Administering medication into a gastric tube

Enteral administration is food or

drug administration Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the ...

via the

human gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascular system ...

. This contrasts with parenteral nutrition or drug administration (Greek ''para'', "besides" + ''enteros''), which occurs from routes outside the GI tract, such as

intravenous Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutr ...

routes. Enteral administration involves the esophagus, stomach, and small and large intestines (i.e., the gastrointestinal tract). Methods of administration include oral, sublingual (dissolving the drug under the tongue), and rectal. Parenteral administration is via a peripheral or central vein. In

pharmacology Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics, pharmacodynamics, therapeutic use, and toxicology. More specifically, it is the study of the interactions that occur betwee ...

, the route of drug administration is important because it affects drug metabolism, drug clearance, and thus dosage. The term is from

Greek Greek may refer to: Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group *Greek language, a branch of the Indo-European language family **Proto-Greek language, the assumed last common ancestor of all kno ...

''enteros'' 'intestine'.

Forms

Man_with_NG_feeding_tube_wearing_a_zebra_baseball_cap

Enteral administration may be divided into three different categories, depending on the entrance point into the GI tract: oral (by

mouth A mouth also referred to as the oral is the body orifice through which many animals ingest food and animal communication#Auditory, vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also t ...

), gastric (through the

stomach The stomach is a muscular, hollow organ in the upper gastrointestinal tract of Human, humans and many other animals, including several invertebrates. The Ancient Greek name for the stomach is ''gaster'' which is used as ''gastric'' in medical t ...

), and rectal (from the

rectum The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...

). (Gastric introduction involves the use of a tube through the nasal passage ( NG tube) or a tube in the belly leading directly to the stomach ( PEG tube). Rectal administration usually involves rectal

suppositories A suppository is a dosage form used to deliver pharmaceutical drug, medications by insertion into a body orifice (any opening in the body), where it dissolves or melts to exert local or systemic effects. There are three types of suppositories, eac ...

Drug absorption from the intestine

The mechanism for drug absorption from the intestine is for most drugs passive transfer, a few exceptions include levodopa and fluorouracil, which are both absorbed through carrier-mediated transport. For passive transfer to occur, the drug has to diffuse through the lipid

cell membrane The cell membrane (also known as the plasma membrane or cytoplasmic membrane, and historically referred to as the plasmalemma) is a biological membrane that separates and protects the interior of a cell from the outside environment (the extr ...

of the epithelial cells lining the inside of the intestines. The rate at which this happens is largely determined by two factors:

Ionization Ionization or ionisation is the process by which an atom or a molecule acquires a negative or positive Electric charge, charge by gaining or losing electrons, often in conjunction with other chemical changes. The resulting electrically charged at ...

and lipid solubility. Factors influencing gastrointestinal absorption: * Gastrointestinal motility. * Splanchnic blood flow. *

Particle In the physical sciences, a particle (or corpuscle in older texts) is a small localized object which can be described by several physical or chemical properties, such as volume, density, or mass. They vary greatly in size or quantity, from s ...

size and formulation. * Physicochemical factors.

First pass metabolism

Drugs given by enteral administration may be subjected to significant first pass metabolism, and therefore, the amount of drug entering the systemic circulation following administration may vary significantly for different individuals and drugs. Rectal administration is not subject to extensive first pass metabolism.

References

{{Dosage forms, state=expanded Routes of administration

Forms

Drug absorption from the intestine

First pass metabolism

See also

References