another, so you need to take them under the guise of another remedy. Only a doctor can prescribe it.

Application

Predominantly, taking drugs in this way is prescribed for drugs that are well absorbed by the mucous membrane of the stomach or intestines. In the treatment of diseases of the digestive system, in some cases, on the contrary, poorly absorbed drugs are used, which makes it possible to achieve their high concentration in the gastrointestinal tract and obtain a good local effect without adverse reactions.

disadvantages

slower than with other methods of taking drugs, the development of a therapeutic effect,
the rate and completeness of absorption (bioavailability) are individual for each patient, since they are influenced by food, organic and functional state gastrointestinal tract, taking other medications,
oral administration is ineffective for drugs that are poorly absorbed or destroyed in the gastrointestinal tract, form ineffective metabolites when passing through the liver, or have a pronounced irritant effect,
oral administration is difficult or impossible with vomiting, in the unconscious state of the patient.

Dosage forms for oral administration

The main oral dosage forms are solutions, powders, tablets, capsules and pills. There are also dosage forms (for example, tablets with multilayer shells), when taking the active drug, it is released longer than usual (compared to conventional dosage forms), which allows to prolong the therapeutic effect.

Most oral medications should be taken with plenty of liquid. When taking certain drugs in a supine position, they can linger in the esophagus and cause ulceration, so it is necessary to drink tablets and capsules with water.

Literature

Bigbaeva M.M. Reference book of a nurse / M.M.Bigbaeva, G.N.Rodionova, V.D.Trifonov.- M.:Eksmo, 2004.

Oral route of administration

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Taking medications by mouth (by mouth) is called oral by introduction. Its advantages include: ease of use, the presence of natural barriers that make the administration of drugs safer, as well as the convenience of topical use of non-absorbable drugs (passage with food).

The disadvantages of the oral route are: inapplicability in a number of situations (swallowing disorder, persistent vomiting, unconsciousness, drugs that are not absorbed or destroyed in the gastrointestinal tract): significant variability in absorption and bioavailability of drugs, slow onset (15-40 minutes after administration) and a lower potency of administered drugs, which limits use of this pathway in emergency care.

Features of oral use of drugs:

simple medicinal forms (solutions, suspensions, emulsions, powders) are absorbed better than ready-made ones (tablets, capsules, dragees), but less convenient to use;
weakly alkaline preparations are absorbed faster with reduced acidity of gastric juice (achilia, taking neutralizing agents of soda, milk), weakly acidic preparations, on the contrary (due to an increase in the degree of ionization);
meal slows down absorption of most drugs (delayed gastric emptying), but increases the absorption of fat-soluble drugs (fat-soluble vitamins, anticoagulants) and the bioavailability of a number of drugs due to the competitive weakening of their metabolism in the liver during the “first pass” (anaprilin, apressin, verapamil, morphine, nitrates, etc.), they are best taken immediately after meals;
drugs with an irritant effect on the gastric mucosa (non-steroidal anti-inflammatory drugs, corticosteroids, reserpine, doxycycline, potassium, etc.) are recommended to be taken after meals;
hypoglycemic oral agents are taken immediately before meals or during meals;
solid medicines (tablets, capsules) for the prevention of esophageal ulceration are washed down with 150 ml of water (3-4 large sips) in a standing position, less preferably sitting.

Sublingual (sublingual) way

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Advantages the sublingual route are as follows: suitability due to rapid absorption for emergency care (nitroglycerin: nifedipine, propropolol), no “first pass” effect (drugs bypass the liver during absorption). For planned therapy, it is used with the introduction of steroid hormones and their derivatives, which are significantly destroyed in the liver.

disadvantages sublingual drug use are inapplicability for drugs with an irritant effect or an unpleasant taste and poor absorption of many drugs.

rectal route

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Advantages: the possibility of use when the oral route is inaccessible (vomiting, impaired swallowing), rapid absorption with minimal destruction by digestive juices and the liver (absorption and bypassing the liver determines the potency of about a third higher than when taken orally).

disadvantages: inconvenience of use, getting part of the medicine into the portal bloodstream (when the suppository is moved upwards), limiting the volume of the therapeutic enema to 50-100 ml.

Injection routes

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Advantages: the strongest and fastest effect (indispensable in emergency care), high bioavailability, good dose control, allows the introduction of non-absorbable drugs.

disadvantages: pain upon injection, trauma, risk of intoxication and severe systemic reactions, risk of infection, the need for special preparation of solutions and their high cost, difficulties in long-term treatment.

1. Intravenous route

usage features:

must be carried out under the supervision of a physician;
the speed of the onset of the effect is maximum (sometimes “at the tip of the needle”);
the potency is 5-10 times greater than with oral administration of the same dose;
the duration of action is shorter than with other routes of administration;
with the introduction of irritants, it is desirable to “wash” the vein with warm saline;
exist jet and slower drip route of administration, jet administration at maximum speed is called bolus.

2. Intramuscular route

usage features:

the speed of the onset of the effect is 10-15 minutes (aqueous solutions);
the strength of action is 2-3 times greater than when taken orally;
the duration of action is less than with oral administration;
when introducing insoluble substances (oily solutions, suspensions), it is necessary to make sure that the needle does not enter the vessel;
convenient for the introduction of depot drugs that provide a stable concentration of the drug for many days;
the best injection sites are the gluteal and deltoid muscles;
absorption can be accelerated with a heating pad or slowed down with an ice pack.

3. Subcutaneous route

usage features:

the speed, strength and duration of the effect are close to the intramuscular route;
significant pain on insertion;
do not inject irritating, hypo- and hyperosmolar solutions;
used for the introduction of prolonged forms of drugs:
injection sites (limbs and abdomen) are the most accessible, which is convenient for self-help and mutual assistance (syringe-tubes).

Non-injection routes (without breaking the integument of the body)

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1. Inhalation route

usage features:

the depth of penetration of drugs into the airways depends on the particle size of the aerosol or fine powder, the best penetration is achieved by gases that through the alveolo-capillary barrier very quickly enter the systemic circulation;
used for local effects on the mucous membranes of the respiratory tract (bronchodilators, corticosteroids) and based on the systemic effect during absorption (gases - oxygen, general anesthetics);
for the introduction of drugs, special devices are used - inhalers, stationary and portable;
even with methodically correct inhalation of an aerosol, a significant part of it (up to 90%) remains in the oral cavity and nasopharynx, which can lead to undesirable local effects (after inhalation, for example, corticosteroids, you should rinse your mouth with alkaline solutions);
with a pronounced violation of bronchial patency (emphysema, severe bronchospasm), the effectiveness of inhalation agents is reduced.

2. Application path

Application path - in the clinic of internal diseases, transdermal can be used. Its advantages are non-traumatic and the absence of the effect of the primary passage through the liver. For transdermal administration, special patches with a prolonged uniform release of the drug are used, for example, Pitroderm, a system for releasing nitroglycerin.

What does oral administration mean? What does it mean to take medicine by mouth? Video about the method of drug administration

Pharmacokinetics

Advantages of the method

Disadvantages of the method

Types of diseases for which this method is preferable

Dosage forms taken by mouth

Conclusion

Two main routes of administration.

The effectiveness of injections and inhalations

What is oral?

Negative aspects of oral administration

Video about the method of drug administration

Why is it so

Features of oral administration

Application

disadvantages

Dosage forms for oral administration

Literature

see also

See what "Oral medication" is in other dictionaries:

Oral route of administration

Sublingual (sublingual) way

rectal route

Injection routes

1. Intravenous route

2. Intramuscular route

3. Subcutaneous route

Non-injection routes (without breaking the integument of the body)

1. Inhalation route

2. Application path