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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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