Arterial administration route

Drug administration route Tissue necrosis has been described in three cases of intravenous administration of promethazine, which is not recommended in two cases the complications were extensive—one patient needed an amputation of a thumb and index finger because of gangrene and the other developed chronic pain and hypersensitivity [17 ]. Other cases have been reported [18, 19 ], as have cases of accidental intra-arterial administration [20, 21, 22" ]. 

Parenteral drug administration means the giving of a drug by the subcutaneous (SC), intramuscular (IM), intravenous (IV), or intradermal route (Fig. 2-5). Other routes of parenteral administration that may be used by the primary care provider are intralesional (into a lesion), intra-arterial (into an artery), intracardiac (into the heart), and intra-articular (into a joint), hi some instances, intra-arterial dragp are administered by a nurse. However, administration is not by direct arterial injection but by means of a catheter that has been placed in an artery. 

The primary care provider may administer a drug by the intracardial, intralesional, intra-arterial, or intra-articular routes. The nurse may be responsible for preparing the drug for administration. The nurse should ask the primary care provider what special materials will be required for administration. 

Intra-arterial contrast administration may have a higher prevalence than the intravenous route... 

The major routes of parenteral administration of drugs are subcutaneous, intramuscular, and intravenous. Other more specialized routes are intrathecal, in-tracistemal, intra-arterial, intraspinal, intraepidural, and intradermal. The intradermal route is not typically used to achieve systemic drug effects. The major routes will be discussed separately. Definitions of the more specialized routes, along with additional information concerning needle sizes, volumes typically administered, formulation constraints, and types of medication administered, are summarized in Table 1. 

Evans SM, Cone EJ, Henningfleld JE (1996) Arterial and venous cocaine plasma concentrations in humans relationship to route of administration, cardiovascular effects and subjective effects. J Pharmacol Exp Ther 279 1345-1356... 

PROMETHAZINE HYDROCHLORIDE The preferred parenteral route of administration is deep IM injection properly administered IV doses are well tolerated, but this method is associated with increased hazard. IV administration should not exceed 25 mg/mL at a rate no more than 25 mg/min. Avoid subcutaneous and intra-arterial injection. Use contraindicated in patients younger than 2 years of age. 

Administration - The IV route is preferred in the convulsing patient. However, if IV administration is impossible, the IM route may be used. Inject deeply into the muscle. Inject IV slowly (at least 1 minute for each 5 mg). Do not use small veins (eg, dorsum of hand or wrist) avoid intra-arterial use and extravasation. 

Some of the dosage formulations available for protein pharmaceuticals are listed in Table 5.7. An examination of Table 5.7 reveals that no protein drug up until this time has been formulated for oral administration. Most protein drugs are administered by means of injection (parenteral administration). Parenteral administration includes intravenous, intra-arterial, intracardiac, intraspinal or intrathecal, intramuscular, intrasynovial, intracuta-neous or intradermal, subcutaneous injections, and injection directly into a dermal lesion (e.g., a wart). The parenteral route of administration requires a much higher standard of purity and sterility than oral administration. It also may require trained... 

Intracoronary, intravenous, or sublingual nitrate administration consistently increases the caliber of the large epicardial coronary arteries except where blocked by concentric atheromas. Coronary arteriolar resistance tends to decrease, though to a lesser extent. However, nitrates administered by the usual systemic routes may decrease overall coronary blood flow (and myocardial oxygen consumption) if cardiac output is reduced due to decreased venous return. The reduction in oxygen consumption is the major mechanism for the relief of effort angina. 

Two phase I trials have been undertaken with rAAV-factor IX (FIX) vectors, one involving intramuscular administration (Kay et al., 2000), and the second involving direct delivery to the liver by way of a catheter in the hepatic artery. Early results from the muscle delivery trial were quite encouraging, but the switch to the intraphepatic route was made in an attempt to exploit the more efficient secretory ability of hepatocytes. One additional trial was initiated using a rAAV-alpha sarcoglycan vector in one patient with limb-girdle muscular dystrophy. This last trial was halted after one patient due to factors unrelated to the study results. 

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