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Countermeasures: glucose administration, rapidly absorbed CH orally or 10–20 g glucose i. v. in case of unconsciousness; if necessary, injection of glucagon, the pancreatic hyperglycemic hormone. Even with optimal control of blood sugar, s. c. administration of insulin cannot fully replicate the physiological situation.
The prolonged contact time of intestinal contents and mucosa may also improve absorption of fluid. With overdosage, there is a hazard of ileus. It is contraindicated in infants below age 2 y. Antibacterial drugs. Use of these agents (e. g. , cotrimoxazole, p. 272) is only rational when bacteria are the cause of diarrhea. This is rarely the case.

 

Parenteral or, alternatively, sublingual, intranasal, or transdermal administration is then required in order to bypass the liver. Irrespective of the route of administration, a portion of administered drug may be taken up into and transiently stored in lung tissue before entering the general circulation. This also constitutes presystemic elimination.
Because of its high potency, fentanyl is suitable for transdermal delivery (A). In opiate abuse, “smack” (“junk,” “jazz,” “stuff,” “China white;” mostly heroin) is self administered by injection (“mainlining”) so as to avoid first-pass metabolism and to achieve a faster rise in brain concentration.

 

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