Preparation &
Administration IM, IV, Subcutaneous
Drugs
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
Administration
Mucus
Membrane
Skin
Inhalation
Systemic
Administration
Enteral
Parenteral
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
