ROUTES OF
DRUG
ADMINISTRATIO
N
classificatio
n
Systemic Local
Skin topical
Intranasal
Ocular drops
Enteral Parenteral
Mucosal throat,
Oral Inhalation vagina, mouth,
Sublingu Injection ear
al transderm Inhalation
rectal al Transdermal
• ENTERAL: ORAL, SUB-LINGUAL
(BUCCAL), RECTAL. NOTE
SOLUBLE, ENTERIC COATED OR
SLOW RELEASE FORMULATIONS
• PARENTERAL: IV, IM, SC, ID, IT,
ETC. DIFFERENT RATES OF
ABSORPTION, DIFFERENT
PLASMA PEAKS. NOTE IV
INFUSORS
• SKIN: FOR LOCAL OR SYSTEMIC
EFFECT - NOTE PATCHES
• LUNGS: INHALATION; LOCAL OR
SYSTEMIC EFFECT?
• VAGINAL: (USUALLY LOCAL)
• EYE : (USUALLY LOCAL)
FACTORS GOVERNING CHOICE
OF ROUTE
• PHYSICAL & CHEMICAL PROPERTIES OF DRUG- SOLID/LIQUID/GAS;
SOLUBILITY, STABILITY, PH, IRRITANCY
• SITE OF DESIRED ACTION- LOCALIZED AND APPROACHABLE OR
GENERALIZED AND NON APPROACHABLE
• RATE & EXTENT OF ABSORPTION FROM VARIOUS ROUTES
• EFFECT OF DIGESTIVE JUICES & FIRST PASS EFFECT
• RAPIDITY OF THE DESIRED RESPONSE- EMERGENCY/ROUTINE
• ACCURACY OF DOSAGE
• CONDITION OF THE PATIENT- UNCONSCIOUS, VOMITING
ORAL ROUTE
• THE MOST COMMON ROUTE OF DRUG ADMINISTRATION.
• DRUG IS GIVEN THROUGH ORAL CAVITY.
ADVANTAGES
• SAFE CONVENIENT- SELF- ADMINISTERED, PAIN
FREE, NONINVASIVE AND EASY TO TAKE
• ECONOMICAL- COMPARED TO OTHER PARENTRAL
ROUTES
• USUALLY GOOD ABSORPTION- TAKES PLACE
ALONG THE WHOLE LENGTH OF THE GI TRACT
• NO NEED FOR STERILIZATION
This Photo by Unknown Author is licensed under
CC BY-SA
DISADVANTAG
ES
• SLOW ABSORPTION SLOW ACTION - CAN NOT USED IN
EMERGENCY.
• IRRITABLE AND UNPALATABLE DRUGS- NAUSEA AND
VOMITING
• CANNOT BE USED UNCO-OPERATIVE, VOMITING AND
UNCONSCIOUS PATIENTS
• SOME DRUGS DESTROYED
• SOMETIMES INEFFICIENT DRUG ABSORBED, SOME DRUGS
ARE NOT ABSORBED LIKE STREPTOMYCIN
• FIRST-PASS EFFECT- DUE TO BIOTRANSFORMATION
• FOOD–DRUG INTERACTIONS AND DRUG-DRUG INTERACTIONS
Dosage forms
Capsules, powders Tablets, spansules Syrup, emulsion
Suspension, elixirs
SUBLINGUAL/BUCCAL
ROUTE
TAB OR PELLET CONTAINING THE DRUG IS PLACED UNDER TONGUE OR
CRUSHED IN MOUTH AND SPREAD OVER THE BUCCAL MUCOSA. EX- GTN,
BUPRENORPHINE, DESAMINOOXYTOCIN
Advantage Disadvantages
•sDrug absorption is quick • Unpalatable & bitter
• Quick termination drugs
• First-pass avoided • Irritation of oral mucosa
• Can be self administered • Large quantities not
• Economical given
• Few drugs are absorbed
RECTAL
• ROUTE RECTALLY AS
DRUGS THAT ARE ADMINISTERED
A SUPPOSITORY.
• IN THIS FORM, A DRUG IS MIXED WITH A WAXY
SUBSTANCE THAT DISSOLVES OR LIQUEFIES
AFTER IT IS INSERTED INTO THE RECTUM.
• EX- DIAZEPAM, INDOMETHACIN, PARALDEHYDE,
ERGOTAMINE
Advantages Disadvantages
This Photo by Unknown Author is licensed under
CC BY-SA
Used in children Inconvenient
Little or no first pass effect (ext Absorption is slow
haemorrhoidal vein) and erratic
Used in vomiting or unconscious Irritation or
Higher concentrations rapidly inflammation of rectal
achieved mucosa can occur
PARENTERAL ROUTES
• DIRECT DELIVERY OF DRUG IN TO SYSTEMIC CIRCULATION WITHOUT INTESTINAL
MUCOSA
INTRADERMAL (I.D.) (INTO SKIN)
SUBCUTANEOUS (S.C.) (INTO SUBCUTANEOUS TISSUE)
INTRAMUSCULAR (I.M.) (INTO SKELETAL MUSCLE)
INTRAVENOUS (I.V.) (INTO VEINS)
INTRA-ARTERIAL (I.A.) (INTO ARTERIES)
INTRATHECAL (I.T.) (CEREBROSPINAL FLUIDS )
INTRAPERITONEAL (I.P.) (PERITONEAL CAVITY)
INTRA - ARTICULAR (SYNOVIAL FLUIDS)
A) Intradermal – into skin
B) Subcutaneous - Absorption of drugs from the subcutaneous tissues
C) Intramuscular (IM) drug injected into skeletal muscle
D) Intravascular (IV)- placing a drug directly into the blood stream
PARENTERAL ROUTES
ADVANTAGES
• HIGH BIOAVAILABILITY Disadvantages
• Infection
• RAPID ACTION
• Sterilization.
(EMERGENCY)
• Invasive assistance
• NO FIRST PASS require
METABOLISM • Pain
Suitable for • Needs skill
• Anaphylaxis
Vomiting • Expensive.
&unconsciousness
Irritant & Bad taste
drugs.
No gastric irritation
No food-drug interaction
INTRAVENOUS
ADVANTAGES ROUTE
• IV IS THE MOST COMMON PARENTERAL ROUTE. FOR DRUGS THAT
ARE NOT ABSORBED ORALLY.
• AVOIDS FIRST-PASS METABOLISM BY THE LIVER.
• INTRAVENOUS DELIVERY PERMITS A RAPID EFFECT AND A
MAXIMAL DEGREE OF CONTROL OVER THE CIRCULATING LEVELS
OF THE DRUG. TITRATION OF DOSE WITH RESPONSE.
• LARGE QUANTITIES CAN BE GIVEN, FAIRLY PAIN FREE
• (100% BIOAVAILABILITY) ABSORPTION PHASE IS BYPASSED
DISADVANTAGES
However, unlike drugs in the GI tract, those that are injected cannot be recalled by
strategies such as emesis or by binding to activated charcoal.
IV injection may also induce hemolysis or cause other adverse reactions by the too-rapid
delivery of high concentrations of drug to the plasma and tissues also vital organs like
heart, brain etc.
Thrombophlebitis of vein and necrosis of adjoining tissue if extravasation occurs
INTRAMUSULAR
ROUTE
LARGE SKELETAL MUSCLE- DELTOID, TRICEPS,
GLUTEUS MAXIMUS, RECTUS FEMORIS
ADVANTAGES DISADVANTAGES
Absorption reasonably Only up-to 10ml drug given
uniform Local pain and abscess
Rapid onset of action Expensive
Mild irritants can be Infection
given Nerve damage
First pass avoided Local hematoma can occur
Gastric factors can be in anticoagulant treated pt.
avoided
SUBCUTANEOUS
•
ROUTE
DRUG IS DEPOSITED IN LOOSE SUBCUTANEOUS TISSUE – RICH NERVE SUPPLY-
IRRITANT DRUGS CANNOT BE INJ. LESS VASCULAR- SLOW ABSORPTION THAN
IM ROUTE
• AVOID IN SHOCK PT – VASOCONSTRICTION
• ONLY SMALL VOLUME CAN BE INJECTED
• SUBCUTANEOUS INJECTION MINIMIZES THE RISKS ASSOCIATED WITH
INTRAVASCULAR INJECTION
• DEPOT PREPARATION CAN BE INJECTED- DERMOJET, PELLET IMPLANTATION,
SIALISTIC AND BIODEGRADABLE IMPLANTS
Intradermal Route
Inj into skin raising bleb – BCG Vaccine, Sensitivity test
Intrathecal/intraventricular
• It is sometimes necessary to introduce drugs directly into the cerebrospinal
fluid. For example, amphotericin B is used in treating Cryptococcal meningitis
TRANSDERM
AL
• THIS ROUTE OF ADMINISTRATION ACHIEVES SYSTEMIC EFFECTS BY APPLICATION OF
DRUGS TO THE SKIN, USUALLY VIA A TRANSDERMAL MEDICATED ADHESIVE PATCH.
• THE RATE OF ABSORPTION CAN VARY MARKEDLY, DEPENDING ON THE PHYSICAL
CHARACTERISTICS OF THE DRUG (LIPID SOLUBLE) AND SKIN AT THE SITE OF
APPLICATION.
• SLOW EFFECT (PROLONGED DRUG ACTION)
• THIS ROUTE IS MOST OFTEN USED FOR THE SUSTAINED DELIVERY OF DRUGS, SUCH
AS THE ANTIANGINAL DRUG NITROGLYCERIN, THE ANTIEMETIC SCOPOLAMINE. THE
NICOTINE PATCHES
• SITE – UPPER ARM, CHEST, ABDOMEN, MASTOID REGION
• FIRST PASS EFFECT AVOIDED
• ABSORPTION- INCREASE BY OILY BASE, OCCLUSIVE DRESSING, RUBBING
PREPARATION
TOPICAL
APPLICATION
• PRODUCE LOCAL EFFECT TO SKIN (PERCUTANEOUS)
E.G. ALLERGY TESTING, TOPICAL LOCAL ANAESTHESIA
• MUCOUS MEMBRANE OF RESPIRATORY TRACT
(INHALATION) E.G. ASTHMA
• EYE DROPS E.G. CONJUNCTIVITIS
• EAR DROPS E.G. OTITIS EXTERNA
• INTRANASAL, E.G. DECONGESTANT NASAL SPRAY
INHALATIO
N
• INHALATION PROVIDES THE RAPID DELIVERY OF A DRUG
ACROSS THE LARGE SURFACE AREA OF THE MUCOUS
MEMBRANES OF THE RESPIRATORY TRACT AND PULMONARY
EPITHELIUM, PRODUCING AN EFFECT ALMOST AS RAPIDLY AS
WITH IV INJECTION.
• THIS ROUTE OF ADMINISTRATION IS USED FOR DRUGS THAT
ARE GASES (FOR EXAMPLE, SOME ANESTHETICS) OR THOSE
THAT CAN BE DISPERSED IN AN AEROSOL.
• THIS ROUTE IS PARTICULARLY EFFECTIVE AND CONVENIENT
FOR PATIENTS WITH RESPIRATORY COMPLAINTS (SUCH AS
ASTHMA, OR CHRONIC OBSTRUCTIVE PULMONARY DISEASE)
BECAUSE THE DRUG IS DELIVERED DIRECTLY TO THE SITE OF
ACTION AND SYSTEMIC SIDE EFFECTS ARE MINIMIZED.
• EXAMPLES OF DRUGS ADMINISTERED VIA THIS ROUTE
INCLUDE ALBUTEROL, AND CORTICOSTEROIDS, SUCH AS
FLUTICASONE.
INHALATION
Advantages Disadvantage
• MUCOUS MEMBRANE OF •sOnly few drugs can be used
RESPIRATORY SYSTEM
• RAPID ABSORPTION (LARGE SURFACE
AREA)
• PROVIDE LOCAL ACTION
• MINOR SYSTEMIC EFFECT
• LOW BIOAVAILABILITY
• LESS SIDE EFFECTS
• NO FIRST PASS EFFECT
INTRANAS
• AL
THIS ROUTE INVOLVES ADMINISTRATION OF DRUGS
DIRECTLY INTO THE NOSE. AGENTS INCLUDE NASAL
DECONGESTANTS SUCH AS THE ANTIINFLAMMATORY
CORTICOSTEROID.
• DESMOPRESSIN IS ADMINISTERED INTRANASALLY IN
THE TREATMENT OF DIABETES INSIPIDUS; SALMON
CALCITONIN, A PEPTIDE HORMONE USED IN THE
TREATMENT OF OSTEOPOROSIS, IS ALSO AVAILABLE AS
A NASAL SPRAY.
• THE ABUSED DRUG, COCAINE, IS GENERALLY TAKEN BY
INTRANASAL SNIFFING.
SKIN - Topical
Dermal - Oil or ointment for local action
Antiseptic cream and lotion
Sunscreen lotion and powders
THANK
YOU
