Nutrition can be given to a patient other than through the intestine by the following routes:
1. Enteral nutrition: This involves the delivery of nutrition directly into the stomach or small intestine through a tube. This can be done through a nasogastric tube, a gastrostomy tube, or a jejunostomy tube.
2. Parenteral nutrition: This involves the delivery of nutrition directly into the bloodstream through an intravenous (IV) line. This is typically used when a patient is unable to take nutrition orally or through an enteral route.
3. Intravenous fat emulsion: This involves the delivery of fat directly into the bloodstream through an IV line. This is typically used when a patient is unable to take nutrition orally or through an enteral route.
4. Oral nutritional supplements: This involves the delivery of nutrition in the form of shakes, bars, or drinks. This is typically used when a patient is unable to take nutrition orally or through an enteral route.
Enteral administration
enteral administration is food or drug administration through human gastrointestinal tract. This contrasts with parenteral nutrition or drug administration (Greek for“beyond” + enteros), which occurs by routes outside the GI tract, such as intravenous routes. Enteral administration involves the esophagus, stomach, and small and large intestines (ie, the gastrointestinal tract). Methods of administration include oral, sublingual (dissolving the drug under the tongue), and rectal. Parenteral administration is through a peripheral or central vein. At the pharmacologythe route of drug administration is important because it affects drug metabolism, drug releaseand so dosage. The term is from Greek enteros“intestine”.
Forms
Enteral administration can be divided into three different categories depending on the point of entry into the GI tract: oral (by mouth), gastric (through the stomach) and rectal (from the straight). (Gastric introduction involves the use of a tube through the nasal passage (NG tube) or a tube in the belly that leads directly to the stomach (PEG tube). Rectal administration usually involves suppositories.)
Absorption of drugs in the intestine
The mechanism of drug absorption in the gut is for most drugs passive transfer, some exceptions include levodopa and fluorouracilboth absorbed by carrier-mediated transport. For passive transfer to occur, the drug has to diffuse through the lipids cell membrane of epithelial cells lining the inside of the intestines. The rate at which this happens is largely determined by two factors: Ionization and lipid solubility.
Factors influencing gastrointestinal absorption:
- gastrointestinal motility.
- Splanchnic blood flow.
- Particle size and formulation.
- Physicochemical factors.
First pass metabolism
Enterally administered drugs can be subject to significant first pass metabolism, and therefore the amount of drug that enters the systemic circulation after administration can vary significantly for different individuals and drugs. Rectal administration is not subject to extensive first-pass metabolism.
See too
References
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| Oral (sublabial), sublingual |
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| respiratory tract |
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otological, nasal
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| organs | ||
| central nervous system |
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| Circulatory, skeletal muscle |
Source: Enteral administration
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