Routes of Drug

Administration
By Saba Aziz
Factors Deciding Choice of
Route
• Type of described effect, systemic or local
• Physiochemical properties, solid or insoluble
• Rapidity of effect
• Quality of effect
• Condition of patient, conscious or unconscious, vomiting
 Drug Administration

Topical/Local Systemic
Administration Administration

Mucus Skin Inhalation Enteral Parenteral

Membrane
Systemic Routes
Enteral through GIT
• Orally
• Buccal or sublingual
• Rectal
Parental
• Intravenous (IV)
• Intramuscular (IM)
• Subcutaneous (SC)
Enteral Route
Oral Administration
• Via mouth
• Tablets, capsules, powder, syrup, mixture suspension or
emulsion
Advantages of oral route
• Convenience and patient comfort
• Safety, since medication can be retrieved in case of error or
intentional overdose
• Economy, since there are few equipment cost
Disadvantages of oral route
• Slower onset of absorption and action
• Rate and degree of absorption vary with gastrointestinal
contents and motility
• Some drugs destroyed by digestive fluids and must be
administered by injection
• Cannot be used with nausea or vomiting
• Dangerous to use if patient has dysphagia, due to the
possibility of aspiration
• Cannot be used for unconscious patients
• Cannot be use for patients who should keep nil by oral
Absorption from stomach and
upper intestine is affected by:-
• Surface area
• Blood flow to site of absorption
• Physical state: solid, solution, suspension
• Water solubility
• Concentration at the site of absorption
• Rate of dissolution
• Rate of disintegration
• Particle size
Via Nasogastric tube/Gastric
tube
• For the patients unable to swallow
• Advantages : ability to bypass mouth and pharynx when
necessary , elimination of numerous injections
• Disadvantages: discomfort specially for the conscious patients
Buccal or sublingual Route
• Buccal – medication placed in the pouch between the cheek
and the gum
• Sublingual – under the tongue
• Advantages: directly absorb to the circulation and rapid action
• Disadvantage: misunderstanding of the way of use
Rectal Route
• For the patients having nausea and vomiting or patients who
are unable to swallow
• Advantages: bypassing the action of digestive enzymes
Avoidance of irritation to the upper GI tract
Disadvantages of Rectal route
• Many medications are unavailable in suppository form
• Prolonged use of rectal suppositories can cause rectal
irritation
• Absorption may be irregular or incomplete if feces are present
• Inconvenient & embarrassing
• Rectal inflammation occurs
Parenteral
Administration
Parenteral Administration
• Intravenous
• Intramuscular
• Subcutaneous
• Intradermal
• Intrathecal
• Intraarterial
• Intra articular
Intravenous Route
• Drug administration directly to the vein
• Direct injection
• Bolus
• Infusion
Advantages of Intravenous
Route
• Immediate effects
• Valuable for emergency use
• Suitable for large volume
• Complete bioavailability
Disadvantages of Intravenous
Route
• Not suitable for oily solutions & insoluble substances
• Drug administered cannot be withdrawn
• Thrombophlebitis occurs at injection site
• Lack of sterility may cause viral hepatitis
or AIDS
• Increased risk of adverse drug reactions
• Time and skill required for venipuncture
• Difficulty of maintaining IV line
• Complications of IV therapy – bleeding, infection and fluid overload
Intramuscular Route ( IM)
• Injections of drugs into certain muscles
• Usually doses 3ml or less
• IM injection
• Depot preparation
• Absorption depends upon rate of blood flow to the injection site
• Rapid action compared to SC route
• Slow releasing compared to IV route
• Advantages : can be use to administer solutions or suspensions
Slow, sustained effect from depot preparation
• Disadvantages: incorrect placement of the needle may damage
blood vessels or nerves
Pain
Abscess formation
Avoid during anticoagulant therapy
Subcutaneous Route (SC)
• Injection of drugs under the skin
• Use for highly soluble, non irritating, small volume of drug
about 1ml or less
• Absorption is slower and the drug action is generally longer
with SC injections than with IV or IM injections
• Advantages :Slow absorption and distribution
• Disadvantages: tissue damage, tissue necrosis and sterile abscess
formation
Only nonirritant drugs
Not suitable for large volume
Intraarterial Route
• Direct injection into artery
• Localization of effect in particular tissue or organ
• Advantages: Diagnostics agents
• Disadvantages: Reserved route for experts
Intrathecal Route
• Injections into cerebrospinal fluid
• Blood Brain Barrier & Blood CSF Barrier slow drug entry into
CNS
• Used when local and rapid effects of drugs on the meninges
or cerebrospinal axis desired
Intradermal Route
• Injection into skin layers
Uses: BCG, Small pox vaccination
Testing drug sensitivity- Penicillin's
Tuberculin test
Intraarticular Route
• Drug administration directly to the joint
• Usually local effect
• Uses: Rheumatology disorders
Topical Application- Mucous
Membrane
• Conjunctiva, nasopharynx, oropharynx, vagina, urethra,
urinary bladder, ear, nose, anal canal for local effects
• Ointment, cream, drops, jelly, powder, tablet, suppository,
pessary, sprays, gargles
Topical Application- Skin
• Absorption depends on surface area of application, lipid
solubility
• Few drugs readily penetrate skin
• Burned, denuded, abraded, inflammation increase systemic
absorption

• Controlled- release topical patches

• Advantages: Absorption rapid
Only local effect
• Disadvantages: Toxicity by highly lipid soluble substances
Inhalation
Inhalation
• Via inhaler
• Via nebulizer
• Medication directly to the respiratory system
Advantages of Inhalation
• Rapid action of the drug, with local effects with in the
respiratory tract
• Potent drugs may be given in small amounts, minimizing the
side effects
• Convenience and comfort of the patient
Disadvantages of Inhalation
• Requires cooperation of the patient in proper breathing techniques
for effectiveness
• Adverse systemic side effects may result rapidly because of
extensive absorption capacity of the lungs
• Improperly administered or too frequently administered, inhalation
can lead to irritation of the trachea or bronchi or bronchospasm
• If not clean properly nebulizers can be a source of infection
Thank you….