ROUTES OF DRUG

ADMINISTRATION

Dr. Chandane R. D.
Asst Professor
Dept of Pharmacology
Govt Medical College, Akola
 CLASSIFICATION
LOCAL
SYSTEMIC Skin topical
Intranasal
Ocular drops
Enteral Parenteral
Mucosal-throat,
Oral Inhalational vagina, mouth,
Sublingual Injections ear
Rectal Transdermal
Intravenous Inhalational

IntramuscularTransdermal
Subcutaneous
Intra-arterial
Intra-articular
Intrathecal
Intradermal
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
 ORAL ROUTE
DISADVANTAGES
1. Slow absorption slow action - can not used
in emergency
2. Irritable and unpalatable drugs- nausea and
vomiting
3. Cannot be used Unco-operative, vomiting and
unconscious patients
4. Some drugs destroyed
5. Sometimes inefficient drug absorbed, some
drugs are not absorbed like streptomycin
6. First-pass effect- Due to Biotransformation
7. FoodDrug interactions and Drug-Drug interactions
Dosage forms
Syrup
Capsules, powders
Tablets, spansules
Syrup, emulsion
Suspension, elixirs

Tablets
Hard- gelatin capsule Soft- gelatin capsule Spansule
 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
ADVANTAGES DISADVANTAGES
Drug absorption is Unpalatable & bitter
quick drugs
Quick termination Irritation of oral
First-pass avoided mucosa
Can be self Large quantities not
administered given
Economical Few drugs are
absorbed
 RECTAL ROUTE
- Drugs that are administered rectally as a
suppository.
- In this form, a drug is mixed with a waxy
substance that
dissolves or liquefies after it is inserted into the
ADVANTAGES
rectum.
Used in children
- ex- Diazepam, indomethacin, paraldehyde,
DISADVANTAGES
Little or no first pass
ergotamine
effect (ext haemorrhoidal Inconvenient
vein) Absorption is slow and
Used in vomiting or erratic
unconscious Irritation or inflammation
Higher concentrations of rectal mucosa can
rapidly achieved 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 inj 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
 First pass Metabolism
Metabolism of drug in the gut wall or portal
circulation before reaching systemic circulation
so the amount reaching system circulation is less than
the amount absorbed
Where ?
Liver
Gut wall
Gut Lumen
Result ?
Low bioavailability.
Short duration of action (t ).
First-pass
metabolism can
occur with orally
administered
drugs.
 Parenteral administration
Disadvantages Advantages
Infection high bioavailability
Sterilization. Rapid action (emergency)
Invasive No first pass metabolism
assistance require Suitable for
Pain Vomiting &unconsciousness
Needs skill Irritant & Bad taste drugs.
Anaphylaxis No gastric irritation
Expensive. No food-drug interaction
Dosage form:
Vial or ampoule
 Ampoule iv infusion
Vial
 INTRAVENOUS ROUTE
ADVANTAGES
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
DISADVANTAGES
ADVANTAGES
Only upto 10ml drug
Absorption given
reasonably uniform Local pain and abcess
Rapid onset of Expensive
action Infection
Mild irritants can be
Nerve damage
given
First pass avoided Local hematoma can
occur in anticoagulant
Gastric factors can treated pt.
be 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
 Transdermal
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
Transdermal therapeutic system

Drug in solution or bound to a polymer is held in reservoir

between occlusive backing film and rate controlling micropore
membrane under surface of which is smeared with an adhesive
impregnated with priming dose of drug. Adhesive layer protected
with film which is peeled off just before application
To provide smooth plasma conc without fluctuations
More convinient pt compliance is better
 Topical application

Produce local effect to

Skin (percutaneous) e.g. allergy testing,
topical local anesthesia
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
 Inhalation
Disadvantages Advantages
Only few Mucous membrane of
drugs can be respiratory system
used Rapid absorption
(large surface area)
Provide local action
Minor systemic effect
Low bioavailability
Less side effects.
No first pass effect
Dosage form: aerosol, nebulizer
Nebulizer
Atomizer
 Inhalation
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.
 Intranasal
This route involves administration of drugs
directly into the nose. Agents include nasal
decongestants such as the anti-inflammatory
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.
Eye drops
 SKIN - Topical
Dermal - Oil or ointment for local action
Antiseptic cream and lotion
Sunscreen lotion and powders
 No single method of drug
administration is ideal for all
drugs in all circumstances

Thank You