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Route of administation

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krishna prasad dahal

This document summarizes the major routes of drug administration and provides details on each route. The four main routes discussed are enteral, parenteral, topical, and inhalation. Enteral routes include oral, buccal, and rectal administration. Parenteral routes involve intravenous, intramuscular, and subcutaneous injection. Topical administration can be to the skin or transdermally. Inhalation allows for rapid absorption in the lungs or nasal passages. Each route is described in terms of absorption pattern, examples of drugs used, advantages, and disadvantages.

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ROUTE OF ADMINISTRATION OF DRUGS Prepared by: KRISHNA PRASAD DAHAL PHARM D. (PU) RPh. (Pb); RPh. (NEPAL) CLINICAL PHARMACIST at G.N.S. SAGARMATHA ZONAL HOSPITAL FACULTY MEMBER OF PHARMACOLOGY AND TOXICOLOGY SAPTARISHI HEALTH SCIENCE COLLEGE RAJBIRAJ, NEPAL
ROUTE OF ADMINISTRATION OF DRUGS The properties of drugs (pH, solubility, ionization) and by therapeutic objectives (onset of action, delivery site) determine the route of administration . The major route of administration include: A) Enteral i) oral ii) buccal/sublingual B) Parenteral i) Intravenous (IV) ii) Intramuscular (IM) iii) Subcutaneous (SC)
C) Topical i) skin ii) Transdermal iii) Rectal D) Inhalation A) Enteral It is the process of administration of drug through the common route i.e. Mouth. The drug may be swallowed, chewed, kept below tongue or kept in buccal cavity. I) Oral Absorption pattern from this route is variable and may be more complicated due to the pH of the stomach, first pass metabolism. advantages: a) safest and most common route of administration b) economical, less toxicities and if toxicities happen can be overcome easily.
Disadvantages a) limited absorption of some drugs b) food may affect absorption c) patient compliance is necessary d) drugs may be metabolized before systemic absorption (first pass metabolism or metabolized by digestive enzymes in stomach and intestine) II) sublingual/buccal sublingual route involves placement of drugs under tongue (e.g. isosorbide dinitrate) whereas buccal route involves putting of drug between cheek and gum ( e.g. Misoprostol) Absorption pattern depends on the drug e.g. nitroglycerine have rapid absorption whereas other drugs have partial absorption.
Advantages a) bypass first pass effect b) bypasses destruction by stomach acid c) drug stability maintained because of the pH of saliva relatively neutral. d) may cause immediate pharmacological effect. Disadvantages a) Limited to certain types of drugs. b) limited to drugs that can be taken in small doses. c) may lose part of the drug dose if swallowed.
B) Parenteral It indicates the route other than oral route in which drug can directly administered into the systemic circulation. This is specially used for the drugs that are poorly absorbed from the GI tract e.g. Heparin or unstable in GI tract e.g. Insulin. This type of administration is also used fro the patients who are unable to take oral medications (unconscious patients) and in condition that require a rapid onset of action. I) intravenous The administration of drug directly into the veins is called IV administration. E.g. of drug administered IV are Vancomycin, Heparin.
Advantages a) can have immediate effect. b) ideal if dosed in large volume. c) suitable for irritating substances and complex mixtures. d) valuable in emergency situation. e) ideal for high molecular weight proteins and peptide drugs. Disadvantages a) unsuitable for oily substances. b) bolus injection may result in adverse effect. c) most substances must be slowly injected. d) strict aseptic techniques needed.
II) Intramuscular Administration of drugs in the skeletal muscles is called IM administration. Absorption pattern depends upon drug diluents used i.e. if aqueous diluents are used absorption is prompt than other. E.g. of drug administered IM are Diclofenac, Haloperidol. Advantages a) suitable if drug volume is moderate. b) suitable for oily vehicles and certain irritating substances. c) preferable to IV if patient must/require self administer.
Disadvantages a) affects certain lab tests (creatinine kinase) b) can be painful c) can cause IM hemorrhage. III) subcutaneous SC administration include injecting the drug below the skin region. In this type of administration also absorption depends upon drug diluents. e.g. of drugs that are administered through SC are Insulin and Epinephrine
Advantages a) suitable for slow release drugs. b) ideal for some poorly soluble suspensions. Disadvantages a) Pain or necrosis may occur if drug is irritating b) Unsuitable for drugs administered in large volumes. C) Topical Topical application is used when local actions of drugs are desired. I) Skin Absorption pattern are variable and are affected by the skin condition, area of skin and other factors. e.g. of drugs that are used in skin are clotrimazole cream, eye/nasal drops.
Advantages a) suitable when local action is desired. b) may be used for skin, eye, intra vaginal and intranasal product. c) minimizes systemic absorption. d) easy for patients. Disadvantages a) rare systemic absorption can occur and results in adverse reactions. b) unsuitable for drugs with high molecular weight or poor lipid solubility. II) Transdermal In this type of administration Transdermal patches are used so that systemic absorption can be achieved. Absorption pattern is slow and sustained. e.g. patches of Nitroglycerine, Nicotine, Scopolamine.
Advantages a) bypasses the first pass effect b) conventional and painless c) ideal for drugs that are lipophilic and have poor oral absorption d) ideal for the drugs that are quickly eliminated from the body. Disadvantages a) some patient are allergic to patches and can cause irritation b) drug must be highly lipophilic c) delayed delivery of drugs towards site of action. d) limited to drugs that can be taken in small daily doses.
III) Rectal In this route drugs are administered through anal region. absorption pattern is random and variable. e.g. of such type of administration are Bisacodyl, Laxatives. Advantages a) Partially bypass first pass effect. b) bypass destruction by stomach acid. c) ideal if drug cause vomiting and ideal in patients who are vomiting. Disadvantages a) drugs may irritate the rectal mucosa. b) not a well accepted route cause of embarrassing.
D) Inhalation If the drugs are rapidly required in the nasal route or the lungs then this route of administration are used. Absorption pattern of this route can be systemic which always is not desirable. E.g. inhalation of Salbutamol and Anesthetics. Advantages a) absorption is rapid and can have immediate effects. b) ideal for gases drugs e.g. nitrous oxide (Anesthetics) c) effective for patients with respiratory problem. d) dose can be titrated. e) fewer systemic side effects.
Disadvantages a) most addictive route of administration (can enter brain quickly) b) patient may have difficulty regulating dose. c) some patient may have difficulty using inhalers.
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Route of administation

  • 1. ROUTE OF ADMINISTRATION OF DRUGS Prepared by: KRISHNA PRASAD DAHAL PHARM D. (PU) RPh. (Pb); RPh. (NEPAL) CLINICAL PHARMACIST at G.N.S. SAGARMATHA ZONAL HOSPITAL FACULTY MEMBER OF PHARMACOLOGY AND TOXICOLOGY SAPTARISHI HEALTH SCIENCE COLLEGE RAJBIRAJ, NEPAL
  • 2. ROUTE OF ADMINISTRATION OF DRUGS The properties of drugs (pH, solubility, ionization) and by therapeutic objectives (onset of action, delivery site) determine the route of administration . The major route of administration include: A) Enteral i) oral ii) buccal/sublingual B) Parenteral i) Intravenous (IV) ii) Intramuscular (IM) iii) Subcutaneous (SC)
  • 3. C) Topical i) skin ii) Transdermal iii) Rectal D) Inhalation A) Enteral It is the process of administration of drug through the common route i.e. Mouth. The drug may be swallowed, chewed, kept below tongue or kept in buccal cavity. I) Oral Absorption pattern from this route is variable and may be more complicated due to the pH of the stomach, first pass metabolism. advantages: a) safest and most common route of administration b) economical, less toxicities and if toxicities happen can be overcome easily.
  • 4. Disadvantages a) limited absorption of some drugs b) food may affect absorption c) patient compliance is necessary d) drugs may be metabolized before systemic absorption (first pass metabolism or metabolized by digestive enzymes in stomach and intestine) II) sublingual/buccal sublingual route involves placement of drugs under tongue (e.g. isosorbide dinitrate) whereas buccal route involves putting of drug between cheek and gum ( e.g. Misoprostol) Absorption pattern depends on the drug e.g. nitroglycerine have rapid absorption whereas other drugs have partial absorption.
  • 5. Advantages a) bypass first pass effect b) bypasses destruction by stomach acid c) drug stability maintained because of the pH of saliva relatively neutral. d) may cause immediate pharmacological effect. Disadvantages a) Limited to certain types of drugs. b) limited to drugs that can be taken in small doses. c) may lose part of the drug dose if swallowed.
  • 6. B) Parenteral It indicates the route other than oral route in which drug can directly administered into the systemic circulation. This is specially used for the drugs that are poorly absorbed from the GI tract e.g. Heparin or unstable in GI tract e.g. Insulin. This type of administration is also used fro the patients who are unable to take oral medications (unconscious patients) and in condition that require a rapid onset of action. I) intravenous The administration of drug directly into the veins is called IV administration. E.g. of drug administered IV are Vancomycin, Heparin.
  • 7. Advantages a) can have immediate effect. b) ideal if dosed in large volume. c) suitable for irritating substances and complex mixtures. d) valuable in emergency situation. e) ideal for high molecular weight proteins and peptide drugs. Disadvantages a) unsuitable for oily substances. b) bolus injection may result in adverse effect. c) most substances must be slowly injected. d) strict aseptic techniques needed.
  • 8. II) Intramuscular Administration of drugs in the skeletal muscles is called IM administration. Absorption pattern depends upon drug diluents used i.e. if aqueous diluents are used absorption is prompt than other. E.g. of drug administered IM are Diclofenac, Haloperidol. Advantages a) suitable if drug volume is moderate. b) suitable for oily vehicles and certain irritating substances. c) preferable to IV if patient must/require self administer.
  • 9. Disadvantages a) affects certain lab tests (creatinine kinase) b) can be painful c) can cause IM hemorrhage. III) subcutaneous SC administration include injecting the drug below the skin region. In this type of administration also absorption depends upon drug diluents. e.g. of drugs that are administered through SC are Insulin and Epinephrine
  • 10. Advantages a) suitable for slow release drugs. b) ideal for some poorly soluble suspensions. Disadvantages a) Pain or necrosis may occur if drug is irritating b) Unsuitable for drugs administered in large volumes. C) Topical Topical application is used when local actions of drugs are desired. I) Skin Absorption pattern are variable and are affected by the skin condition, area of skin and other factors. e.g. of drugs that are used in skin are clotrimazole cream, eye/nasal drops.
  • 11. Advantages a) suitable when local action is desired. b) may be used for skin, eye, intra vaginal and intranasal product. c) minimizes systemic absorption. d) easy for patients. Disadvantages a) rare systemic absorption can occur and results in adverse reactions. b) unsuitable for drugs with high molecular weight or poor lipid solubility. II) Transdermal In this type of administration Transdermal patches are used so that systemic absorption can be achieved. Absorption pattern is slow and sustained. e.g. patches of Nitroglycerine, Nicotine, Scopolamine.
  • 12. Advantages a) bypasses the first pass effect b) conventional and painless c) ideal for drugs that are lipophilic and have poor oral absorption d) ideal for the drugs that are quickly eliminated from the body. Disadvantages a) some patient are allergic to patches and can cause irritation b) drug must be highly lipophilic c) delayed delivery of drugs towards site of action. d) limited to drugs that can be taken in small daily doses.
  • 13. III) Rectal In this route drugs are administered through anal region. absorption pattern is random and variable. e.g. of such type of administration are Bisacodyl, Laxatives. Advantages a) Partially bypass first pass effect. b) bypass destruction by stomach acid. c) ideal if drug cause vomiting and ideal in patients who are vomiting. Disadvantages a) drugs may irritate the rectal mucosa. b) not a well accepted route cause of embarrassing.
  • 14. D) Inhalation If the drugs are rapidly required in the nasal route or the lungs then this route of administration are used. Absorption pattern of this route can be systemic which always is not desirable. E.g. inhalation of Salbutamol and Anesthetics. Advantages a) absorption is rapid and can have immediate effects. b) ideal for gases drugs e.g. nitrous oxide (Anesthetics) c) effective for patients with respiratory problem. d) dose can be titrated. e) fewer systemic side effects.
  • 15. Disadvantages a) most addictive route of administration (can enter brain quickly) b) patient may have difficulty regulating dose. c) some patient may have difficulty using inhalers.