VARIOUS PARENTERAL ROUTES
OF DRUG ADMINISTRATION
DR. N HAMSINI
INTRAMUSCULAR ROUTE
Advantages Disadvantages
• Rate of absorption is reasonably • Perfect aseptic conditions are required.
uniform. • There is a danger of injecting into the
• Onset of action is fairly rapid. blood stream.
• It bypasses the 1st pass metabolism. • IM absorption is not always faster than
oral absorption.
• Depot injections can be given by this
• Large volumes cannot be
route with sustained effect.
administered(Max. 5 mL).
• In addition to soluble substances, • Pain at the site of injection, irritation,
mild irritants, suspensions and abscess formation and nerve damage
colloids can be injected by this route. may occur.
• It also avoids the gastric factors • Requires trained professionals for
governing drug absorption. administration.
E.g.; Paracetamol, diclofenac, Tetanus toxoid, iron preparations
SUBCUTANEOUS ROUTE
Advantages Disadvantages
Smooth but slower duration of Can be painful.
action. Only a small volume(max. 1 ml)
Self- administration is possible. can be given.
Action of drug is sustained and Irritant drugs can cause
uniform. sloughing and necrosis.
Drugs in oils or implants can be Not suitable in states of shock
given. because reduced peripheral
vascular circulation reduces the
absorption rate.
E.g. Insulin, Morphine and Epinephrine
INTRA-DERMAL ROUTE
Advantages Disadvantages
Improved vaccine Can be painful.
efficacy. Slower absorption
Dose sparing strategy Very less volume(0.1 mL) of
during shortage, the drug can be injected.
especially during Cannot be self-
pandemics- epidemics. administered.
E.g.- BCG Vaccine, sensitivity test, Tuberculin test.
INTRAVENOUS(IV) ROUTE- ADVANTAGES
• BA is 100%, as it bypasses all other barriers.
• Onset of action – is immediate. (Quickest of all routes)
• Ideal route in case of emergency.
• Any desirable plasma drug concentration can be achieved and accurately
adjusted.
• Suitable even for large volumes
• Can be continued for long duration by maintaining an IV line.
• Highly irritant drugs can be given by proper dilution.
• Suitable for high molecular weight compounds & hypertonic solutions.
5
INTRAVENOUS(IV) ROUTE- DISADVANTAGES
• Technically difficult in infants, small children, obese individuals and in severe
dehydration cases.
• Requires skill, technique, experience & responsibility.
• Requires absolute aseptic precautions.
• Not suitable for insoluble preparations, suspensions, emulsions and oily
injections.
• Few oily drugs can be given as microemulsion like Diazepam, Amphotericin-B
• Most risky – as vital organs are rapidly exposed to high concentrations of the
drug.
• Toxicity is rapid and more
• Drugs once given cannot be withdrawn.
• Faulty technique may result in:
• Double puncture
• Air embolism (pressure in vein is always
negative & hence can suck air)
• Highly irritant drugs can cause venous endothelial damage
– resulting in inflammation, thrombosis and
thrombophlebitis.
• Not suitable for repository preparations. i.e. slow release/
long acting formulation.
• Rapid infusion of large volumes can result in overloading of
the circulation and may precipitate pulmonary edema.
