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Intrathecal administration
Intrathecal administration is a route of administration for drugs via an injection into the spinal canal, or into the subarachnoid space (sin. intrathecal space) so that it reaches the cerebrospinal fluid (CSF). It is useful in several applications, such as for spinal anesthesia, chemotherapy, or pain management. 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 blood–brain barrier, 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.
Intrathecal pseudodelivery is a technique where the drug is encapsulated in a porous capsule that is placed in communication with the 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.
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 anatomic space or potential space inside a sheath, most commonly the arachnoid membrane of the brain or spinal cord (under which is the subarachnoid space). For example, intrathecal immunoglobulin production is production of antibodies in the spinal cord. The abbreviation "IT" is best not used; instead, "intrathecal" is spelled out to avoid medical mistakes.[citation needed]
Intrathecal administration of drugs for anaesthesia or analgesia can be utilized in the form of single-dose or continuous via catheter with external or internal pump depending on indication and duration needed. Usually a combination of a local anesthetic and one or more adjuvant drugs are used.
Intrathecal clonidine or dexmedetomidine can be used to prolong duration of anaesthesia and analgesia but comes with increased risk of hypotension.
Lipophilic opioids such as fentanyl and sufentanil can be administered intrathecally for short duration of anaesthesia and analgesia.
Hydrophilic opioids such as morphine, diamorphine and hydromorphone can be administered intrathecally for longer duration of analgesia, up to 24 hours.
Pethidine has the unusual property of being both a local anaesthetic and opioid analgesic, which occasionally permits its use as the sole intrathecal anaesthetic agent.
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Intrathecal administration AI simulator
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Intrathecal administration
Intrathecal administration is a route of administration for drugs via an injection into the spinal canal, or into the subarachnoid space (sin. intrathecal space) so that it reaches the cerebrospinal fluid (CSF). It is useful in several applications, such as for spinal anesthesia, chemotherapy, or pain management. 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 blood–brain barrier, 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.
Intrathecal pseudodelivery is a technique where the drug is encapsulated in a porous capsule that is placed in communication with the 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.
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 anatomic space or potential space inside a sheath, most commonly the arachnoid membrane of the brain or spinal cord (under which is the subarachnoid space). For example, intrathecal immunoglobulin production is production of antibodies in the spinal cord. The abbreviation "IT" is best not used; instead, "intrathecal" is spelled out to avoid medical mistakes.[citation needed]
Intrathecal administration of drugs for anaesthesia or analgesia can be utilized in the form of single-dose or continuous via catheter with external or internal pump depending on indication and duration needed. Usually a combination of a local anesthetic and one or more adjuvant drugs are used.
Intrathecal clonidine or dexmedetomidine can be used to prolong duration of anaesthesia and analgesia but comes with increased risk of hypotension.
Lipophilic opioids such as fentanyl and sufentanil can be administered intrathecally for short duration of anaesthesia and analgesia.
Hydrophilic opioids such as morphine, diamorphine and hydromorphone can be administered intrathecally for longer duration of analgesia, up to 24 hours.
Pethidine has the unusual property of being both a local anaesthetic and opioid analgesic, which occasionally permits its use as the sole intrathecal anaesthetic agent.