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MCAT
Course: MCAT > Unit 10
Lesson 7: Drug dependence- Drug dependence questions
- Overview of psychoactive drugs
- Psychoactive drugs: Depressants and opiates
- Psychoactive drugs: Stimulants
- Psychoactive drugs: Hallucinogens
- Drug dependence and homeostasis
- Routes of drug entry
- Reward pathway in the brain
- Tolerance and withdrawal
- Substance use disorders
- Treatments and triggers for drug dependence
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Routes of drug entry
Created by Carole Yue.
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- With those transdermal delivery systems, can't a lot of different things affect the absorption of the medication? like body temperature, environmental temperature, metabolism, heart rate, even skin conductivity, couldn't they all have radical impacts on the absorption rates of a dermal delivered medication? Thanks! T.S.(11 votes)
- You're right. Some factors are constant enough that do not need to be considered. One of them is the body temperature. Metabolism isn't that different from person to person, and what it mostly affects is how quickly the drug is used, rather than absorbed. But what affects drug delivery through the trans-dermal route the most is skin conductivity. Drugs have different properties. Some are fat soluble, and some are not. Nicotine is water soluble, and that's why when administered in high doses, it can seep through your skin and into the blood stream. Fat soluble drugs do not do as well. That's a huge setback, because trans-dermal delivery is the proffered way of drug delivery in medicine as well. All the doctors will have to do is to give you a stamp, and you'll be set for several doses, as these patches last for a much longer time than a pill does. One solution for this set back is making tiny spikes on the drug patch that scratch their way through the dead layer of your skin, where the drug can be absorbed more easily. If the spikes are just the right size you won't even feel them.(5 votes)
- How can the intravenous route of drug administration be faster than the inhalation technique, since intravenously injected drugs must return to the right atrium, enter the right ventricle, be pumped to the lungs, and then return to the left atrium and left ventricle before being pumped out through the aorta to the rest of the body, whereas inhaled drugs go directly to the pulmonary system before returning to the left atrium & ventricle to be distributed to the systemic circulation? Inhaled drugs completely bypass the right atrium & right ventricle. I think that inhaled drugs get to your brain quicker than IV drugs.(6 votes)
- There is some truth to what Tina says, that diffusion slows the effect of the inhalation technique, but far more significant in the arena of drug abuse is the effect of dosage. For most drugs of abuse, it is a lot easier to get a big dose on board by injection, rather than inhalation. Moreover, with injection, all of a given drug dosage gets into the bloodstream, while the lungs are about 1/3 deadspace and a fair proportion of drug that makes it to the alveoli never makes that final diffusive journey into the pulmonary capillaries.(6 votes)
- Can someone please explain what an Epi-Pen is? I've seen it a lot but don't really understand it.(3 votes)
- An Epi-Pen is an injector for the drug epinephrine. Epinephrine is usually injected into a person's muscle. The Epi-Pen contains a set amount of the drug and a spring loaded needle, making it much easier for a person to take the medication than if it was in a traditional needle and syringe.
Epinephrine is a hormone, also known as adrenaline. It acts as a vasoconstrictor (makes blood vessels smaller), increases blood glucose, and increases blood flow to muscles. It is most commonly used for allergic reactions.(6 votes)
- How can the intravenous route of drug administration be faster than the inhalation technique, since intravenously injected drugs must return to the right atrium, enter the right ventricle, be pumped to the lungs, and then return to the left atrium and left ventricle before being pumped out through the aorta to the rest of the body, whereas inhaled drugs go directly to the pulmonary system before returning to the left atrium & ventricle to be distributed to the systemic circulation? Inhaled drugs completely bypass the right atrium & right ventricle. I think that inhaled drugs get to your brain quicker than IV drugs.(4 votes)
- You have to consider the rate of gas exchange occurring in the lungs on the alveolar sacs as well. But I believe that either of these react within seconds as shown in the video so it's very close. It may depend on the chemical structure of the drug, it's solubility, and other factors that affect blood transport.(2 votes)
- should a depressed person take drugs ?(1 vote)
- A depressed person should talk with his doctor, or psychiatrist.
A possible treatment for depression is taking anti-depressive drugs.(5 votes)
- Is sublingual application quicker than ingesting?(3 votes)
- Yes, capillaries under the tongue absorb many drugs quickly. Also, if absorbed by the stomach and intestines, the drug will travel to the liver which may remove some of the drug before the remaining amount goes to general circulation. Wikipedia is an open source dictionary and should be checked for accuracy, but it is a good place to start.https://en.m.wikipedia.org/wiki/Sublingual_administration(1 vote)
- Does intramuscular count as injection as well?(2 votes)
- Yes, injections of liquid drugs into the muscle are performed routinely. Example: Flu shots are delivered intramuscularly into the deltoid.(3 votes)
- Are there patches for other drugs besides nicotine?(1 vote)
- Opiate patches are also available such as Pethidine, however this is a highly addictive drug and is best avoided prescribing to people in the first place. It depends on the properties of the drug whether it can be administered as a patch, such as the molecule size etc(4 votes)
- For somebody who smokes Marijuana everyday after about a month and a half of being sober from it..would the effect of it be stronger or lighter if the person were to smoke again? I used to smoke and stopped but then smoked again after a month or so and it had no effect..why is that?(2 votes)
- Why are faster routes of administration associated with higher addiction potential? Is it because there is a more obvious connection between substance and effect?(1 vote)
- I think it's because some routes of administration lead to higher bioavailability. This means that a higher percentage of the drugs eventually end up in your systemic circulation. For example, if you take a tablet orally, and only 50% of it ends up being circulated (the other 50% was broken down by your liver, or on the way there), then it only has a 50% bioavailability compared to if it was injected intravenously, where it would have a 100% bioavailability. Thus, if something has a higher concentration in your system, there's more potential for an addiction to form.(1 vote)
Video transcript
Although there are
surprisingly high number of ways of getting drugs into your body, called routes of entry, we're just going to talk
about some of the most common. So one that might come
to mind pretty easily when you think about,
maybe hard-core drugs is injection, so we'll talk about that. The other main routes are
oral entry and inhalation. Oral entry means that
you swallow something, so that could be a pill or some alcohol. Either way you're eating or drinking it. You're ingesting it in some way, and this is one of the
slowest routes of entry because it has to go through
your gastrointestinal tract in order to get absorbed
by your bloodstream, which can take about half an hour, give or take a few minutes. Inhalation, on the other
hand, which is when you snort or smoke or breathe in the drugs is actually much faster because once you inhale it, it pretty much goes
straight to your brain. It can be there within 10 seconds, and then you start feeling the effects. So this would be, a lot of times, tobacco or cocaine is often snorted. And finally the most
direct route is injection. With injection, we're
usually talking about intravenous injection, which means it goes right into a blood vein. This begins to take effect within seconds. Intravenous injection
can be very dangerous because you're much more
likely to inject bacteria or other unexpected toxins
along with the drugs, especially if you're using
unsterilized paraphernalia. So if someone else has
used the needle before you, then this increases the
likelihood you'll be exposed to something harmful, such as HIV. OK, so those are the three
most common routes of entry and I'm just going to mention two more that are moderately common,
transdermal and intramuscular. Transdermal entry means that the drug is absorbed through the skin. This is how patches like the nicotine patch, for example, works. The drug in the patch has
to be pretty potent and it can be released into the
bloodstream over several hours. Intramuscular entry means that
a needle is stuck directly into the muscle, so before we talked about intravenous injection,
this is intramuscular. Depending on the chemical
properties of the drug, this method can deliver
the drugs to your system very quickly or more gradually. One example of a really quick entry for intramuscular injection is when an EpiPen is administered
to someone experiencing a severe allergic reaction. So when people have such a reaction, their airway start to close
up, so they need to get a dose of epinephrine into their body to open their airways
as quickly as possible. If you've ever seen or done this, the needle usually goes into
a large muscle in your thigh because studies have shown that to have the most access points to blood vessels, you need to stick it in
that particular muscle, so the epinephrine can
take effect really quickly. Many vaccines are also
administered intramuscularly which is why your arm gets
sore after some shots, like the flu shot or something. Now I've been talking about
how fast these different drugs take effect based on the route of entry which might be clearly relevant
in the case of the EpiPen when you're trying to save someone's life. But another important element connected to the rate of absorption is the potential to produce dependence. People are more likely to become dependent on drugs that take effect more quickly. For example, injected drugs have higher addictive potential than pills.