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Intrathecal administration - Wikipedia

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class="vector-toc-numb">1.3</span> <span>Cancer chemotherapy</span> </div> </a> <ul id="toc-Cancer_chemotherapy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Baclofen" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Baclofen"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Baclofen</span> </div> </a> <ul id="toc-Baclofen-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mesenchymal_Stem_Cell_Therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mesenchymal_Stem_Cell_Therapy"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5</span> <span>Mesenchymal Stem Cell Therapy</span> </div> </a> <ul id="toc-Mesenchymal_Stem_Cell_Therapy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div 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class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Drug injected into the spinal canal</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color:dimgray; color: white">Subarachnoid space</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:1316_Meningeal_LayersN.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/1316_Meningeal_LayersN.jpg/250px-1316_Meningeal_LayersN.jpg" decoding="async" width="250" height="136" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4c/1316_Meningeal_LayersN.jpg/375px-1316_Meningeal_LayersN.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4c/1316_Meningeal_LayersN.jpg/500px-1316_Meningeal_LayersN.jpg 2x" data-file-width="949" data-file-height="515" /></a></span><div class="infobox-caption">Diagrammatic representation of a section across the top of the skull, showing the membranes of the brain, etc. ("Subarachnoid cavity" visible at left.)</div></td></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Gray770-en.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/31/Gray770-en.svg/250px-Gray770-en.svg.png" decoding="async" width="250" height="98" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/31/Gray770-en.svg/375px-Gray770-en.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/31/Gray770-en.svg/500px-Gray770-en.svg.png 2x" data-file-width="709" data-file-height="279" /></a></span><div class="infobox-caption">Diagrammatic transverse section of the medulla spinalis and its membranes. (Subarachnoid cavity colored blue.)</div></td></tr><tr><th colspan="2" class="infobox-header" style="background-color: #efefef">Details</th></tr><tr><th colspan="2" class="infobox-header" style="background-color: #efefef">Identifiers</th></tr><tr><th scope="row" class="infobox-label" style="padding-right:0.25em"><a href="/wiki/Latin" title="Latin">Latin</a></th><td class="infobox-data"><i>Spatium subarachnoideum, <br />cavum subarachnoideale</i></td></tr><tr><td colspan="2" class="infobox-below"><a href="/wiki/Anatomical_terminology" title="Anatomical terminology">Anatomical terminology</a><div style="text-align: right;"><small class="noprint">&#91;<a href="https://www.wikidata.org/wiki/Q1320251" class="extiw" title="d:Q1320251">edit on Wikidata</a>]</small></div></td></tr></tbody></table> <p><b>Intrathecal administration</b> is a <a href="/wiki/Route_of_administration" title="Route of administration">route of administration</a> for drugs via an <a href="/wiki/Injection_(medicine)" title="Injection (medicine)">injection</a> into the <a href="/wiki/Spinal_canal" title="Spinal canal">spinal canal</a>, or into the <a href="/wiki/Subarachnoid_space" class="mw-redirect" title="Subarachnoid space">subarachnoid space</a> so that it reaches the <a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">cerebrospinal fluid</a> (CSF). It is useful in several applications, such as for <a href="/wiki/Spinal_anesthesia" class="mw-redirect" title="Spinal anesthesia">spinal anesthesia</a>, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, or <a href="/wiki/Pain_management" title="Pain management">pain management</a>. This route is also used to introduce drugs that fight certain infections, particularly post-neurosurgical. Typically, the drug is given this way to avoid being stopped by the <a href="/wiki/Blood%E2%80%93brain_barrier" title="Blood–brain barrier">blood–brain barrier</a>, as it may not be able to pass into the brain when given orally. Drugs given by the intrathecal route often have to be compounded specially by a pharmacist or technician because they cannot contain any preservative or other potentially harmful inactive ingredients that are sometimes found in standard injectable drug preparations. </p><p>Intrathecal pseudodelivery is a technique where the drug is encapsulated in a porous capsule that is placed in communication with the cerebrospinal CSF. In this method, the drug is not released into the CSF. Instead, the CSF is in communication with the capsule through its porous walls, allowing the drug to interact with its target within the capsule itself. This allows for localized treatment while avoiding systemic distribution of the drug, potentially reducing side effects and enhancing the therapeutic efficacy for conditions affecting the central nervous system. </p><p>The route of administration is sometimes simply referred to as "intrathecal"; however, the term is also an adjective that refers to something occurring in or introduced into the <a href="/wiki/Anatomic_space" title="Anatomic space">anatomic space</a> or <a href="/wiki/Potential_space" title="Potential space">potential space</a> inside a sheath, most commonly the <a href="/wiki/Arachnoid_membrane" class="mw-redirect" title="Arachnoid membrane">arachnoid membrane</a> of the <a href="/wiki/Brain" title="Brain">brain</a> or <a href="/wiki/Spinal_cord" title="Spinal cord">spinal cord</a><sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup> (under which is the <a href="/wiki/Subarachnoid_space" class="mw-redirect" title="Subarachnoid space">subarachnoid space</a>). For example, intrathecal immunoglobulin production is production of antibodies in the spinal cord.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> The abbreviation "IT" is best not used; instead, "intrathecal" is spelled out to avoid medical mistakes.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2024)">citation needed</span></a></i>&#93;</sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Applications_of_intrathecal_administration">Applications of intrathecal administration</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=1" title="Edit section: Applications of intrathecal administration"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Analgesics">Analgesics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=2" title="Edit section: Analgesics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Intrathecal administration is often used for a single 24-hour dose of analgesia (<a href="/wiki/Opioid" title="Opioid">opioid</a> with <a href="/wiki/Local_anesthetic" title="Local anesthetic">local anesthetic</a>). Caution should be exercised with intrathecal opioids due to the risk of late onset <a href="/wiki/Hypoventilation" title="Hypoventilation">hypoventilation</a>. The use of intrathecal <a href="/wiki/Morphine" title="Morphine">morphine</a> may be limited by severe <a href="/wiki/Itch" title="Itch">pruritus</a> and <a href="/wiki/Urinary_retention" title="Urinary retention">urinary retention</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2024)">citation needed</span></a></i>&#93;</sup> </p><p><a href="/wiki/Pethidine" title="Pethidine">Pethidine</a> has the unusual property of being both a local anaesthetic and opioid <a href="/wiki/Analgesic" title="Analgesic">analgesic</a>, which occasionally permits its use as the sole intrathecal anaesthetic agent.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2024)">citation needed</span></a></i>&#93;</sup> </p><p>An intrathecal pump system can be used to deliver a local anaesthetic, and/or an opioid and/or an atypical analgesic agent as <a href="/wiki/Ziconotide" title="Ziconotide">ziconotide</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Antifungals">Antifungals</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=3" title="Edit section: Antifungals"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Amphotericin_B" title="Amphotericin B">Amphotericin B</a> is administered intrathecally to treat fungal infections involving the central nervous system infections.<sup id="cite_ref-&#80;MID32349999_3-0" class="reference"><a href="#cite_note-PMID32349999-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cancer_chemotherapy">Cancer chemotherapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=4" title="Edit section: Cancer chemotherapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Currently, only four agents are licensed for intrathecal cancer chemotherapy: <a href="/wiki/Methotrexate" title="Methotrexate">methotrexate</a>, <a href="/wiki/Cytarabine" title="Cytarabine">cytarabine</a>, <a href="/wiki/Hydrocortisone" title="Hydrocortisone">hydrocortisone</a>, and <a href="/wiki/Thiotepa" title="Thiotepa">thiotepa</a>.<sup id="cite_ref-pmid8445432_4-0" class="reference"><a href="#cite_note-pmid8445432-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup> </p><p>Administration of any <a href="/wiki/Vinca_alkaloid" title="Vinca alkaloid">vinca alkaloids</a>, especially <a href="/wiki/Vincristine" title="Vincristine">vincristine</a>, via the intrathecal route is nearly always fatal.<sup id="cite_ref-pmid15378106_5-0" class="reference"><a href="#cite_note-pmid15378106-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-pmid17355029_6-0" class="reference"><a href="#cite_note-pmid17355029-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-IMSN-gTMSBP_7-0" class="reference"><a href="#cite_note-IMSN-gTMSBP-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Baclofen">Baclofen</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=5" title="Edit section: Baclofen"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Often reserved for <a href="/wiki/Spastic_cerebral_palsy" title="Spastic cerebral palsy">spastic cerebral palsy</a>, <a href="/wiki/Baclofen" title="Baclofen">baclofen</a> can be administered through an <a href="/wiki/Intrathecal_pump" title="Intrathecal pump">intrathecal pump</a> implanted just below the skin of the abdomen or behind the chest wall, with a catheter connected directly to the base of the spine. Intrathecal baclofen pumps sometimes carry serious clinical risks, such as infection or a possibly fatal sudden malfunction.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (May 2024)">citation needed</span></a></i>&#93;</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Mesenchymal_Stem_Cell_Therapy">Mesenchymal Stem Cell Therapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=6" title="Edit section: Mesenchymal Stem Cell Therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Treatment of chronic spinal injuries via the administration of <a href="/wiki/Mesenchymal_stem_cells" class="mw-redirect" title="Mesenchymal stem cells">mesenchymal stem cells</a>,<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> either from adipose tissue or bone marrow, is experimental, with better results from the former method. Introduction of mesenchymal stem cells promote the microenvironment needed for axonal regrowth and reduction of inflammation caused by astrocytes proliferation and glial scar tissue.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup> </p><p>Animal models have showed improved motor control under the site of injury. A clinical trial also showed statistically significant improved sensitivity under the site of injury in patients.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=7" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Cancer_pain#Interventional" title="Cancer pain">Cancer pain/Interventional/Intrathecal pump</a></li> <li><a href="/wiki/History_of_neuraxial_anesthesia" title="History of neuraxial anesthesia">History of neuraxial anesthesia</a></li> <li><a href="/wiki/Intrathecal_pump" title="Intrathecal pump">Intrathecal pump</a></li> <li><a href="/wiki/Theca" title="Theca">Theca</a></li> <li><a href="/wiki/Thecal_sac" title="Thecal sac">Thecal sac</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Intrathecal_administration&amp;action=edit&amp;section=8" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.fda.gov/Drugs/DevelopmentApprovalProcess/FormsSubmissionRequirements/ElectronicSubmissions/DataStandardsManualmonographs/ucm071667.htm">"Route of Administration"</a>. <i>Data Standards Manual</i>. 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href="/wiki/Special:EditPage/Template:Routes_of_administration,_dosage_forms" title="Special:EditPage/Template:Routes of administration, dosage forms"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Routes_of_administration,_dosage_forms" style="font-size:114%;margin:0 4em"><a href="/wiki/Route_of_administration" title="Route of administration">Routes of administration</a>, <a href="/wiki/Dosage_form" title="Dosage form">dosage forms</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oral_administration" title="Oral administration">Oral</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="/wiki/Human_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">Digestive tract</a> (<a href="/wiki/Enteral_administration" title="Enteral administration">enteral</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="/wiki/Solid" title="Solid">Solids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tablet_(pharmacy)" title="Tablet (pharmacy)">Tablet</a></li> <li><a href="/wiki/Capsule_(pharmacy)" title="Capsule (pharmacy)">Capsule</a></li> <li><a href="/wiki/Pastille" title="Pastille">Pastille</a></li> <li><a href="/wiki/Time_release_technology" class="mw-redirect" title="Time release technology">Time release technology</a></li> <li><a href="/wiki/Osmotic-controlled_release_oral_delivery_system" title="Osmotic-controlled release oral delivery system">Osmotic delivery system</a></li></ul> </div></td><td class="noviewer navbox-image" rowspan="2" style="width:1px;padding:0 0 0 2px"><div><span typeof="mw:File"><a href="/wiki/File:FlattenedRoundPills.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/00/FlattenedRoundPills.jpg/60px-FlattenedRoundPills.jpg" decoding="async" width="60" height="45" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/00/FlattenedRoundPills.jpg/90px-FlattenedRoundPills.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/00/FlattenedRoundPills.jpg/120px-FlattenedRoundPills.jpg 2x" data-file-width="2048" data-file-height="1536" /></a></span><br /><span typeof="mw:File"><a href="/wiki/File:Hexaaquatitanium(III)-solution.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bf/Hexaaquatitanium%28III%29-solution.jpg/60px-Hexaaquatitanium%28III%29-solution.jpg" decoding="async" width="60" height="67" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bf/Hexaaquatitanium%28III%29-solution.jpg/90px-Hexaaquatitanium%28III%29-solution.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bf/Hexaaquatitanium%28III%29-solution.jpg/120px-Hexaaquatitanium%28III%29-solution.jpg 2x" data-file-width="1619" data-file-height="1816" /></a></span></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="/wiki/Liquid" title="Liquid">Liquids</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Decoction" title="Decoction">Decoction</a></li> <li><a href="/wiki/Elixir" title="Elixir">Elixir</a></li> <li><a href="/wiki/Electuary" title="Electuary">Electuary</a></li> <li><a href="/wiki/Emulsion" title="Emulsion">Emulsion</a></li> <li><a href="/wiki/Effervescent_tablet" title="Effervescent tablet">Effervescent powder or tablet</a></li> <li><a href="/wiki/Herbal_tea" title="Herbal tea">Herbal tea</a></li> <li><a href="/wiki/Hydrogel" title="Hydrogel">Hydrogel</a></li> <li><a href="/wiki/Molecular_encapsulation" class="mw-redirect" title="Molecular encapsulation">Molecular encapsulation</a></li> <li><a href="/wiki/Powder" title="Powder">Powder</a></li> <li><a href="/wiki/Softgel" title="Softgel">Softgel</a></li> <li><a href="/wiki/Solution_(chemistry)" title="Solution (chemistry)">Solution</a></li> <li><a href="/wiki/Suspension_(chemistry)" title="Suspension (chemistry)">Suspension</a></li> <li><a href="/wiki/Syrup" title="Syrup">Syrup</a></li> <li><a href="/wiki/Tincture" title="Tincture">Tincture</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="/wiki/Oral_mucosa" title="Oral mucosa">Oral mucosa</a> (<a href="/wiki/Buccal_administration" title="Buccal administration">buccal</a>, <a href="/wiki/Sublabial_administration" title="Sublabial administration">sublabial</a>, <a href="/wiki/Sublingual_administration" title="Sublingual administration">sublingual</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="/wiki/Solid" title="Solid">Solids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Orally_disintegrating_tablet" title="Orally disintegrating tablet">Orally disintegrating tablet</a></li> <li><a href="/wiki/Thin_film_drug_delivery" class="mw-redirect" title="Thin film drug delivery">Film</a></li> <li><a href="/wiki/Lollipop#Medicinal_use" title="Lollipop">Lollipop</a></li> <li><a href="/wiki/Drop_(liquid)" title="Drop (liquid)">Sublingual drops</a></li> <li><a href="/wiki/Throat_lozenge" title="Throat lozenge">Lozenges</a></li> <li><a href="/wiki/Effervescent" class="mw-redirect" title="Effervescent">Effervescent</a> tablet</li> <li><a href="/wiki/Chewing_gum" title="Chewing gum">Chewing gum</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="/wiki/Liquid" title="Liquid">Liquids</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Mouthwash" title="Mouthwash">Mouthwash</a></li> <li><a href="/wiki/Toothpaste" title="Toothpaste">Toothpaste</a></li> <li><a href="/wiki/Topical" class="mw-redirect" title="Topical">Ointment</a></li> <li>Spray</li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="/wiki/Respiratory_tract" title="Respiratory tract">Respiratory tract</a> (<a href="/wiki/Inhalation" title="Inhalation">inhalation</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="/wiki/Solid" title="Solid">Solids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dry-powder_inhaler" title="Dry-powder inhaler">Dry-powder inhaler</a></li> <li><a href="/wiki/Smoking" title="Smoking">Smoking</a></li></ul> </div></td><td class="noviewer navbox-image" rowspan="3" style="width:1px;padding:0 0 0 2px"><div><span typeof="mw:File"><a href="/wiki/File:Inhaler.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Inhaler.jpg/60px-Inhaler.jpg" decoding="async" width="60" height="60" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Inhaler.jpg/90px-Inhaler.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b6/Inhaler.jpg/120px-Inhaler.jpg 2x" data-file-width="1704" data-file-height="1715" /></a></span><br /><span style="visibility:hidden;color:transparent;">0</span><br /><span style="visibility:hidden;color:transparent;">0</span></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="/wiki/Liquid" title="Liquid">Liquids</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anesthetic_vaporizer" class="mw-redirect" title="Anesthetic vaporizer">Anesthetic vaporizer</a></li> <li><a href="/wiki/Heated_humidified_high-flow_therapy" title="Heated humidified high-flow therapy">Heated humidified high-flow therapy</a></li> <li><a href="/wiki/List_of_medical_inhalants" title="List of medical inhalants">Medical inhalants</a></li> <li><a href="/wiki/Metered-dose_inhaler" title="Metered-dose inhaler">Metered-dose inhaler</a> (MDI)</li> <li><a href="/wiki/Nebulizer" title="Nebulizer">Nebulizer</a></li> <li><a href="/wiki/Vaporizer_(inhalation_device)" title="Vaporizer (inhalation device)">Vaporizer</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;white-space:normal;"><a href="/wiki/Gas" title="Gas">Gas</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Oxygen_mask" title="Oxygen mask">Oxygen mask</a> and <a href="/wiki/Nasal_cannula" title="Nasal cannula">Nasal cannula</a></li> <li><a href="/wiki/Oxygen_concentrator" title="Oxygen concentrator">Oxygen concentrator</a></li> <li><a href="/wiki/Anaesthetic_machine" title="Anaesthetic machine">Anaesthetic machine</a></li> <li><a href="/wiki/List_of_medical_inhalants" title="List of medical inhalants">Medical inhalants</a></li> <li><a href="/wiki/Relative_analgesia_machine" title="Relative analgesia machine">Relative analgesia machine</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ophthalmic_drug_administration" title="Ophthalmic drug administration">Ophthalmic</a>,<br /><a href="/wiki/Ear" title="Ear">otic</a>, <a href="/wiki/Nasal_administration" title="Nasal administration">nasal</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><figure class="mw-halign-right" typeof="mw:File"><a href="/wiki/File:Action_photo_of_nasal_spray_on_a_black_background.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Action_photo_of_nasal_spray_on_a_black_background.jpg/30px-Action_photo_of_nasal_spray_on_a_black_background.jpg" decoding="async" width="30" height="45" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Action_photo_of_nasal_spray_on_a_black_background.jpg/45px-Action_photo_of_nasal_spray_on_a_black_background.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a7/Action_photo_of_nasal_spray_on_a_black_background.jpg/60px-Action_photo_of_nasal_spray_on_a_black_background.jpg 2x" data-file-width="680" data-file-height="1024" /></a><figcaption></figcaption></figure> <ul><li><a href="/wiki/Nasal_spray" title="Nasal spray">Nasal spray</a></li> <li><a href="/wiki/Ear_drop" title="Ear drop">Ear drops</a></li> <li><a href="/wiki/Eye_drop" title="Eye drop">Eye drops</a></li> <li><a href="/wiki/Topical" class="mw-redirect" title="Topical">Ointment</a></li> <li><a href="/wiki/Hydrogel" title="Hydrogel">Hydrogel</a></li> <li><a href="/wiki/Insufflation_(medicine)" title="Insufflation (medicine)">Insufflation</a></li> <li><a href="/wiki/Bioadhesive" title="Bioadhesive">Mucoadhesive microdisc</a></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Genitourinary_system" title="Genitourinary system">Urogenital</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <li><a href="/wiki/Topical" class="mw-redirect" title="Topical">Ointment</a></li> <li><a href="/wiki/Pessary" title="Pessary">Pessary</a></li> <li><a href="/wiki/Vaginal_ring" title="Vaginal ring">Vaginal ring</a></li> <li><a href="/wiki/Douche" title="Douche">Douche</a></li> <li><a href="/wiki/Intrauterine_device" title="Intrauterine device">Intrauterine device</a> (IUD)</li> <li><a href="/wiki/Extra-amniotic_administration" title="Extra-amniotic administration">Extra-amniotic infusion</a></li> <li><a href="/wiki/Urinary_bladder" class="mw-redirect" title="Urinary bladder">Intravesical infusion</a></li> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectal_(medicine)" class="mw-redirect" title="Rectal (medicine)">Rectal</a> (<a href="/wiki/Enteral_administration" title="Enteral administration">enteral</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><figure class="mw-halign-right" typeof="mw:File"><a href="/wiki/File:Glycerin_suppositories.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/98/Glycerin_suppositories.jpg/30px-Glycerin_suppositories.jpg" decoding="async" width="30" height="23" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/98/Glycerin_suppositories.jpg/45px-Glycerin_suppositories.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/98/Glycerin_suppositories.jpg/60px-Glycerin_suppositories.jpg 2x" data-file-width="2126" data-file-height="1623" /></a><figcaption></figcaption></figure> <ul><li><a href="/wiki/Topical" class="mw-redirect" title="Topical">Ointment</a></li> <li><a href="/wiki/Suppository" title="Suppository">Suppository</a></li> <li><a href="/wiki/Enema" title="Enema">Enema</a> <ul><li><a href="/wiki/Solution_(chemistry)" title="Solution (chemistry)">Solution</a></li> <li><a href="/wiki/Hydrogel" title="Hydrogel">Hydrogel</a></li></ul></li> <li><a href="/wiki/Murphy_drip" title="Murphy drip">Murphy drip</a></li> <li><a href="/wiki/Nutrient_enema" title="Nutrient enema">Nutrient enema</a></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dermis" title="Dermis">Dermal</a> (<a href="/wiki/Topical_medication" title="Topical medication">topical</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><figure class="mw-halign-right" typeof="mw:File"><a href="/wiki/File:SPF15SunBlock.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/9a/SPF15SunBlock.JPG/40px-SPF15SunBlock.JPG" decoding="async" width="40" height="55" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/9a/SPF15SunBlock.JPG/60px-SPF15SunBlock.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/9a/SPF15SunBlock.JPG/80px-SPF15SunBlock.JPG 2x" data-file-width="246" data-file-height="338" /></a><figcaption></figcaption></figure> <li><a href="/wiki/Topical" class="mw-redirect" title="Topical">Ointment</a></li> <li><a href="/wiki/Topical_cream" class="mw-redirect" title="Topical cream">Topical cream</a></li> <li><a href="/wiki/Topical_gel" class="mw-redirect" title="Topical gel">Topical gel</a></li> <li><a href="/wiki/Liniment" title="Liniment">Liniment</a></li> <li><a href="/wiki/Paste_(rheology)" title="Paste (rheology)">Paste</a></li> <li><a href="/wiki/Thin_film_drug_delivery" class="mw-redirect" title="Thin film drug delivery">Film</a></li> <li><a href="/wiki/Dimethyl_sulfoxide" title="Dimethyl sulfoxide">DMSO</a> solution</li> <li><a href="/wiki/Iontophoresis" title="Iontophoresis">Iontophoresis</a></li> <li><a href="/wiki/Hydrogel" title="Hydrogel">Hydrogel</a></li> <li><a href="/wiki/Liposome" title="Liposome">Liposomes</a></li> <li><a href="/wiki/Transfersome" title="Transfersome">Transfersome vesicles</a></li> <li><a href="/wiki/Cream_(pharmaceutical)" class="mw-redirect" title="Cream (pharmaceutical)">Cream</a></li> <li><a href="/wiki/Lotion" title="Lotion">Lotion</a></li> <li><a href="/wiki/Lip_balm" title="Lip balm">Lip balm</a></li> <li><a href="/wiki/Shampoo" title="Shampoo">Medicated shampoo</a></li> <li><a href="/wiki/Dermal_patch" title="Dermal patch">Dermal patch</a></li> <li><a href="/wiki/Transdermal_patch" title="Transdermal patch">Transdermal patch</a></li> <li><a href="/wiki/Transdermal_spray" title="Transdermal spray">Transdermal spray</a></li> <li><a href="/wiki/Jet_injector" title="Jet injector">Jet injector</a></li></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0;"><div class="plainlist"><ul><li><a href="/wiki/Parenteral" class="mw-redirect" title="Parenteral">Parenterals</a></li><li><a href="/wiki/Injection_(medicine)" title="Injection (medicine)">Injections</a></li><li><a href="/wiki/Infusion_pump" title="Infusion pump">infusions</a></li></ul></div><br /><small><i>(into tissue/blood)</i></small></div></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="/wiki/Human_skin" title="Human skin">Skin</a> (<a href="/wiki/Transdermal" title="Transdermal">transdermal</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <li><a href="/wiki/Intradermal_injection" title="Intradermal injection">Intradermal</a></li> <li><a href="/wiki/Subcutaneous_injection" class="mw-redirect" title="Subcutaneous injection">Subcutaneous</a> <ul><li><a href="/wiki/Injector_pen" title="Injector pen">Injector pen</a></li></ul></li> <li><a href="/wiki/Transdermal_implant" title="Transdermal implant">Transdermal implant</a></li> </div></td><td class="noviewer navbox-image" rowspan="4" style="width:1px;padding:0 0 0 2px"><div><span typeof="mw:File"><a href="/wiki/File:Injection_Syringe_01.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Injection_Syringe_01.jpg/60px-Injection_Syringe_01.jpg" decoding="async" width="60" height="83" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Injection_Syringe_01.jpg/90px-Injection_Syringe_01.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a5/Injection_Syringe_01.jpg/120px-Injection_Syringe_01.jpg 2x" data-file-width="1002" data-file-height="1386" /></a></span></div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="/wiki/Human_anatomy#Major_organ_systems" class="mw-redirect" title="Human anatomy">Organs</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intracavernous_injection" title="Intracavernous injection">Intracavernous</a></li> <li><a href="/wiki/Intravitreal_administration" title="Intravitreal administration">Intravitreal</a></li> <li><a href="/wiki/Intra-articular_injection" class="mw-redirect" title="Intra-articular injection">Intra-articular</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="/wiki/Central_nervous_system" title="Central nervous system">Central nervous system</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/w/index.php?title=Intracerebral_injection&amp;action=edit&amp;redlink=1" class="new" title="Intracerebral injection (page does not exist)">Intracerebral</a></li> <li><a class="mw-selflink selflink">Intrathecal</a></li> <li><a href="/wiki/Epidural_administration" title="Epidural administration">Epidural</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:10em;white-space:normal;"><a href="/wiki/Circulatory_system" title="Circulatory system">Circulatory</a>,<br /><a href="/wiki/Human_musculoskeletal_system" title="Human musculoskeletal system">musculoskeletal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intravenous" class="mw-redirect" title="Intravenous">Intravenous</a></li> <li><a href="/wiki/Intracardiac_injection" title="Intracardiac injection">Intracardiac</a></li> <li><a href="/wiki/Intramuscular_injection" title="Intramuscular injection">Intramuscular</a></li> <li><a href="/wiki/Intraosseous_infusion" title="Intraosseous infusion">Intraosseous</a></li> <li><a href="/wiki/Intraperitoneal_injection" title="Intraperitoneal injection">Intraperitoneal</a></li> <li><a href="/wiki/Nanocell" title="Nanocell">Nanocell injection</a></li> <li><a href="/wiki/Patient-controlled_analgesia" title="Patient-controlled analgesia">Patient-controlled analgesia</a> pump</li> <li><a href="/wiki/PIC_line" class="mw-redirect" title="PIC line">PIC line</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by mw‐web.codfw.main‐d465dfd78‐q56xn Cached time: 20241126125450 Cache expiry: 2592000 Reduced expiry: false Complications: [vary‐revision‐sha1, show‐toc] CPU time usage: 0.554 seconds Real time usage: 0.772 seconds Preprocessor visited node count: 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