D Pharmacy 1st Year Notes PDF Download -ADME -Pharmacology

D Pharmacy 1st Year Notes PDF Download -ADME -Pharmacology


Absorption, distribution, metabolism, and excretion are sometimes referred to collectively as ADME processes. These processes determine when the drug appears in the blood stream and for how long it remains in the blood stream to give noticeable action.

  • Absorption, distribution, metabolism, and excretion

  • When & how long the drug appears in the blood stream

  • therapeutic response is dependent upon the ADME processes

In order for a drug to cause a therapeutic response, it must reach adequate concentrations in the blood so that it can reach and interact with drug receptors in adequate numbers to trigger a noticeable action. The course of drug action is, therefore, directly correlated with the concentration of the drug in the blood stream, and is dependent upon the ADME processes.


Absorption is the transfer of a drug from its site of administration to the bloodstream. The rate and extent of absorption depends on the route of administration, the formulation and chemical properties of the drug, and physiologic factors that can impact the site of absorption.

  • Transfer of a drug from site to the blood

  • route of administration, Drug properties

  • IV route is fastest and effective for ABSORPTION

  • Highly water-soluble drugs absorb more readily than fat-soluble drugs

  • Drugs with smaller particle sizes ABSORB easily

When a drug is administered intravenously, absorption is not required because the drug is transferred from the administration device directly into the bloodstream. In the case of intravenous administration, the entire dose of the drug is available to move to the sites of drug action. Administration by other routes may result in less availability due to incomplete absorption. When this occurs, less of the drug is delivered by the bloodstream to the site of action. When a tablet or capsule is swallowed it must dissolve before it can be absorbed. The dissolving of a tablet or capsule is referred to as dissolution. Manufacturing processes and the water solubility of the drug affect dissolution rates. Highly water-soluble medications dissolve more readily in the gastrointestinal (GI) tract, while fat-soluble drugs dissolve more slowly. Drugs with smaller particle sizes go into solution more readily. The inert ingredients added to formulations can also affect their dissolution


Distribution is a process when a drug is absorbed into the bloodstream it can be carried throughout the body. This process specifically carrying is called distribution. It is a reversible process; while some molecules may be interacting with receptors on cell membranes or inside of cells, other molecules may move back into the bloodstream.

  • Process of distribution of a drug from the bloodstream to the site of absorption.

  • Factors influencing distribution are blood flow, capillary permeability, the degree of binding and its solubility.

  • Blood-brain barrier protects the brain from entering high concentrations of drugs to CNS central nervous system.

The delivery of a drug from the bloodstream to the site of drug action primarily depends on blood flow, capillary permeability, the degree of binding (attachment) of the drug to blood and tissue proteins, and the relative lipid-solubility of the drug molecule. Blood flow to different organs of the body is not equal. The most vitally important organs of the body receive the greatest supply of blood. These organs include the brain, liver, and kidneys. Skeletal muscle and bone receive less blood, and adipose tissue (fat) receives the least. If blood flow were the only factor affecting distribution, it would be reasonable to expect that high concentrations of administered medications would always appear in the brain and liver. In reality, few drugs exhibit good penetration of the central nervous system. The anatomical structure of the capillary network in the brain creates a significant barrier to the passage of many drugs and is commonly referred to as the blood-brain barrier. This barrier is an adaptation that for the most part protects brain tissue from invasion by foreign substances. To readily penetrate into the brain, drugs must be fairly small and lipidsoluble or must be picked up by the carrier-mediated transport mechanism in the central nervous system. This explains why the small and highly fat-soluble anesthetic gases quickly and easily penetrate the brain to cause anesthesia, while other larger and water soluble molecules like penicillin antibiotics penetrate the central nervous system to a much lesser degree.


Drugs are eliminated from the body either unchanged through the kidneys and bile, or they may undergo chemical changes that allow them to be more easily excreted. The process of undergoing chemical changes is called biotransformation, or metabolism. As previously noted, anything absorbed through the GI tract goes directly into the portal circulaextracellular Outside of the cell or cells. interstitial Situated within or between parts of a particular organ or tissue. intracellular Existing or functioning inside a cell or cells. hydrophilic Having an affinity for, readily absorbing, or mixing with water. lipophilic Having an affinity for, or ability to absorb or dissolve in, fats. biotransformation Chemical alterations of a compound that occur within the body, as in drug metabolism. prodrug An inactive drug precursor that is converted in the body to the active drug form. Absorption  that feeds into the liver. The liver is adapted to clear toxins from the body and is the major site for drug metabolism, but specific drugs may undergo biotransformation in other tissues. The kidneys cannot efficiently excrete highly fat-soluble drugs that readily cross cell membranes because they are reabsorbed in the last stages of filtration. These compounds must first be metabolized in the liver to more water-soluble compounds and then removed. There are two types of metabolic processes drugs undergo in the liver. Most undergo one or both types of reactions. In the first type of reaction drugs are made more polar through oxidation-reduction reactions or hydrolysis. These reactions use metabolic enzymes, most often those of the cytochrome P450 enzyme system, to catalyze the biotransformation.

  • Metabolism is the process of undergoing chemical changes to get excreted easily is called metabolism

  • Biotransformation is also known as metabolism

  • Major site for drug metabolism is liver and Kidney

  • two types of metabolic processes

  • hydrolysis an enzyme-catalyzed reactions

  • conjugation reactions with glucuronic acid, sulfuric acid, acetic acid, or an amino acid like Glucuronidation.

  • Metabolism converts the prodrug to the active form. Example: Fosphenytoin is a prodrug of phenytoin,


In enzyme-catalyzed reactions, the rate of the reaction is accelerated by the presence of enzymes. A limited amount of enzyme is present at any given time in the liver. Since the rate of enzyme-catalyzed drug metabolism is limited by the quantity of available enzyme, metabolism in these cases is considered a saturable process. This means that the rate of conversion will only continue at the normal pace until the available supply of enzyme is used. At that point, metabolism is slowed until enzyme becomes available again. For the usual doses of most drugs, these reactions never reach saturation. There are a few drugs where doses may reach the saturation point of the enzymes. Once enzymes become saturated, blood levels increase exponentially toward toxicity. Examples include metabolism of alcohol and phenytoin. The second type of metabolism involves conjugation reactions. In this type of reaction the drug undergoing change is joined with another substance, such as glucuronic acid, sulfuric acid, acetic acid, or an amino acid. Glucuronidation is the most common conjugation reaction. The result of conjugation is a more water-soluble compound that is easier for the kidneys to excrete. These metabolites are most often therapeutically inactive. Some agents are initially administered as an inactive compound (prodrug) in order to improve availability or reduce side effects. Metabolism converts the prodrug to the active form. Fosphenytoin, for example, is a prodrug of phenytoin, a drug used for seizure disorders. Fosphenytoin is more completely and quickly absorbed when given by IM injection than phenytoin and can be used in critical situations with greater ease because it dose not require insertion of an intravenous catheter.


When a drug is taken into and distributed throughout the body, it must be subsequently removed, or concentrations of the drug would continue to rise with each successive dose. The complete removal of the drug from the body is referred to as elimination. Elimination of the drug encompasses both the metabolism of the drug, and excretion of the drug through the kidneys, and to a much lesser degree into the bile. Excretion into the urine is one of the most important mechanisms of drug removal. The kidneys act as a filter for the blood and create urine as a vehicle for removal of waste. Blood enters the kidney through renal arteries and then is filtered by the glomerulus.

  • The complete removal of the drug from the body is referred to as elimination.

  • Excretion of the drug through the kidneys into the urine is one of the most important mechanisms of drug removal aside of liver.

  • the amount being taken in by the patient is equal to the amount being removed by the liver and kidneys. This state of equilibrium is called steady state

The glomerular filtrate becomes concentrated and substances are removed as it passes through the renal tubule and eventually becomes urine. Drug molecules in the bloodstream that are not bound to albumin are also filtered out into the glomerular filtrate. When drugs have not been converted to water soluble compounds in the liver, they are likely to be reabsorbed back into the bloodstream at the end of the filtration process, and will cycle through the body again. If they are water soluble, they will end up in the urine and be excreted. When a medication is given repeatedly, as most are in real patients, the total amount of drug in the body will increase up to a point and then stabilize. At this point, the amount being taken in by the patient is equal to the amount being removed by the liver and kidneys (Fig. 3.7). This state of equilibrium is called steady state, and drug levels will remain fairly constant unless there is a dose change, an interruption in treatment, or failure of the organs of elimination. The therapeutic effects of many drugs are closely correlated to a specific range of steady state serum drug levels, and physicians or clinical pharmacists will monitor these levels and adjust doses when necessary so that patients obtain the appropriate drug response.

What are Non Patentable Inventions? Types & Examples

THE PATENTS ACT, 1970 is an Act to amend and consolidate the law relating to patents.


What are not inventions.
The following are not inventions within the meaning of this
(a) an invention which is frivolous or which claims anything obviously contrary to well established natural laws;
(b) an invention the primary or intended use or commercial exploitation of which could be contrary public order or morality or which causes serious prejudice to human, animal or
plant life or health or to the environment;
(c) the mere discovery of a scientific principle or the formulation of an abstract theory or discovery of any living thing or non-living substance occurring in nature;
(d) the mere discovery of a new form of a known substance which does not result in the enhancement of the known efficacy of that substance or the mere discovery of any new property or new use for a known substance or of the mere use of a known process, machine or apparatus unless such known process results in a new product or employs at least one new reactant.
Explanation.—For the purposes of this clause, salts, esters, ethers, polymorphs,metabolites, pure form, particle size, isomers, mixtures of isomers, complexes, combinations and other derivatives of known substance shall be considered to be the same substance, unless they differ significantly in properties with regard to efficacy;
(e) a substance obtained by a mere admixture resulting only in the aggregation of the properties of the components thereof or a process for producing such substance;
(f) the mere arrangement or re-arrangement or duplication of known devices each functioning independently of one another in a known way;
(g) Omitted by the Patents (Amendment) Act, 2002
(h) a method of agriculture or horticulture;
(i) any process for the medicinal, surgical, curative, prophylactic diagnostic, therapeutic or other treatment of human beings or any process for a similar treatment of animals to render them free of disease or to increase their economic value or that of their products.
(j) plants and animals in whole or any part thereof other than micro organisms but including seeds, varieties and species and essentially biological processes for production or propagation of plants and animals;
(k) a mathematical or business method or a computer programme per se or algorithms;
(l) a literary, dramatic, musical or artistic work or any other aesthetic creation whatsoever including cinematographic works and television productions;
(m) a mere scheme or rule or method of performing mental act or method of playing game;
(n) a presentation of information;
(o) topography of integrated circuits;
(p) an invention which in effect, is traditional knowledge or which is an aggregation or duplication of known properties of traditionally known component or components.
4. Inventions relating to atomic energy not patentable.—No patent shall be granted in respect of an invention relating to atomic energy falling within sub section (1) of section 20 of the
Atomic Energy Act, 1962 (33 of 1962).
5. Inventions where only methods or processes of manufacture patentable: [Omitted by the Patents (Amendment) Act, 2005]

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[C program code] Demonstration of Backslash Characters or Escape sequences

Demonstration of Backslash Characters or Escape sequences

First year of B- Pharmacy has a subject Remedial Maths & Computers in which C language is the important topic. This is one of the important questions of it “[C program code] Demonstration of Backslash Characters or Escape sequences”

Backslash or escape characters


/*Demonstration of Backslash Characters or
Escape sequences
main  ()
{int i;
printf(“this is formfeed\t\t Example\f  (\\f)\n”);
printf(“this is audible alert\t\t Example\a  (\\a)\n”);
printf(“this is Backspace\t\t Example\b  (\\b)\n”);
printf(“this is NULL\t\t Exam\n\0ple (\\0)\n”);
printf(“this is newline\t\t \n Example (\\n)\n”);
printf(“this is horizontal tab\t\t Exam\tple  (\\t)\n”);
printf(“this is Vertical tab\t\t Example\v  (\\v)\n”);
printf(“this is formfeed\t\t Example\f  (\\f)\n”);
printf(“this is carriage return\t\t \rExample(\\r)”);


Demonstration of Backslash Characters or Escape sequences

🤦‍♀️3rd B-PHARM D- Pharm Juris Notes=Narcotic Drugs & Psychotropic Act,1985

3rd B-PHARM Notes

3rd B-PHARM Notes for Pharmaceutical Jurisprudence on Narcotic Drugs and Psychotropic Substances Act,1985 and Rules, 1985

Narcotic drugs and psychotropic substances are the habit forming substances which may produce a sleep. At higher concentration, those substances proved to be toxic and therefore, there is a restriction for the cultivation, collection, import, manufacture, purchase, sale, transportation of narcotic drugs and psychotropic substances. Psychotropic substances are substance, salt or any preparation which is included in the list of narcotic substance as specified in the Schedules to the Act.


Charas :

separated resin whether crude or purified obtained from Cannabis plant and also includes concentrated preparations and resin known as hashish oil or liquid hashish.


Flowering and fruiting tops of Cannabis plant excluding from seeds and leaves, or

Any mixture with or without neutral material of any above forms of Cannabis or any drink prepared from them.

Coca derivatives:

Crude cocaine which can be used directly or indirectly for the manufacture of cocaine; or

  1. b) Ecgonine and all the derivatives of ecgonine from which it can be recovered; or
  2. c) Cocaine i.e. methyl ester of benzoyl ecgonine; or
  3. d) All the preparations containing more than 0.1% cocaine
  4. 3rd B-PHARM Notes

Opium poppy

The plant of species Papaver somniferum or the plant of any other species of Papaver from which opium or any other phenanthrene alkaloids can be extracted and Central Government may declare to be Opium poppy.

Poppy straw

Parts of Opium poppy after harvesting them in their original form, cut or rushed and whether or not the juice has been extracted therefrom.

Poppy straw concentrate

Material arising when the poppy straw has entered into processes for the concentration of its alkaloids

Coca Leaf

Leaf of coca plant except a leaf from which cocaine and all the derivatives of ecgonine have been removed and any mixture with or without neutral material but does not include any preparation containing not more than 0.1% cocaine.

Coca Plant

Plant of any species of the genus Erythroxylon.

Medicinal Cannabis (hemp) is Extract or tincture of Cannabis (hemp).

Prepared opium

Opium which is obtained by any series of operations design to transform opium into an extract suitable for smoking and the dross or other residue remaining after the opium is being smoked.

Medicinal opium

Opium which has undergone the processes necessary to adopt it for its medicinal use in accordance with the requirements of Indian Pharmacopoeia or any other Pharmacopoeia notified, whether in powder form or granulated or mixed with the neutral material.

*only for educational purpose


Dry Granulation

Dry granulation is a powder agglomeration process used in the pharmaceutical industry to improve the flowability of powders by increasing the particle size (granules). This operation is achieved using a roller press, which can have different configurations and equipment designs.
In simple terms Granulation is the process in which primary powder particles are made to adhere to form larger multiparticle entities called granules.

Dry granulation Roller compactor

Dry Granulation Advantages & Limitations:

(Slugging of rollercompaction)
* Eliminates exposure to moisture and drying.
* Dusty procedure.

This is also called double compression or slugging method, this is valuable alternative to direct compression,
where the dose of drug is too high or to wet granulation when the drug is sensitive to heat, moisture or both.
This method is also used when other methods of granulation yield granules with poor flow or compression
properties, because there are less chances of segregation of drug and excipients.

* Not suitable for all compounds.
* Slow process.

Long processing time, a relatively high capital investment on heavy duty presses or compactors.


Steps involved in dry granulation process

I. Milling of drugs and excipients
II. Mixing of milled powders
III. Compression into large, hard tablets to make slug
IV. Screening of slugs
V. Mixing with lubricant and disintegrating agent
VI. Tablet compression


In dry granulation method the primary powder particles are aggregated at high pressure. There are two main processes – either a large tablet (known as slug) is produced in a heavy duty tableting press( known as slugging) or the powder is squeezed between two rollers to produce a sheet of material (roller compaction) . The two different types are illustrated in below:

Slugging process

how well a material may slug will depend on the below terms

  1. Compressibility or cohesiveness of the matter,
  2. Compression ratio of powder
  3. Density of the powder
  4. Machine type
  5. Punch and die size
  6. Slug thickness
  7. Speed of compression
  8. Pressure used to produce slug

Granulation by slugging is the process of compressing dry powder of tablet formulation with tablet press having die cavity large enough in diameter to fill quickly. The accuracy or condition of slug is not too important. Only sufficient pressure to compact the powder into uniform slugs should be used. Once slugs are produced they are reduced to appropriate granule size for final compression by screening and milling

Slugging (Old Method)Slugging (Old Method) • material to be granulized is first made into a large compressed mass or “slug” typically by way of a tablet press using large flat-faced too long.

Disadvantages of Slugging:

  1. single batch processing
  2. frequent maintenance changeover
  3. poor process control
  4. poor economies of scale
  5. low manufacturing output per hour
  6. excessive air and sound pollution,
  7. Increased use of storage containers,
  8. more energy and time required to produce

Roller compaction:

In a roller compactor material particles are consolidated and densified by passing the material between two high-pressure rollers. The densified material from a roller compactor is then reduced to a uniform granule size by milling.
Roller compaction dry granulation process is capable of handling a large amount of material in a short period of time. As a special subtype briquetting utilizes special designed compaction rolls which divides the compacted powder in pieces (briquettes).
For dry granulation the compaction force in extend and uniformity of distribution is essential in regard to uniformity of granules porosity to ensure uniform hardness and disintegration of the final product. Because of its advantages, roll compaction is being increasingly used as a granulation technique, but it is not a simple process and may involve many variables for example roll pressure, roll speed, horizontal/vertical feed screw speed, roller gap, screen size. These parameters need to be optimized depending on the materials and the type of equipment used in order to obtain products of desirable quality.

Pneumatic Dry Granulation:

The pneumatic dry granulation process is a new and patent pending technology. The granulation process is based on the
use of roller compaction with very low compaction force together with a proprietary air classification method. The method enables production of granules with extraordinary combination of flow ability and compressibility. The granules produced by Pneumatic Dry Granulation and tablets produced show fast disintegration properties, offering the potential for fast
release dosage forms, and Release time can be tailored to requirements.
PDG technology can achieve, high drug loading, even with difficult APIs and combinations along with Taste masking and Excellent stability



  1. Ankit Sharma, Pooja sethi, Dinesh pawar. “Granulation techniques and innovations”, Inventi Rapid: Pharmtech, Vol.10, 2011
  2. Himanshu.K.Solanki, Tarashankar Basuri, Jalaram H.Thakkar, “Recent advances in granulation technology, International Journal of Pharmaceutical Sciences Review and Research, 3(5), 48,2010 . 11.
  3. Nidhi Prakash Sapkal, Vaishali A. Kilor, Minal Nandkumar Bonde. Application of a convenient and cost and effective granulation technology for the formulation of tablets using conventional excipients, Asian Journal of Pharmaceutics – 225-254, 2014.
  4. Rudnic EM, Schwartz JD. Oral solid dosage forms In: Remington: The science and practice of pharmacy Gennaro, Lippincott Williams and Wilkins, USA, 2000: 858.
  5. Gohel MC. A review of co-processed directly compressible excipients. J Pharm Pharmaceut Sci 2005; 8: 76-93.
  6. Schwartz JB, Fonner DE, Anderson NR, Banker GS. Granulation and tablet characteristics, Lieberman HA, Lachman L, eds. Pharmaceutical Dosage Forms: Tablets. Vol. 2, New York, Marcel Dekker, 1981:201.

Oxytocin: Functions Drugs Side Effects Contraindications Pharmacokinetics Dynamics

Oxytocin: Functions Drugs Side Effects Contraindications Pharmacokinetics Dynamics

Oxytocin is a hormone, predominately belonging to mammalian family; it is secreted by the posterior pituitary gland. After its release in the blood stream it cannot re-enter the brain due to the presence of blood brain barrier .Oxytocin is a hormone that has both peripheral and central actions. y are synthesized in the magnocellular neurons present in the supra–optic and Para –ventricular nucleus present in the hypothalamus. The universally known functions would include its role at the time of labour and ejection of milk. The functions which remain partially unknown are in erectile responses, ejaculation, bonding, and feeling of love and maintenance of eye contact during a conversation. 

Functions and roles of Oxytocin:

Oxytocin plays a key role in establishing trust , falling in love , parturition , milk ejection, mother – child bond , erection and ejaculatory response in males. Oxytocin insuffiency is leads to increased stress and sleep disturbances. The solution to the above mentioned problem lies in creating a drug which can mimic the functional properties of Oxytocin, which was achieved. Oxytocin has been widely used in the field of gynaecology to induce labour. It is also administered to patients i.e. mothers who are unable to produce milk after parturition. The invention of Oxytocin nasal sprays is not unknown. Recommended doses when administered to autism patients are proven to increase the sense of trust at the time of communication.

Mechanism of OXYTOCIN

Oxytocin is a naturally occurring nonapeptide hormone which acts through a G-protein coupled cell surface receptor to stimulate contractions of the uterus. A synthetic version of this hormone is used to induce contractions of the uterus which are indistinguishable from spontaneous labour.


Oxytocin is administered as a slow intravenous infusion (to induce or augment labour), or as a single intramuscular or intravenous injection to help prevent and treat uterine atony and postpartum haemorrhage. In pregnant women, oxytocin is metabolised very quickly in the maternal circulation by an aminopeptidase enzyme which cleaves the protein leaving it without biological function. This oxytocinase activity is also seen within the placenta and uterine tissue, and activity increases throughout pregnancy where at term the half -life of oxytocin is between 2 and 20 minutes.

Oxytocin: Functions Drugs Side Effects Contraindications Pharmacokinetics Dynamics

Adverse effects

The main side effects are related to overstimulation of the uterus which can compromise the placental blood supply and fetal well-being, and can also contribute to rupture of the uterus especially in women who have had a previous caesarean delivery. Oxytocin is similar in structure to Vasopressin which is also produced by the posterior pituitary, and prolonged administration with intravenous fluids may lead to fluid overload, pulmonary oedema and water intoxication.

Oxytocin Molecular Formula

It has a molecular formula of C43H66N12O12S 2.

Oxytocin drugs:

Oxytocin is also known as Pitocin, Syntocinon, Ocytocin, Endopituitrina, Oxitocina, Oxytocine, Oxytocinum, Oxytocic hormone and Orasthin.

It has a molecular formula of C43H66N12O12S 2. They are commercially available as intravenous and intramuscular injections , nasal sprays and sublingual tablets .The commonly used Anirudha kabilan /J. Pharm. Sci. & Res. Vol. 6(4), 2014, 220-223 221 drug types are pitocin and syntocinon, the chemical resemblance to Oxytocin makes them an ideal drug of choice for various cases for example at time if parturition . Pitocin is composed of oxtocic acid/ml along with chlorobutanol , a chloroform derivative. However medical supervision is mandatory to rule out the onset of complications (20,31). The general uses of these Oxytocin drugs would include induction of labour .Under appropriate level , at the time delivery, Oxytocin binds to the receptors present in the myometrium , activates the pathway of hydrolysis of phoshotidyl inositol and diacyl glycerol, there by activating the same. This activation causes the release of intracellular Ca+ which causes contraction of the uterus .In conditions associated with low level of Oxytocin production this process is carried out by Oxytocin drugs (29, 27) Incase of people suffering from autism, administration of pitocin is said to reduce repetitive behaviour and also enhances speech. Few researches have proved the improvement of trust in people affected by autism when they were given pitocin nasal sprays. It also enhances eye to eye contact in these individuals. Pitcoin helps in social interaction in people who suffer from schizophrenia . So pitocin may not only combat hallucinogens and psychosis, but also make human interaction easier . Being a new field if research there is not enough evidence to prove the role pitocin in both autism and schizophrenia. Further, they are also used to cure problems in erectile responses, ejaculation, depression, anxiety, and stress management

Dosage of Oxytocin:

10 units by intravenous route or 20-40 mUnit/min by Intramuscular route are injected for post partum haemorrhage. 0.5-1 mUnit/min by intravenous route for the induction of labour.10-20 mUnit/min is administered along with other drugs for termination of pregnancy.


Uterine contractions are seen after 3-5 minutes and approx 1 minute of aministration through intramuscular and intravenous routes respectively. A steady state of the drug is reached after 40 mins of parenteral route of administration. It is distributed throughout extracellular fluid compartment of the mother; small amounts may cross the placental barrier and reach foetus. Metabolism takes place rapidly via the liver and plasma by the enzyme oxytocinase a few steps of metabolism also takes place via mammary gland. It has a half-life of 1-5 minute. Kidney and liver help in the elimination of Oxytocin drugs( 9) unchanged form of this drug is rarely excreted in urine (30). Overdose can cause titanic uterine contractions, impaired blood flow to the uterus, uterine ruptures, seizures and amniotic fluid embolism contractions, impaired blood flow to the uterus, uterine ruptures, seizures and amniotic fluid embolism.


Significant cephalopelvic disproportion
Unfavourable foetal positions
Obstetric emergencies which favours surgery
Hyperactive or hypertonic uterus
When vaginal delivery is contraindicated,
Anaphylactic patients, Foetal distress
Partial placenta pervia
Elective labour induction

Side effects

 Nausea or vomiting
 Memory problems or confusion
 Runny nose, sore throat, or coughing
 severe headaches
 hallucinations
 vomiting
 confusion
 Seizures and severe hypertension

Clinical Scenario 1

 Which of the following abnormalities of labor is associated with a significantly increased incidence of neonatal
a. Prolonged latent phase
b. Protracted descent
c. Secondary arrest of dilation
d. Protracted active-phase dilation
Answer: c (Secondary arrest of dilation)
Three significant advances in the treatment of uterine dysfunction have reduced the risk of perinatal morbidity (PNM) and
mortality: (1) the avoidance of undue prolongation of labor, (2) the use of intravenous oxytocin in the treatment of some patterns
of uterine dysfunction, and (3) the liberal use of cesarean section (rather than midforceps) to affect delivery when oxytocin fails.

Clinical Scenario 2

Management of obstructed labor includes all, except:
[AIIMS May 2004]
a. IV fluids
b. Oxytocin use
c. Antibiotics
d. Cesarean section
Answer: b (Oxytocin use)
Two main principles in management of obstructed labor are:
1. Never wait and watch.
2. Never use oxytocin.
In patients of obstructed labor, the uterine contractions (power) are always adequate.
There is a problem with the passage or the passenger.
By increasing the power (by giving oxytocin) we are increasing the risk of rupture uterus.
It is like flogging a dead horse. Uterus is already contracting, and there is no point in increasing the contractions further in
a case of obstructed labor.
The patient should be given IV fluids to correct the dehydration and ketoacidosis, which usually develops due to prolonged
labor. Patient should be given antibiotics to prevent infection, and then steps should be taken to immediately relieve
the obstruction either by instrumental deliver or by LSCS. LSCS may have to be done even if the baby is dead and if vaginal
delivery is not possible, or else rupture uterus will occur.
NOTE: In cases of prolonged labor where there are hypotonic uterine contractions, oxytocin is justified.

LABELING -Pharmaceutical Labeling Requirements Theory PPT PDF

LABELING -Pharmaceutical Labeling Requirements Theory PPT PDF


The term “labeling” designates all labels and other written, printed, or graphic matter upon an immediate container of an article or upon, or in, any package or wrapper in which it is enclosed, except any outer shipping container.


The term “label” designates that part of the labeling upon the immediate container. A shipping container containing a single article, unless such container is also essentially the immediate container or the outside of the consumer package, is labeled with a minimum of product identification (except for controlled articles), lot number, expiration date, and conditions for storage and distribution. Articles in these compendia are subject to compliance with such labeling requirements as may be promulgated by governmental bodies in addition to the compendial requirements set forth for the articles.

Label: Amount of Ingredient Per Dosage Unit:

The strength of a drug product is expressed on the container label in terms of micrograms or milligrams or grams or percentage of the therapeutically active moiety or drug substance, whichever form is used in the title, unless otherwise indicated in an individual monograph. Both the active moiety and drug substance names and their equivalent amounts are then provided in the labeling. Official articles in capsule, tablet, or other unit dosage form shall be labeled to express the quantity of each active ingredient or recognized nutrient contained in each such unit; except that, in the case of unit-dose oral solutions or suspensions, whether supplied as liquid preparations or as liquid preparations that are constituted from solids upon addition of a designated volume of a specific diluent, the label shall express the quantity of each active ingredient or recognized nutrient delivered under the conditions prescribed in Deliverable Volume 〈698〉. Official drug products not in unit dosage form shall be labeled to express the quantity of each active ingredient in each milliliter or in each gram, or to express the percentage of each such ingredient (see 8.140., Percentage Concentrations), except that oral liquids or solids intended to be constituted to yield oral liquids may, alternatively, be labeled in terms of each 5-mL portion of the liquid or resulting liquid. Unless otherwise indicated in a monograph or chapter, such declarations of strength or quantity shall be stated only in metric units. 

Labeling: Use of Leading and Terminal Zeros

To help minimize the possibility of errors in the dispensing and administration of drugs, the quantity of active ingredient when expressed in whole numbers shall be shown without a decimal point that is followed by a terminal zero (e.g., express as 4 mg [not 4.0 mg]). The quantity of active ingredient when expressed as a decimal number smaller than 1 shall be shown with a zero preceding the decimal point (e.g., express as 0.2 mg [not .2 mg]).

Labeling of Salts of Drugs

It is an established principle that official articles shall have only one official title. For purposes of saving space on labels, and because chemical symbols for the most common inorganic salts of drugs are well known to practitioners as synonymous with the written forms, the following alternatives are permitted in labeling official articles that are salts: HCl for hydrochloride; HBr for hydrobromide; Na for sodium; and K for potassium. The symbols Na and K are intended for use in abbreviating names of the salts of organic acids, but these symbols are not used where the word Sodium or Potassium appears at the beginning of an official title (e.g., Phenobarbital Na is acceptable, but Na Salicylate is not to be written).

Labeling Vitamin-Containing Products

LABELING -Pharmaceutical Labeling Requirements Theory PPT PDF
The vitamin content of an official drug product shall be stated on the label in metric units per dosage unit. The amounts of vitamins A, D, and E may be stated also in USP Units. Quantities of vitamin A declared in metric units refer to the equivalent amounts of retinol (vitamin A alcohol). The label of a nutritional supplement shall bear an identifying lot number, control number, or batch number. 10.40.50. Labeling Botanical-Containing Products The label of an herb or other botanical intended for use as a dietary supplement bears the statement, “If you are pregnant or nursing a baby, seek the advice of a health professional before using this

Labeling Parenteral and Topical Preparations

The label of a preparation intended for parenteral or topical use states the names of all added substances (see 5.20., Added Substances, Excipients, and Ingredients and see Labeling under Injections 〈1〉), and, in the case of parenteral preparations, also their amounts or proportions, except that for substances added for adjustment of pH or to achieve isotonicity, the label may indicate only their presence and the reason for their addition.

Labeling Electrolytes:

The concentration and dosage of electrolytes for replacement therapy (e.g., sodium chloride or potassium chloride) shall be stated on the label in milliequivalents (mEq). The label of the product shall indicate also the quantity of ingredient(s) in terms of weight or percentage concentration.

Labeling Alcohol:

The content of alcohol in a liquid preparation shall be stated on the label as a percentage (v/v) of C2H5OH.

Symbols Commonly Employed for SI Metric Unit

Symbols commonly employed for SI metric units and other units
are as follows:
Bq = becquerel dL = deciliter
kBq = kilobecquerel L = liter
MBq = megabecquerel mL = milliliterc
GBq = gigabecquerel μL = microliter
Ci = curie Eq = gram-equivalent weight
mCi = millicurie mEq = milliequivalent
μCi = microcurie mol = gram-molecular weight (mole)
nCi = nanocurie Da = dalton (relative molecular mass)
Gy = gray mmol = millimole
mGy = milligray Osmol = osmole
m = meter mOsmol = milliosmole
dm = decimeter Hz = hertz
cm = centimeter kHz = kilohertz
mm = millimeter MHz = megahertz
μm = micrometer (0.001mm) V = volts
nm = nanometera MeV = million electron volts
kg = kilogram keV = kilo-electron volt
g = gram mV = millivolt
mg = milligram psi = pounds per square inch
μg; mcg = microgramb Pa = pascal
ng = nanogram kPa = kilopascal
pg = pictogram g = gravity (in centrifugation)
fg = femtogram
a Previously the symbol mμ (for millimicron) was used.
b One milliliter (mL) is used herein as the equivalent of one cubic centimeter (cc).
c The symbol μg is used in the USP and NF to represent micrograms, but micrograms
may be represented as “mcg” for labeling and prescribing purposes. The term
“gamma,” symbolized by γ, frequently is used to represent micrograms in biochemical

Pharmacology MCQ for NEET PG GPAT PHARMACIST Nursing Questions with Answers pdf Book

Pharmacology MCQ for NEET PG GPAT PHARMACIST Nursing Questions with Answers pdf Book

Today Pharmawiki is here with very important 40+ Pharmacology multiple choice questions along with answers. These are published especially for all our pharmacy students who are ready to take up different competitive exams like NEET PG GPAT PHARMACIST qualifying examinations. These questions are also very helpful to all the students and professionals of Nursing to take up different examinations for their career growth. This article specifically provides questions with answers pdf Book at the end for our readers convenience. You can click on the right side and download the entire copy to study easily. 

Pharmacology MCQ for Anti Cancer Chemotherapy Drugs


All of the following antiviral drugs are the analogs of nucleosides, EXCEPT:

a) Acyclovir

b) Zidovudine

c) Saquinavir

d) Didanozine

Tick the drug, a derivative of adamantane:

a) Didanozine

b) Rimantadine

c) Gancyclovir

d) Foscarnet

Tick the drug, a derivative of pyrophosphate:

a) Foscarnet

b) Zidovudine

c) Vidarabine

d) Acyclovir

Tick the drug, inhibiting viral DNA synthesis:

a) Interferon

b) Saquinavir

c) Amantadine

d) Acyclovir

Tick the drug, inhibiting uncoating of the viral RNA:

a) Vidarabine

b) Rimantadine

c) Acyclovir

d) Didanozine

Tick the drug, inhibiting viral reverse transcriptase:

a) Zidovudine

b) Vidarabine

c) Rimantadine

d) Gancyclovir

Tick the drug, inhibiting viral proteases:

a) Rimantadine

b) Acyclovir

c) Saquinavir

d) Zalcitabine

Tick the drug of choice for herpes and cytomegalovirus infection treatment:

a) Saquinavir

b) Interferon alfa

c) Didanozine

d) Acyclovir


Tick the drug which belongs to nonnucleoside reverse transcriptase inhibitors:

a) Zidovudine

b) Vidarabine

c) Nevirapine

d) Gancyclovir

All of the following antiviral drugs are antiretroviral agents, EXCEPT:

a) Acyclovir

b) Zidovudine

c) Zalcitabine

d) Didanozine

Tick the drug used for influenza A prevention:

a) Acyclovir

b) Rimantadine

c) Saquinavir

d) Foscarnet

Tick the drug used for HIV infection treatment, a derivative of nucleosides:

a) Acyclovir

b) Zidovudine

c) Gancyclovir

d) Trifluridine

Tick the antiviral drug which belongs to endogenous proteins:

a) Amantadine

b) Saquinavir

c) Interferon alfa

d) Pencyclovir

Tick the drug which belongs to nucleoside reverse transcriptase inhibitors:

a) Didanosine

b) Gancyclovir

c) Nevirapine

d) Vidarabine

All of the following antiviral drugs are anti-influenza agents, EXCEPT:

a) Acyclovir

b) Amantadine

c) Interferons

d) Rimantadine

Pharmacology MCQ for NEET PG GPAT PHARMACIST Nursing Questions with Answers pdf Book

Tick the unwanted effects of zidovudine:

a) Hallucinations, dizziness

b) Anemia, neutropenia, nausea, insomnia

c) Hypertension, vomiting

d) Peripheral neuropathy

Tick the unwanted effects of intravenous acyclovir infusion:

a) Renal insufficiency, tremors, delerium

b) Rash, diarrhea, nausea

c) Neuropathy, abdominal pain

d) Anemia, neutropenia, nausea, insomnia

Tick the drug that can induce peripheral neuropathy and oral ulceration:

a) Acyclovire

b) Zalcitabine

c) Zidovudine

d) Saquinavir

Tick the unwanted effects of didanozine:

a) Hallucinations, dizziness, insomnia

b) Anemia, neutropenia, nausea

c) Hypertension, vomiting, diarrhea

d) Peripheral neuropathy, pancreatitis, diarrhea, hyperuricemia

Tick the unwanted effects of indinavir:

a) Hypotension, vomiting, dizziness

b) Nephrolithiasis, nausea, hepatotoxicity

c) Peripheral neuropathy, pancreatitis, hyperuricemia

d) Anemia, neutropenia, nausea

Tick the drug that can induce nausea, diarrhea, abdominal pain and rhinitis:


a) Acyclovire

b) Zalcitabine

c) Zidovudine

d) Saquinavir

All of the following effects are disadvantages of anticancer drugs, EXCEPT:

a) Low selectivity to cancer cells

b) Depression of bone marrow

c) Depression of angiogenesis

d) Depression of immune system

Rational combination of anticancer drugs is used to:

a) Provide synergism resulting from the use of anticancer drugs with different mechanisms combination

b) Provide synergism resulting from the use of anticancer drugs with the same mechanisms combination

c) Provide stimulation of immune system

d) Provide stimulation of cell proliferation

Tick the anticancer alkylating drug, a derivative of chloroethylamine:

a) Methotrexate

b) Cisplatin

c) Cyclophosphamide

d) Carmustine

Tick the anticancer alkylating drug, a derivative of ethylenimine:

a) Mercaptopurine

b) Thiotepa

c) Chlorambucil

d) Procarbazine

Tick the group of hormonal drugs used for cancer treatment:

a) Mineralocorticoids and glucocorticoids

b) Glucocorticoids and gonadal hormones

c) Gonadal hormones and somatotropin

d) Insulin

Tick the anticancer alkylating drug, a derivative of alkylsulfonate:

a) Fluorouracil

b) Carboplatin

c) Vinblastine

d) Busulfan

Tick the anticancer drug of plant origin:

a) Dactinomycin

b) Vincristine

c) Methotrexate

d) Procarbazine

Action mechanism of alkylating agents is:

a) Producing carbonium ions altering protein structure

b) Producing carbonium ions altering DNA structure

c) Structural antagonism against purine and pyrimidine

d) Inhibition of DNA-dependent RNA synthesis

Tick the anticancer drug, a pyrimidine antagonist:

a) Fluorouracil

b) Mercaptopurine

c) Thioguanine

d) Methotrexate

Methotrexate is:

a) A purine antagonist

b) A folic acid antagonist

c) An antibiotic

d) An alkylating agent

Tick the antibiotic for cancer chemotherapy:

a) Cytarabine

b) Doxorubicin

c) Gentamycin

d) Etoposide

Fluorouracil belongs to:

a) Antibiotics

b) Antimetabolites

c) Plant alkaloids

d) Bone marrow growth factor

Tick the action mechanism of anticancer drugs belonging to plant alkaloids:

a) Inhibition of DNA-dependent RNA synthesis

b) Cross-linking of DNA

c) Mitotic arrest at a metaphase

d) Nonselective inhibition of aromatases


General contraindications for anticancer drugs are:

a) Depression of bone marrow

b) Acute infections

c) Severe hepatic and/or renal insufficiency

d) All of the above

Action mechanism of methotrexate is:

a) Inhibition of dihydrofolate reductase

b) Activation of cell differentiation

c) Catabolic depletion of serum asparagine

d) All of the above

Tick the anticancer drug belonging to inorganic metal complexes:

a) Dacarbazine

b) Cisplatin

c) Methotrexate

d) Vincristine

Tick the indication for estrogens in oncological practice:

a) Leukemia

b) Cancer of prostate

c) Endometrial cancer

d) Brain tumors

Enzyme drug used for acute leukemia treatment:

a) Dihydrofolate reductase

b) Asparaginase

c) Aromatase

d) DNA gyrase

All of the following drugs are derivatives of nitrosoureas, EXCEPT:

a) Carmustine

b) Vincristine

c) Lomustine

d) Semustine

Tick the group of drugs used as subsidiary medicines in cancer treatment:

a) Cytoprotectors

b) Bone marrow growth factors

c) Antimetastatic agents

d) All of the above

Tick the estrogen inhibitor:

a) Leuprolide

b) Tamoxifen

c) Flutamide

d) Anastrozole

Tick the antiandrogen drug:

a) Flutamide

b) Aminoglutethimide

c) Tamoxifen

d) Testosterone

Tick the drug belonging to aromatase inhibitors:

a) Octreotide

b) Anastrozole

c) Flutamide

d) Tamoxifen

Tick the drug belonging to gonadotropin-releasing hormone agonists:

a) Leuprolide

b) Tamoxifen

c) Flutamide

d) Anastrozole

Pharmacology MCQ for Anti Cancer Chemotherapy Drugs

Pharmacology MCQ for Anti Cancer Chemotherapy Drugs

Please keep visiting our website as we assure you great  content with loads of valid information. Do not hesitate to speak to us if you have any doubts. We will guide you through any of your academic doubts. To be a successful pharma professional all you need is great pool of knowledge and network.  it is recommended you to build your network right from the day you enter your college. Every contact can count. So never miss an opportunity to meet your alumni or any meet ups to build your network.network building is great for you in this competitive field. 🙂

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Pharmacodynamics – Dose Response relationship- Terms Definitions PDF

Pharmacodynamics - Dose Response relationship- Terms Definitions PDF

Pharmacodynamics. We exactly know what pharmacodynamics is. It involves how the drugs act on target cells to alter cellular function. Let us discuss Dose Response relationship in this article. The exact relationship between the dose and the response depends on the biological object under observation and the drug employed is called Dose Response relationship.

Dose Response relationship

When a logarithm of dose as abscissa and responses as ordinate are constructed graphically, the “S” shaped or sigmoid type curve is obtained.
The lowest concentration of a drug that elicits a response is minimal dose, and the largest concentration after which further increase in concentration will not change the response is the maximal dose.

1. Graded dose effect:

As the dose administered to a single subject or tissue increases, the pharmacological response also increases in graded fashion up to ceiling effect.
– It is used for characterization of the action of drugs. The concentration that is required to produce 50 % of the maximum effect is termed as EC50 or ED50.

2. Quantal dose effect:

It is all or none response, the sensitive objects give response to small doses of a drug while some will be resistant and need very large doses. The quantal dose effect curve is often characterized by stating the median effective dose and the median lethal dose.

Median lethal dose or LD50:

This is the dose (mg/kg), which would be expected to kill one half of a population of the same species and strain.

Median effective dose or ED50:

This is the dose (mg/kg), which produces a desired response in 50 per cent of test population.

Pharmacodynamics - Dose Response relationship- Terms Definitions PDF

Therapeutic index:

It is an approximate assessment of the safety of the drug. It is the ratio of the median lethal dose and the median effective dose. Also called as therapeutic window or safety.
Herapeutic index (T. I) = The larger the therapeutic index, the safer is the drug.

Penicillin has a very high therapeutic index, while it is much smaller for the digitalis preparation.

D. Structural activity relationship 
The activity of a drug is intimately related to its chemical structure. Knowledge about the chemical structure of a drug is useful for:
(i) Synthesis of new compounds with more specific actions and fewer adverse
(ii) Synthesis of competitive antagonist and
(iii) Understanding the mechanism of drug action.
Slight modification of structure of the compound can change the effect completely.

Download the pdf of this article here to read:

Pharmacodynamics – Dose Response relationship- Terms Definitions PDF

These are few very important terms you need to understand in pharmacodynamics.


Hope you like the article. Please share your views comments and doubts in the comments section. We ,love to hear from you and help you.

ROUTES OF DRUG ADMINISTRATION PPT PDF 10 Routes of Drug Administration

Which drug administration route is fastest?,

ROUTES OF DRUG ADMINISTRATION: The possible routes for drug entry into the body. Most drugs can be administered by a variety of routes. The choice of appropriate route in a given situation depends both on drug as well as patient related factors. Mostly common sense considerations, feasibility and convenience dictate the route to be used. Generally routes of drug administration refer to the right path or the required route through which a drug has to be administered into the body to obtain maximum benefit. Here is the list of  5, 10+ outes of drug administration.

  1. oral
  2. sublingual
  3. rectal
  4. nasal
  5. ocular
  6. otic
  7. inhalation
  8. nebulization
  9. transdermal
  10. Subcutaneous (under the skin)
  11. Intramuscular (in a muscle)
  12. Intravenous (in a vein)
  13. Intrathecal (around the spinal cord

Factors governing choice of route

  1. Physical and chemical properties of the drug (solid/ liquid/gas; solubility, stability, pH, irritancy).
  2. Site of desired action—localized and approachable or generalized and not approachable.
  3. Rate and extent of absorption of the drug from different routes.
  4. Effect of digestive juices and first pass metabolism on the drug.
  5. Rapidity with which the response is desired (routine treatment or emergency).
  6. Accuracy of dosage required (i.v. and inhalational can provide fine tuning).
  7. Condition of the patient (unconscious, vomiting).

Routes of Administration can be broadly divided into those for

(a) Local action and (b) Systemic action.


These routes can only be used for localized lesions at accessible sites and for drugs whose systemic absorption from these sites is minimal or absent. Thus, high concentrations are attained at the desired site without exposing the rest of the body. Systemic side effects or toxicity are consequently absent or minimal. For drugs (in suitable dosage forms) that are absorbed from these sites/routes, the same can serve as systemic route of administration, e.g. glyceryl trinitrate (GTN) applied on the skin as ointment or transdermal patch. The local routes are:

  1. Topical

This refers to external application of the drug to the surface for localized action. It is often more convenient as well as encouraging to the patient. Drugs can be efficiently delivered to the localized lesions on skin, oropharyngeal/ nasal mucosa, eyes, ear canal, anal canal or vagina in the form of lotion, ointment, cream, powder, rinse, paints, drops, spray, lozengens, suppositories or pesseries. Nonabsorbable drugs given orally for action on g.i. mucosa (sucralfate, vancomycin), inhalation of drugs for action on bronchi (salbutamol, cromolyn sodium) and irrigating solutions/jellys (povidone iodine, lidocaine) applied to urethra are other forms of topical medication.

  1. Deeper tissues

Certain deep areas can be approached by using a syringe and needle, but the drug should be in such a form that systemic absorption is slow, e.g. intra-articular injection (hydrocortisone acetate in knee joint), infiltration around a nerve or intrathecal injection (lidocaine), retrobulbar injection (hydrocortisone acetate behind the eyeball).

  1. Arterial supply

Close intra-arterial injection is used for contrast media in angiography; anticancer drugs can be infused in femoral or brachial artery to localise the effect for limb malignancies.


The drug administered through systemic routes is intended to be absorbed into the blood streamand distributed all over, including the site of action, through circulation

  1. Oral

Oral ingestion is the oldest and commonest mode of drug administration. It is safer, more convenient, does not need assistance, noninvasive, often painless, the medicament need not be sterile and so is cheaper. Both solid dosage forms (powders, tablets, capsules, spansules, dragees, moulded tablets, gastrointestinal therapeutic systems— GITs) and liquid dosage forms (elixirs, syrups, emulsions, mixtures) can be given orally.

Limitations of oral route of administration

  • Action of drugs is slower and thus not suitable for emergencies.
  • Unpalatable drugs (chloramphenicol) are difficult to administer; drug may be filled in capsules to circumvent this.
  • May cause nausea and vomiting (emetine).
  • Cannot be used for uncooperative/unconscious/ vomiting patient.
  • Absorption of drugs may be variable and erratic; certain drugs are not absorbed (streptomycin).
  • Others are destroyed by digestive juices (penicillin G, insulin) or in liver (GTN, testosterone, lidocaine).
  1. Sublingual (s.l.) or buccal

The tablet or pellet containing the drug is placed under the tongue or crushed in the mouth and spread over the buccal mucosa. Only lipid soluble and non-irritating drugs can be so administered. Absorption is relatively rapid—action can be produced in minutes. Though it is somewhat inconvenient, one can spit the drug after the desired effect has been obtained. The chief advantage is that liver is bypassed and drugs with high first pass metabolism can be absorbed directly into systemic circulation. Drugs given sublingually are—GTN, buprenorphine, desamino-oxytocin.

  1. Rectal

Certain irritant and unpleasant drugs can be put into rectum as suppositories or retention enema for systemic effect. This route can also be used when the patient is having recurrent vomiting or is unconscious. However, it is rather inconvenient and embarrassing; absorption is slower, irregular and often unpredictable, though diazepam solution and paracetamol suppository are rapidly and dependably absorbed from the rectum in children. Drug absorbed into external haemorrhoidal veins (about 50%) bypasses liver, but not that absorbed into internal haemorrhoidal veins. Rectal inflammation can result from irritant drugs. Diazepam, indomethacin, paracetamol, ergotamine and few other drugs are some times given rectally.

  1. Cutaneous

Highly lipid soluble drugs can be applied over the skin for slow and prolonged absorption. The liver is also bypassed. The drug can be incorporated in an ointment and applied over specified area of skin. Absorption of the drug can be enhanced by rubbing the preparation, by using an oily base and by an occlusive dressing.


Transdermal therapeutic systems (TTS)


These are devices in the form of adhesive patches of various shapes and sizes (5–20 cm2) which deliver the contained drug at a constant rate into systemic circulation via the stratum corneum (Fig. 1.2). The drug (in solution or bound to a polymer) is held in a reservoir between an occlusive backing film and a rate controlling micropore membrane, the under surface of which is smeared with an adhesive impregnated with priming dose of the drug. The adhesive layer is protected by another film that is to be peeled off just before application. The drug is delivered at the skin surface by diffusion for percutaneous absorption into circulation. The micropore membrane is such that rate of drug delivery to skin surface is less than the slowest rate of absorption from the skin. This offsets any variation in the rate of absorption according to the properties of different sites. As such, the drug is delivered at a constant and predictable rate irrespective of site of application. Usually chest, abdomen, upper arm, lower back, buttock or mastoid region are utilized. Transdermal patches of GTN, fentanyl, nicotine and estradiol are available in India, while those of isosorbide dinitrate, hyoscine, and clonidine are marketed elsewhere. For different drugs, TTS have been designed to last for 1–3 days. Though more expensive, they provide smooth plasma concentrations of the drug without fluctuations; minimize interindividual variations (drug is subjected to little first pass metabolism) and side effects. They are also more convenient— many patients prefer transdermal patches to oral tablets of the same drug; patient compliance is better. Local irritation and erythema occurs in some, but is generally mild; can be minimized by changing the site of application each time by rotation. Discontinuation has been necessary in 2–7% cases.


  1. Inhalation

Volatile liquids and gases are given by inhalation for systemic action, e.g. general anaesthetics. Absorption takes place from the vast surface of alveoli—action is very rapid. When administration is discontinued the drug diffuses back and is rapidly eliminated in expired air. Thus, controlled administration is possible with moment to moment adjustment. Irritant vapours (ether) cause inflammation of respiratory tract and increase secretion.

  1. Nasal

The mucous membrane of the nose can readily absorb many drugs; digestive juices and liver are bypassed. However, only certain drugs like GnRH agonists and desmopressin applied as a spray or nebulized solution have been used by this route. This route is being tried for some other peptide drugs like insulin, as well as to bypass the bloodbrain barrier.

  1. Parenteral

Conventionally, parenteral refers to administration by injection which takes the drug directly into the tissue fluid or blood without having to cross the enteral mucosa. The limitations of oral administration are circumvented. Drug action is faster and surer (valuable in emergencies). Gastric irritation and vomiting are not provoked. Parenteral routes can be employed even in unconscious, uncooperative or vomiting patient. There are no chances of interference by food or digestive juices. Liver is bypassed. Disadvantages of parenteral routes are—the preparation has to be sterilized and is costlier, the technique is invasive and painful, assistance of another person is mostly needed (though self injection is possible, e.g. insulin by diabetics), there are chances of local tissue injury and, in general, parenteral route is more risky than oral.

The important parenteral routes are:

(i) Subcutaneous (s.c.)

The drug is deposited in the loose subcutaneous tissue which is richly supplied by nerves (irritant drugs cannot be injected) but is less vascular (absorption is slower than intramuscular). Only small volumes can be injected s.c. Self-injection is possible because deep penetration is not needed. This route should be avoided in shock patients who are vasoconstricted— absorption will be delayed. Repository (depot) preparations that are aqueous suspensions can be injected for prolonged action. Some special forms of this route are:

 (a) Dermojet

In this method needle is not used; a high velocity jet of drug solution is projected from a microfine orifice using a gun like implement. The solution passes through the superficial layers and gets deposited in the subcutaneous tissue. It is essentially painless and suited for mass inoculations.

(b) Pellet implantation

The drug in the form of a solid pellet is introduced with a trochar and cannula. This provides sustained release of the drug over weeks and months, e.g. DOCA, testosterone.

(c) Sialistic (nonbiodegradable) and biodegradable implants

Crystalline drug is packed in tubes or capsules made of suitable materials and implanted under the skin. Slow and uniform leaching of the drug occurs over months providing constant blood levels. The nonbiodegradable implant has to be removed later on but not the biodegradable one. This has been tried for hormones and contraceptives (e.g. NORPLANT).

 (ii) Intramuscular (i.m.)

The drug is injected in one of the large skeletal muscles—deltoid, triceps, gluteus maximus, rectus femoris, etc. Muscle is less richly supplied with sensory nerves (mild irritants can be injected) and is more vascular (absorption of drugs in aqueous solution is faster). It is less painful, but self injection is often impracticable because deep penetration is needed. Depot preparations (oily solutions, aqueous suspensions) can be injected by this route. Intramuscular injections should be avoided in anticoagulant treated patients, because it can produce local haematoma.

(iii) Intravenous (i.v

.) The drug is injected as a bolus (Greek: bolos–lump) or infused slowly over hours in one of the superficial veins. The drug reaches directly into the blood stream and effects are produced immediately (great value in emergency). The intima of veins is insensitive and drug gets diluted with blood, therefore, even highly irritant drugs can be injected i.v., but hazards are—thrombophlebitis of the injected vein and necrosis of adjoining tissues if extravasation occurs. These complications can be minimized by diluting the drug or injecting it into a running i.v. line. Only aqueous solutions (not suspensions, because drug particles can cause embolism) are to be injected i.v. and there are no depot preparations for this route. Chances of causing air embolism is another risk. The dose of the drug required is smallest (bioavailability is 100%) and even large volumes can be infused. One big advantage with this route is—in case response is accurately measurable (e.g. BP) and the drug short acting (e.g. sodium nitroprusside), titration of the dose with the response is possible. However, this is the most risky route—vital organs like heart, brain, etc. get exposed to high concentrations of the drug.



routes of administration PPT

(iv) Intradermal injection

The drug is injected into the skin raising a bleb (e.g. BCG vaccine, sensitivity testing) or scarring/multiple puncture of the epidermis through a drop of the drug is done. This route is employed for specific purposes only.

Search Terms

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