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Course Title: Drug Rehabilitation

Course Instructor: MS Maham Saleem
Routes of Drug Administration
A route of administration is the path by which a drug, fluid, poison, or other substance is taken into the
body.

OR

The route through which the drug, fluid, poison or other substance administered or introduced into the
body is called Routes of Administration.

Enteral Route

The word enteral is derived from the word Enteron means

Intestine. There are three main divisions of enteral route and are as follows: -

1. Oral Route- Drug kept in mouth and swallowed.

2. Sublingual Route/ Buccal Route- Drug kept below the tongue and allow to dissolve in saliva.

Oral Route

Dosage forms like tabs, capsules or liquid etc. can be taken through this route. Drugs in solid or
liquid form such as tablet or syrup is kept in mouth cavity and swallowed with water or milk. After the
administration of drug by oral route, absorption of a drug takes place in stomach or intestine.

Advantages:

 Most commonly preferred & used route for drug administration.

 Does not required any special skill for administration.
 Self-medication is possible.
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 Very convenient and economical from infants to

aged patients.
 Does not required any complicated process like
sterilization.

Disadvantages:

 Onset of action is very slow.

 Not useful in emergency cases.
 Irritant, unpalatable drugs cannot be given by this route.
 Can't be used in cases of unconscious & uncooperative patients.
 This route does not suitable in conditions like nausea, vomiting & diarrhea.
 After oral administration certain drugs like testosterone are destroyed in the liver cells i.e.
Hepatic first pass metabolism because of that 100% bioavailability is not possible.
 High doses are effective
 Some drugs like penicillin, insulin are destroyed by gastric juice hence cannot be given by this
route.

Sublingual Route

Also called as Buccal Route. In this case, the tablet medicament is placed below the tongue or chewed in
mouth and spread over the buccal mucosa. Thus, the active medicaments get absorbed through buccal
mucous membrane and then it directly passed into the systemic circulation.

Advantages:

 Rapid onset of action.

 Useful in emergency cases like angina pectoris.
 Adverse effect of the drug can be prevented simply by spitting the tablet.
 Also, one can spit the drug after getting desired effect or action.
 Degradation of drug in stomach or liver is avoided because the drug directly reaches the
systemic circulation.
 Overdose can be avoided.

Disadvantages:

The only disadvantage of this route is that the drugs having direct or toxic effect on heart should
be carefully administered to avoid any such effects.

Parenteral Route

It includes the routes of administration of drugs other than alimentary tract. The word
parenteral is derived from two Latin words i.e. Par means Beyond / Other and Enteron means Intestine.

Thus, parenteral routes means the drugs are Subcutaneous Intravenous Intradermal
administered beyond the intestine i.e. the drugs are taken other than oral route is known as Parenteral
route of administration. In this case the drugs in the suspension or solutions are injected in the body
with the help of needle & syringe (Injections) or the drug in the form of vapours or fine droplets are
inhaled in respiratory tract (Inhalation).
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Parenteral route can be divided into: - 1) Injections & 2) Inhalation.

Advantages:

 Rapid onset of action.

 This route is preferred in uncooperative or unconscious patient.
 This route is also suitable in conditions like nausea & vomiting.
 Useful in emergency cases.
 Degradation of drugs by Hcl in stomach can be avoided so that 100% bioavailability is possible.
 Accuracy of dosage is possible.
 Low doses are effective.
 Irritant or unpalatable drugs can be given.

Disadvantages:

 The preparations have to be sterilized in order to avoid possibility of infections.

 It is a costly route.
 Self-medication is not possible as it requires a special technical skill for administration of a drug.
4. Injections are painful at site of administration.
 Very difficult to reverse or control the effect of drug once it administered.

Injections

Intravenous Injections: In this route the drug is directed injected into the vein. Median basilic vein
near the anterior surface of the elbow.
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Advantages:

 Rapid onset of action.

 This route gives 100% bioavailability.
 This route is preferred in uncooperative or unconscious patient.
 This route is also suitable in conditions like nausea & vomiting.
 Degradation of drugs by Hcl in stomach can be avoided so that 100% bioavailability is possible.
 Useful in emergency cases.
 Low doses are effective.
 Accuracy of dosage is possible.
 Irritant or unpalatable drugs can be given.

Disadvantages:

 The preparations have to be sterilized in order to avoid possibility of infections.

 Drugs with oily vehicles or those precipitated in a blood constituents should not be given by this
route.
 Self-medication is not possible as it requires a special technical skill for administration of a drug.
 Injections are painful at site of administration.
 Very difficult to reverse or control the effect of drug once it administered.

Intramuscular Injection

In this route the drug is deeply injected into the muscular tissue.

Advantages:

 The drug administered by IM route includes soluble substances, mild irritants,

suspensions
 and colloids.
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 The absorption from this route is uniform

and rapid as compare to subcutaneous route.
 First pass effect can be avoid.
 Degradation of drug by stomach can be
avoided.

Disadvantages:

 The volume of drug injection should be upto

10 ml means only upto 10 ml drug can be
 given.
 Pain at the site of injection and chances of
abscess formation.
 Chances of nerve damage.
 This route also ensures uniform and slow absorption of drugs.

Intradermal Injections

In this route the drug is injected in the layer of skin. It is given between inner layer or dermis &
outer layer or epidermis. Small volume can be injected through this route usually 0.1 to 0.2 ml. Fine
short (26 Gauze) needle is used. This route is used as diagnostic purpose s/a to check drug allergy like
penicillin given ID to observe its allergic reactions. Also used for Schick test for diphtheria, Dick test for
Scarlet fever and Tuberculin Test. This route is also used for introduction of vaccines like BCG.

Subcutaneous Injections

The drugs are injected below the skin in loose subcutaneous tissues. Only non-irritant
substances can be injected by this route. There is slow absorption of the drug in this route as compare to
IM & IV.
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Inhalations:

In case of inhalation route the drug may be administered as aerosol system or in the form of
vapours. Certain drugs may be sprayed in the form of minute droplets which are deposited over mucous
membrane. Thus producing local effect. Eg., Adrenaline spray- In the treatment of asthma. The drugs can
be administered as gaseous or in the form of smoke. Eg., CO, gas, volatile general anesthetics-
Absorption by this route is rapid, easy and high local as well as systemic concentration of the drug can be
achieved.

Local/Topical Application

These preparations are meant for their action at the site of application on local affected area.
Eg., Dusting powder, paste, lotions, drops, ointments, plaster etc. Occasionally the drugs may be utilized
for their systemic action i.e. by induction or applied by rubbing. Eg., Cod liver oil.

Advantages:

 Easy route of administration of certain medicament.

 Are useful when prolonged effect of the drug is designed.
 These preparations decrease the possibility of systemic absorption of medicaments.
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Disadvantage:

1. Drugs in the form of watery solutions are sometimes absorbing in the blood which may lead
to the desired toxic effect when applied on the mucous membrane.