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Related Concept Videos

Drug Delivery: Parenteral Route01:29

Drug Delivery: Parenteral Route

The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
Drug Delivery: Miscellaneous Routes01:22

Drug Delivery: Miscellaneous Routes

Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection,  and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs through the...
Additional Routes of Drug Administration01:18

Additional Routes of Drug Administration

Choosing the appropriate route of drug administration is significantly influenced by two key factors: the therapeutic objectives and the inherent properties of the drug being used.
Administering drugs via inhalation allows for the direct delivery of gaseous, volatile substances or droplets to different parts of the respiratory tract. One of the advantages of the inhalation route is the rapid absorption of drugs into the circulatory system, which is possible because of the large surface area of...
Intrauterine Drug Delivery Systems01:21

Intrauterine Drug Delivery Systems

Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Transdermal Drug Delivery Systems01:18

Transdermal Drug Delivery Systems

Transdermal drug delivery systems (TDDS) enable the controlled release of drugs across the skin into systemic circulation. They are particularly advantageous for drugs with short half-lives or narrow therapeutic indices, as they maintain consistent plasma concentrations and reduce the risk of subtherapeutic or toxic levels.TDDS are categorized into monolithic, reservoir, and mixed systems. Monolithic systems embed the drug in a polymer matrix, where diffusion governs release. Reservoir systems...

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Intrathecal Delivery of Antisense Oligonucleotides in the Rat Central Nervous System
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Published on: October 29, 2019

Intrathecal drug delivery.

Howard S Smith1, Timothy R Deer, Peter S Staats

  • 1Department of Anesthesiology, Albany Medical College, Albany, NY 12208, USA. smithh@mail.amc.edu

Pain Physician
|June 17, 2008
PubMed
Summary
This summary is machine-generated.

Intrathecal analgesia offers pain relief for difficult cases. While effective for cancer pain, more research is needed for non-cancer pain management using intrathecal infusion systems.

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Area of Science:

  • Pain Management
  • Neurology
  • Pharmacology

Background:

  • Intrathecal analgesia is a key option for patients with refractory pain or those experiencing side effects from other therapies.
  • The use of intrathecal analgesic infusions has grown since the late 1980s for persistent pain management.

Purpose of the Study:

  • To provide research-based clinical insights into the safe and appropriate use of intrathecal infusion therapy.
  • To review the progression and evidence supporting long-term intrathecal analgesic therapy over the past 25 years.

Main Methods:

  • Literature review of studies on intrathecal infusion systems for pain management.
  • Analysis of evidence for efficacy in malignancy-related, neuropathic, and persistent non-cancer pain.

Main Results:

  • Strong evidence supports intrathecal infusion systems for short-term pain relief in malignancy and neuropathic pain.
  • Moderate evidence exists for long-term management of persistent pain, with stronger support for cancer pain.
  • Evidence for long-term efficacy in persistent non-cancer pain is less convincing.

Conclusions:

  • Intrathecal analgesic therapy is supported for moderate to severe cancer and non-cancer pain.
  • Further research is essential to define optimal patient selection, effective agents, and combinations for various pain conditions.
  • Future studies should investigate novel combinations like clonidine and gabapentin, device complications, and long-term safety and efficacy.