Intra-arterial drug

Intra-arterial drug administration has potential safety implications. Embolization, arterial occlusion, and localized drug toxicity have been reported. 

Intra-arterial drug (lA) delivery to brain tumors involves the use of cerebral arteries for the local delivery of anti-tumor agents. With IA drug delivery, a catheter is placed in an artery in close proximity to the lesion(s) (left or right... 

Cardiac El-Khatib et al. (H - ) endocarditis Mills and Drew (37 ) serratia marcescens endocarditis Paranthaman and Khan(42 ) acute cardiomyopathy Friedman (15 - ) dissecting aneurysm of coronary artery Hawkins et al. (23= ) intra-arterial drug injection. 

Hawkins, L. G., Lischer, C. and Sweeney, M. (1973) The main line accidental intra-arterial drug injection. Clin. Orthop. relat. Res., 33, 268. 

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. 

The active drug and metabolites can be detected from the urine by thin-layer chromatography, gas-liquid chromatography, or gas chromatography-mass spectrometry. However, assays are available only at specialized centers. Treatment of acute intoxication with mescaline is virtually identical to the treatment outlined for LSD intoxication. DOM-induced vasospasm responds well to intra-arterial tolazohne or sodium nitroprusside. Major life-threatening complications of hallucinogenic amphetamine derivatives include hyperthermia, hypertension, convulsions, cardiovascular collapse, and self-inflicted trauma. 

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. 

Supplementation of drug therapy using internal radiation by intra-arterial delivery of radiolabeled microspheres Yttrium 90... 

In a report from the Boston Collaborative Drug Surveillance Program, pediatric nurses have reported a much higher frequency of complications from IM injections than that observed in the adult population. Twenty-three percent of pediatric nurses surveyed had observed complications (local pain, abscess, hematoma) versus a rate of 0.4% reported in adult patients [86]. Serious complications, such as paralysis from infiltration of the sciatic nerve, quadriceps myofibrosis, and accidental intra-arterial injection, are usually the... 

GaUo et al. [65] applied a physiologically-based pharmacokinetic model to the targeting of anti-cancer drugs to the brain following intra-arterial administration in gUoma-2 bearing rats. 

Drugs that decrease the coagulability of blood, such as coumarins andhep-arin (A), are employed for the prophylaxis of thromboses. In addition, attempts are directed at inhibiting the aggregation of blood platelets, which are prominently involved in intra-arterial thrombogenesis (p. 148). For the therapy of thrombosis, drugs are used that dissolve the fibrin meshwork->fibrino-lytics (p. 146). 

IV Inject slowly, taking at least 1 minute for each 5 mg (1 mL). Do not use small veins (ie, dorsum of hand or wrist). Avoid intra-arterial administration or extravasation. Do not mix or dilute with other solutions or drugs. 

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... 

The nicotinic receptors on the neuromuscular end plate apparatus are similar but not identical to the receptors in the autonomic ganglia (Table 7-1). Both types respond to acetylcholine and nicotine. (However, as noted in Chapter 8, the receptors differ in their structural requirements for nicotinic blocking drugs.) When a nicotinic agonist is applied directly (by iontophoresis or by intra-arterial injection), an immediate depolarization of the end plate results, caused by an... 

Systemic administration of endothelin receptor antagonists or endothelin-converting enzyme inhibitors causes vasodilation and decreases arterial pressure in humans and experimental animals. Intra-arterial administration of the drugs also causes slow-onset forearm vasodilation in humans. These observations provide evidence that the endothelin system participates in the regulation of vascular tone, even under resting conditions. The activity of the system is higher in males than in females. It increases with age, an effect that can be counteracted by regular aerobic exercise. 

Intra-arterial. The injection of a drug directly into an artery is understandably a difficult and dangerous... 

The pressor response to ephedrine is due in part to peripheral constriction and in part to myocardial stimulation. Vasoconstriction can be demonstrated by intra-arterial injection, but compared to epinephrine, ephedrine is only about one thousandth as active. This would imply that the cardiac effect is predominant in increasing the arterial pressure. This, however, is difficult to demonstrate. In perfused hearts, ephedrine produces only minor stimulation and cardiac depression appears if the drug is repeated. 

Various characteristics of the molecule influence its chances of reaching its target receptor since they influence the nature and extent of the body s effect on it. A drug s pharmacokinetic profile therefore determines the extent of the drug s opportunity to exert its pharmacodynamic effect. While there are various routes for human drug administration (oral rectal intravenous, subcutaneous, intramuscular, and intra-arterial injections topical and direct inhalation into the lungs), the most common for small-molecule drugs is oral administration, and discussions in the first part of this chapter therefore focus on oral administration. (In contrast, biopharmaceuticals are typically administered by injection, often directly into the bloodstream.)... 

Donnan GA, Howells DW, Markus R, Toni D, Davis SM (2003) Can the time window for administration of thrombolytics in stroke be increased CNS Drugs 17 995-1011 Ernst R, Pancioli A, Tomsick T, Kissela B, Woo D, Kanter D, Jauch E, Carrozzella J, Spilker J, Broderick J (2000) Combined intravenous and intra-arterial recombinant tissue plasminogen activator in acute ischemic stroke. Stroke 31 2552-2557... 

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