routes of adminstration of drug
TRANSCRIPT
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:
