2. Parenteral products are dosage forms, which are delivered to the patient by a injection or implantation through the skin or other-external layers such as stratum corneum and directed into the body fluids, tissues or organs. The drug is then transport from the site of administration to the site of action. PARENTERAL PRODUCTS

3. l- Produce a local effect, e.g. local anesthetics for tooth extraction. 2- Administer drugs if the oral route cannot be used. 3- Deliver drugs to the unconscious patient. 4- Rapidly correct fluid and electrolyte imbalances. 5- Ensure delivery of the drug to the target tissues. 6- Ensure delivery of adequate concentration of the drug to diseased or target area of the body e.g. intraventicular injection of aminoglycerides in meningitis Parenteral therapy is used to:

5. Route of Parenteral Administration

6. Routes of Administration Intravenous (IV) Intramuscular (IM) Subcutaneous (SQ) Intradermal (ID) Intraspinal Intra-arterial Intra-cardiac injections Intra- articular injections

7. Intravenous Injection (I.V.)  These are made into a vein, therefore are introduced directly into the blood stream.  The volume injected varies from 1 ml or less to 500 ml or even more.  Drugs are given by this route when a very rapid effect is required.

8. Advantages 1)Predictable dosage 2)I.v. route may be used to administer drugs which are too irritating or caustic when given by other routes. Due to the rapid dilution in the circulating blood and the general insensitivity of the venous wall to pain. 3) Immediate presence in blood plasma and provides maximum availability and assurance in delivering the drug to the site of action. 4) I.V. infusion, large - volume parenterals (LVP). can be used to replace body fluids lost from the circulation as a result of severe burns, vomiting, diarrhea or hemorrhage

9. Disadvantages 1)The risk of thrombosis is increased when irritating IN. products are used. 2) A certain level of knowledge and skill are required for safely parenteral administration. 3) The rapidity of absorption makes antidoting very difficult, if not impossible 4)Only drugs in aqueous or hydroalcohloic solution are to be given by IV route.

10. I.M. route of administration is second only to the I.V. route in rapidity onset of systemic action. The volume is rarely greater than 2 ml and should not exceed 4 ml at one site. Intramuscular injection (I.M.) I.M. route is the only site to be used for suspensions and oily solutions and can tolerates them. because they cause pain and irritation if given subcutaneously or cause blockage of small blood vessels if given intravenously.

11.  These are made under the skin, into the subcutaneous tissue.  The volume injected is 2 ml or less.  This is the most popular route for administration of a great variety of drugs including vaccines and insulin.  Drugs given by this route will have a slower onset of action than by I.M. or IN. routes, and total absorption may also be less.  When daily or frequent administration is required, the injection site should be continuously changed. Subcutaneous or Hypodermic injection (S.Q.)

12.  These are made into the skin, between the inner layer (dermis) and the outer layer (epidermis).  The volume that can be injected intradermally is necessarily small, usually 0.1- 0.2 ml.  The route is use mainly for diagnostic purposes in investigations of immunity and allergy. Intradermal injections (I.D.)

13.  These are aqueous solutions, which are injected in volumes less than 20ml into particular areas of the spinal column.  The specific gravity of these injections may be adjusted to localize the site of action of the drug. Intraspinal injections Injection

14. These are similar to I.V. injections Used occasionally for an immediate effect in a peripheral area: to improve circulation to the extremities when arterial flow is restricted by arterial spasm (early gangrene) To direct the drug to the target organ e.g. (liver, spleen, lung) to minimize the side effect of the drug in the other body tissues (anticancer drugs) etc., Intra- arterial injections

15. These are given into the heart muscle or ventricle in emergency only as a stimulant following cardiac arrest. using Adrenaline or isoprenaline. Intra-cardiac injections

16. These are administered as an aqueous solution or suspension into the synovial fluid in a joint cavity. They are often used for the local administration of anti- inflammatory agents. Intra- articular injections

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