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Medicines > routes : nebulized or thigh or transdermal

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classes:
NDRI (1) · Psychostimulant (1) · [[:Category:Acetylcholinesterase inhibitors|Acetylcholinesterase inhibitor]] (1) · [[:Category:ADHD medicines|ADHD medicine]] (1) · [[:Category:Alpha-2 adrenergic agonists|Alpha-2 adrenergic agonist]] (1) · [[:Category:Analgesics|Analgesic]] (1) · [[:Category:Anti-dementia medicines|Anti-dementia medicine]] (1) · [[:Category:Antianginals|Antianginal]] (1) · [[:Category:Antihypertensives|Antihypertensive]] (1) · [[:Category:Antimuscarinics|Antimuscarinic]] (1) · [[:Category:Catecholamines|Catecholamine]] (1) · [[:Category:Corticosteroids|Corticosteroid]] (1) · [[:Category:Crystalloid_IV_fluids|Crystalloid IV fluid]] (1) · [[:Category:Electrolyte_replacements|Electrolyte replacement]] (1) · [[:Category:Estrogens|Estrogen]] (1) · [[:Category:Glucocorticoids|Glucocorticoid]] (1) · [[:Category:Hormone_replacement_therapy|Hormone replacement therapy]] (1) · [[:Category:Inhaled_corticosteroids|Inhaled corticosteroid (ICS)]] (1) · [[:Category:Inotropes|Inotrope]] (1) · [[:Category:Nitrates|Organic nitrate]] (1) · [[:Category:NSAIDs|Non-steroidal anti-inflammatory (NSAID)]] (1) · [[:Category:Opioid withdrawal medicines|Opioid withdrawal medicine]] (1) · [[:Category:Overactive_bladder_medications|Overactive bladder medication]] (1) · [[:Category:Sex_hormones|Sex hormone]] (1) · [[:Category:Sympathomimetics|Sympathomimetic]] (1) · [[:Category:Vasodilators|Vasodilator]] (1) · [[:Category:Vasopressors|Vasopressor]] (1) · [[GLP-1 receptor agonist]] · [[Antidiabetic medicines|Antidiabetic]] · Fc-fusion biologic (1) · [[GLP-1 receptor agonist]] · [[Antidiabetic medicines|Antidiabetic]] · First-in-class incretin mimetic (1) · [[GLP-1 receptor agonist]] · [[Antidiabetic medicines|Antidiabetic]] · [[Anti-obesity medicines|Anti-obesity]] · [[Cardiovascular risk reduction]] agent (2) · [[GLP-1 receptor agonist]] · [[GIP receptor agonist]] · [[Antidiabetic medicines|Antidiabetic]] · [[Anti-obesity medicines|Anti-obesity]] · "Twincretin" (1)
uses:
ADHD, narcolepsy (1) · [[Type 2 diabetes mellitus]] (adjunct, second-line) (1) · [[Type 2 diabetes mellitus]] (incl. pediatric ≥10 y) · [[Obesity]] (incl. pediatric ≥12 y) · [[Cardiovascular risk reduction]] in T2DM (1) · [[Type 2 diabetes mellitus]] · [[Cardiovascular risk reduction]] in T2DM (1) · [[Type 2 diabetes mellitus]] · [[Obesity]] · [[Cardiovascular risk reduction]] in obesity without diabetes · [[MASH]] with stage 2–3 fibrosis · [[Chronic kidney disease]] in T2DM (1) · [[Type 2 diabetes mellitus]] · [[Obesity]] · [[Obstructive sleep apnea]] in obesity (1) · '"`UNIQ--vote-00000017-QINU`"', '"`UNIQ--vote-00000018-QINU`"', '"`UNIQ--vote-00000019-QINU`"', '"`UNIQ--vote-0000001A-QINU`"' (1) · '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"' (1) · '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"', '"`UNIQ--vote-00000026-QINU`"', '"`UNIQ--vote-00000027-QINU`"', '"`UNIQ--vote-00000028-QINU`"' (1) · '"`UNIQ--vote-00000039-QINU`"', '"`UNIQ--vote-0000003A-QINU`"', '"`UNIQ--vote-0000003B-QINU`"', '"`UNIQ--vote-0000003C-QINU`"', '"`UNIQ--vote-0000003D-QINU`"' (1) · '"`UNIQ--vote-000003B5-QINU`"', '"`UNIQ--vote-000003B6-QINU`"', '"`UNIQ--vote-000003B7-QINU`"', '"`UNIQ--vote-000003B8-QINU`"', '"`UNIQ--vote-000003B9-QINU`"' (1) · '"`UNIQ--vote-000006DE-QINU`"', '"`UNIQ--vote-000006DF-QINU`"', '"`UNIQ--vote-000006E0-QINU`"' (1) · '"`UNIQ--vote-0000099F-QINU`"', '"`UNIQ--vote-000009A0-QINU`"', '"`UNIQ--vote-000009A1-QINU`"', '"`UNIQ--vote-000009A2-QINU`"', '"`UNIQ--vote-000009A3-QINU`"', '"`UNIQ--vote-000009A4-QINU`"' (1) · '"`UNIQ--vote-00000C0A-QINU`"', '"`UNIQ--vote-00000C0B-QINU`"', '"`UNIQ--vote-00000C0C-QINU`"', '"`UNIQ--vote-00000C0D-QINU`"', '"`UNIQ--vote-00000C0E-QINU`"' (1) · '"`UNIQ--vote-00000E4C-QINU`"', '"`UNIQ--vote-00000E4D-QINU`"', '"`UNIQ--vote-00000E4E-QINU`"', '"`UNIQ--vote-00000E4F-QINU`"', '"`UNIQ--vote-00000E50-QINU`"', '"`UNIQ--vote-00000E51-QINU`"' (1)
starting dose:
None (1) · 0.75 mg SC weekly'"`UNIQ--ref-00000053-QINU`"' (1) · 2.5 mg SC weekly × 4 wk (non-therapeutic ramp)'"`UNIQ--ref-000002FB-QINU`"' (1) · 5 mg PO once daily at bedtime; titrate to 10 mg/day after 4-6 weeks. Severe Alzheimer disease: may escalate to 23 mg/day. Adlarity patch: 5 or 10 mg/day applied weekly (1) · ADHD (Kapvay ER): 0.1 mg PO at bedtime, titrate weekly to 0.4 mg/day divided BID. HTN (IR): 0.1 mg PO BID, titrate by 0.1 mg increments (1) · Anaphylaxis IM 0.3-0.5 mg (adult) into lateral thigh, repeat q5-15 minutes prn; pediatric 0.01 mg/kg IM (max 0.3 mg, max 0.5 mg in adolescents); cardiac arrest 1 mg IV/IO q3-5 minutes; severe asthma neb 0.1 mg/kg up to 5 mg; never IV bolus for anaphylaxis outside critical care (1) · Byetta: 5 µg SC twice daily, within 60 min before morning and evening meals'"`UNIQ--ref-000000E3-QINU`"' · Bydureon BCise: 2 mg SC once weekly'"`UNIQ--ref-000000E4-QINU`"' (1) · ICS Pulmicort Flexhaler 180-360 mcg BID; intranasal Rhinocort 64 mcg/spray, 1-2 sprays/nostril daily; Entocort EC 9 mg PO daily for active Crohn's; Symbicort 80/4.5 or 160/4.5 mcg, 2 puffs BID (1) · IR 5 mg PO BID-TID; ER 5-10 mg PO daily, titrate; transdermal patch 3.9 mg/d twice weekly (OTC) (1) · IR oral 50 mg PO TID or 75 mg BID. Voltaren 1% gel: apply 2-4 g to affected area QID. Pennsaid 2%: 40 drops to knee BID. Flector patch: every 12 hours (1) · Oral 1-2 mg daily; transdermal patch 0.025-0.05 mg/d twice weekly; transdermal gel 0.5-1 g/d; vaginal 10 mcg tablet twice weekly for GSM. Always combine with a progestogen in patients with an intact uterus. (1) · Ozempic: 0.25 mg SC weekly × 4 wk'"`UNIQ--ref-00000245-QINU`"' · Wegovy: 0.25 mg SC weekly × 4 wk'"`UNIQ--ref-00000246-QINU`"' · Rybelsus: 3 mg PO daily × 30 d'"`UNIQ--ref-00000247-QINU`"' (1) · SL 0.3-0.6 mg every 5 minutes up to 3 doses for acute angina (call EMS if not resolved after the third); IV infusion 5-10 mcg/min titrated; transdermal patch 0.2-0.4 mg/hr for 12-14 hours daily (nitrate-free interval prevents tolerance) (1) · Victoza: 0.6 mg SC daily × 1 wk'"`UNIQ--ref-00000181-QINU`"' · Saxenda: 0.6 mg SC daily × 1 wk'"`UNIQ--ref-00000182-QINU`"' (1) · Volume and concentration titrated to clinical status; symptomatic hyponatremia: 3% NaCl 100-150 mL bolus, reassess (1)
preparations:
None (1) · 0.225%, 0.45%, 0.9%, 3%, 5% IV solutions; 0.9% nasal spray; 3% and 7% nebulizer solutions; oral tablets (1 g) (1) · 5 mg IR tablets; 5, 10, 15 mg ER tablets; 5 mg/5 mL syrup; 3.9 mg/24 h transdermal patch (Oxytrol); 10% topical gel (1) · Auto-injectors 0.15 mg (Jr/pediatric), 0.3 mg (adult); 1 mg/mL (1:1,000) ampules for IM/SC use; 0.1 mg/mL (1:10,000) for IV use; 2.25% racemic nebulizer (1) · Byetta pre-filled multi-dose pen: 5 µg / 10 µg per dose'"`UNIQ--ref-000000E5-QINU`"' · Bydureon BCise single-dose autoinjector: 2 mg extended-release microsphere suspension'"`UNIQ--ref-000000E6-QINU`"' (1) · IR tablets 0.1, 0.2, 0.3 mg; ER tablets 0.1, 0.2 mg (Kapvay); transdermal patches 0.1, 0.2, 0.3 mg/24h (TTS-1/2/3, weekly); epidural injection (Duraclon) (1) · IR tablets 25, 50 mg; ER tablets 100 mg; Cataflam IR 50 mg; Zorvolex 18, 35 mg; Voltaren gel 1%; Pennsaid 2% topical solution; Flector transdermal patch; Solaraze 3% gel; Cambia oral powder 50 mg (1) · Oral 0.5, 1, 2 mg tablets; transdermal patches (twice-weekly and once-weekly); 0.06% gel; 1.53 mg/spray topical; vaginal ring (Estring); vaginal tablet (Vagifem/Yuvafem); vaginal cream (1) · Oral tablets 5, 10, 23 mg; ODT 5, 10 mg; Adlarity transdermal patch 5, 10 mg/day (weekly application) (1) · Pre-filled multi-dose pen (0.25 / 0.5 / 1 / 2 mg, Ozempic;'"`UNIQ--ref-00000248-QINU`"' 0.25 / 0.5 / 1 / 1.7 / 2.4 mg, Wegovy'"`UNIQ--ref-00000249-QINU`"') · Oral tablet 3 / 7 / 14 mg co-formulated with SNAC absorption enhancer (Rybelsus)'"`UNIQ--ref-0000024A-QINU`"' (1) · Pre-filled multi-dose pen (3 mL): Victoza 6 mg/mL (0.6 / 1.2 / 1.8 mg per day);'"`UNIQ--ref-00000183-QINU`"' Saxenda 6 mg/mL (0.6 / 1.2 / 1.8 / 2.4 / 3.0 mg per day)'"`UNIQ--ref-00000184-QINU`"' (1) · Pre-filled single-dose pen and vial: 2.5 / 5 / 7.5 / 10 / 12.5 / 15 mg'"`UNIQ--ref-000002FC-QINU`"''"`UNIQ--ref-000002FD-QINU`"' (1) · Pre-filled single-dose pen: 0.75 / 1.5 / 3 / 4.5 mg'"`UNIQ--ref-00000054-QINU`"' (1) · Pulmicort Flexhaler DPI 90, 180 mcg/dose; Pulmicort Respules 0.25, 0.5, 1 mg/2 mL nebulized; Rhinocort intranasal 32 mcg/spray; Entocort EC 3 mg capsules; Uceris 9 mg ER tablets and rectal foam (1) · SL 0.3, 0.4, 0.6 mg tablets; lingual spray 0.4 mg/spray; ER 2.5-9 mg capsules; transdermal patch 0.1-0.8 mg/hr; 2% ointment; 0.4% rectal ointment; 5 mg/mL IV (1)
routes: (Click arrow to add another value)
bioavailability:
100% (IV); essentially complete (oral) (1) · Highly route-dependent: SL bypasses first-pass; oral has extensive first-pass (used only for chronic ER preparations); transdermal predictable'"`UNIQ--ref-00000C10-QINU`"' (1) · IM/SC ~100%; oral negligible (extensive first-pass and gut metabolism — hence the no-oral route)'"`UNIQ--ref-00000E53-QINU`"' (1) · Oral ~5% (extensive first-pass to estrone and conjugates); transdermal bypasses first-pass, giving more physiologic estradiol:estrone ratio'"`UNIQ--ref-000003BB-QINU`"' (1) · SC ~47%–65%'"`UNIQ--ref-0000005A-QINU`"' (1) · SC ~55%'"`UNIQ--ref-0000018B-QINU`"' (1) · SC ~65%–75%<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · SC ~80%<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · SC ~89%<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> · Oral ~0.4–1% (SNAC-enhanced)'"`UNIQ--ref-00000254-QINU`"' (1) · ~100% (oral)'"`UNIQ--ref-0000001C-QINU`"' (1) · ~30% (high first-pass) (1) · ~50-60% (oral; substantial first-pass metabolism)'"`UNIQ--ref-0000002A-QINU`"' (1) · ~6% IR oral (substantial first-pass to active N-desethyl metabolite, which contributes most of the antimuscarinic adverse effects); transdermal bypasses first-pass and is better tolerated'"`UNIQ--ref-000006E2-QINU`"' (1) · ~6-13% inhaled lung deposition; ~10% oral (Entocort EC; extensive first-pass via CYP3A4 — this is the basis of the favorable hepatic-targeted local-effect profile in IBD)'"`UNIQ--ref-000009A6-QINU`"' (1) · ~75-85% (oral); ~60% (transdermal at steady state)'"`UNIQ--ref-00000027-QINU`"' (1)
pregnancy:
None (1) · Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)'"`UNIQ--ref-0000002B-QINU`"' (1) · Avoid. Discontinue at least 1 month before planned pregnancy. Animal data show embryofetal harm.'"`UNIQ--ref-0000005B-QINU`"' (1) · Avoid. Discontinue before planned pregnancy.'"`UNIQ--ref-000000EF-QINU`"' (1) · Avoid. Discontinue before planned pregnancy.'"`UNIQ--ref-0000018C-QINU`"' (1) · Avoid. Discontinue ≥1 month pre-conception. May reduce oral contraceptive efficacy during titration.'"`UNIQ--ref-00000304-QINU`"' (1) · Contraindicated in pregnancy (use is not appropriate during gestation; class label X). Lactation considerations vary by indication.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data; rarely indicated in pregnancy given the patient population.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Long the preferred ICS in pregnancy (Pulmicort) due to the most pregnancy data among the class.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Older agent with substantial use experience but limited controlled data; case reports of neonatal sedation and transient hypertension with maternal use near term.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Pregnancy categories were retired by FDA in 2015. Limited reproductive data with small observational signal for cardiac malformations; risk-benefit decision, with many patients deferring ADHD treatment during pregnancy. See pregnancy_details for the full discussion. (1) · Standard fluid and electrolyte management (1) · Used in life-threatening obstetric anaphylaxis without hesitation; benefits clearly outweigh.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Used in obstetric emergencies (uterine relaxation, severe hypertension) when needed; otherwise limited routine use.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

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