routes of adminstration of drug

Routes of

Drugs Administration

By Sameh AM. Abdel-Ghany

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Routes of Drug administration

Other routes

Parenteral routes

Enteral routes

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A- Enteral routes

Oral Sublingual Rectal

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I- Oral route

Forms used

Requirements needed

Advantages

Disadvantages

N.B. Gastric gavage-Gastric lavage

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Forms used

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Advantages

osafe

o easy

o selfuse

o no need for sterilization

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Disadvantages

o Maybe inefficient - high dose, low

solubility

o First-pass effect – GIT enzymes

o Food Interaction

o Local effect - GI flora

o Unconscious patient - not able to

swallow

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II- Sublingual route

Forms used

Requirements needed

Advantages

Disadvantages

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Forms used

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Advantages

oAvoid first pass effect

oRapid absorption

oDrug stability

oAvoid GIT problems

oCan remove medicine

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Disadvantages

oInconvenience

oadvantages lost if swallowed

oSmall dose limit

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III- Rectal route

Forms used:

a- suppository

b- enema

Requirements needed

Advantages

Disadvantages

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a- supppsitory

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b- Enema

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Advantages

oBy pass liver – GIT enzymes

oUseful – children

oadministration of large volume of

fluids (enema)

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Disadvantages

oIrregular absorption

omay cause irritation of the rectal

mucosa

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B- Parentral route

1

Injections 2

Inhalation3

Transdermaldelivery system

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I- Injections

Definition

Forms used

Requirements needed

Advantages

Disadvantages

Indications

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Forms used

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Advantages

oRapid effect.

oNo destruction of drug by G.I.

enzymes & no local action on

G.I.T.

ouseful in coma and convulsions

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Disadvantages

oneeds trained person.

oneeds aseptic precautions.

oPain at site of injection.

oDanger of infection.

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Indications

oThe drug is ineffective by other routes

oThe drug has intense local irritant.

oa high concentration of the drug is

required very rapidly.

o In emergencies and in unconscious

patients.

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Types of

injections

Intradermal

Subcutaneous

Intramuscular

Intracardiac

Intraperitoneal

Intrathecal

Intravenous

Intrarterial

Intra-articular

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a- Intradermal route

Definition

Requirements needed

Advantages

Disadvantages

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b- Subcutaneous route

Definition

Requirements needed

Sites

Advantages

Disadvantages

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Sites

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Advantages

oCan be given by the patient

oSlow but generally complete

oabsorption

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Disadvantages

oPainful

oTissue damage from irritant drugs

oMaximum of 2 ml injection.

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c- Intramuscular route

Requirements needed

Sites

Advantages

Disadvantages

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Sites

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Advantages

o injection of moderately irritant drugs.

o injection of large amount of fluid than

S.C..

o suitable for solutions or suspensions of

insoluble drugs in water or oil.

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Disadvantages

oTrained personnel

oAbsorption may be incomplete

oAvoid in patients with bleeding

tendency

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d- Intravenous route

Forms used

Intravenous infusion

Requirements needed

Sites

Advantages

Disadvantages

Precautions

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Forms

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Intravenous infusion

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Sites

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Advantages

o rapid (used in emergency).

o avoid rapid chemical decomposition

o very irritant drugs can be given

o Large amount of fluids can be given by

I.V. infusion and for nutrition.

o Immediate cessation of administration is

possible of unwanted effects occur

during drug administration.

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Disadvantages

oPyrogenic reactions and

anaphylactoid reactions

oExtravasation

oNot suitable for drugs in an oily

vehicle or those that hemolyse

RBcs.

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Precautionso must be performed slowly.

o Not add more than one drug to one infusion.

o Saline is generally suitable for infusing many drugs.

o Fresh preparation

o Change the infusion set whenever clear fluids are to follow blood proteins or

amino acids.

o Do not add drugs to blood, amino acid solutions or fat emulsion.

o Do not add aminophylline, hydrocortisone or erythromycin to dextrose

solution.

o Do not add corticotrophin, tertracyclines, suxamethonium or metaraminol to

any strength of mannitol.

o Do not add tetracyclines, calcium salts, corticotrophin, hydrocortisone or

insulin or methicillin to sodium bicarbonate.

o Heparin and aminophylline must not be added to acidic solutions.

o Insulin must not be added to strongly alkaline solutions

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e- Intra-arterial route

oDefinition

oUses

i. Diagnstic

ii. Therapeutic

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f- Intracardiac route

oDefinition

oUses

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g- Intraperitoneal route

oDefinition

oUses

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h- Intrathecal route

oDefinition

oUses:

i. Diagnstic

ii. Therapeutic

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i- Intra-articular route

oDefinition

oUses

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II- Inhalation

Definition

Preparation

Advantages

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Preparations

o Gases

o Vapours

o Steam inhalation

o Inhalers:

i. Aerosols e.g MDI - Nebulizer

ii. Dry powder inhalers e.g spinhaler

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NebulizerSpinhalerMDI(metered

dose inhaler)

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Advantages

orapid

oavoid GIT problems like first

pass effect

oMinimize side effects if used

locally

oAbsorption of gases efficient

and rapid

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III- Transdermal delivery system

Definition

Forms used

Advantages

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Administration for local use

Topical

Injections

Inhalation

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a- Topical

Skin :

i. Ointment

ii. Cream

iii. Liniment

iv. Lotions

v. Powder

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Cont.

Mouth: washes – gargles

Eye : drops – solution

Nose – Ear: drops

Vagina: douches

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b- injections:

i. infiltration anaesthesia

ii. nerve block

iii. intra-articular

c- Inhalation

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C- Other routes

B- InsufflationA- Diadermal

administration

(Iontophoresis)

Other routes

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Contact informations

Facebook: Dr-Sameh Abdel-Ghany

www.facebook.com/samghany

Tel: 01003798288

Email:

dr.samghany@gmail.com