Alcohol administration routes

Drug administration route Extended-release injectable naltrexone 380 mg for alcohol dependence in primary care settings in 72 patients seeking treatment produced good patient satisfaction, and adverse reactions were as expected [216 "]. 

Abuse of phencyclidine hydrochloride (PCP) is a national problem that has reached epidemic proportions in urban areas of the United States. The drug is inexpensive, readily obtainable, and is usually used in combination with other drugs such as marijuana, heroin, cocaine, and alcohol (Golden et al. 1982). The routes of PCP use include inhalation, ingestion and parenteral administration. 

Benzodiazepines are the evidence-based treatment of choice for uncomplicated alcohol withdrawal.17 Barbiturates are not recommended because of their low therapeutic index due to respiratory depression. Some of the anticonvulsants have also been used to treat uncomplicated withdrawal (particularly car-bamazepine and sodium valproate). Although anticonvulsants provide an alternative to benzodiazepines, they are not as well studied and are less commonly used. The most commonly employed benzodiazepines are chlordiazepoxide, diazepam, lorazepam, and oxazepam. They differ in three major ways (1) their pharmacokinetic properties, (2) the available routes for their administration, and (3) the rapidity of their onset of action due to the rate of gastrointestinal absorption and rate of crossing the blood-brain barrier. 

Oral (PO = per os) By the mouth. Oral administration is the most common route employed for a variety of dosage forms tablets, capsules, liquids, suspensions. The major site of absorption is the small intestine. Alcohol is absorbed from the stomach. 

Glucocorticoids are available in a wide range of preparations, so that they can be administered parenterally, orally, topically, or by inhalation. Obviously the oral route is preferred for prolonged therapy. However, parenteral administration is required in certain circumstances. Intramuscular injection of a water-soluble ester (phosphate or succinate) formed by esterification of the C21 steroid alcohol produces peak plasma steroid levels within 1 hour. Such preparations are useful in emergencies. By contrast, acetate and tertiary butylacetate esters must be injected locally as suspensions and are slowly absorbed from the injection site, which prolongs their effectiveness to approximately 8 hours. 

The intravenous route of administration was usually used for testing these compounds in animals. Because they are insoluble in aqueous solvents, they were dissolved in small amounts of alcohol or emulsified with an oil-lecithin mixture or polyethylene glycol. 

A. It s probably not like what you expect. Even if you have considerable experience with various drugs. Salvia is not much like what you have encountered. Salvia is unique, and it is best understood on its own terms, and not by analogy with other substances. Salvia is not a recreational drug, rather, it is best used by those wishing to explore deep meditative states, spiritual realms, mysticism, the nature of consciousness and reality, or the possibilities of shamanistic healing. Experiences vary with the individual, set, and setting as well as with dose and route of administration. It produces a short-lived inebriation that is very different from that of alcohol. However, like alcohol it interferes with the ability to drive, produces incoordination (ataxia), and may produce slurred speech. 

Drug(s) Alcohol Classification/ Action Sedative-hypnotic Route/Method of Administration Oral, from various beverages [wine, beer, other alcoholic drinks] Effect Desired by User Euphoria relaxed inhibitions decreased anxiety sense of escape Principal Adverse Effects Physical dependence impaired motor skills chronic degenerative changes in the brain, liver, and other organs Additional Information See Chapter 6... 

Hydromorphone is available through injections, tablets, oral solution, and suppositories. The usual route of administration is by way of swallowing tablets. For patients who have difficulty swallowing tablets, a flavored oral solution is available. This liquid form of the drug can be poured into a medicine dropper for measurement by the patient or a nurse. The liquid can also be added to soft foods to make it easier for the patient to ingest. Some of these liquid formulations may contain alcohol. 

The oldest publication on structure-activity relationships (SARs) known to us from the literature is a paper by Cros from 1861. He compared the toxic effect of alcohols in various species after different routes of administration. He found an increase in toxic effect with decreasing water solubility, that is increasing lipophilicity. Cros was also the first to detect a maximum in activity followed by a decrease, i.e. a non-linear relationship, as a function of solubility of alcohols in water. 

Further pharmacological effects of deltorphins have been demonstrated under various experimental conditions. D-Ala-deltorphin improves memory consolidation in a passive avoidance apparatus in mice this effect is abolished by naltrindole [75]. D-Ala-deltorphin-II caused hypothermia in cold-adapted animals [76]. In contrast to mu opiate agonists, D-Ala-deltorphin-I, at low doses, stimulates respiratory activity in fetal lambs, and this effect is blocked by simultaneous administration of naltrindole [77], The peptide D-Ala-deltorphin-II inhibits diarrhea induced by castor oil and colonic bead expulsion, but it leaves the rate of transit through the small intestine unchanged [78,79]. By the SC route D-Ala-deltorphin-I inhibits acidified alcohol-induced gastric mucosal lesions [80], but by the ICV route, it fails to affect gastric secretion [81], The peptide is involved also in the control of ingestive behavior. It stimulates the intake of food [82] and of sucrose [83],... 

Localized tissue irritation can be seen from the intramuscular (IM) route. This is especially an issue when the formulation pH differs from the pH of the surrounding tissue or when precipitation of poorly soluble drugs occurs. Incorrect administration of IM injections is probably the most important factor that causes local adverse effects. Local skin irritation can also be seen with transdermal delivery systems due to the alcohols, nonionic surfactants, and adhesives. 

For this reason, a drug product that is to be used multiple times (multidose) must contain a preservative to prevent bacterial growth. A list of preservatives that have been used in pharmaceutical formulations is shown in Table 2. However, most of these are not usually compatible with protein formulations. Some, such as the parabens, are not active in the presence of nonionic surfactants—excipients that are typically required in protein formulations.Others may not be acceptable for a particular route of administration. Benzalkonium chloride, a commonly used preservative in topical formulations, causes ototoxicity when applied to the ear. As with buffering species, the list of preservatives available to the formulation scientist quickly narrows to just a few compounds including benzyl alcohol, phenol, w-cresol, and benzethonium chloride. A benzyl alcohol-containing formulation of epoetin alfa has been shown to be stable, even when dispensed in plastic syringes. ... 

Rodent and human studies have shown that MTBE is rapidly absorbed following inhalation exposure. In addition, rodent studies have shown rapid distribution of MTBE after oral and intraperitoneal exposure. Dermal absorption occurs more slowly. Evidence supports metabolic transformation of MTBE by P450 enzymes to the parent alcohol, t-butyl alcohol (TBA), and formaldehyde in rodents and humans. Further oxidative metabolism of TBA seems to be slow, and glucuronidation is a major competing pathway. Formaldehyde metabolism to formate is very rapid. The toxicokinetic parameters of MTBE and TBA depend on the dose and route of administration although they appear to be linear following inhalation exposures up to 50 ppm. 

---