Oral administration of tablets. Orally is how to take it. Oral dosage forms

This method of administration implies the use of drugs through the oral cavity followed by swallowing, i.e. through the mouth.

Oral administration of medicinal components is one of the most traditional and easiest to administer. Most of the drugs produced in the form of tablets, capsules, powders, mixtures, and syrups are subject to maximum dissolution and absorption in the stomach cavity. To achieve a local therapeutic effect in diseases of the stomach, oral administration of drugs is carried out, the absorption of which is almost impossible through the wall of the stomach.

What are the main advantages and disadvantages of this method of taking medicinal substances, as well as for which dosage forms it is permissible to use the oral route of administration, will be detailed below.

When applied

In the process of selecting possible dosage forms for oral administration, the advantages are possessed by those medicines that are able to dissolve easily and quickly be absorbed through the stomach wall. Natural exceptions are medicinal substances for the treatment of stomach diseases. In this case, the main goal is to achieve the maximum concentration of these substances in the stomach cavity, followed by the provision of a local therapeutic effect.

For oral administration, dosage forms such as dragees, capsules, tablets, solutions, powders, decoctions, syrups, infusions, and pills are available.

Do not forget that there are drugs, the action of which can be aimed at treating one disease, and at the same time provoking another. A striking example is Diclofenac, which perfectly copes with inflammation in the joints, but at the same time provokes the development of gastric ulcer.

Dignity

The main points of this method of taking medications include:

• ease of use;
• there is no need for additional assistance from medical personnel;
• the introduction into the internal environment of the body is not carried out;
• in pediatric practice, this method helps to avoid additional stress in the child, which is caused by injections.

Flaws

In addition to the existing advantages, oral administration of medications also has its own disadvantages, among which are:

• in comparison with other methods of taking medicinal substances, this method is distinguished by a particular slowness, which is expressed in an increase in the absorption time and the onset of a therapeutic effect;
• how quickly and thoroughly the drug will be absorbed when taken orally depends directly on the individual characteristics, as well as on the effect of the food and liquid consumed;
• oral administration of drugs is absolutely meaningless in relation to those drugs that are poorly dissolved and absorbed in the stomach cavity, this is how to use pacifiers (placebo);
• the use of this method is impossible with organic pathologies of the gastrointestinal tract, in particular, the esophagus (stenosis, tumors), during vomiting, and during unconsciousness;
• in newborns and infants, oral administration of drugs can be significantly difficult;
• getting into the gastrointestinal tract, many medicinal substances undergo biochemical transformations, which result in harmful metabolites that have a toxic effect on the body.

Another significant disadvantage of this method is the low bioavailability of many medicinal components, which, when taken orally, will not have any therapeutic effect. It is for such drugs that alternative methods of introduction into the body have been created.

General rules of admission

1. Before taking a pill orally, you should carefully read the instructions attached to it. Tablet formulations can be taken whole or chewed with a sufficient amount of any liquid. It is not recommended to use fruit juices, coffee, and even more so alcohol as a liquid. Plain or mineral water is best suited for this purpose.
2. The drugs produced in the form of capsules are used unchanged and washed down with plenty of water in order to ensure their fastest passage along the entire length of the esophagus.
3. Before taking several medicinal substances orally, attention should be paid to their compatibility. Combinations of certain drugs can cause serious side effects from organs and systems.

The selection of the method of taking medications should be carried out exclusively by the attending physician, taking into account the individual characteristics of a particular person, as well as the clinical case.

Greetings, dear readers! In the process of treating various diseases, we often have to deal with medical terms, many of which remain incomprehensible to us. For example, when prescribing a drug, the doctor recommends oral administration. And only when we start fulfilling the prescriptions, the question arises: orally - what does it mean and how to take the medicine. Let's figure it out.

What does oral mean?

Immediately I answer the question: orally it means in the mouth, that is, the pill must be swallowed.

There are two main ways of introducing medicinal substances into the body: enteral and parenteral. The enteral route is directly related to the gastrointestinal tract, while the parenteral route bypasses the gastrointestinal tract. The oral route is of the first type.

Traditionally, medications are taken internally in the form of:

• tablets;
• powders;
• solutions;
• capsules;
• tinctures.

These drugs can be swallowed, chewed, or drunk. Most often, patients have to take pills: this is the most popular form of use. They give effect within a quarter of an hour after ingestion.

Oral drugs pass through the body in the following way:

• The medication enters the stomach and begins to be digested.
• The medicinal substance is actively absorbed into the blood and gastrointestinal tract.
• The drug molecules are carried throughout the body.
• Passing through the liver, some of the substances that enter the body become inactive and are excreted by the liver and kidneys.

The use of oral agents has been known in medicine for a long time. Psychologically, this is the most comfortable way of taking medications, even for children, especially if the drug tastes good. Being conscious, a person of any age can take a pill or tincture and relieve his condition.

However, despite the high popularity, oral agents have their disadvantages along with advantages.

How do they work?

Today, many patients prefer to inject themselves with medication in the form of injections, especially when it comes to antibiotics. The motivation is simple: when injected, the active substance immediately enters the bloodstream, bypassing the stomach, while when used internally, the intestinal microflora suffers.

However, injections are always associated with psychological discomfort, and drugs are no less able to harm the stomach than when taken orally.

Medicines for oral administration (i.e. oral administration) are perfectly absorbed through the mucous membranes of the gastrointestinal tract. The advantages of such administration are that in some diseases it is possible to use drugs that are poorly absorbed in the intestine, due to which their high concentration is achieved. This method of treatment is very popular for gastrointestinal diseases.

The disadvantages of this method of taking medications are quite a few:

• in comparison with some other methods of drug administration, this one acts rather slowly;
• the duration of absorption and the result of exposure are individual, since they are affected by the food taken, the state of the gastrointestinal tract and other factors;
• oral administration is impossible if the patient is unconscious, or vomiting has opened;
• some drugs are not quickly absorbed into the mucous membranes, so they require a different form of use.

The intake of many drugs is tied to food intake, which allows you to achieve the best therapeutic effect. For example, many antibiotics recommend drinking after meals to reduce the damage to the intestinal microflora.

The drugs are washed down, as a rule, with water, less often with milk or juice. It all depends on what effect is expected from the medication and how it interacts with fluids.

Despite obvious shortcomings, internal drugs continue to be actively used in medicine, forming the basis of home treatment.

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Most prophylactic agents and vitamins are usually administered orally to patients. This, as a rule, allows the course to be carried out with minimal discomfort. After all, the patient simply uses powders, tablets or capsules, drinking them with a sufficient amount of liquid.

If the medicine was prescribed to take how?

Unfortunately, some patients do not understand the medical terminology, and they are embarrassed to ask when prescribing treatment (or do not want to look stupid). Therefore, having received a prescription, they try to figure out what oral medication means. Well, if we are talking about pills (here, as a rule, everything is clear anyway). And if incomprehensible powders or liquids in ampoules are prescribed, you can get confused.

But everything turns out to be not so difficult. This method of treatment is perhaps the simplest of all available. And it means elementary swallowing, that is, introduction into the body through the mouth. So taking the medicine orally is like simply swallowing food. Usually, when prescribing such a treatment, the specialist also indicates the dosage, the number of doses per day and recommends that the treatment be carried out before, after or during meals.

Types of drug intake

When are oral medications prescribed? These are, as a rule, cases when the patient is at home and also in the hospital in cases where immediate administration of the drug is not required, there are no contraindications to this method of application. In more severe situations, when the patient is unconscious, there are certain digestive problems that prevent the normal swallowing of drugs, another is used - enteral administration of medications (already using probes and other devices). By the same method, nutritional mixtures can be supplied directly to the stomach of patients who, for one reason or another, are deprived of the ability to swallow food on their own.

In the case when immediate administration of the drug is required, parenteral routes of its administration (subcutaneous, intravenous or intramuscular) are used. They are also used for medicines, the contact of which with the digestive tract is undesirable or contraindicated.

Advantages and Disadvantages of Oral Medication

Undoubtedly, this is the easiest and least unpleasant way of introducing a substance into the body. Its main advantage is naturalness. A person eats food every day to get enough nutrients, water and other drinks to replenish the fluid supply. Therefore, it will not be difficult for him to swallow a few additional tablets or capsules. Powders and liquids are a little more complicated, but they can also be drunk.

Of the shortcomings, it should be noted, firstly, possible problems with the use of children's medicines. Babies do not always accept even pleasant-tasting fruit mixtures, not to mention bitter pills or powders. Secondly, some drugs, when interacting with gastric juice, lose their properties, and some, on the contrary, can harm the digestive organs. Thirdly, it takes time for the substances administered orally to enter the bloodstream, which sometimes simply does not exist in stock. It is for this reason that the method of administration of medicines should be prescribed by a specialist, based on the current situation.

The enteral route of drug administration is through the gastrointestinal tract (GIT).
Oral (by mouth) route of administration- the simplest and safest, the most common. When taken orally, medicinal substances are absorbed mainly in the small intestine, through the portal vein system they enter the liver, where they can be inactivated, and then into the general bloodstream. The therapeutic level of the drug in the blood is reached within 30-90 minutes after taking it and lasts for 4-6 hours, depending on the properties of the active ingredient and the composition of the drug.
When drugs are administered orally, their ratio with food intake is of great importance. Medicine taken on an empty stomach is usually absorbed faster than medicine taken after a meal. Most drugs are recommended to be taken 1 / 2-1 hour before meals, so that they are less destroyed by the enzymes of digestive juices and better absorbed in the digestive tract. Drugs that irritate the mucous membrane (containing iron, acetylsalicylic acid, calcium chloride solution, etc.) are given after meals. Enzyme preparations that improve digestion processes (festal, natural gastric juice, etc.) should be given to patients during meals. Sometimes, to reduce irritation of the gastric mucosa, some medicines are taken with milk or jelly.
When giving the patient tetracycline preparations, it should be remembered that dairy products and some medicines containing salts of iron, calcium, magnesium, etc., form insoluble (non-absorbable) compounds with them.
Benefits of the oral route of administration:
- the possibility of introducing various dosage forms - powders, tablets, pills, dragees, decoctions, mixtures, infusions, extracts, tinctures, etc .;
- simplicity and availability of the method:
- the method does not require compliance with sterility.
Disadvantages of the oral route of administration:
- slow and incomplete absorption in the digestive tract;
- partial inactivation of drugs in the liver;
- the dependence of the action of the drug on age, state of the body, individual sensitivity and the presence of concomitant diseases.
To swallow a tablet (dragee, capsule, pill), the patient places it on the root of the tongue and drinks it with water. Some tablets can be chewed beforehand (with the exception of iron tablets). Dragee, capsules, pills are taken unchanged. The powder can be poured onto the root of the patient's tongue and allowed to wash down with water or pre-dilute it with water.
Sublingual (sublingual) route of administration- the use of drugs under the tongue; they are well absorbed, enter the bloodstream bypassing the liver, and are not destroyed by digestive enzymes.
The sublingual route is used relatively rarely, since the suction surface of this area is small. Therefore, only very active substances are prescribed "under the tongue", used in small quantities and intended for self-administration in urgent situations (for example: nitroglycerin at 0.0005 g, validol at 0.06 g), as well as some hormonal preparations.
Rectal route of administration through the rectum... Both liquid drugs (decoctions, solutions, mucus) and suppositories are injected rectally. In this case, medicinal substances have a resorptive effect on the body, being absorbed into the blood through hemorrhoidal veins, and local - on the rectal mucosa. In general, when administered rectally, drugs are poorly absorbed, and therefore this route of administration in order to obtain systemic effects should be used only as an alternative.
Note. Before the introduction of medicinal substances into the rectum, you should do a cleansing enema!
Introduction of suppositories (suppositories) into the rectum
Prepare: candles, liquid petroleum jelly.
Take action:
- lay the patient on his left side with knees bent and legs brought to the stomach;
- open the package and take out the candle;
- spread the buttocks with your left hand, lubricate the anus with liquid vaseline oil;
- with the right hand, insert the entire candle with the narrow end into the anal opening behind the external sphincter of the rectum.
Administration of liquid medicines
Liquid forms of drugs are injected into the rectum in the form of medicinal enemas. Medicinal substances of resorptive action enter the bloodstream, bypassing the liver, and therefore are not destroyed. Due to the lack of enzymes in the rectum, they are not degraded. Medicinal substances of proteinaceous, fatty and polysaccharide nature are not absorbed from the rectum and into the blood, therefore they are prescribed only for local exposure in the form of medicinal microclysters.
In the lower part of the colon, only water, isotonic sodium chloride solution, glucose solution, and some amino acids are absorbed. Therefore, for a resorptive effect on the body, these substances are administered in the form of drip enemas.
The rectal route of drug administration is used in cases where oral administration is impossible or impractical (with vomiting, impaired swallowing, unconsciousness of patients, lesions of the gastric mucosa, etc.) or when local action is necessary.

And rectal administration.

The advantage of the oral route of drug administration is that after administration, the drug passes through two natural barriers - the mucous membrane of the gastrointestinal tract and liver. The effectiveness of the oral route of administration depends both on the pharmacokinetic parameters of the drug - its physicochemical properties, the rate of absorption and the time to reach the maximum concentration, the half-life of the drug, and on the physiological properties of the body - changes (acidity) in various parts of the digestive system, surface area, with which drugs are absorbed, perfusion of tissues of the digestive system, secretion of bile and mucus, properties of membranes of epithelial cells of the digestive system organs and other physiological processes occurring in the digestive system.

The effectiveness of oral administration also depends on the food intake: most drugs are characterized by decline when taken with food, but for some of the funds, bioavailability when taken with food can rise.

It is better to take medicines orally 20-30 minutes before meals (unless otherwise indicated in the instructions for medical use), in a standing position, with water. This sequence is due to the fact that, before eating, the stomach has not yet had time to release the juices of the digestive system that can destroy the chemical structure of the drug, and drinking with water is necessary so that the agent less irritates the gastric mucosa. Taking medication in a standing position is recommended in order to avoid drug retention in the esophagus: when taken orally, the agent sequentially passes through the mouth, esophagus, stomach, duodenum and small intestine.

The action of the digestive system begins directly in the oral cavity, as a result of which most drugs for oral administration are covered with a special membrane that prevents the effects of salivary enzymes on them.

In addition, oral medications are not recommended to be chewed.

Preparations, covered with a special membrane, resistant to the action of enzymes of saliva and stomach, are not subject not only to chewing, but also to dividing into parts.

There are medicinal preparations in the form of orodispersing tablets that are resistant to the action of enzymes of the digestive system and provide rapid absorption and rapid onset of its therapeutic action.

The process of assimilating some of the drugs begins in the stomach. The duration of the process of absorption of drugs in the stomach depends on the acidity of the gastric juice, the state of the gastric mucosa and the time of gastric emptying. From the stomach, drugs enter the duodenum, where, under the influence of duodenal and pancreatic juice, as well as under the influence of bile components, the assimilation of drugs continues.

After the duodenum, the drug enters the small intestine, where the process of its absorption is completed. Most drugs are absorbed precisely in the small intestine, which is facilitated by a high absorption area (400-500 m²). Increased absorption in the small intestine is also achieved due to the folds of the mucous membrane and the large number of villi on the mucous membrane. The rate of absorption of the drug also depends on the intensity of the intestinal blood supply in the absorption zone. The components of intestinal juice also contribute to the dissolution of drug membranes, which do not dissolve in the mouth and stomach.

Forms of medicines for oral administration

For oral administration, medicinal products are available in the following forms:

• pills,
• capsules
• microcapsules,
• pills,
• dragee,
• powders,
• solutions,
• suspensions,
• syrups,
• emulsions,
• infusions,
• decoctions,
• granules,
• drops.

To improve the absorption of the main active substances of drugs, technologies have been created to improve this process:

• Special tablet compression,
• Coating tablets or other drugs with an acid-resistant film,
• Creation of therapeutic oral systems in the form of a tablet (with a multilayer coating, including) for a uniform release of active drug components in the gastrointestinal tract.
• Controlled release of medicinal substances can also be achieved through the creation of special forms in the form of microcapsules with the drug, coated with a special substance (polymer), slowly dissolving under the influence of the juices of the digestive system and providing a uniform flow of the drug into the gastrointestinal tract by diffusion of the drug through the capsule membrane ...

Advantages and Disadvantages of Oral Drug Administration

The advantages of oral administration of drugs are the passage of drugs and their metabolites before absorption into the blood of two natural barriers - the mucous membrane of the gastrointestinal tract and liver, on the membranes of which the substances entering the body undergo selective filtration.

The advantage of the oral route of administration of medicinal substances is that this method is the most physiological, simpler - there is no need to resort to the help of medical personnel. In addition, oral administration causes fewer side effects from administration of the agent that may occur with parenteral administration.

The advantage of oral administration is that the absorption of the drug is slower than with parenteral administration, which also reduces the number of side effects from the action of drugs.

Certain drugs for oral administration are poorly absorbed in the gastrointestinal tract and are used for local action in the lumen of the gastrointestinal tract (antihelminthic agents, part of antibacterial, antifungal and antacids), which also reduces the likelihood of systemic side effects from taking these drugs.

The disadvantages of oral administration of drugs is that part of the drugs (for example, or) when taken orally are destroyed by the enzymes of the digestive system, and therefore it is impossible to use them per os. In addition, drugs with a local irritant effect, or drugs that decompose to form toxic or inactive metabolites, should not be used internally.

The disadvantage of oral administration is that the effect of the drug is influenced by food intake and the characteristics of the biochemical reactions of the body of a particular person.

Among the factors affecting the effectiveness of drugs, there is also the intake of other drugs, the patient's age, the state of the enzymatic activity of his body.

When taken orally, drugs are absorbed more slowly, which makes impossible the use of oral administration in the provision of emergency medical care.

Also, drugs are not used orally in unconscious patients, with vomiting, in patients with mental disabilities, with congestion in the systemic circulation and in young children.

For the correct choice of the route of administration of the drug, one should take into account the purpose of prescribing the drug, the general state of the physiological functions of the body, the nature of the patient's main and concomitant diseases, as well as the patient's adherence to one or another treatment method.

Denial of responsibility

The article on oral administration of medicines from the medical portal "My Tablets" is a compilation of materials obtained from authoritative sources, a list of which is posted in the "Notes" section. Despite the fact that the accuracy of the information presented in the article “ Oral medication»Checked by qualified specialists, the content of the article is for reference only, is not guidance for independent(without referring to a qualified medical specialist, doctor) diagnostics, diagnosis, choice of means and methods of treatment.

The editorial staff of the portal "My tablets" does not guarantee the truth and relevance of the materials presented, since the methods of diagnosis, prevention and treatment of diseases are constantly being improved. To receive full medical care, you should make an appointment with a doctor, a qualified medical specialist.

Notes (edit)

Notes and explanations for the article "Oral administration of medicines".

• Enteral the route of drug administration is the route of administration into the body, in which the absorption of the drug is carried out in a physiologically adequate way, that is, through the mucous membrane of the gastrointestinal tract. In this sense, enteral administration is opposed to parenteral (when the drug is delivered to the body bypassing intestinal mucosa - usually intravenously).
• At sublingual application, drugs, bypassing the liver and not being exposed to gastric juice, enter the bloodstream. The drug is taken sublingually by placing it under the tongue (accordingly, the drug is directed into the circulation through its absorption under the tongue).
• For buccal the introduction of drugs, special dosage forms are used, on the one hand, providing rapid absorption in the oral cavity, on the other hand, providing the ability to prolong absorption to increase the duration of the drug's action. An example is the drug Trinitrolong (the active ingredient is Nitroglycerin), which is produced in the dosage form of a film for sticking to the gums. Trinitrolong is a biopolymer base plate that is glued to the mucous membrane of the cheek or gums.
• pH, pH, acidity - a measure of activity (in very dilute solutions it is equivalent to the concentration) of hydrogen ions in a solution, quantitatively expressing its acidity. The pH value is usually measured in values ​​from 0 to 14, where pH = 7.0 is considered neutral acidity (normal physiological acidity in humans is also 7, but the critical limits are in the range from 5 to 9 pH). The easiest and most affordable way to check the pH of the body is a urinalysis pH test, which uses visual pH test strips.
• Bioavailability drug substance is the amount (in relation to the amount of the initial dose) of the unchanged drug substance reaching the blood plasma.
• Enzymes, enzymes - as a rule, protein molecules or ribozymes (RNA molecules) or their complexes that catalyze (accelerate) chemical reactions in living systems. Enzymes, like all proteins, are synthesized as a linear chain of amino acids, folding in a certain way. Each peptide sequence is folded in a special way, as a result of which the resulting protein globule (molecule) has unique properties. Enzymes are present in all living cells and contribute to the conversion of some substances into others. Enzymatic activity can be regulated by inhibitors and activators (inhibitors - decrease, activators - increase). By the type of catalyzed reactions, enzymes are divided into six classes: oxidoreductases, transferases, hydrolases, lyases, isomerases, and ligases.
• Insulin- a protein hormone of a peptide nature, formed in the beta cells of the islets of Langerhans of the pancreas. Insulin has a significant effect on metabolism in almost all tissues, while its main function is to reduce (maintain normal) blood sugar levels. Insulin increases the permeability of plasma membranes for glucose, activates key glycolysis enzymes, stimulates the formation of glycogen from glucose in the liver and muscles, and enhances the synthesis of proteins and fats. In addition, insulin inhibits the activity of enzymes that break down fats and glycogen. Absolute (with type 1 diabetes) or relative (with type 2 diabetes) insulin deficiency is the cause of elevated blood sugar levels in diabetes mellitus, which is treated with an analogue of human insulin (first released by Eli Lilly in 1923). Today, insulins are administered parenterally (subcutaneously), but not so long ago, inhaled insulin was developed for oral administration.
• Streptomycin- a medicinal product produced, as a rule, in the form of a powder for the preparation of a solution for intramuscular administration, historically the first antibiotic of the aminoglycoside group, the second after penicillin. Streptomycin is formed during the vital activity of the radiant fungi Streptomyces globisporus streptomycini or other related microorganisms, is a first-line anti-tuberculosis drug used to treat diseases caused by bacteria resistant to penicillin. Streptomycin is administered intratracheally, intrabronchially (in the form of aerosols), intracavernosally. In tuberculosis, streptomycin is administered intramuscularly, that is, parenterally.

When writing an article on oral administration of drugs (drugs), materials of information and reference Internet portals, news sites MerckManuals.com, FDA.gov, HowMed.net, ScienceDaily.com, STGMU.ru, Wikipedia were used as sources, as well as the following printed editions:

• Frolkis A. V. "Functional diseases of the gastrointestinal tract." Publishing house "Medicine", 1991, Moscow,
• V. M. Pokrovsky, G. F. Korotko (editors) Human Physiology. Educational literature for students of medical universities ". Publishing house "Medicine", 2007, Moscow,
• Zimmerman Ya. S. “Clinical gastroenterology. Library of a specialist doctor ". Publishing house "GEOTAR-Media", 2009, Moscow,
• Sokolova N. G., Obukhovets T. P., Chernova O. V., Barykina N. V. "Nurse's Pocket Guide". Phoenix Publishing House, 2015, Rostov-on-Don,

It's pretty simple in Latin- per os means through the mouth. This is how many drugs are taken. This is how it was once written in recipes. So they taught us to write, but it turns out, they taught in vain. Recipes today are not at all the same as they used to be. And there is no need at all to write that this pill needs to be taken per os.

Taking medications orally- the most traditional and widespread. Many tablets dissolve well in the stomach and are absorbed by its walls and intestinal walls. Sometimes, on the contrary, in order to treat stomach diseases, medications are used that are very poorly absorbed in the stomach. However, this allows you to achieve the maximum concentration of the drug in the stomach and at the same time get a good effect from local treatment.

Oral medication has quite a few drawbacks. The biggest of them is the long time before the onset of the action of a particular pill. This is called a therapeutic effect. The rate of absorption of the drug and the completeness of absorption, and this is called the bioavailability of the drug, is also different for each person. This is due to many reasons - with age, with the condition of the gastrointestinal tract, with food intake, with age, and sometimes with the sex of a person. Some drugs have very low bioavailability on their own. Therefore, if the drug's instructions say that its bioavailability is no more than 20%, then it is better to look for some alternative drug.

Oral medication is simply not possible with vomiting, unconsciousness, and in young children. And this can also be considered a big disadvantage of this method of taking medications. Among other things, some oral medications create very harmful metabolites that are destroyed in the liver, causing great harm to it.

But at the same time, taking pills by mouth is very convenient and no one is going to refuse this method of introducing drugs into the body.

In addition to tablets, you can take orally powders, capsules, pills, solutions, infusions, decoctions, syrups, pills. Most medications are taken orally with plenty of water. however, it should be borne in mind that there are medications that perfectly help to cure one disease, but negatively affect another organ. Examples include tablets such as otrofen and diclofenac. They are great at helping to cure joint pain and inflammation in arthritis, but at the same time, it is these drugs that can lead to the development of stomach ulcers. Therefore, they need to be taken under the guise of another drug. It can be omez or any other antiulcer drug. Therefore, here again you need to carefully read the instructions. It's not for nothing that these clever pieces of paper are put in every box with medicine.

If the drug enters the body bypassing the gastrointestinal tract, then this method will be called parenteral. And this is, first of all, inhalations and injections.

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

Why exactly so

By tradition, the doctor prescribes the intake of medicines by 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 by the walls of the intestine. Oral administration is also indicated in the opposite situation - when drugs are poorly absorbed by the stomach. A good therapeutic effect from such treatment is achieved due to the maximum concentration of the drug in the stomach, allowing for the success of the disease of this organ.

But oral medication is not without its drawbacks. The most significant of these is the long time that elapses before the onset of the swallowed action. In addition, the bioavailability of the drug, that is, the rate of absorption and absorption is different for each person and depends on age, gastrointestinal tract condition, characteristics of food intake, and sometimes gender. Some medicines 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, suppositories.

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 medications by mouth is inappropriate because they create harmful metabolites that can cause great damage to the liver. It is most rational to take the medicine 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.

It is possible to 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 according to the doctor's prescription 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, by eliminating one disease, cause another, so it is necessary to take them under the guise of another remedy. Only a doctor can prescribe it.

Application

Mostly, 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 allows them to reach a high concentration in the gastrointestinal tract and obtain a good local effect without side reactions.

Flaws

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

Oral dosage forms

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

Most oral medications should be taken with plenty of fluids. When taking some medications in the supine position, they can linger in the esophagus and cause ulceration, so take the tablets and capsules with water.

Literature

• Bigbaeva M.M. Reference book of a nurse / M.M. Bigbaev, G.N. Rodionova, V.D. Trifonov.- M.: Eksmo, 2004. ISBN 5-699-08074-0

see also

Wikimedia Foundation. 2010.

See what "Oral drug intake" is in other dictionaries:

A polysemantic word Can mean: Action on the meaning of the verb to receive, take, receive any transmitted object Acceptance of dishes Acceptance of information Acceptance of mail Acceptance (introduction) of medicines Sublingual intake ... ... Wikipedia

- (lat. buccalis, "buccal") a pharmacological term that means taking a certain medicine by placing it between the upper lip and the gum or in the mouth until it is completely absorbed. In this case, the medicine is sent to ... ... Wikipedia

Drugs (lat buccalis buccal) is a pharmacological term that means taking a certain medicine by placing it between the upper lip and the gum or in the mouth until it is completely absorbed. In this case, the medicine is sent to ... ... Wikipedia

The existing methods of administering medicinal substances are divided into enteral (through the digestive tract) and parenteral (bypassing the digestive tract).

The method of administration of the drug largely determines its entry into a certain place (for example, into the focus of inflammation), the rate of development of the effect, its severity and duration, as well as the effectiveness of treatment in general. In some cases, the method of administration of the drug is determined by the nature of the action of the drugs. As an example, Diclofenac tablets with an enteric coating and injections of the same drug can be cited: the tablets begin to act, as a rule, after 2-4 hours, and the drug administered by injection, after 10-20 minutes.

Another example is antibiotics. When using oral antibiotics, it is advisable to use capsules, if possible, rather than tablets, since the drug is absorbed from the capsule much faster. The therapeutic effect is manifested even faster with injections of antibiotics, in addition, with this method of administration, it is possible to avoid many side effects from the strone of the gastrointestinal tract and liver, which occur when taken orally.

Enteral methods include the introduction of drugs through the mouth (orally), under the tongue (sublingually), behind the cheek (buccal), in the rectum (rectally) and some others. The advantages of the enteral route of administration are its convenience (no medical assistance is required), as well as comparative safety and the absence of complications typical for parenteral administration.

Drugs administered enterally can have both local (some antimicrobial, antifungal and antihelminthic agents) and systemic (general) effects on the body. Most drugs are administered enterally.

Oral route of administration

• The simplest and most common way to take medications.
• Most drugs are taken orally (tablets, capsules, microcapsules, dragees, pills, powders, solutions, suspensions, syrups, emulsions, infusions, decoctions, etc.). The active substance contained in the preparation enters the bloodstream, being absorbed from the gastrointestinal tract.
• To prevent irritation due to contact of the drug with the mucous membrane of the mouth and stomach, as well as to avoid the destructive effect of gastric juice on the drug itself, use dosage forms (tablets, capsules, pills, dragees) coated with membranes resistant to the action of gastric juice , but degrading in the alkaline environment of the intestine. They should be swallowed without chewing, unless otherwise specified in the instructions.
• For the oral route of administration, a relatively slow onset of action of the drug is characteristic (after a few tens of minutes, rarely - a few minutes after administration), which, in addition, depends on individual characteristics (the state of the stomach and intestines, the regimen of food and water intake, etc.). However, this property is used to create drugs with prolonged (long-acting) action. The word "retard" is present in their description (for example, retard tablets, retard capsules). Retard dosage forms are not subject to crushing if there is no dividing strip on them, since in this case their properties are lost. For example, tablets containing the digestive enzyme pancreatin (Festal, Mexaza, Panzinorm, etc.) should never be divided into parts, since if the integrity of the tablet coating is violated, it is already in the oral cavity and then in the stomach, pancreatin is inactivated by saliva and acidic stomach contents.
• Some substances, such as insulin and streptomycin, break down in the gastrointestinal tract, so they cannot be taken orally.
• It is most rational to take the drugs inside on an empty stomach, 20-30 minutes before meals. At this time, the digestive juices are almost not secreted, and the likelihood of loss of drug activity due to their destructive action is minimal. And in order to reduce the irritating effect of the drug itself on the gastric mucosa, the drug should be taken with water. However, it must be remembered that each drug has its own recommendations for taking, which are indicated in the instructions for it.

Sublingual and buccal routes of administration

When the drug is administered sublingually and bucally, its action begins rather quickly, since the mucous membrane of the mouth is abundantly supplied with blood, and the substances are absorbed into it faster.

• Some powders, granules, pills, tablets, capsules, solutions and drops are taken sublingually.
• When administered sublingually, drugs are not exposed to the destructive effects of gastric juice and enter the bloodstream, bypassing the liver.
• Especially often, Nitroglycerin is used sublingually to relieve angina attacks, Nifedipine and Clonidine for hypertensive crises and other fast-acting vasodilators.
• The drug should be kept under the tongue until it is completely absorbed. Swallowing the undissolved part of the drug with saliva reduces the effectiveness of the action.
• For buccal administration of drugs, special dosage forms are used, which, on the one hand, ensure rapid absorption in the oral cavity, and on the other hand, allow prolonging absorption to increase the duration of the drug's action. This, for example, Trinitrolong - one of the dosage forms of Nitroglycerin, which is a plate made of a biopolymer base, which is glued to the mucous membrane of the gums or cheeks.
• It should be remembered that with frequent sublingual and buccal drug use, irritation of the oral mucosa is possible.

Rectal, vaginal and urethral routes of administration

• When administered rectally, the active substances are absorbed into the blood faster than when taken orally, without being exposed to the destructive action of gastric juice and liver enzymes.
• Suppositories (rectal suppositories), ointments, capsules, suspensions, emulsions and solutions are injected rectally using microclysters, as well as enemas, no more than 50-100 ml for adults; for children - 10-30 ml. It should be remembered that the absorption of the active substance from suppositories is slower than from solution.
• The main disadvantages of the rectal route of drug administration are inconvenience in use and individual fluctuations in the rate and completeness of drug absorption. Therefore, rectally, drugs are mainly used in cases where it is difficult or impracticable to administer them through the mouth (vomiting, spasm and obstruction of the esophagus) or when a rapid flow of the drug into the blood is required, and the injection method is undesirable or impracticable due to the lack of the required dosage form.
• Suppositories, tablets, solutions, creams, emulsions and suspensions are injected vaginally.
• Vaginal and urethral methods of administration are most often used to treat an infectious process in these organs or for diagnostic purposes - for example, the introduction of contrast agents (iodamide, triombrast, etc.).

Parenteral drugs are usually administered subcutaneously, intramuscularly, intravenously (sometimes intraarterially), but always with a violation of the integrity of the skin.

With parenteral administration, the drug enters the bloodstream directly. This eliminates its side effects on the gastrointestinal tract and liver. By parenteral methods, drugs are administered that are not absorbed from the gastrointestinal tract, irritate its mucous membrane, as well as those that are destroyed in the stomach under the action of digestive enzymes.

Most of the listed parenteral routes of administration of the drug require the use of sterile additional equipment (syringe). The dosage form must also be sterile, and infusion solutions (i.e., solutions administered intravenously in large quantities - more than 100 ml) must, in addition, be necessarily pyrogen-free (i.e., not containing the waste products of microorganisms). All infusions are carried out by drip under strict medical supervision.

Injections can be performed on an outpatient basis (i.e. in a polyclinic, first-aid post), in a hospital (hospital), or at home, inviting a nurse. Insulin preparations, as a rule, are administered by patients themselves with the help of special single-dose devices - "penfills".

Intravenous administration

• Intravenous administration of a drug substance provides a quick effect (from a few seconds to minutes), accurate dosing.
• The methods of intravenous administration depend on the volume of the injection solution: up to 100 ml can be injected with a syringe, more than 100 ml (infusion) - with a dropper. Intravenous drugs are usually administered slowly. A single, fractional, drip injection is also possible.
• It is forbidden to inject intravenously:
  • insoluble compounds (suspensions - for example, insulin preparations, Bismoverol, Zimozan, etc., as well as oil solutions), since there is a high likelihood of embolism - vessel blockage, thrombus formation;
  • funds with a pronounced irritant effect (can lead to the development of thrombosis, thrombophlebitis). For example, a concentrated alcohol solution (over 20%);
  • drugs that cause accelerated blood clotting

Intramuscular and subcutaneous administration

• Intramuscular and subcutaneous injections usually contain up to 10 ml of the drug. The therapeutic effect develops more slowly than with intravenous administration (soluble active ingredients are absorbed within 10-30 minutes). Intramuscularly drugs are injected, as a rule, in the gluteus muscle or in the forearm; subcutaneously - in the forearm or abdomen.
• Subcutaneous injections are usually performed (Fig. 2) into the subscapularis (A) or the outer surface of the shoulder (B). For independent subcutaneous injections, it is recommended to use the anterolateral abdomen (D). Intramuscular injections are performed in the upper outer quadrant of the buttock (B). For independent intramuscular injections, it is convenient to use the anterolateral surface of the thigh (D).
• With intramuscular administration of the drug, the therapeutic effect occurs relatively quickly if the active substance is soluble in water. However, in the presence of an oil solution, the suction process slows down due to the higher degree of its viscosity (compared to water).
• To prolong the action of the drug, medicinal substances are injected into the muscle in a slightly soluble form (suspension or suspension), in oil or other bases that delay the absorption of substances from the injection site.
• Thus, by changing the solvent or the solubility of the active substance, preparations are created with its sustained release and absorption into the tissues of the body. With the introduction of such a drug, a "depot" of the drug is created in the body (that is, the bulk of the active substance is localized in one place in the body). From this place, the drug enters the blood at a certain speed, creating the necessary concentration of the active substance in the body.
• After intramuscular injection, local soreness (redness of the skin, itching) and even abscesses may appear - suppurations inside the muscle layer, which are subsequently opened surgically. This is possible, for example, with the introduction of oil, suspension preparations that are rather slowly absorbed (for example, Bismoverol, camphor oil, hormonal agents: Sinestrol, Diethylstilbistrol propionate, etc.).
• Substances that have a pronounced irritant effect are not injected intramuscularly and subcutaneously, since this can cause inflammatory reactions, infiltrates, the formation of seals and suppurations, and even necrosis (tissue necrosis).

Intra-arterial administration

Medicines are injected inside the arteries, which quickly disintegrate in the body. At the same time, a high concentration of the drug is created only in the corresponding organ, and the general effect on the body can be avoided.

Intra-arterial drugs are administered in the treatment of certain diseases (liver, limbs, heart). For example, the introduction of thrombolytics into the coronary artery (injections of Heparin, Streptokinase, etc.) makes it possible to reduce the size of a thrombus (up to its resorption) and thereby relieve the inflammatory process.

X-ray contrast agents are also injected intraarterially, which makes it possible to accurately determine the localization of the tumor, thrombus, vasoconstriction, and aneurysm. For example, the introduction of a radio-opaque substance based on the isotope of iodine makes it possible to determine the localization of the stone in the urinary system and, on the basis of this, use one or another type of treatment.

For gaseous and volatile compounds, the main method is inhalation, which requires a special device - an inhaler. They are usually supplied with a medicinal product in an aerosol can, or the package itself (aerosol can) has a valve-spray dispensing device.

When administered by inhalation, the active substances are quickly absorbed and have both local and systemic effects on the entire body, depending on the degree of their dispersion, that is, the size of the preparation. Medicines can penetrate the alveoli of the lungs and enter the bloodstream very quickly, which necessitates their exact dosage.

Inhalation administration of drugs allows to reduce the absorption time, to introduce gaseous and volatile substances, and also has a selective effect on the respiratory system.

Source: Encyclopedic reference. Modern medicines. - M .: Russian Encyclopedic Association, 2005; M .: OLMA-PRESS, 2005