Journal articles: 'Routes of administration'

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Kwatra, Shubhika, Guncha Taneja, and Nimisha Nasa. "Alternative Routes of Drug Administration- Transdermal, Pulmonary & Parenteral." Indo Global Journal of Pharmaceutical Sciences 02, no. 04 (2012): 409–26. http://dx.doi.org/10.35652/igjps.2012.47.

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Oral Route is considered to be the most common route of drug delivery to obtain a systemic effect. However, with the recent developments in the field of drug delivery, it has been found that delivery through alternative routes is sometimes more beneficial. This article deals with the salient features, advantages and disadvantages of some of the alternative routes of drug administration- Transdermal, Pulmonary and Parenteral routes. Though the mechanisms of action of drugs delivered by these routes are different, they offer a common advantage- increased Therapeutic Index with simultaneously decreased side effects. The latest innovations in drug formulations delivered through these routes have also been discussed. © 2011 IGJPS. All rights reserved.

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Mouro, Viviane G. S., Ana L. P. Martins, Janaina Silva, Tatiana P. Menezes, Marcos L. M. Gomes, Juraci A. Oliveira, Fabiana C. S. A. Melo, and Sérgio L. P. Matta. "Subacute Testicular Toxicity to Cadmium Exposure Intraperitoneally and Orally." Oxidative Medicine and Cellular Longevity 2019 (November 25, 2019): 1–14. http://dx.doi.org/10.1155/2019/3429635.

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The toxic effects of cadmium (Cd) on reproductive parameters are widely described in the literature. Experimental models often make use of the intraperitoneal route (i.p.), although human intoxication occurs preferentially by the oral route and can be continuous. However, little is known about the effect of Cd administration routes on the testicular structure. Thus, this study investigated the testicular impact of Cd exposure comparing both i.p. and oral routes, both single dose (SD), in addition to the oral route in fractional doses (FD). Swiss adult male mice received CdCl2 1.5 mg/kg i.p., 30 mg/kg oral SD, and 4.28 mg/kg oral FD for 7 consecutive days. The Cd bioaccumulation was observed in all routes, mainly in the oral FD route. The concentrations of testicular Ca and Cu decreased in all animals exposed to Cd, while Zn and Mn decreased only in the i.p. route. Testicular SOD activity was reduced in both routes of oral administration, while CAT increased in the i.p. route, and GST increased in all animals exposed to Cd. Changes in the tubular parameters and cell viability were observed in both routes of Cd administration but were more intense in the oral route, mainly in the FD. Serum testosterone concentration was reduced in both routes of oral administration. Tubular damage, such as the vacuolization of the seminiferous epithelium, germ cell detachment, and seminiferous tubule degeneration, occurred in all groups exposed to Cd. Therefore, the oral Cd administration presented greater potential to promote testicular damage, mainly when the metal was given in a fractionated way.

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Gad, Shayne C. "Routes in Toxicology: An Overview." Journal of the American College of Toxicology 13, no. 1 (February 1994): 34–39. http://dx.doi.org/10.3109/10915819409140653.

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How a route of administration is selected, and what concerns govern the development and execution of techniques for administration of various materials by different routes is an essential component of knowledge for the working toxicologist. More than 26 routes see at least some use in toxicology, each with its own specific concerns, advantages, and disadvantages. Most are infrequently used and poorly understood. The purpose of this communication is to summarize these potential routes and to present an overview of some of the factors that may influence results achieved by the use of different routes of administration.

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Maria Mtalsi, Mouna Hamza, Fatima Ezzahra Elgasmi, Amal Chlyah, Badreddine Hmamouchi, and Samira Elarabi. "Conscious sedation by Midazolam in pediatric odontology: A randomized clinical trial." GSC Biological and Pharmaceutical Sciences 14, no. 2 (February 28, 2021): 172–80. http://dx.doi.org/10.30574/gscbps.2021.14.2.0056.

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Objectives: The objectives of this study are to evaluate the efficacy of midazolam as a means of conscious sedation in pediatric odontology through three routes of administration: oral, rectal and nasal administration, to compare the efficacy of these different routes and to assess the general safety of Midazolam. Materials and Methods: Thirty healthy non-cooperating (ASAI) patients (levels 1 and 2 on the FRANKL scale), aged 2 to 5 years and requiring a minimum of three dental sessions were recruited. Each patient received three sessions of sedation, using a different route of administration each time: oral (0.5 mg/kg), rectal (0.3 mg/kg) and nasal (0.2 mg/kg). The assessment of the behavior throughout the dental care was made using the Houpt scale. Physiological parameters(heart rate and oxygen saturation) were measured every five minutes to assess tolerance. Results: The three routes of administration of midazolam were considered effective since all patients presented a behavior allowing a complete management without interruption of care except for one patient. The sedative effect of the oral and rectal routes was similar, as to the nasal route, it was judged to be clinically better but without any statistically significant differences. The most accepted route of administration by patients was the oral one followed by the nasal and rectal routes. No intolerance to midazolam was observed. Conclusion: Midazolam is an effective sedative for dental care, acceptable by patients and well tolerated regardless of the route of administration.

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Bhatt, M., G. Bhatt, P. Kothiyal, and S. Chaudhary. "A REVIEW ON BUCCAL MUCOSAL ROUTE OF DRUG ADMINISTRATION." INDIAN DRUGS 53, no. 08 (August 28, 2016): 5–16. http://dx.doi.org/10.53879/id.53.08.10631.

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Oral route is the most preferred rote of drug administration. In oral route buccal mucosal route is one of the advantageous routes of drug administration. This route provides direct access to systemic circulation through the jugular vein, bypassing the first pass hepatic metabolism, which leads to high bioavailability. The drugs having low bioavailability, shorter half life and those who undergoes extensive first pass metabolism are good candidat for this rote. Various formulations have been developed for this routes, one of which is buccal film. Buccal films were prepared by using methods like solvent casting method, hot-melt extrusion method and direct milling method. Buccal films were evaluated for thickness, swelling property, surface pH, drug content, % moisture loss, etc.

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Le Nedelec, Martin, Paul Glue, Helen Winter, Chelsea Goulton, and Natalie J. Medlicott. "The effect of route of administration on the enantioselective pharmacokinetics of ketamine and norketamine in rats." Journal of Psychopharmacology 32, no. 10 (June 13, 2018): 1127–32. http://dx.doi.org/10.1177/0269881118780013.

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Background: Ketamine has been shown to produce a rapid and potent antidepressant response in patients with treatment-resistant depression. Currently ketamine is most commonly administered as a 40-minute intravenous infusion, though it is unknown whether this is the optimal route of administration. Aims: To determine the plasma concentration time course of the R- and S-enantiomers of ketamine and norketamine following administration of ketamine by four different routes of administration. Methods: Plasma from conscious non-anaesthetised rats was collected following administration of ketamine by either subcutaneous (SC), intramuscular (IM), intravenous infusion (IVI) or intravenous bolus (IVB) routes of administration. Concentrations of the enantiomers of ketamine and norketamine were determined by LC/MS. Results: Administration by the SC, IM and IVI routes produced an overall similar drug exposure. In contrast, administration by the IVB route produced approximately 15-fold higher peak plasma concentrations for the enantiomers of ketamine and an approximately four-fold lower AUC for the enantiomers of norketamine. Conclusions: Route of administration can significantly influence ketamine and norketamine exposures. These differences may influence safety and tolerability, and potentially drug efficacy in humans. This knowledge adds to current research into the optimisation of the use of ketamine for the treatment of depression.

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Almohaish, Sulaiman, Melissa Sandler, and Gretchen M. Brophy. "Time Is Brain: Acute Control of Repetitive Seizures and Status Epilepticus Using Alternative Routes of Administration of Benzodiazepines." Journal of Clinical Medicine 10, no. 8 (April 17, 2021): 1754. http://dx.doi.org/10.3390/jcm10081754.

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Time plays a major role in seizure evaluation and treatment. Acute repetitive seizures and status epilepticus are medical emergencies that require immediate assessment and treatment for optimal therapeutic response. Benzodiazepines are considered the first-line agent for rapid seizure control. Thus, various routes of administration of benzodiazepines have been studied to facilitate a quick, effective, and easy therapy administration. Choosing the right agent may vary based on the drug and route properties, patient’s environment, caregiver’s skills, and drug accessibility. The pharmacokinetic and pharmacodynamic aspects of benzodiazepines are essential in the decision-making process. Ultimately, agents and routes that give the highest bioavailability, fastest absorption, and a modest duration are preferred. In the outpatient setting, intranasal and buccal routes appear to be equally effective and more rapidly administered than rectal diazepam. On the other hand, in the inpatient setting, if available, the IV route is ideal for benzodiazepine administration to avoid any potential absorption delay. In this article, we will provide an overview and comparison of the various routes of benzodiazepine administration for acute control of repetitive seizures and status epilepticus.

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Auletta, Carol S. "Vaginal and Rectal Administration." Journal of the American College of Toxicology 13, no. 1 (February 1994): 48–63. http://dx.doi.org/10.3109/10915819409140655.

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Vaginal and rectal routes of administration of test substances are not often used in animal testing procedures. However, these routes are almost obligatory when therapeutic agents intended for vaginal or rectal use in humans have to be evaluated for safety in animals. Applicable study designs and experiences with these routes are described in this report.

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Cedars, Marcelle I., and Howard L. Judd. "Nonoral Routes of Estrogen Administration." Obstetrics and Gynecology Clinics of North America 14, no. 1 (March 1987): 269–98. http://dx.doi.org/10.1016/s0889-8545(21)00583-0.

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Johanson, Gary A. "New routes of opiate administration." American Journal of Hospice and Palliative Medicine® 9, no. 4 (July 1992): 4–5. http://dx.doi.org/10.1177/104990919200900405.

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King, Brent R. "Alternative Routes of Drug Administration." Emergency Medicine News 27, no. 8 (August 2005): 23–24. http://dx.doi.org/10.1097/00132981-200508000-00033.

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Nimmo, Walter S. "Novel routes of drug administration." Current Opinion in Anaesthesiology 4, no. 4 (August 1991): 497–501. http://dx.doi.org/10.1097/00001503-199108000-00005.

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MENASCHE, P. "Cardioplegia: Alternate routes of administration." Journal of Molecular and Cellular Cardiology 22 (July 1990): 43. http://dx.doi.org/10.1016/0022-2828(90)90251-v.

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Alexander-Williams, J. M., and D. J. Rowbotham. "Novel routes of opioid administration." British Journal of Anaesthesia 81, no. 1 (July 1998): 3–7. http://dx.doi.org/10.1093/bja/81.1.3.

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Beyssac, E. "The unusual routes of administration." European Journal of Drug Metabolism and Pharmacokinetics 21, no. 2 (June 1996): 181–87. http://dx.doi.org/10.1007/bf03190268.

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Hidiroglou, M., and K. Karpinski. "Vitamin E kinetics in sheep." British Journal of Nutrition 58, no. 1 (July 1987): 113–25. http://dx.doi.org/10.1079/bjn19870075.

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1. Kinetics of physiological doses of D-α-[5-Me-3H]tocopherol(200 μCi) administered to twenty-four sheep were studied using one of four routes: intravenous, oral (capsules), intraruminal and intramuscular.2. Blood samples were withdrawn from the jugular vein periodically for 96 h after the intravenous and oral administrations, for 168 h after the intraruminal administration and for 216 h after the intramuscular administration.3. The study indicated that the biological availability of α-tocopherol followed the order intravenous > intramuscular > oral > intraruminal.4. The rate of elimination was in the order intravenous > oral > intraruminal ˜ intramuscular.5. The intravenous route was fitted with a three-compartment model, whereas the other routes exhibited a good fit for either a one- or two-compartment model.

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Liles, Darla, Charles N. Landen, Dougald M. Monroe, Celeste M. Lindley, Marjorie s. Read, Harold R. Roberts, and Kenneth M. Brinkhous. "Extravascular Administration of Factor IX: Potential for Replacement Therapy of Canine and Human Hemophilia B." Thrombosis and Haemostasis 77, no. 05 (1997): 0944–48. http://dx.doi.org/10.1055/s-0038-1656082.

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SummaryCurrent therapy for hemophilia B requires large intravenous doses of factor IX (F.IX) given in the clinic or at home. Although home therapy is possible for many patients, it is often complicated by factors such as the lack of good venous access. Very little is known about extravascular routes for administering proteins like F.IX (57 kD) or other vitamin K-dependent procoagulant factors into the circulation. Questions about the absorption rate from extravascular administration as well as plasma recovery and bioavailability have arisen recently with the growing availibility of highly purified procoagulant proteins and increased interest in gene therapy of hemophilia B. Therefore, a group of studies were undertaken to determine the absorption rate, plasma recovery, and bioavailability of high purity, human plasma-derived F.IX concentrates administered via extravascular routes in hemophilia B dogs and in one human hemophilia B subject. Five hemophilia B dogs were given human F.IX via either a subcutaneous (SC), intramuscular (IM), intra- peritoneal (IP) or intravenous (IV) route. In a subsequent study, a single SC administration of human F.IX was compared to an identical IV dose of F.IX in the human hemophilia B subject. All extravascular routes of F.IX administration in both the canine and human gave lower levels of circulating plasma F.IX than the IV route, however all routes resulted in measurable F.IX activity. Of the extravascular routes, the IM injection in the canine resulted in a bioavailibility of 82.8%, while the SC injection resulted in a bioavailability of 63.5%. F.IX reached the plasma compartment by all extravascular routes used, confirming that F.IX can be absorbed extravascularly. The duration of measurable F.IX activity following extravascular administration is prolonged beyond that typically seen with IV administration. These data show that significant levels of F.IX may be obtained via SC injection in canine and ‘ human hemophilia B subjects and further highlight the potential of extravascular routes of administration for future experimental and clinical uses of F.IX and other procoagulant proteins.

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Lakshmi, P. k., D. Prasanthi, and B. Veeresh. "NON INVASIVE DELIVERY OF PROTEIN AND PEPTIDE DRUGS: A REVIEW." Asian Journal of Pharmaceutical and Clinical Research 10, no. 8 (August 1, 2017): 25. http://dx.doi.org/10.22159/ajpcr.2017.v10i8.18274.

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Till recent, injections remained the most common route for administration of protein and peptide drugs because of their poor bioavailability in the other routes. Because it is generally recognized that injection based delivery is a major impediment to the commercial success of therapeutic proteins and peptides, research in both academia and industry continues to focus on ways to overcome this problem. Possible non-parenteral administration routes for delivery of peptide and protein drugs include oral, nasal, ocular, transdermal, rectal, colonic, and vaginal route. The large surface area associated with most of these routes makes them attractive targets for drug delivery. While non-invasive administration by these routes is considered a more logical and achievable option for local treatment regimens, systemic delivery of proteins and peptides is significantly more challenging. In spite of effort made on the development of drugs for these routes, most of the successes fail to address how the technology will be transformed to a commercial product. The only notable exceptions have been the successful commercialization of nasal formulations for systemic delivery of a limited number of therapeutic peptides, and recent regulatory approvals of both pulmonary and buccal delivery systems for systemic delivery of insulin and an oral formulation of a small peptide analog, cyclosporine, have been commercialized. The present review aims to discuss the potential non-invasive routes of protein and peptide drug delivery. The factors which will affect drug transport and the bioavailability of proteins administered through these routes is also emphasized

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Chopra, R., M. Mittal, K. Bansal, and P. Chaudhuri. "Buccal Midazolam Spray as an Alternative to Intranasal Route for Conscious Sedation in Pediatric Dentistry." Journal of Clinical Pediatric Dentistry 38, no. 2 (December 1, 2013): 171–73. http://dx.doi.org/10.17796/jcpd.38.2.n055763721297702.

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Objectives: To evaluate the acceptance of midazolam spray through buccal route as compared to intranasal route and compare the efficacy of the drug through both the routes. Study Design: 30 patients aged 2-8 years with Grade I or II Frankl's Behaviour Rating Scale were selected who required similar treatment under local anesthesia on two teeth. Midazolam spray was administered randomly through buccal or intranasal routes for the two appointments. Scoring was done for the acceptance of drug and Houpt's score was recorded for the behaviour of patients during the treatment. Results: Acceptance of drug through buccal route was significantly better than the intranasal route (p<0.05) but no statistically significant difference was found in the behaviour scores for the two routes of administration (p≯0.05). Conclusion: Midazolam spray can be effectively used through the buccal mucosa in children who give poor compliance with the intranasal administration.

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Kemp, Peter A. "Escape routes from poverty." Benefits: A Journal of Poverty and Social Justice 13, no. 3 (October 2005): 173–78. http://dx.doi.org/10.51952/vrwe4908.

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In recent years, researchers have begun to move away from a static, cross-sectional analysis of poverty to examine income dynamics, including routes into and out of poverty. The aim of this article is to provide an overview of what is known from quantitative research on routes out of income poverty. It shows that there is a diversity of routes out of poverty, with some routes being more important for some types of household than for others. The research supports the Labour government’s argument that work is the surest route out of poverty. But it also shows that it is not a guaranteed one, as some people who move into work remain poor. And nor is it a route that is equally applicable to all households. For pensioners and the more severely disabled people, for instance, increases in benefit income are likely to be the most effective escape routes from poverty.

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Ripamonti, Carla, Ernesto Zecca, and Franco De Conno. "Pharmacological Treatment of Cancer Pain: Alternative Routes of Opioid Administration." Tumori Journal 84, no. 3 (May 1998): 289–300. http://dx.doi.org/10.1177/030089169808400302.

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Cancer-related pain is present in 51% of patients at various stages of the disease, and the incidence increases up to 74% in advanced and terminal stages. The World Health Organization proposed and issued very simple guidelines for the pharmacologic treatment of cancer-related pain. According to the guidelines, opioid analgesics are the mainstay of analgesic therapy, and the first choice for drug administration is considered to be the oral route. However, in some clinical situations, the oral route is not feasible, and analgesic drugs consequently have to be administered via an alternative route. For example, this is the case when the patient presents vomiting, bowel obstruction, severe dysphagia, mental confusion and when the opioid dose has to be increased drastically in order to achieve adequate pain control. This review of the literature is aimed at describing the indications, the limits and the main aspects of the pharmacokinetics and pharmacodynamics relative to the alternative routes of administration of opioids most commonly used in clinical practice. Sublingual, rectal, subcutaneous, intravenous, transdermal and spinal administration routes are examined.

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Usoltceva, Elena O., Liailia Kh Dzhemlikhanova, Dariko A. Niauri, Igor Yu Kogan, and Alexander M. Gzgzyan. "Endometrial stem cells expansion capability for local and systemic routes of administration in a model of experimentally injured endometrium." Journal of obstetrics and women's diseases 65, no. 1 (March 15, 2016): 62–68. http://dx.doi.org/10.17816/jowd65162-68.

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Endometrial stem cells due to their therapeutic characteristics could to be an effective tool of cell technologies in reproductive medicine. The aim of the study was to determine the most therapeutically effective route of administration for endometrial stem cells suspension. The study was conducted in approved animal model of injured endometrium. To create the experimental model tissue pieces of autologous endometrium were implanted on the anterior abdominal wall peritoneum using general surgical techniques. Experimental group animals were treated with endometrial stem cells suspension; in the control animal group a placebo was used. Local and systemic routes of endometrial stem cells administration were compared. The direct injections of stem cells suspension in the endometrial implants were used as the local route of administration, the intravenous injections of stem cells suspension were used as a systemic route. Endometrial stem cells expansion didn’t depend on the routes of administration, whereas therapeutic effects of stem cells was more obvious in tissue pieces after local injection of stem cells.

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Matsumoto, Yoshihisa, and Hiroya Kinoshita. "Current development in analgesic administration routes." Drug Delivery System 26, no. 5 (2011): 476–79. http://dx.doi.org/10.2745/dds.26.476.

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Gee, Siobhan, and David Taylor. "Alternative Routes of Administration of Clozapine." CNS Drugs 36, no. 2 (February 2022): 105–11. http://dx.doi.org/10.1007/s40263-022-00900-w.

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Torgerson, Troy R. "Overview of Routes of IgG Administration." Journal of Clinical Immunology 33, S2 (December 11, 2012): 87–89. http://dx.doi.org/10.1007/s10875-012-9845-2.

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Andriuoli, G., M. Bossi, I. Caramazza, and G. Zoppetti. "Heparin by Alternative Routes of Administration." Pathophysiology of Haemostasis and Thrombosis 20, no. 1 (1990): 154–58. http://dx.doi.org/10.1159/000216174.

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Ciglanová, D., Z. Jurčacková, D. Mudroňová, E. Dvorožňáková, and G. Hrčková. "Differential activity of human leukocyte extract on systemic immune response and cyst growth in mice with Echinococcus multilocularis infection after oral, subcutaneous and intraperitoneal routes of administration." Helminthologia 59, no. 4 (December 1, 2022): 341–56. http://dx.doi.org/10.2478/helm-2022-0038.

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Summary Alveolar echinococcosis (AE) caused by the larval stage of Echinococcus multilocularis is serious parasitic diseases associated with the host´s immunosuppression. The effects of human non-immune dialyzable leukocyte extract (DLE) on immune cells in blood and spleen and parasitic cysts weight in Balb/c mice after oral (PO), subcutaneous (SC) and intraperitoneal administration (IP) were compared. The reduction in cysts weight (p < 0.01) was recorded after PO route, whereas moderate reduction was found after SC and IP routes. The elevation of lymphoid populations in blood and spleen was found after PO administration (p < 0.01) in parallel with reduced myeloid population. Infection-elicited decline in B220+B cells was partially abolished by PO route, but DLE routes did not influence the CD3+ T cells. The proportions of CD3+CD4+Th lymphocytes were moderately upregulated, whereas CD3+CD8+Tc populations were reduced after all DLE routes (p < 0.01). PO administration increased CD11b+MHCIIhigh blood monocytes, CD11b-SigleF+ cell, but not CD11b+Si-glecF+ eosinophils in the blood, stimulated after SC and IP routes. DLE induced downregulation of NO production by LPS-stimulated adherent splenocytes ex vivo. Con A-triggered T lymphocyte proliferation was associated with the elevated IFN-γ production and transcription factor Tbet mRNA expression. The alleviation of Th2 (IL-4) and Treg (TGF-β) cytokine production by lymphocytes ex vivo paralleled with downregulation of gene transcription for cytokines, GATA and FoxP3. Reduction of myeloid cells with suppressive activity was found. The SC and IP routes affected partially the cysts weights, diminished significantly gene transcription, NO levels and Th2 and Treg cytokines production. Results showed that PO route of DLE administration was the most effective in ameliorating immunosuppression via stimulation of Th1 type, reducing Th2 and Treg type of immunity and CD3+CD8+Tc lymphocytes in the blood and spleens during E. multilocularis infection in mice.

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De Conno, F., C. Ripamonti, L. Saita, T. MacEachern, J. Hanson, and E. Bruera. "Role of rectal route in treating cancer pain: a randomized crossover clinical trial of oral versus rectal morphine administration in opioid-naive cancer patients with pain." Journal of Clinical Oncology 13, no. 4 (April 1995): 1004–8. http://dx.doi.org/10.1200/jco.1995.13.4.1004.

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PURPOSE The aim of this double-blind, double-dummy, crossover study was to compare the efficacy, tolerability, and time of onset of analgesia after the administration of 10 mg of morphine hydrochloride via the oral and rectal routes in opioid-naive cancer patients with pain. PATIENTS AND METHODS Thirty-four patients with cancer pain and no previous opioid treatment were randomized to receive morphine hydrochloride 10 mg orally or rectally (in the form of a microenema) for 2 days. During days 3 and 4, a crossover took place. The scores of pain, nausea, and sedation (visual analog scale of 0 to 100) calculated as the percentage change from baseline (before opioid administration) were assessed at different intervals up to 240 minutes. The number of vomiting episodes was recorded. Parity tests and analysis of variance (ANOVA) were performed to compare the two administration routes. RESULTS A significant difference in pain intensity was achieved 10 minutes after rectal administration compared with 60 minutes after oral administration. There was still a significant reduction in pain via the rectal route after 180 minutes versus via the oral route after 120 minutes. No significant difference was observed in the intensity of sedation, nausea, or number of vomiting episodes between the oral and rectal routes. CONCLUSION A liquid solution of morphine is well absorbed via the rectal route. Rectal morphine is safe, effective, easy to manage, and inexpensive, with a rapid onset of action. Rectal morphine can be considered a valid alternative route for opioid administration and may also be used when rescue doses of morphine are required in patients regularly treated with oral or parenteral opioids.

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Ammar, Mahmoud A., Madhu Sasidhar, and Simon W. Lam. "Inhaled Epoprostenol Through Noninvasive Routes of Ventilator Support Systems." Annals of Pharmacotherapy 52, no. 12 (June 12, 2018): 1173–81. http://dx.doi.org/10.1177/1060028018782209.

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Background: The administration of inhaled epoprostenol (iEPO) through noninvasive routes of ventilator support systems has never been previously evaluated. Objective: Describe the use of iEPO when administered through noninvasive routes of ventilator support systems. Methods: Critically ill patients admitted to the intensive care unit who received iEPO through noninvasive routes were analyzed. Improvements in respiratory status and hemodynamic parameters were evaluated. Safety end points assessed included hypotension, rebound hypoxemia, significant bleeding, and thrombocytopenia. Results: A total of 36 patients received iEPO through noninvasive routes: high-flow oxygen therapy through nasal cannula, n = 29 (81%) and noninvasive positive-pressure ventilation, n = 7 (19%). Sixteen patients had improvement in their respiratory status: mean decrease in fraction of inspired oxygen (FiO2), 20% ± 13%; mean increase in partial pressure of arterial oxygen to FiO2 (PaO2/FiO2) ratio, 60 ± 50 mm Hg; and mean decrease in HFNC oxygen flow rate, 6 ± 3 liters per minute (LPM). Eight patients had declines in their respiratory status (mean increase in FiO2, 30% ± 20%; mean decrease in PaO2/FiO2 ratio, 38 ± 20 mm Hg; and mean increase in HFNC oxygen flow rate, 15 ± 10 LPM), and 12 patients had no change in their respiratory status. Conclusion and Relevance: This represents the first evaluation of the administration of iEPO through noninvasive routes of ventilator support systems and demonstrates that in critically ill patients, iEPO could be administered through a noninvasive route. Further evaluation is needed to determine the extent of benefit with this route of administration.

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Stanković, Sanja, and Marija Tasić-Kostov. "Formulation of biologics for alternative routes of administration: Current problems and perspectives." Acta Facultatis Medicae Naissensis 39, no. 4 (2022): 410–21. http://dx.doi.org/10.5937/afmnai39-35426.

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Introduction: Biologics (biopharmaceuticals) present new promising therapies for many diseases such as cancers, chronical inflammatory diseases and today's biggest challenge - COVID-19. Research: Today, most biologics have been synthetized using modern methods of biotechnology, in particular DNA recombinant technology. Current pharmaceutical forms of protein/peptide biopharmaceuticals are intended for parenteral route of administration due to their instability and large size of molecules. In order to improve patient compliance, many companies are working on developing adequate forms of biopharmaceuticals for alternative, non-invasive routes of administration. The aim of this work is to review current aspirations and problems in formulation of biopharmaceuticals for alternative (non-parenteral) routes of administration and to review the attempts to overcome them. These alternative routes of administration could be promising in prevention and treatment of COVID-19, among other serious diseases. Conclusion: The emphasis is on stabilizing monoclonal antibodies into special formulations and delivery systems; their application should be safer, more comfortable and reliable. When it comes to hormones, vaccines and smaller peptides, some companies have already registered drugs intended for nasal and oral delivery.

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Zuberi, Zavuga, Elingarami Sauli, Liu Cun, Jing Deng, Wen-Jun Li, Xu-Liang He, and Wen Li. "Insulin-delivery methods for children and adolescents with type 1 diabetes." Therapeutic Advances in Endocrinology and Metabolism 11 (January 2020): 204201882090601. http://dx.doi.org/10.1177/2042018820906016.

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Efforts directed toward restoring normal metabolic levels by mimicking the physiological insulin secretion, thereby ensuring safety, efficacy, minimal invasiveness and conveniences, are of great significance in the management of type 1 diabetes among children and adolescents. Regardless of the various technologies being discovered in addressing invasiveness and enhancing medication adherence in the management of type 1 diabetes, yet limited success had been observed among children and adolescents. The multiple daily subcutaneous insulin injections route using vial and syringe, and occasionally insulin pens, remain the most predictable route for insulin administration among children and adolescents. However, this route has been associated with compromised patient compliance, fear of injections and unacceptability, resulting in poor glycemic control, which promote the demand for alternative routes of insulin administration. Alternative routes for delivering insulin are being investigated in children and adolescents with type 1 diabetes; these include the hybrid closed-loop ‘artificial pancreas’ system, oral, inhalation, intranasal routes, and others. This review article explores the current advances in insulin-delivery methods that address the needs of children and adolescents in the treatment of type 1 diabetes.

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Homayun, Bahman, Xueting Lin, and Hyo-Jick Choi. "Challenges and Recent Progress in Oral Drug Delivery Systems for Biopharmaceuticals." Pharmaceutics 11, no. 3 (March 19, 2019): 129. http://dx.doi.org/10.3390/pharmaceutics11030129.

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Routes of drug administration and the corresponding physicochemical characteristics of a given route play significant roles in therapeutic efficacy and short term/long term biological effects. Each delivery method has favorable aspects and limitations, each requiring a specific delivery vehicles design. Among various routes, oral delivery has been recognized as the most attractive method, mainly due to its potential for solid formulations with long shelf life, sustained delivery, ease of administration and intensified immune response. At the same time, a few challenges exist in oral delivery, which have been the main research focus in the field in the past few years. The present work concisely reviews different administration routes as well as the advantages and disadvantages of each method, highlighting why oral delivery is currently the most promising approach. Subsequently, the present work discusses the main obstacles for oral systems and explains the most recent solutions proposed to deal with each issue.

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Tsyvunin, V. V., S. Yu Shtrygol’, M. V. Mishchenko, and D. V. Shtrygol’. "The anticonvulsant effect of digoxin on basic models of primary generalized seizures does not depend on the route of administration." News of Pharmacy 104, no. 2 (November 7, 2022): 61–66. http://dx.doi.org/10.24959/nphj.22.98.

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Improving the prevention and treatment of epilepsy is one of the urgent tasks. Based on the available data on the anticonvulsant activity of the cardiac glycoside digoxin, it is advisable to compare the anticonvulsant effect of the drug by different routes of administration in the experiment. Aim. To determine the impact of the route of administration on the anticonvulsant effect of the cardiac glycoside digoxin on basic models of primary generalized seizures induced by pentylenetetrazol and maximal electric shock. Materials and methods. Two basic models were used: the model of primary generalized convulsions induced in mice by pentylenetetrazol (80 mg/kg subcutaneously) and maximal electric shock (current strength – 50 mA, frequency – 50 Hz, 0.2 sec corneally). Digoxin was administered in the dose of 0.8 mg/kg (about 1/10 LD50) 30 min before modeling seizures in the stomach and subcutaneously. Standard parameters of convulsive syndrome severity and mortality were recorded. Results and discussion. In both seizure models, the anticonvulsant effect of digoxin was little dependent on the route of administration. In the pentylenetetrazole-induced model, with both routes of administration, lethality tended to decrease; when administered intragastrically, digoxin statistically significantly reduced the number of clonic-tonic seizures per 1 mouse, the number of animals with the most severe tonic seizures, and the duration of the convulsive period; when administered subcutaneously, it significantly increased the latent period of seizures and reduced the number of animals with tonic seizures. In the model of maximal electric shock, digoxin reduced seizure severity andlethality almost equally by both routes of administration (by 55 % with the intragastric administration and by 67.5 % with the subcutaneous administration). In both models, there were no statistically significant differences in the course of seizures in both routes of the digoxin administration. With subcutaneous administration, the anticonvulsant effect was somewhat more pronounced at the level of a weak tendency. Conclusions. The anticonvulsant effect of digoxin when administered intragastrically and subcutaneously in mice with models of pentylenetetrazole-induced seizures and maximal electric shock is practically independent of the routeof administration. Digoxin has a pronounced anticonvulsant effect on the model of electrically induced seizures, and a moderate effect on the model of pentylenetetrazole seizures.

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Tucker, Calvin, Lyn Tucker, and Kyle Brown. "The Intranasal Route as an Alternative Method of Medication Administration." Critical Care Nurse 38, no. 5 (October 1, 2018): 26–31. http://dx.doi.org/10.4037/ccn2018836.

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Intranasal drug administration is a less invasive method of drug delivery that is easily accessible for adult and pediatric patients. Medications administered by the intranasal route have efficacy comparable to intravenous administration and typically have superior efficacy to subcutaneous or intramuscular routes. The intranasal route is beneficial in emergent situations when the intravenous route is not available. The intranasal route is safe and effective in various indications, and therapeutic systemic concentrations of medication can be attained via this route. As the evidence for and comfort with intranasal administration continue to grow, guidance on correct technique, medications, and dosing is vital for appropriate use. This article reviews the process and practices of appropriate intranasal medication administration.

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Bedrosian, Isabelle, Rosemarie Mick, Shuwen Xu, Harvey Nisenbaum, Mark Faries, Paul Zhang, Peter A. Cohen, Gary Koski, and Brian J. Czerniecki. "Intranodal Administration of Peptide-Pulsed Mature Dendritic Cell Vaccines Results in Superior CD8+ T-Cell Function in Melanoma Patients." Journal of Clinical Oncology 21, no. 20 (October 15, 2003): 3826–35. http://dx.doi.org/10.1200/jco.2003.04.042.

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Purpose: We evaluated the feasibility, safety, and immunogenicity of mature, peptide-pulsed dendritic cell (DC) vaccines administered by different routes. Patients and Methods: We performed a randomized, phase I, dose-escalation study in 27 patients with metastatic melanoma receiving four autologous peptide-pulsed DC vaccinations. Patients were randomly assigned to an intravenous (IV), intranodal (IN), or intradermal (ID) route of administration (ROA). For each route, primary end points were dose-limiting toxicity, maximum-tolerated dose, and T-cell sensitization. Sensitization was evaluated through tetramer staining, in vitro peptide recognition assays, and delayed-type hypersensitivity (DTH) responses. Results: Twenty-two (81.5%) of 27 patients completed all four vaccinations. Vaccinations were well tolerated; a few patients exhibited grade 1 to 2 toxicities including rash, fever, and injection site reaction. All routes of administration induced comparable increases in tetramer-staining CD8+ T cells (five of seven IV, four of seven IN, and four of six ID patients). However, the IN route induced significantly higher rates for de novo development of CD8+ T cells that respond by cytokine secretion to peptide-pulsed targets (six [85.7%] of seven IN patients v two [33%] of six ID patients v none [0%] of six IV patients; P = .005) and de novo DTH (seven [87.5%] of eight IN patients v two [33.3%] of six ID patients v one [14.3%] of seven IV patients; P = .01) compared with other routes. Conclusion: Administration of this peptide-pulsed mature DC vaccine by IN, IV, or ID routes is feasible and safe. IN administration seems to result in superior T-cell sensitization as measured by de novo target-cell recognition and DTH priming, indicating that IN may be the preferred ROA for mature DC vaccines.

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Andreata-Santos, Robert, Rúbens Prince dos Santos Alves, Sara Araujo Pereira, Lennon Ramos Pereira, Carla Longo de Freitas, Samuel Santos Pereira, Alexia Adrianne Venceslau-Carvalho, et al. "Transcutaneous Administration of Dengue Vaccines." Viruses 12, no. 5 (May 6, 2020): 514. http://dx.doi.org/10.3390/v12050514.

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In the present study, we evaluated the immunological responses induced by dengue vaccines under experimental conditions after delivery via a transcutaneous (TC) route. Vaccines against type 2 Dengue virus particles (DENV2 New Guinea C (NGC) strain) combined with enterotoxigenic Escherichia coli (ETEC) heat-labile toxin (LT) were administered to BALB/c mice in a three-dose immunization regimen via the TC route. As a control for the parenteral administration route, other mouse groups were immunized with the same vaccine formulation via the intradermic (ID) route. Our results showed that mice vaccinated either via the TC or ID routes developed similar protective immunity, as measured after lethal challenges with the DENV2 NGC strain. Notably, the vaccine delivered through the TC route induced lower serum antibody (IgG) responses with regard to ID-immunized mice, particularly after the third dose. The protective immunity elicited in TC-immunized mice was attributed to different antigen-specific antibody properties, such as epitope specificity and IgG subclass responses, and cellular immune responses, as determined by cytokine secretion profiles. Altogether, the results of the present study demonstrate the immunogenicity and protective properties of a dengue vaccine delivered through the TC route and offer perspectives for future clinical applications.

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&NA;. "Looking at novel routes of drug administration." Inpharma Weekly &NA;, no. 1106 (September 1997): 3. http://dx.doi.org/10.2165/00128413-199711060-00005.

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King, Brent R. "Rectal and Transdermal Routes of Drug Administration." Emergency Medicine News 27, no. 9 (September 2005): 14. http://dx.doi.org/10.1097/00132981-200509000-00018.

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Ritter, Megan J., Suruchi Gupta, and James V. Hennessey. "Alternative routes of levothyroxine administration for hypothyroidism." Current Opinion in Endocrinology, Diabetes & Obesity 27, no. 5 (July 28, 2020): 318–22. http://dx.doi.org/10.1097/med.0000000000000558.

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Goadsby, Peter J. "Routes of Administration of Acute Migraine Therapy." Headache: The Journal of Head and Face Pain 39, s2 (April 1999): S35—S39. http://dx.doi.org/10.1111/j.1526-4610.1999.00009.x.

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McQuay, H. J. "Opioid clinical pharmacology and routes of administration." British Medical Bulletin 47, no. 3 (July 1991): 703–17. http://dx.doi.org/10.1093/oxfordjournals.bmb.a072502.

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Graves, Terri, and Jane Pruemer. "New Methods of Chemotherapy Administration-Selected Routes." Journal of Pharmacy Practice 4, no. 1 (February 1991): 49–63. http://dx.doi.org/10.1177/089719009100400106.

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Sitruk-Ware, Regine. "Estrogen and progestogens – different routes of administration." Climacteric 8, sup1 (August 2005): 1–2. http://dx.doi.org/10.1080/13697130500148818.

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Thompson, Diane, and Andrea DiMartini. "Nonenteral Routes of Administration for Psychiatric Medications." Psychosomatics 40, no. 3 (May 1999): 185–92. http://dx.doi.org/10.1016/s0033-3182(99)71234-x.

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Sato, Kyoko, Takashi Ando, Tomohiro Nishi, Mayumi Karino, Hiroshi Ishiguro, and Tadashi Miyamori. "Alternative routes of administration in palliative medicine: availability of sublingual administration." Palliative Care Research 5, no. 1 (2010): 201–5. http://dx.doi.org/10.2512/jspm.5.201.

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Leyva-Grado, Victor H., Gene S. Tan, Paul E. Leon, Mark Yondola, and Peter Palese. "Direct Administration in the Respiratory Tract Improves Efficacy of Broadly Neutralizing Anti-Influenza Virus Monoclonal Antibodies." Antimicrobial Agents and Chemotherapy 59, no. 7 (May 4, 2015): 4162–72. http://dx.doi.org/10.1128/aac.00290-15.

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ABSTRACTThe emergence of influenza virus strains resistant to approved neuraminidase inhibitors and the time constrains after infection when these drugs can be effective constitute major drawbacks for this class of drugs. This highlights a critical need to discover new therapeutic agents that can be used for the treatment of influenza virus-infected patients. The use of broadly neutralizing anti-influenza monoclonal antibodies (MAbs) has been sought as an alternative immunotherapy against influenza infection. Here, we tested in mice previously characterized broadly neutralizing anti-hemagglutinin (HA) stalk MAbs prophylactically and therapeutically using different routes of administration. The efficacy of treatment against an influenza H1N1 pandemic virus challenge was compared between two systemic routes of administration, intraperitoneal (i.p.) and intravenous (i.v.), and two local routes, intranasal (i.n.) and aerosol (a.e.). The dose of MAb required for prophylactic protection was reduced by 10-fold in animals treated locally (i.n. or a.e.) compared with those treated systemically (i.p. or i.v.). Improved therapeutic protection was observed in animals treated i.n. on day 5 postinfection (60% survival) compared with those treated via the i.p. route (20% survival). An increase in therapeutic efficacy against other influenza virus subtypes (H5N1) was also observed when a local route of administration was used. Our findings demonstrate that local administration significantly decreases the amount of broadly neutralizing monoclonal antibody required for protection against influenza, which highlights the potential use of MAbs as a therapeutic agent for influenza-associated disease.

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Ghadiri, Maliheh, Paul Young, and Daniela Traini. "Strategies to Enhance Drug Absorption via Nasal and Pulmonary Routes." Pharmaceutics 11, no. 3 (March 11, 2019): 113. http://dx.doi.org/10.3390/pharmaceutics11030113.

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New therapeutic agents such as proteins, peptides, and nucleic acid-based agents are being developed every year, making it vital to find a non-invasive route such as nasal or pulmonary for their administration. However, a major concern for some of these newly developed therapeutic agents is their poor absorption. Therefore, absorption enhancers have been investigated to address this major administration problem. This paper describes the basic concepts of transmucosal administration of drugs, and in particular the use of the pulmonary or nasal routes for administration of drugs with poor absorption. Strategies for the exploitation of absorption enhancers for the improvement of pulmonary or nasal administration are discussed, including use of surfactants, cyclodextrins, protease inhibitors, and tight junction modulators, as well as application of carriers such as liposomes and nanoparticles.

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Abramova, Olga, Yana Zorkina, Timur Syunyakov, Eugene Zubkov, Valeria Ushakova, Artemiy Silantyev, Kristina Soloveva, et al. "Brain Metabolic Profile after Intranasal vs. Intraperitoneal Clomipramine Treatment in Rats with Ultrasound Model of Depression." International Journal of Molecular Sciences 22, no. 17 (September 4, 2021): 9598. http://dx.doi.org/10.3390/ijms22179598.

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Background: Molecular mechanisms of depression remain unclear. The brain metabolome after antidepressant therapy is poorly understood and had not been performed for different routes of drug administration before the present study. Rats were exposed to chronic ultrasound stress and treated with intranasal and intraperitoneal clomipramine. We then analyzed 28 metabolites in the frontal cortex and hippocampus. Methods: Rats’ behavior was identified in such tests: social interaction, sucrose preference, forced swim, and Morris water maze. Metabolic analysis was performed with liquid chromatography. Results: After ultrasound stress pronounced depressive-like behavior, clomipramine had an equally antidepressant effect after intranasal and intraperitoneal administration on behavior. Ultrasound stress contributed to changes of the metabolomic pathways associated with pathophysiology of depression. Clomipramine affected global metabolome in frontal cortex and hippocampus in a different way that depended on the route of administration. Intranasal route was associated with more significant changes of metabolites composition in the frontal cortex compared to the control and ultrasound groups while the intraperitoneal route corresponded with more profound changes in hippocampal metabolome compared to other groups. Since far metabolic processes in the brain can change in many ways depending on different routes of administration, the antidepressant therapy should also be evaluated from this point of view.

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Fonseca-Santos, Bruno, Patrícia Bento Silva, Roberta Balansin Rigon, Mariana Rillo Sato, and Marlus Chorilli. "Formulating SLN and NLC as Innovative Drug Delivery Systems for Non-Invasive Routes of Drug Administration." Current Medicinal Chemistry 27, no. 22 (June 30, 2020): 3623–56. http://dx.doi.org/10.2174/0929867326666190624155938.

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Colloidal carriers diverge depending on their composition, ability to incorporate drugs and applicability, but the common feature is the small average particle size. Among the carriers with the potential nanostructured drug delivery application there are SLN and NLC. These nanostructured systems consist of complex lipids and highly purified mixtures of glycerides having varying particle size. Also, these systems have shown physical stability, protection capacity of unstable drugs, release control ability, excellent tolerability, possibility of vectorization, and no reported production problems related to large-scale. Several production procedures can be applied to achieve high association efficiency between the bioactive and the carrier, depending on the physicochemical properties of both, as well as on the production procedure applied. The whole set of unique advantages such as enhanced drug loading capacity, prevention of drug expulsion, leads to more flexibility for modulation of drug release and makes Lipid-based nanocarriers (LNCs) versatile delivery system for various routes of administration. The route of administration has a significant impact on the therapeutic outcome of a drug. Thus, the non-invasive routes, which were of minor importance as parts of drug delivery in the past, have assumed added importance drugs, proteins, peptides and biopharmaceuticals drug delivery and these include nasal, buccal, vaginal and transdermal routes. The objective of this paper is to present the state of the art concerning the application of the lipid nanocarriers designated for non-invasive routes of administration. In this manner, this review presents an innovative technological platform to develop nanostructured delivery systems with great versatility of application in non-invasive routes of administration and targeting drug release.

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McVay, Catherine S., Marisela Velásquez, and Joe A. Fralick. "Phage Therapy of Pseudomonas aeruginosa Infection in a Mouse Burn Wound Model." Antimicrobial Agents and Chemotherapy 51, no. 6 (June 2007): 1934–38. http://dx.doi.org/10.1128/aac.01028-06.

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ABSTRACT Mice compromised by a burn wound injury and subjected to a fatal infection with Pseudomonas aeruginosa were administered a single dose of a Pseudomonas aeruginosa phage cocktail consisting of three different P. aeruginosa phages by three different routes: the intramuscular (i.m.), subcutaneous (s.c.), or intraperitoneal (i.p.) route. The results of these studies indicated that a single dose of the P. aeruginosa phage cocktail could significantly decrease the mortality of thermally injured, P. aeruginosa-infected mice (from 6% survival without treatment to 22 to 87% survival with treatment) and that the route of administration was particularly important to the efficacy of the treatment, with the i.p. route providing the most significant (87%) protection. The pharmacokinetics of phage delivery to the blood, spleen, and liver suggested that the phages administered by the i.p. route were delivered at a higher dose, were delivered earlier, and were delivered for a more sustained period of time than the phages administered by the i.m. or s.c. route, which may explain the differences in the efficacies of these three different routes of administration.

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Journal articles on the topic 'Routes of administration'

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