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Parenteral Drug Administration

Parenteral Drug Administration. Department of Anaesthesia University of Glasgow. Parenteral Route in Dentistry. General Dental Council Intravenous sedation drugs Emergency drugs . Drug Administration. subcutanous. oral. intramuscular. topical. intravenous. Absorbtion. Tissue.

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Parenteral Drug Administration

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  1. Parenteral Drug Administration Department of Anaesthesia University of Glasgow

  2. Parenteral Route in Dentistry • General Dental Council • Intravenous sedation drugs • Emergency drugs

  3. Drug Administration subcutanous oral intramuscular topical intravenous Absorbtion Tissue Site of Action Plasma water Metabolism Excretion

  4. Parenteral Injection Sites subcutanously intramuscularly intravenously

  5. Subcutaneous Route • Absorption depending on blood flow • Constant & slow absorption • Prolonged effect Drugs • Insulin • Heparin

  6. Subcutaneous Injection Sites • Abdominal wall • Thigh • Deltoid area

  7. Intramuscular Route • Absorption depending on blood flow • Rapid onset & shorter duration • Shock • Drugs • Glucagon • Adrenaline

  8. Intramuscular Injection Sites

  9. Intramuscular Injection Sites

  10. Intramuscular Injection Sites

  11. Intramuscular Route • Limitations • Neurovascular damage • Bleeding (eg anticoagulant therapy) • Pain • Infection • Delayed absorption in shock • Interpretation of diagnostic tests

  12. Intravenous Route • Rapid immediate onset • Permits titration • Administer slowly • Drugs • Midazolam

  13. Intravenous Injection Sites • Peripheral • Central

  14. Intravenous • Limitations • May be more difficult to obtain • Increased risk of adverse effects • Requires intravenous access • Infection • Pain

  15. Anaphylaxis • Definition • Immunologically mediated reaction to antigen causing systemic symptoms • Potentially life threatening • Frequent Antigens • Antibiotics • Latex • Anaesthetic agents • Colloid fluids

  16. Anaphylaxis • Diagnosis • Collapse • Difficulty breathing • Wheeze • Angio-oedema • Urticaria

  17. Management Anaphylaxis • Prevention • Avoid unnecessary drugs particularly iv • Take drug history • Adequate staff training and facilities

  18. Immediate Management 1 • Remove trigger agent • Stop injection or infusion of drug • Remove triggering materials • Remember latex allergy • Chlorhexidine • Summon assistance

  19. Immediate Management 2 • Basic life support • Check airway, breathing, circulation • Oxygen • Give adrenaline (0.5-1mg im) • Elevate legs • (Give intravenous fluids)

  20. Subsequent Management • Antihistamines • Chlorpheniramine iv • Steroids • Hydrocortisone iv • Intensive care unit • Immunological Testing

  21. Summary • Parenteral drug administration • Sites • Drug availability • Limitations • Anaphylaxis

  22. Questions ?

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