OBJECTIVE - The purpose of this study was to elucidate the mechanisms of diabetes reversibility after malabsorptive bariatric surgery. Corresponding urine samples are tested qualitatively for the presence of glucose and ketone bodies. malabsorption syndrome). IP: 109.75.181.146. An exception is topical administration, which generally means that both the application location and the effect thereof is local. Chicago. [25] However, in some cases, patients are taught to self-inject, such as SC injection of insulin in patients with insulin-dependent diabetes mellitus. Substances may also be placed into the small intestines, as with a duodenal feeding tube and enteral nutrition. CiteSeerX - Document Details (Isaac Councill, Lee Giles, Pradeep Teregowda): OBJECTIVE — The purpose of this study was to elucidate the mechanisms of diabetes re-versibility after malabsorptive bariatric surgery. Several variables have to be considered when performing tolerance tests, including nutritional state (fasted vs fed), time of the day, route of administration, glucose/insulin dose and the level of restraint required for blood sampling. IVGTT may be chosen for patients who are unable to absorb an oral dose of glucose (eg. Patient should report to the laboratory after fasting for 12-16 hours. JG (4 g, Tid, PO) + C. First three days: 20% mannitol (250 mL, Ivgtt, Qd) + dexamethasone (10 mg, Ivgtt, Qd) After three days: 20% mannitol (250 mL, Ivgtt, Qd) + dexamethasone (5 mg, Ivgtt… [26] Upon contact with the skin, the drug penetrates into the dead stratum corneum and can afterwards reach the viable epidermis, the dermis, and the blood vessels. The highest peak value is reached within 1 hour. [40], Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC. or IM Intramuscular route I.T. Fasting blood glucose is definitely raised above 110 mg/dl. [25] However, some drugs can cause gastrointestinal tract irritation. GTT is of two types depending upon the route of glucose administration : Oral Glucose Tolerance Test (OGTT) Intravenous Glucose Tolerance Test (IVGTT) OGTT is mostly preferred and is explained in detail here. An IVGTT was performed preoperatively and within 1 month postoperatively. Ivgt.de. Transmucosal (diffusion through a mucous membrane), e.g. Your theory is well for practical theory.best for MLT student! The blood glucose level doesnot return to fasting level within 2.5 hours. Oral administration is often denoted "PO" from "per os", the Latin for "by mouth". malabsorption syndrome). GTT is of two types depending upon the route of glucose administration : Oral Glucose Tolerance Test (OGTT) Intravenous Glucose Tolerance Test (IVGTT) OGTT is mostly preferred and is explained in detail here. First-Phase Insulin Secretion Restoration and Differential Response to Glucose Load Depending on the Route of Administration in Type 2 Diabetic Subjects After Bariatric Surgery. 65: p. 1-8, risk of systemic exposure of the administered drug absorbed, TheFreeDictionary.com > route of administration, "Oklahoma Administrative Code and Register > 195:20-1-3.1. Enteric coated tablets are designed to dissolve in the intestine, not the stomach, because the drug present in the tablet causes irritation in the stomach. The return to normal value is rapid and complete. This can be illustrated by the action of naloxone (Narcan), an antagonist of opiates such as morphine. The route or course the active substance takes from application location to the location where it has its target effect is usually rather a matter of pharmacokinetics (concerning the processes of uptake, distribution, and elimination of drugs). Furthermore, some application locations often classified as enteral, such as sublingual[6] (under the tongue) and sublabial or buccal (between the cheek and gums/gingiva), are taken up in the proximal part of the gastrointestinal tract without reaching the intestines. Patients should be in a position to wait at the laboratory for at least 2-3 hours, since 5 or more blood samples are collected at the interval of 30 minutes. [38] The remainder of 50-70% undeposited aerosolized particles are cleared out of lung as soon as exhalation. In hospice care, a specialized rectal catheter, designed to provide comfortable and discreet administration of ongoing medications provides a practical way to deliver and retain liquid formulations in the distal rectum, giving health practitioners a way to leverage the established benefits of rectal administration. It is indicated by the nature of blood glucose curve following the administration of glucose. The Glucose Tolerance Test (GTT) is the most sensitive test for detecting borderline diabetes mellitus. A curve is plotted by plotting time on X-axis and plasma glucose level on Y-axis, which is called. [29], Inhaled medications can be absorbed quickly and act both locally and systemically. [7][8][9][10][11][12][13] The walls of the rectum absorb many medications quickly and effectively. The fasting level is again reached by 2-2.5 hours. The systemic treatment was dexamethasone 10 mg ivgtt (give the medicine intravenously, iv drip) once daily for 5 days and tapering to 5 mg ivgtt once daily for another 7 days. First-phase insulin secretion restoration and differential response to glucose load depending on the route of administration in type 2 diabetic subjects after bariatric Surgery. FDA Center for Drug Evaluation and Research Data Standards Manual: Dosage Form. Administration methods directly into the stomach include those by gastric feeding tube or gastrostomy. However, some drugs can not be used enterally because their absorption in the digestive tract is low or unpredictable. A total of five specimens of venous blood and urine are collected every 1/2 hour (30 minutes) after the oral glucose administration. At 8:00–9:00 a.m. , after a 12-h overnight fast, an intravenous catheter was placed in one antecubital vein and an intravenous bolus of 0.33 g glucose/kg body weight as 50% water solution was injected in the contralateral antecubital vein. Naloxone counteracts opiate action in the central nervous system when given intravenously and is therefore used in the treatment of opiate overdose. [41] They also have essentially 100% bioavailability and can be used for drugs that are poorly absorbed or ineffective when they are given orally. However, uptake of drugs administered orally may also occur already in the stomach, and as such gastrointestinal (along the gastrointestinal tract) may be a more fitting term for this route of administration. [14] Medications delivered to the distal one-third of the rectum at least partially avoid the "first pass effect" through the liver, which allows for greater bio-availability of many medications than that of the oral route. Ranking. [39] The severity of dependence on psychoactive drugs tends to increase with more rapid drug delivery. The bioavailability of oral administration is affected by the amount of drug that is absorbed across the intestinal epithelium and first-pass metabolism. Common examples include oral and intravenous administration. Enteral medications are therefore often preferred in the treatment of chronic disease. [43], Disadvantages of injections include potential pain or discomfort for the patient and the requirement of trained staff using aseptic techniques for administration. Site of desired action: the action may be localised and approachable or generalised and not approachable. Pediatric conscious sedation utilizing enteral methods (oral, rectal, sublingual)", "Use of Rectal Meds for Palliative Care Patients. A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body.[1]. Transdermal administration is a comfortable alternative; there are, however, only a few drug preparations that are suitable for transdermal administration. Retrieved March 12, 2021, from https://www.allacronyms.com/IVGTT/medical. A fasting sample of venous blood is collected in a fluoride vial. Good. End of Life / Palliative Education Resource Center, Medical College of Wisconsin", "MDMA (ecstasy) metabolites and neurotoxicity: No occurrence of MDMA neurotoxicity from metabolites when injected directly into brain, study shows", "A potential application for the intracerebral injection of drugs entrapped within liposomes in the treatment of human cerebral gliomas", "Acute Decreases in Cerebrospinal Fluid Glutathione Levels after Intracerebroventricular Morphine for Cancer Pain", "Perivascular medical devices and drug delivery systems: Making the right choices", "DDS Medication Administration Recertification Manual", Connecticut Department of Developmental Services, "Ionic liquids for oral insulin delivery", "Lungs - Anatomy of the Respiratory System", "Diagram for majour zones of respiratory system", "Drug Absorption - Clinical Pharmacology", The 10th US-Japan Symposium on Drug Delivery Systems. Used in experimental research of chemicals, Epicutaneous (application onto the skin). in people who have LAG storage curve , for many years they remain like this. 2021. The IVGTT, however, fails to conform to Groop’s list of desirable properties of a methodology to measure insulin sensitivity, inasmuch as it creates unphysiological conditions. Share IVGTT in Medicalpage. Thus “glucose tolerance test” is a valuable diagnostic aid in the diagnosis of diabetes mellitus, insulin resistance, impaired beta-cell functionnand sometimes reactive hypoglycemia and acromegaly. The patient is advised to come to the laboratory in a fasting state, where after taking a fasting blood sample, the patient is given 75 grams of glucose. Lavik, E. and R. Langer, Tissue engineering; current state and perspectives. [25], Drug administration via the nasal cavity yields rapid drug absorption and therapeutic effects. For example, some drugs are not significantly absorbed into the bloodstream from the gastrointestinal tract and their action after enteral administration is therefore different from that after parenteral administration. [4][5] By this definition, topical administration also includes transdermal application, where the substance is administered onto the skin but is absorbed into the body to attain systemic distribution. Routes of administration are usually classified by application location (or exposition). The parenteral route is any route that is not enteral (par- + enteral). The IVGTT is more widely employed and has been used in intervention studies with many hundreds of participants [4, 5]. Administration through the gastrointestinal tract is sometimes termed enteral or enteric administration (literally meaning 'through the intestines'). Enteral/enteric administration usually includes oral[6] (through the mouth) and rectal (into the rectum)[6] administration, in the sense that these are taken up by the intestines. The same drug, when swallowed, acts exclusively on the bowels; it is here used to treat constipation under opiate pain therapy and does not affect the pain-reducing effect of the opiate. Parenteral administration can be performed by injection, that is, using a needle (usually a hypodermic needle) and a syringe,[16] or by the insertion of an indwelling catheter. [25] The oral route is limited to formulations containing small molecules only while biopharmaceuticals (usually proteins) would be digested in the stomach and thereby become ineffective. Biopharmaceuticals have to be given by injection or infusion. The test should not be done in acutely ill patients. The rectal route is an effective route of administration for many medications, especially those used at the end of life. Action may be topical (local), enteral (system-wide effect, but delivered through the gastrointestinal tract), or parenteral (systemic action, but delivered by routes other than the GI tract). [44], Buccally administered a medication is achieved by placing the drug between gums and the inner lining of the cheek. Always need such information.Thanks a lot. A.S.P.E.N. Some medications can have an unpleasant taste or irritate the mouth. Effect of digestive juices and the first pass metabolism of drugs. Rises rapidly in the 1/2 to 1 hour and exceeds the renal threshold so that the corresponding urine specimens show glucose. Urine sample always contains glucose except in some chronic diabetes or nephritis who may have raised renal threshold. [38], An inhaled powdery particle that is >8 μm is structurally predisposed to depositing in the central and conducting airways (conducting zone) by inertial impaction. Glucose content of all five samples of blood are estimated by the specific methods used in laboratory. In order to evaluate the diagnostic reliability of the oral glucose tolerance test (OGTT) and the intravenous glucose tolerance test (IVGTT), the results of these two teats have been-compared both to each other as well as to a third test of carbohydrate tolerance termed the pancreatic suppression test (PST), in forty-five subjects. Many drugs as tablets, capsules, or drops are taken orally. Intraocular, into the eye, e.g., some medications for. V Allegra's 24 research works with 282 citations and 71 reads, including: Lipid and apolipoprotein patterns during erythropoietin therapy: Roles of erythropoietin, route of administration, and diet Group 1 patients received combined therapy synchronously. [25], Skin absorption (dermal absorption), for example, is to directly deliver drug to the skin and, hopefully, to the systemic circulation. It can be used both for local effect as in allergy testing and typical. Enteral routes are generally the most convenient for the patient, as no punctures or sterile procedures are necessary. The oral route is generally the most convenient and costs the least. The location of the target effect of active substances are usually rather a matter of pharmacodynamics (concerning e.g. Rectal mucosa is highly vascularized tissue that allows for rapid and effective absorption of medications. An empirical index of insulin sensitivity from short IVGTT: validation against the minimal model and glucose clamp indices in patients with different clinical characteristics. APA. Thanks a lot for give a right information in easy lenguage .. © 2021 LaboratoryInfo.com. Glucose tolerance means ability of the body to utilize glucose in the circulation. [44], Intranasal absorption features low lipophilicity, enzymatic degradation within the nasal cavity, large molecular size, and rapid mucociliary clearance from the nasal passages, which explains the low risk of systemic exposure of the administered drug absorbed via intranasal. IVGTT may be chosen for patients who are unable to absorb an oral dose of glucose (eg. All Rights Reserved. An IVGTT was performed preoperatively and within 1 month postoperatively. Patients should avoid drugs likely to influence the blood glucose levels, at least 2 days prior to the test. Smeltzer SC Bare BG, Textbook of Medical-Surgical Nursing, 9th ed, Philadelphia: Lippincott, 2000. Identical drugs can produce different results depending on the route of administration. The IVGTT is more widely employed and has been used in intervention studies with many hundreds of participants [4, 5]. All Acronyms. Strictly enteral administration (directly into the intestines) can be used for systemic administration, as well as local (sometimes termed topical), such as in a contrast enema, whereby contrast media is infused into the intestines for imaging. 1. Intralesional (into a skin lesion), is used for local skin lesions, e.g. IVGTT may be chosen for patients who are unable to absorb an oral dose of glucose (eg. American Society for Parenteral and Enteral Nutrition, https://en.wikipedia.org/w/index.php?title=Route_of_administration&oldid=1013058794, Creative Commons Attribution-ShareAlike License, Intracerebral (into the cerebrum) administration by direct injection into the brain. In spite of these disadvantages, the intravenous route is one of the most important routes in drug self-administration studies both because of the data that have been obtained and because humans often use drugs intravenously; with regard to the latter point, it is worth noting that infection and death by overdose are not uncommon among humans who intravenously self-inject drugs. The highest value is reached after 1-1.5 hours. [26], In general, only 20–50% of the pulmonary-delivered dose rendered in powdery particles will be deposited in the lung upon mouth inhalation. Exceptions include the transdermal or transmucosal routes, which are still commonly referred to as routes of administration. He/She can drink water. [38], An inhaled powdery particle that is between 3 and 8 μm in diameter tend to largely deposit in the transitional zones of the lung by sedimentation. [45][44] In comparison with sublingual tissue, buccal tissue is less permeable resulting in slower absorption. Blood samples were obtained at −15, −5, 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, … Following a standard oral dose of glucose, plasma and urine glucose levels are monitored at regular intervals, in order to measure tolerance under defined conditions. If defined strictly as having local effect, the topical route of administration can also include enteral administration of medications that are poorly absorbable by the gastrointestinal tract. 2. One poorly absorbable antibiotic is vancomycin, which is recommended by mouth as a treatment for severe Clostridium difficile colitis.[24]. IVGTT. malabsorption syndrome). All the details are given in crisp form.very useful for students especially those who write exams. In other cases, topical is defined as applied to a localized area of the body or to the surface of a body part regardless of the location of the effect. [44], Neural drug delivery is the next step beyond the basic addition of growth factors to nerve guidance conduits. These experimental conditions have been tested and discussed in detail [6,7,8,9,10,11]. or AU Each ear or both ears HHN Hand held nebulizer I.D. should they be offerred Metformin or left untreated. This is the most characteristic feature of DM. However, for the purposes of classification based on location of effects, the term enteral is reserved for substances with systemic effects. 3. We chose the bolus route, since it is the most practical route of IV filgrastim administration recommended by the manufacturer. [26] Proper technique with inhaler devices is necessary to achieve the correct dose. of the IVGTT is that basing the glucose dose on the individual total body ... Irrespective of route of administration rela-tively low doses of glucose were not able to discriminate differences in glucose tolerance between normal weight and obese mice. [38], Inhalation by smoking a substance is likely the most rapid way to deliver drugs to the brain, as the substance travels directly to the brain without being diluted in the systemic circulation. [25] Some medications, such as certain antipsychotics, can be administered as long-acting intramuscular injections. This is the most reliable route, as in acutely ill patients the absorption of substances from the tissues and from the digestive tract can often be unpredictable due to altered blood flow or bowel motility. [44], Sublingual administration is fulfilled by placing the drug between the tongue and the lower surface of the mouth. Applied Microbiology Biotechnology, 2004. GTT is of two types depending upon the route of glucose administration : Oral Glucose Tolerance Test (OGTT) Intravenous Glucose Tolerance Test (IVGTT) OGTT is mostly preferred and is explained in detail here. The patient should be on balanced diet, containing normal daily requirement of carbohydrates, at least 2-3 days prior to the test. [15] A suppository is a solid dosage form that fits for rectal administration. [29] However, skin irritation may result, and for some forms such as creams or lotions, the dosage is difficult to control. All samples of blood should be venous preferably. GTT is of two types depending upon the route of glucose administration : OGTT is mostly preferred and is explained in detail here. [46], Path by which a drug, fluid, poison, or other substance is taken into the body, CS1 maint: multiple names: authors list (, Stahl SM, Stahl's Essential Psychopharmacology: Neuroscientific basis and practical applications, New York: Cambridge University Press, 2008. Rate of extent of absorption of the drug from different routes. IVGTT. This page was last edited on 19 March 2021, at 20:07. [42] Ongoing IV infusions can be used to deliver continuous medication or fluids. It is indicated only for the initial diagnosis. Patients should avoid drugs likely to influence the blood glucose levels, at least 2 days prior to the test. Patients who show no glucosuria when fasting may have glucosuria when blood glucose is raised. In particular, a threefold increase in the insulin sensitivity estimated by either the IVGTT minimal model or the EHC was observed, whereas the same index computed by the OGTT minimal model was raised six times ( P < 0.05). Intravenous glucose tolerance test (IVGTT) provocations are informative, but complex and laborious, for studying the glucose-insulin system. Nutrition, Nutrition Science, Nursing. Locations of application of parenteral administration include: The definition of the topical route of administration sometimes states that both the application location and the pharmacodynamic effect thereof is local.[3]. Members - International Textile Manufacturers Federation-ITMF. He/… As the drug is delivered to the site of action extremely rapidly with IV injection, there is a risk of overdose if the dose has been calculated incorrectly, and there is an increased risk of side effects if the drug is administered too rapidly. malabsorption syndrome). Whereas these results were reassuring, one source of concern was that the experimental conditions during the IVGTT were markedly different from those during the oral test both in terms of the route of glucose administration and in the pattern of change … [3], Topical administration is sometimes defined as both a local application location and local pharmacodynamic effect,[3] and sometimes merely as a local application location regardless of location of the effects.[4][5]. However, 1 month after BPD, insulin sensitivity reached values comparable to those found in control subjects, independently of the glucose administration route. IVGTT may be chosen for patients who are unable to absorb an oral dose of glucose (eg. Drug delivery systems allow the rate of growth factor release to be regulated over time, which is critical for creating an environment more closely representative of in vivo development environments. The intratympanic methylprednisolone was administered to patients 40 mg/1 mL every other day for a total of 4 doses. The bladder is emptied completely and urine is collected for qualitative test for glucose and ketone bodies. The highest value doesnot exceed the renal threshold (160-180 mg/dl). Alternatively search Google for IVGTT. Modification and Validation of the Triglyceride-to-HDL Cholesterol Ratio as a Surrogate of Insulin Sensitivity in White Juveniles and Adults without Diabetes Mellitus: The Single Point Insulin Sensitivity Estimator (SPISE) Right ear a.s. or A.S. Left ear a.u. During pregnancy, excessive weight gaining is noticed, with a past history of big baby (more than 4 kg) or a past history of miscarriage. Estimated Average Requirement. FDA Center for Drug Evaluation and Research Data Standards Manual: Route of Administration. The patient should be on balanced diet, containing normal daily requirement of carbohydrates, at least 2-3 days prior to the test. [39], The term injection encompasses intravenous (IV), intramuscular (IM), subcutaneous (SC) and intradermal (ID) administration. [28], By delivering drugs almost directly to the site of action, the risk of systemic side effects is reduced. The physical properties are solid, liquid and gas. the physiological effects of drugs[2]). [38], An inhaled powdery particle that is <3 μm in diameter is structurally predisposed to depositing primarily in the respiratory regions of the peripheral lung via diffusion. Patient should report to the laboratory after fasting for 12-16 hours. A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. No glucose or ketone bodies are detected in any specimen of urine. First-Phase Insulin Secretion Restoration and Differential Response to Glucose Load Depending on the Route of Administration in Type 2 Diabetic Subjects After Bariatric Surgery . [44] This is because drug absorption through the nasal passages doesn't go through the gut before entering capillaries situated at tissue cells and then systemic circulation and such absorption route allows transport of drugs into the central nervous system via the pathways of olfactory and trigeminal nerve. The disposition index from OGTT data was increased about 10-fold and became similar to the values found in control subjects, and the disposition index from IVGTT data increased about 3.5-fold, similarly to what happened after the euglycemic clamp. Initial fasting glucose within normal limits. Other regimens include admixing G‐CSF with albumin in the administration bag or administering it in a concentration >15 … Good work, God bless. Routes can also be classified based on where the target of action is. Route of administration and dosage form are aspects of drug delivery. acne medication. Any increased cardiovascular risk in these people or no. [44] The sublingual mucosa is highly permeable and thereby provides access to the underlying expansive network composed of capillaries, leading to rapid drug absorption. or IV Intravenous route IVP Intravenous push IVPB Intravenous piggyback NGT Nasogastric tube od or O.D. The IVGTT, however, fails to conform to Groop's list of desirable properties of a methodology to measure insulin sensitivity, inasmuch as it creates unphysiological conditions. [26] For drugs that come in delayed release or time-release formulations, breaking the tablets or capsules can lead to more rapid delivery of the drug than intended. The reason for choice of routes of drug administration are governing by various factors: In acute situations, in emergency medicine and intensive care medicine, drugs are most often given intravenously. OGTT has no role in follow up of diabetes. If the capillary blood from ‘finger-prick’ is used, all samples should be capillary blood. The OGTT is indicated in following conditions : There is no indication of doing OGTT in following conditions: Graph of OGTT, Interpretation of Glucose Tolerance Test, Interpretation of GTT, Interpretation of OGTT, Oral Glucose Tolerance Test, Principle of Glucose Tolerance Test, Principle of GTT, Principle of OGTT, Procedure of Glucose Tolerance Test, Very detailed and straight forward, easy to understand. Intrathecal route I.V. Route of Administration shall consist of an alphabetic term which has a maximum length shall be restricted to 60 characters, with the hyphen and virgule being only punctuation permissible. At 8:00–9:00 a.m., after a 12-h overnight fast, an intravenous catheter was placed in one antecubital vein and an intravenous bolus of 0.33 g glucose/kg body weight as 50% water solution was injected in the contralateral antecubital vein. A typical normal response shows following features. all about medical laboratories : microbiology, biochemistry, hematology, histopathology, virology, bacteriology, mycology and parasitology, Ketones in Urine (Ketonuria) – Clinical importance, How to perform test (Normal values) and interpretation, Benedict’s Test : Principle, Reagent Preparation, Procedure and Interpretation, Urinalysis (Urine testing) – Types, Process, Results Interpretation, Reference charts, Difference between Homozygous and Heterozygous, Difference between Transcription and Translation, Difference between Absorption and Adsorption, Difference Between Phenotype and Genotype, Difference between Biotic and Abiotic factors, Patients having symptoms suggestive of diabetes mellitus, but fasting blood sugar value is inconclusive (between. RESULTS: The first phase of insulin secretion after the IVGTT was fully normalized after the operation. However, recent research (2018) found an organic ionic liquid suitable for oral insulin delivery (a biopharmaceutical) into the blood stream.[27]. The highest value exceeds the renal threshold. Routes of administration are generally classified by the location at which the substance is applied. Note the time of oral glucose administration. Glucose appears in the urine at levels of blood glucose much below renal threshold. Intradermal route I.M. The objective of this study was to evaluate, through optimal design methodology, the possibilities of more informative and/or less laborious study design of the insulin modified IVGTT in type 2 diabetic patients.
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