What does it mean to take medications orally? What is oral administration? How to take it orally? Types of drug administration For oral administration

Greetings, dear readers! In the process of treating various diseases, we often have to deal with medical terms, many of which remain incomprehensible to us. For example, when prescribing a drug, a doctor recommends oral administration. And only when we begin to follow the instructions, the question arises: orally - what does it mean and how to take the medicine. Let's figure it out.

What does orally mean?

I’ll answer the question right away: “orally” means in the mouth, that is, the tablet must be swallowed.

There are two main ways of administering drugs into the body: enteral and parenteral. The enteral route is directly connected to the gastrointestinal tract, while the parenteral route bypasses the gastrointestinal tract. The oral route belongs to the first type.

Traditionally, medications taken orally come in the form of:

tablets;
powders;
solutions;
capsules;
tinctures

These drugs can be swallowed, chewed, or drunk. Most often, patients have to take tablets: this is the most popular form of use. They give effect within a quarter of an hour after administration.

Drugs taken orally pass through the body in the following way:

The medication enters the stomach and begins to be digested.
The drug substance is actively absorbed into the blood and gastrointestinal tract.
The drug molecules are distributed throughout the body.
Passing through the liver, part of the substances entering the body becomes inactive and is excreted by the liver and kidneys.

The use of oral medications has been known in medicine for a long time. Psychologically, this is the most comfortable way to take medications, even for children, especially if the drug has a pleasant taste. Being conscious, a person of any age can take a tablet or tincture and alleviate their condition.

However, despite their high popularity, drugs taken orally have their disadvantages along with their advantages.

How do they work?

Today, many patients prefer to administer medications to themselves in the form of injections, especially when it comes to antibiotics. The motivation is simple: when injected, the active substance immediately enters the bloodstream, bypassing the stomach, while when used internally, the intestinal microflora suffers.

However, injections are always associated with psychological discomfort, and medications are no less capable of harming the stomach than when taken orally.

Medicines for oral administration (that is, oral administration) are well absorbed through the mucous membranes of the gastrointestinal tract. The advantages of this administration also lie in the fact that for some diseases it is possible to use drugs that are poorly absorbed in the intestine, due to which their high concentration is achieved. This treatment method is very popular for gastrointestinal diseases.

There are quite a few disadvantages to this method of taking medications:

compared to some other methods of drug administration, this one acts rather slowly;
the duration of absorption and the result of exposure are individual, since they are affected by the food taken, the state of the gastrointestinal tract and other factors;
oral administration is impossible if the patient is unconscious or vomiting;
Some medications are not rapidly absorbed into the mucous membranes, so they require a different form of administration.

The intake of many medications is tied to food intake, which allows for a better therapeutic effect to be achieved. For example, many antibiotics are recommended to be taken after meals in order to harm the intestinal microflora to a lesser extent.

The medications are usually taken with water, less often with milk or juice. It all depends on what effect is expected from taking the medicine and how it interacts with liquids.

Despite the obvious disadvantages, internal remedies continue to be actively used in medicine, forming the basis of home treatment.

If the article was useful to you, recommend that your friends read it. On social media networks. The information has been provided for informational purposes only. We are waiting for you on our blog!

Hello everyone. Today I have an unusual article. The fact is that my cousin Zhenya has been living and working in Denmark for two months now. And now, on Christmas Eve, real miracles are happening there. I asked Zhenya to tell us about her observations in the new country. And the topic of today's conversation

Hello, dear parents! Most likely, you are very interested in knowing how your baby should develop. When and in what sequence do certain skills and movements appear, what is a variant of the norm, and in what case should we urgently sound the alarm.

Good afternoon, dear parents! Today we invite you to talk about water. Do not be surprised! Water is the basis of life on Earth. The human body contains the most water. Amniotic fluid surrounds the baby during intrauterine development. And although after birth we are surrounded by air, being in

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How is it taken orally?

Often, when reading the instructions for use of some medicine or on TV, we come across the phrase “take the drug orally.” The natural question that everyone probably asked at one time or another was “how is it actually done orally?”

Oral means by mouth, that is, in other words, the medicine must be swallowed.

There are many ways for the drug to enter the body; oral administration is usually prescribed with the condition that the drug will be well absorbed by the stomach.

If these are tablets, then a special outer capsule is made for them - a special shell, which increases the absorption of the drug by the food system.

The oral route has its disadvantages

Before the therapeutic effect of the drug occurs, a fairly large amount of time will pass, since the stomach does not immediately determine where exactly it is necessary to “deliver” the drug.

The rate of absorption, as well as the absorption process, is strictly individual for each patient, since the body has individual, unique features of the digestive system.

Drugs can form ineffective metabolites that are very poorly absorbed by the stomach. In addition, the liver and pancreas may simply not “pass” the drug into the blood, thereby blocking any manifestation of the therapeutic effect of the drug.

Oral administration of the drug is ineffective if the patient has an increased level of gag reflexes or if the person is unconscious.

Oral medication is most often prescribed for medications available in the following dosage forms: tablets, solutions, capsules, pills and powders.

Well, now we can say with confidence that you are familiar with the term “oral” and, if necessary, you can understand the features of the annotations.

The article was prepared specifically for the site - http://zhenskiy-sait.ru

Types of medications

Among the disadvantages, it should be noted, firstly, possible problems when using children's medications. Even pleasant-tasting fruit mixtures are not always readily accepted by children, not to mention bitter pills or powders. Secondly, some drugs, when interacting with gastric juice, lose their properties, and some, on the contrary, can harm the digestive organs. Thirdly, it takes time for substances administered orally to enter the bloodstream, which sometimes simply is not available. It is for this reason that the method of administering medications should be prescribed by a specialist, based on the current situation.

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Taking medications orally - what is it like?

Most preventive medications and vitamins are usually prescribed to patients orally. This, as a rule, allows the course to be completed with minimal discomfort. After all, the patient simply consumes powders, tablets or capsules, washing them down with a sufficient amount of liquid.

If you are prescribed a medicine to take orally, what is it like?

Unfortunately, some patients do not understand medical terminology, and are embarrassed to ask when prescribing treatment (or do not want to look stupid). Therefore, when they receive a prescription, they try to figure out what it means to take medications orally. It’s good if we are talking about pills (here, as a rule, everything is clear). And if they prescribe strange powders or liquids in ampoules, you can get confused.

But everything turns out to be not so difficult. This treatment method is perhaps the simplest of all available. And it means elementary ingestion, that is, introduction into the body through the mouth. So taking the medicine orally is like simply swallowing food. Usually, when prescribing such treatment, the specialist also indicates the dosage, the number of doses per day and recommends treatment before, after or during meals.

Types of medications

When are oral medications prescribed? These are, as a rule, cases where the patient is undergoing home (outpatient) treatment, as well as in a hospital in cases where immediate administration of the medicine is not required and there are no contraindications to this method of administration. In more severe situations, when the patient is unconscious, there are certain digestive problems that prevent the normal swallowing of drugs, something else is used - enteral administration of medications (using probes and other devices). The same method can be used to deliver nutritional mixtures directly into the stomach of patients who, for one reason or another, are deprived of the ability to swallow food on their own.

In cases where immediate administration of the drug is required, parenteral routes of administration are used (subcutaneous, intravenous or intramuscular). They are also used for medications whose contact with the digestive tract is undesirable or contraindicated.

Advantages and disadvantages of taking oral medications

Undoubtedly, this is the simplest and least unpleasant way of introducing a substance into the body. Its main advantage is naturalness. A person eats food every day to get enough nutrients, water and other drinks to replenish fluid. Therefore, it will not be difficult for him to swallow a few additional tablets or capsules. With powders and liquids things are a little more complicated, but you can drink them too.

Application

Preferably, taking medications in this way is prescribed for drugs that are well absorbed by the mucous membrane of the stomach or intestines. In the treatment of diseases of the digestive system, in some cases, on the contrary, poorly absorbed drugs are used, which makes it possible to achieve their high concentration in the gastrointestinal tract and obtain a good local effect without adverse reactions.

Flaws

slower development of the therapeutic effect than with other methods of taking medications,
the speed and completeness of absorption (bioavailability) are individual for each patient, as they are influenced by food, the organic and functional state of the gastrointestinal tract, taking other medications,
oral administration is ineffective for drugs that are poorly absorbed or destroyed in the gastrointestinal tract, form ineffective metabolites when passing through the liver, or have a pronounced irritant effect,
oral administration is difficult or impossible when the patient is vomiting or unconscious.

Dosage forms for oral use

The main dosage forms for oral administration are solutions, powders, tablets, capsules and pills. There are also dosage forms (for example, tablets with multilayer shells), in which the active drug is released longer than usual (compared to conventional dosage forms), which allows the therapeutic effect to be prolonged.

Most medications taken orally should be taken with plenty of liquid. When taking some medications while lying down, they can linger in the esophagus and cause ulceration, so it is necessary to wash down the tablets and capsules with water.

Literature

Bigbaeva M.M. Nurse's Directory / M.M. Bigbaeva, G.N. Rodionova, V.D. Trifonov. - M.: Eksmo, 2004. ISBN 5-699-08074-0

What does orally mean?

I’ll answer the question right away: “orally” means in the mouth, that is, the tablet must be swallowed.

Traditionally, medications taken orally come in the form of:

tablets;
powders;
solutions;
capsules;
tinctures

These drugs can be swallowed, chewed, or drunk. Most often, patients have to take tablets: this is the most popular form of use. They give effect within a quarter of an hour after administration.

Drugs taken orally pass through the body in the following way:

The medication enters the stomach and begins to be digested.
The drug substance is actively absorbed into the blood and gastrointestinal tract.
The drug molecules are distributed throughout the body.
Passing through the liver, part of the substances entering the body becomes inactive and is excreted by the liver and kidneys.

However, despite their high popularity, drugs taken orally have their disadvantages along with their advantages.

How do they work?

However, injections are always associated with psychological discomfort, and medications are no less capable of harming the stomach than when taken orally.

There are quite a few disadvantages to this method of taking medications:

compared to some other methods of drug administration, this one acts rather slowly;
the duration of absorption and the result of exposure are individual, since they are affected by the food taken, the state of the gastrointestinal tract and other factors;
oral administration is impossible if the patient is unconscious or vomiting;
Some medications are not rapidly absorbed into the mucous membranes, so they require a different form of administration.

The medications are usually taken with water, less often with milk or juice. It all depends on what effect is expected from taking the medicine and how it interacts with liquids.

Despite the obvious disadvantages, internal remedies continue to be actively used in medicine, forming the basis of home treatment.

If the article was useful to you, recommend that your friends read it. On social media networks. The information has been provided for informational purposes only. We are waiting for you on our blog!

Drugs (lat. buccalis buccal) is a pharmacological term that means taking a certain medicine by placing it between the upper lip and gum or in the oral cavity until completely absorbed. In this case, the medicine is sent to... ... Wikipedia

Types of medications

If you are prescribed medication, how should you take it?

Advantages and disadvantages of taking oral medications

The enteral route of drug administration is through the gastrointestinal tract (GIT).
Oral (by mouth) route of administration- the simplest and safest, the most common. When taken orally, drugs are absorbed mainly in the small intestine, enter the liver through the portal vein system, where they can be inactivated, and then into the general bloodstream. The therapeutic level of the drug in the blood is achieved 30-90 minutes after its administration and persists for 4-6 hours, depending on the properties of the active ingredient and the composition of the drug.
When administering drugs orally, their relationship with food intake is of great importance. Medicine taken on an empty stomach is usually absorbed faster than medicine taken after a meal. Most drugs are recommended to be taken 1/2-1 hour before meals so that they are less destroyed by enzymes of digestive juices and are better absorbed in the digestive tract. Drugs that irritate the mucous membrane (containing iron, acetylsalicylic acid, calcium chloride solution, etc.) are given after meals. Enzyme preparations that improve digestive processes (festal, natural gastric juice, etc.) should be given to patients during meals. Sometimes, to reduce irritation of the gastric mucosa, some medications are washed down with milk or jelly.
When giving tetracycline preparations to the patient, it should be remembered that dairy products and some medications containing salts of iron, calcium, magnesium, etc., form insoluble (non-absorbable) compounds with them.
Advantages of the oral route of administration:
- the possibility of introducing various dosage forms - powders, tablets, pills, dragees, decoctions, mixtures, infusions, extracts, tinctures, etc.;
- simplicity and accessibility of the method:
- the method does not require sterility.
Disadvantages of the oral route of administration:
- slow and incomplete absorption in the digestive tract;
- partial inactivation of drugs in the liver;
- dependence of the action of the drug on age, condition of the body, individual sensitivity and the presence of concomitant diseases.
To swallow a tablet (dragée, capsule, pill), the patient places it on the root of the tongue and washes it down with water. Some tablets can be chewed beforehand (with the exception of tablets containing iron). Dragees, capsules, pills are taken unchanged. The powder can be poured onto the root of the patient’s tongue and washed down with water or pre-diluted with water.
Sublingual (sublingual) route of administration- use of drugs under the tongue; They are well absorbed, enter the bloodstream bypassing the liver, and are not destroyed by digestive enzymes.
The sublingual route is used relatively rarely, since the suction surface of this area is small. Therefore, only very active substances are prescribed “under the tongue”, used in small quantities and intended for self-administration in emergency situations (for example: nitroglycerin 0.0005 g, validol 0.06 g), as well as some hormonal drugs.
Rectal route of administration through the rectum. Both liquid medications (decoctions, solutions, mucus) and suppositories are administered rectally. In this case, medicinal substances have both a resorptive effect on the body, being absorbed into the blood through hemorrhoidal veins, and local - on the mucous membrane of the rectum. In general, when administered rectally, drugs are poorly absorbed, and therefore this route of administration should be used only as an alternative in order to obtain systemic effects.
Note. Before introducing medications into the rectum, you should do a cleansing enema!
Insertion of suppositories (candles) into the rectum
Prepare: candles, liquid vaseline oil.
Take action:
- place the patient on his left side with his knees bent and legs brought to his stomach;
- open the package and take out the candle;
- spread your buttocks with your left hand, lubricate the anus area with liquid Vaseline oil;
- with your right hand, insert the narrow end of the entire suppository into the anus behind the external sphincter of the rectum.
Administration of liquid medications
Liquid forms of the drug are administered into the rectum in the form of medicinal enemas. Medicinal substances with a resorptive effect enter the bloodstream, bypassing the liver, and therefore are not destroyed. Due to the lack of enzymes in the rectum, they are not broken down. Medicinal substances of protein, fat and polysaccharide nature are not absorbed from the rectum and into the blood, so they are prescribed only for local action in the form of medicinal microenemas.
In the lower part of the colon, only water, isotonic sodium chloride solution, glucose solution, and some amino acids are absorbed. Therefore, for a resorptive effect on the body, these substances are administered in the form of drip enemas.
The rectal route of drug administration is used in cases where oral administration is impossible or inappropriate (for vomiting, difficulty swallowing, unconsciousness of patients, damage to the gastric mucosa, etc.) or when local exposure is necessary.

And rectal administration.

The advantage of the oral route of drug administration is that after administration, the drug passes through two natural barriers - the mucous membrane of the gastrointestinal tract and the liver. The effectiveness of the oral route of administration depends both on the pharmacokinetic parameters of the drug - its physicochemical properties, absorption rate and time to reach maximum concentration, half-life of the drug, and on the physiological properties of the body - changes (acidity) in various parts of the digestive system, surface area, which drugs are absorbed, perfusion of tissues of the digestive system, secretion of bile and mucus, properties of the membranes of epithelial cells of the organs of the digestive system and other physiological processes occurring in the digestive system.

The effectiveness of oral administration also depends on food intake: for most drugs it is typical decline when taken with food, but for some products, bioavailability when taken with food may rise.

It is better to take medications orally 20-30 minutes before meals (unless otherwise indicated in the instructions for medical use), in a standing position, with water. This sequence is determined by the fact that before eating, the juices of the digestive system have not yet been released in the stomach, which can destroy the chemical structure of the drug, and drinking water is necessary so that the drug is less irritating to the gastric mucosa. Taking medications in a standing position is recommended to avoid retention of the drug in the esophagus: when taken orally, the drug sequentially passes through the oral cavity, esophagus, stomach, duodenum and small intestine.

The action of the digestive system begins directly in the oral cavity, as a result of which most medications for oral administration are coated with a special coating that prevents the action of salivary enzymes on them.

In addition, it is not recommended to chew oral medications.

Preparations coated with a special coating that is resistant to the action of salivary and stomach enzymes cannot only not be chewed, but also cannot be divided into parts.

There are medications in the form of orodispersant tablets that are resistant to the action of enzymes of the digestive system and ensure rapid absorption and a rapid onset of its therapeutic effect.

The process of assimilation of some medications begins in the stomach. The duration of the process of absorption of drugs in the stomach depends on the acidity of gastric juice, the condition of the gastric mucosa and the time of gastric emptying. From the stomach, drugs enter the duodenum, where, under the influence of duodenal and pancreatic juice, as well as under the influence of bile components, the absorption of drugs continues.

After the duodenum, the medicine enters the small intestine, where the process of its absorption is completed. Most drugs are absorbed in the small intestine, which is facilitated by a high absorption area (400-500 m²). Increased absorption in the small intestine is also achieved due to the folds of the mucous membrane and the large number of villi on the mucous membrane. The rate of absorption of the drug also depends on the intensity of blood supply to the intestine in the absorption zone. The components of intestinal juice also contribute to the dissolution of the membranes of drugs that do not dissolve in the oral cavity and stomach.

Forms of drugs for oral administration

For oral use, drugs are available in the following forms:

pills,
capsules
microcapsules,
pills,
dragee,
powders,
solutions,
suspensions,
syrups,
emulsions,
infusions,
decoctions,
granules,
drops.

To improve the absorption of the main active ingredients of medicines, technologies have been created to improve this process:

Special pressing of tablets,
Coating tablets or other medicines with acid-resistant film,
Creation of therapeutic oral systems in the form of tablets (with multilayer coating, among others) for uniform release of active drug components in the gastrointestinal tract.
Controlled release of medicinal substances can also be achieved by creating special forms in the form of microcapsules with the drug, coated with a special substance (polymer), which slowly dissolves under the influence of the juices of the digestive system and ensures uniform delivery of the drug into the gastrointestinal tract by diffusion of the medicinal substance through the capsule membrane .

Advantages and disadvantages of oral medications

The advantages of oral administration of drugs are that drugs and their metabolites pass through two natural barriers before being absorbed into the blood - the mucous membrane of the gastrointestinal tract and the liver, on the membranes of which selective filtration of substances entering the body takes place.

The advantage of the oral method of administering drugs is that this method is the most physiological, simpler - there is no need to resort to the help of medical personnel. In addition, oral administration causes fewer side effects from taking the drug, which can be observed with parenteral administration.

The advantage of oral administration is that the absorption of the drug occurs more slowly than with parenteral administration, which also reduces the number of side effects from the drugs.

Some drugs for oral administration are poorly absorbed from the gastrointestinal tract and are used for local action in the lumen of the gastrointestinal tract (anthelminthics, some antibacterial, antifungal and antacid agents), which also reduces the likelihood of systemic side effects from taking these drugs.

The disadvantages of oral administration of drugs are that some drugs (for example, or) when taken orally are destroyed by enzymes of the digestive system, and therefore it is impossible to use them per os. In addition, drugs with a local irritant effect, or drugs whose breakdown produces toxic or inactive metabolites, should not be used orally.

The disadvantage of oral administration is that the effect of the drug is affected by food intake and the characteristics of the biochemical reactions of the body of a particular person.

Factors that influence the effectiveness of drugs also include the use of other drugs, the age of the patient, and the state of the enzymatic activity of his body.

When taken orally, drugs are absorbed more slowly, which makes impossible use of oral administration in emergency medical care.

Also, medications are not used orally in unconscious patients, with vomiting, in patients with mental disorders, with congestion in the systemic circulation and in young children.

To correctly select the route of administration of a drug, one should take into account the purpose of prescribing the drug, the general state of the physiological functions of the body, the nature of the patient’s underlying and concomitant diseases, as well as the patient’s adherence to one or another treatment method.

Denial of responsibility

The article on oral administration of medications on the medical portal “My Tablets” is a compilation of materials obtained from authoritative sources, a list of which is posted in the “Notes” section. Despite the fact that the reliability of the information presented in the article “ Oral medication» checked by qualified specialists, the contents of the article are for reference purposes only, is not guidance for independent(without contacting a qualified medical specialist, doctor) diagnostics, diagnosis, choice of means and methods of treatment.

The editors of the portal “My Tablets” do not guarantee the truth and relevance of the materials presented, since methods of diagnosis, prevention and treatment of diseases are constantly being improved. To receive complete medical care, you should make an appointment with a doctor, a qualified medical specialist.

Notes

Notes and explanations to the article “Oral administration of medications.”

Enteral The route of administration of a drug is the route of administration into the body in which the drug is absorbed in a physiologically adequate way, that is, through the mucous membrane of the gastrointestinal tract. In this sense, enteral administration is contrasted with parenteral administration (when the drug is delivered to the body bypassing intestinal mucosa - usually intravenously).
At sublingual When used, drugs bypass the liver and are not exposed to gastric juice and enter the bloodstream. Sublingual administration of the drug is carried out by placing it under the tongue (accordingly, the drug is sent into the blood circulation through its absorption under the tongue).
For buccal When administering medications, special dosage forms are used, on the one hand, ensuring rapid absorption in the oral cavity, on the other hand, providing the opportunity to prolong absorption to increase the duration of action of the drug. An example is the drug Trinitrolong (active ingredient Nitroglycerin), produced in the dosage form of a film for gluing to the gums. Trinitrolong is a plate made of a biopolymer base that is glued to the mucous membrane of the cheek or gum.
pH, hydrogen index, acidity - a measure of the activity (in very dilute solutions it is equivalent to the concentration) of hydrogen ions in a solution, quantitatively expressing its acidity. The pH value is usually measured in values from 0 to 14, where pH = 7.0 is considered neutral acidity (normal physiological acidity in humans is also 7, but the critical limits are in the range from 5 to 9 pH). The simplest and most affordable way to check the pH of the body is a pH urine test, which uses visual pH test strips.
Bioavailability drug substance is the amount (relative to the amount of the original dose) of unchanged drug substance that reaches the blood plasma.
Enzymes, enzymes are usually protein molecules or ribozymes (RNA molecules) or their complexes that catalyze (accelerate) chemical reactions in living systems. Enzymes, like all proteins, are synthesized as a linear chain of amino acids that fold in a specific way. Each peptide sequence folds in a special way, as a result of which the resulting protein globule (molecule) has unique properties. Enzymes are present in all living cells and help convert one substance into another. Enzyme activity can be regulated by inhibitors and activators (inhibitors decrease, activators increase). Based on the type of reactions they catalyze, enzymes are divided into six classes: oxidoreductases, transferases, hydrolases, lyases, isomerases and ligases.
Insulin– a protein hormone of peptide nature, formed in the beta cells of the islets of Langerhans of the pancreas. Insulin has a significant effect on metabolism in almost all tissues, while its main function is to reduce (maintain normal) blood sugar levels. Insulin increases the permeability of plasma membranes to glucose, activates key enzymes of glycolysis, stimulates the formation of glycogen from glucose in the liver and muscles, and enhances the synthesis of proteins and fats. In addition, insulin suppresses the activity of enzymes that break down fats and glycogen. Absolute (in type 1 diabetes) or relative (in type 2 diabetes) insulin deficiency is the cause of elevated blood sugar levels in diabetes mellitus, which is treated with an analogue of human insulin (first released by Eli Lilly in 1923). Today, insulins are administered parenterally (subcutaneously), but more recently, inhaled insulin for oral administration has been developed.
Streptomycin– a drug produced, as a rule, in the form of a powder for the preparation of a solution for intramuscular administration, historically the first antibiotic of the aminoglycoside group, the second after penicillin. Streptomycin is formed during the life of the radiant fungi Streptomyces globisporus streptomycini or other related microorganisms; it is a first-line anti-tuberculosis drug used to treat diseases caused by bacteria resistant to penicillin. Streptomycin is administered intratracheally, intrabronchially (in the form of aerosols), intracavernosally. For tuberculosis, streptomycin is administered intramuscularly, that is, parenterally.

When writing an article about oral administration of drugs (drugs), materials from information and reference Internet portals, news sites MerckManuals.com, FDA.gov, HowMed.net, ScienceDaily.com, STGMU.ru, Wikipedia, as well as the following were used as sources printed publications:

Frolkis A. V. “Functional diseases of the gastrointestinal tract.” Publishing house "Medicine", 1991, Moscow,
Pokrovsky V. M., Korotko G. F. (editors) “Human Physiology. Educational literature for students of medical universities.” Publishing house "Medicine", 2007, Moscow,
Zimmerman Y. S. “Clinical gastroenterology. Library of a medical specialist." Publishing house "GEOTAR-Media", 2009, Moscow,
Sokolova N. G., Obukhovets T. P., Chernova O. V., Barykina N. V. “Pocket reference book for a nurse.” Publishing house "Phoenix", 2015, Rostov-on-Don,

In Latin it's pretty simple- per os means through the mouth. This is how many medications are taken. This is exactly what was once written in recipes. This is how we were taught to write, but it turns out that we were taught in vain. Today's recipes are completely different from what they used to be. And there is no need to write that this pill needs to be taken orally.

Taking medications orally- the most traditional and widespread. Many tablets dissolve well in the stomach and are absorbed by its walls and intestinal walls. Sometimes, on the contrary, in order to treat stomach diseases, medications are used that are very poorly absorbed in the stomach. However, this allows you to achieve maximum concentration of the drug in the stomach and at the same time get a good effect from local treatment.

There are quite a few disadvantages to taking medications orally. The biggest one is the long time it takes for a particular pill to take effect. This is called a therapeutic effect. The rate of absorption of the drug and the completeness of absorption, and this is called the bioavailability of the drug, is also different for each person. This is due to many reasons - with age, with the state of the gastrointestinal tract, with food intake, with age, and sometimes with the gender of the person. Some drugs have very low bioavailability on their own. Therefore, if a medicine’s instructions say that its bioavailability is no more than 20%, then it is better to look for some alternative drug.

Taking medications orally is simply not possible when vomiting, in an unconscious state, or in small children. And this can also be considered a big disadvantage of this method of taking medications. Among other things, some oral medications create very harmful metabolites, which, when destroyed in the liver, cause great harm to it.

But at the same time, taking tablets by mouth is very convenient and no one is going to give up this method of introducing drugs into the body.

In addition to tablets, you can take powders, capsules, dragees, solutions, infusions, decoctions, syrups, pills orally. Most medications should be taken orally with plenty of water. however, it is worth keeping in mind that there are medications that perfectly help cure one disease, but negatively affect another organ. Examples include tablets such as otrophen and diclofenac. They are great for treating joint pain and reducing inflammation in arthritis, but at the same time, these medications can lead to the development of stomach ulcers. Therefore, they need to be taken under the guise of another drug. This could be omez or any other antiulcer drug. Therefore, here again you need to carefully read the instructions. It’s not for nothing that these smart pieces of paper are put in every box of medicine.

If the drug enters the body bypassing the gastrointestinal tract, then this method will be called parenteral. And these are, first of all, inhalations and injections.

To treat patients with non-insulin-dependent diabetes, which cannot be compensated by dietary nutrition, it is often necessary to use sulfonylurea drugs. These substances are easy to use and appear to be harmless. Concerns expressed in reports by the University Diabetes Group (UDG) about the possible increase in mortality from coronary heart disease as a result of the use of these drugs were largely dissipated due to the questionable design of the study. On the other hand, the widespread use of oral medications is hampered by the belief that better diabetes management can slow down the development of late complications. Although in some patients with relatively mild diabetes the plasma glucose level is normalized under the influence of oral medications, in patients with high hyperglycemia it, if reduced, is not to normal. Therefore, currently a large percentage of patients with non-insulin-dependent diabetes receive insulin.

Sulfonylureas act primarily as stimulators of insulin secretion by b-cells. They also increase the number of insulin receptors in target tissues and accelerate insulin-mediated disappearance of glucose from the blood, independent of increased insulin binding. Since treatment with these agents does not lead to an increase in mean plasma insulin levels despite a significant decrease in mean glucose concentrations, extrapancreatic effects of sulfonylureas could play an important role; However, the paradoxical improvement in glucose metabolism in the absence of a constant increase in insulin levels found an explanation when it was shown that when the glucose level was increased to the level observed before treatment, the concentration of insulin in the plasma in such patients increased to higher levels than before treatment

Table 327-9. Sulfonylureas

Substance	Daily dose, mg	Number of appointments per day	Duration of hypoglycemic effect, h	Metabolism/excretion
Acetohexamid (Acetohexamidi)				Liver/kidneys
Chlorpropamide
Tolazamide

Glibenclamide				Liver/kidneys
Glipizide
Glibornuride

From: R. H. Unger, D. W. Foster, Diabetes mellitus, in Williams Textbook of Endocrinology, 7th ed. J. D. Wilson, D. W. Foster (eds), Philadelphia, Saunders, 1985, p.1018-1080. Adapted from H. E. LebowitzaM.N. Feinglos.

Thus, these substances first increase insulin secretion and thereby reduce plasma glucose. As the glucose concentration decreases, the insulin level also decreases, since it is plasma glucose that serves as the main stimulus for insulin secretion. Under such conditions, the insulinogenic effect of drugs can be detected by increasing the glucose level to the initial elevated level. The fact that sulfonylurea drugs are ineffective in IDDM, in which the mass of b-cells is reduced, confirms the idea that the pancreatic action of these drugs plays a leading role, although extrapancreatic mechanisms of their action are undoubtedly also important.

The characteristics of sulfonylurea drugs are summarized in Table 327-9. Compounds such as glipizide and glibenclamide are effective in lower doses but are otherwise little different from long-standing agents such as chlorpropamide and butamide. For patients with significant kidney damage, it is better to prescribe butamide or tolazamide, since they are metabolized and inactivated only in the liver. Chlorpropamide is capable of sensitizing the renal tubules to the action of antidiuretic hormone. Therefore, it helps some patients with partial diabetes insipidus, but in diabetes mellitus it can cause water retention in the body. When using oral medications, hypoglycemia occurs less frequently than when using insulin, but if it occurs, it usually manifests itself more severely and lasts longer. Some patients require massive glucose infusions several days after the last dose of sulfonylurea. Therefore, if hypoglycemia occurs in patients receiving such drugs, hospitalization is necessary.

Other oral agents effective for adult-onset diabetes include the biguanides. They reduce plasma glucose levels presumably by inhibiting gluconeogenesis in the liver, although phenformin may increase the number of insulin receptors in some tissues. These compounds are usually used only in combination with sulfonylureas, when the latter alone cannot achieve adequate compensation. Because numerous publications have suggested an association between phenformin use and the development of lactic acidosis, the Food and Drug Administration has banned clinical use of this compound in the United States except in limited cases where it continues to be used for research purposes. In other countries, phenformin and other biguanides are still used. They should not be prescribed to patients with renal pathology and should be discontinued if nausea, vomiting, diarrhea or any intercurrent illness occurs.

Fig. 327-3. Formation of aldomine and ketoamine.

Taking medications orally is the most traditional and common way of taking medications. Most tablets dissolve well in the stomach and are absorbed by its walls, as well as by the walls of the intestines. In some cases, medications that are very poorly absorbed in the stomach are used to treat stomach diseases. However, this approach allows you to achieve maximum concentration of the drug in the stomach and thus obtain the maximum effect from local treatment.

Taking medications orally has quite a few disadvantages. The most significant of them is the long time before a particular pill begins to act on the body, especially if the therapeutic effect is needed immediately. It is worth noting that the rate of absorption of the drug and the completeness of absorption, called bioavailability, is different for each person. It depends on many factors - age, state of the gastrointestinal tract, time of meal, and sometimes the gender of the person. Some drugs have very low bioavailability. Therefore, if a medicine’s instructions indicate that its bioavailability does not exceed 20%, then it is better to pay attention to some alternative drugs.

Taking medications orally is usually not possible if you are vomiting, unconscious, or in small children. And this can also be attributed to the big disadvantage of this method of taking medications. In addition, some oral medications tend to create very harmful metabolites that, when broken down in the liver, cause significant damage to the liver.

At the same time, taking pills by mouth is very convenient and no one is going to give up this method of taking medications.

In addition to tablets, various powders, capsules, dragees, solutions, infusions, decoctions, syrups, pills are taken orally. Most medications taken orally should be taken with plenty of water. It is worth considering that there are medications that do an excellent job of healing one organ, but have a negative effect on another organ. Examples include tablets such as otrophen and diclofenac. They help with joint pain and relieve inflammation in arthritis, but at the same time, these drugs can provoke the development of stomach ulcers. Therefore, it is recommended to take them under the guise of an additional drug. This could be omeprazole or some other anti-ulcer drug.

If drugs enter the body bypassing the gastrointestinal tract, then this method will be called parenteral. And these are, first of all, inhalations and injections.

Together with the article “Oral – how is that?” read:

What does it mean to take medications orally? What is oral administration? How to take it orally? Types of drug administration For oral administration

What does orally mean?

How do they work?

How is it taken orally?

The oral route has its disadvantages

Types of medications

Taking medications orally - what is it like?

If you are prescribed a medicine to take orally, what is it like?

Types of medications

Advantages and disadvantages of taking oral medications

Application

Flaws

Dosage forms for oral use

Literature

see also

2010.

What does orally mean?

How do they work?

Drugs (lat. buccalis buccal) is a pharmacological term that means taking a certain medicine by placing it between the upper lip and gum or in the oral cavity until completely absorbed. In this case, the medicine is sent to... ... Wikipedia

Types of medications

Advantages and disadvantages of taking oral medications

Forms of drugs for oral administration

Advantages and disadvantages of oral medications

Denial of responsibility

Notes

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