Administration route surface area

Perocular Route. The administration of drugs or accidental exposure of chemicals to the eyes is not commonly a concern in systemic toxicity due to the small surface area exposed and the efficiency of the protective mechanisms (i.e., blink reflex and tears). As long as the epithelium of the eyes remains intact, it is impermeable to many molecules, but, if the toxicant has a suitable polar-nonpolar balance, penetration may occur (Kondrizer et al., 1959 Swan and White, 1972). 

The advantages of administration by intramuscular injection are that the muscle can act as a depot, and the rate of disappearance of drug from the site of injection can be calculated. Inhalational, intranasal, and intratracheal administration are normally reserved for vapors and aerosols including anesthetics. Absorption is facilitated by small-sized particles, high lipid solubility, sufficient pulmonary blood flow, and a large absorptive surface area, as it is present in healthy lungs. Administration by these routes can be very rapid when several of the factors favoring increased absorption are combined. 

Inhalation Inhalation provides the rapid delivery of a drug across the large surface area of the mucous membranes of the respiratory tract and pulmonary epithelium, producing an effect almost as rapidly as by intravenous injection. This route of administration is used for drugs that are gases (for example, some anesthetics), or those that can be dispersed in an aerosol. The route is particularly effective and convenient for patients with respiratory complaints (for example, asthma or chronic obstructive pulmonary disease) as drug is delivered directly to the site of action and systemic side effects are minimized (see p. 219). 

Transdermal administration can avoid first-pass metabolism as well as provide a large surface area for continuous-controlled administration of drugs with short biological half-lives and narrow therapeutical indices. The route has been used for nitroglycerin ointments, and transdermal therapeutical systems (patches) have been developed for scopolamine, nitroglycerin, clonidine, estradiol, and nicotine. 

Drugs may be administered directly into the respiratory tract for activity on, or through, the pulmonary epithelium and mucous membranes. Access to the systemic circulation is relatively enhanced and rapid following administration by this route because the pulmonary surface area is large. A drug solution can be administered as an aerosol that is inhaled. The advantage of this route of administration is the almost instantaneous... 

Drugs are applied topically primarily for local effects however, this route can be used to administer drugs for systemic action. Few drugs readily penetrate intact skin. The absorption of drugs that do penetrate the skin is proportional to the surface area over which they are applied and to their lipid solubility. Increased cutaneous blood flow also enhances absorption. Systemic toxicity can become evident when highly lipid-soluble substances (e.g. lipid-soluble insecticides) are absorbed through the skin. Controlled-release patches are now commonly used in human medicine for transcutaneous drug administration. 

---