CHANNELS OF

DRUG
ADMINISTRATION

ENTERAL PARENTERAL TOPICAL

ENTERAL

ORAL

SUBLINGUAL

BUCCAL

RECTAL
 ORAL ROUTE
• Oral refers to
two methods of administration:
– applying topically to the mouth
– swallowing for absorption along the
gastrointestinal (GI) tract into systemic
circulation
❖Paracetamol-fever
• po (from the Latin per os) is the abbreviation used
to indicate oral route of medication administration
 ORAL

• Advantages
– Convenient -self- administered, pain free, easy
to take
– Absorption - takes place along the whole
length of the GI tract
– Cheap - compared to most other parenteral
routes
 ORAL
• Disadvantages
– Sometimes inefficient - only part of the drug may be
absorbed
– First-pass effect - drugs absorbed orally are initially
transported to the liver via the portal vein
– Irritation to gastric mucosa - nausea and vomiting
– Destruction of drugs by gastric acid and digestive juices
– effect too slow for emergencies
– unpleasant taste of some drugs
– unable to use in unconscious patient
 SUBLINGUAL ROUTE
• Sublingual administration
is where the dosage form is
placed under the tongue
– rapidly absorbed by
sublingual mucosa

❖Nitroglycerine- acute
angina
 BUCCAL ROUTE
• Buccal administration
is where the dosage
form is placed
between gums and
inner lining of the
cheek (buccal pouch)
– absorbed by buccal
mucosa
• Advantages
• Quick onset of action
• Bypass first pass effect
• Self administer

• DISADVANTAGES
• Not suitable for irritant, lipid insoluble drugs
and drugs with bad taste
 RECTAL ROUTE
10
Suppository & Enema
ADVANTAGES
▪ USED IN CHILDREN
▪ LITTLE OR NO FIRST PASS EFFECT
▪ USED IN
VOMITING/UNCONSCIOUS
▪ HIGHER CONCENTRATIONS RAPIDLY ACHIEVED
DISADVANTAGES
▪ INCONVENIENT
▪ ABSORPTION IS SLOW AND ERRATIC
▪ IRRITATION OR INFLAMMATION OF RECTAL
MUCOSA CAN OCCUR
 SYSTEMIC-PARENTERAL
• Parenteral administration is
injection or infusion by means of a
needle or catheter inserted into the
body

• This route of administration

bypasses the alimentary canal
 SYSTEMIC-PARENTERAL
▪ INJECTABLES
I. INTRAVENOUS
II. INTRAMUSCULAR
III. SUBCUTANEOUS
IV. INTRADERMAL
V. INTRA-ARTERIAL
VI. INTRA-ARTICULAR
VII. INTRATHECAL

▪ INHALATION - Absorption through the lungs 12

 Inhalation
• Volatile liquids and gases
• Ex: general anaesthetics, salbutamol

• ADVANTAGES
• Quick onset of action
• Systemic toxicity less
• Amount of drug administer can be calculated

• DISADVANTAGES
• Local irritation
• Bronchospasm
 INTRAVENOUS

• Bolus: single dose injected rapidly or slowly

• Ex: Ranitidine in bleeding peptic ulcer
• Slow IV infusion: around 10-20 ml fluid slowly
injected
• Ex: morphine in MI
• IV infusion: Large amount 500-1000ml slowly
over the period of 2-6 hrs
• Ex: dopamine in cardiogenic shock
 INTRAVENOUS
15
DISADVANTAGES

ADVANTAGES
• IRRITATION &
CELLULITIS
• BIOAVAILABILITY 100% • THROMBOPHELEBITIS
• LARGE QUANTITIES • REPEATED INJECTIONS
• HYPERTONIC SOLUTION NOT ALWAYS FEASIBLE
• VOMITING & DIARRHEA • LESS SAFE
• EMERGENCY SITUATIONS • TECHNICAL
• FIRST PASS AVOIDED ASSISTANCE REQUIRED
• DANGER OF INFECTION
• EXPENSIVE
• LESS CONVENIENT AND
PAINFUL
 INTRAMUSULAR ROUTE
• Large muscle:
✓Deltoid
✓Gluteus maximus
✓Vastus lateralis

❖Paracetamol
❖Diclofenac
 INTRAMUSULAR ROUTE
17

ADVANTAGES
DISADVANTAGES
• ABSORPTION
REASONABLY UNIFORM • ONLY UPTO 10ML DRUG
GIVEN
• RAPID ONSET OF
ACTION • LOCAL PAIN AND
ABCESS
• FIRST PASS AVOIDED
• EXPENSIVE
• MILD IRRITANT AND
DEPOT INJECTION CAN • INFECTION
BE GIVEN • NERVE DAMAGE
SUBCUTANEOUS

• Subcutaneous tissue
• Thigh
• Abdomen
• Arm

❖Insulin
❖Adrenaline
 SUBCUTANEOUS
• Injected under the skin.
• Absorption is slow, so action is prolonged.

IMPLANT: a tablet or porous capsule is inserted

into the loose tissues by incision of the skin,
which is then stiched up.
example : certain hormonal drugs
 INTRADERMAL
• Drug is given within skin
layers (dermis)
• Painful
• Mainly used for testing
sensitivity to drugs.
e.g. Penicillin,
ATS (anti tetanus serum)
BCG Vaccine
 INTRA-ARTICULAR
• Injections of
antibiotics and
corticosteroids are
administered in
inflammed joined
cavities by experts.
example:
hydrocortisone in
rheumatoid arthritis
 INTRA-ARTERIAL
• Rarely used
• Anticancer drugs are given for localized
effects
• Drugs used for diagnosis of peripheral vascular
diseases
 Topical Routes of Administration

• Topical administration is the application of a drug

directly to the surface of the skin or mucous
membrane
• Includes administration of drugs to any mucous
membrane
– eye – vagina
– nose – urethra
– ears – colon
– lungs
Topical Dosage Forms

Dose forms for topical administration include:

• Skin:
– creams • Eye or ear:
– ointments – solutions
– lotions – suspensions
– gels – ointments
– transdermal patches • Nose and lungs:
– disks – sprays and powders
• Oral cavity: lignocaine – anaesthesia
• GI tract : neomycin – sterilization of gut before
surgery
• Rectum : soap water enema,
Methylprednisolone in ulcerative colitis
Bisacodyl suppository
• Eye, ear, nose: Gentamicin- infection
• Bronchi: Salbutamol – asthma
• Vagina: tablet, cream, Pessary
• Urethra: Lignocaine jel
• Skin: Clotrimazole - candidiasis
Factors determine selection of route of
administration
• Age of patient
• Associated disease
• Characteristic of drug
• Condition of patient
• Doctor/ Patient choice
• Emergency/ routine use
 Intrathecal
• Into subarachnoid space

• Lignocaine-Spinal
Anaesthesia
• Antibiotics-
(amphotericine B)
 Transdermal Route
• Patch
• Ointment
 Transdermal
• Deliver the contained drug at a constant rate into
systemic circulation
• Examples:
• Scopolamine- motion sickness
• Nitroglycerine- angina
• Oestrogen- hormone replacement therapy
• Clonidine- hypertension
• Fentanyl- chronic pain
• Nicotine- tobacco de-addiction
 Transdermal
• ADVANTAGES
• Duration of action prolong
• Constant plasma concentration
• First pass effect bypass

• DISADVANTAGES
• Expensive
• Local irritation-dermatitis, itching
• Patch may fall
 Special drug delivery system
Ocusert
• Beneath the lower eyelid in glaucoma
• Single application
• Slowly release for week
• Pilocarpine
 Progestasert
• Intrauterine contraceptive device
• Progesterone
• Slowly release for one year
 Liposomes
• Minute vehicles made of phospholipids into
which drug incorporated
• Targeted delivery of drug
• Amphotericine B in fungal infection
 Monoclonal antibodies
• Immunglobulines
• Produced by cell culture
• React with specific antigen
• Targeted delivery of drug
• Anticancer drugs
 Drug eluting stents
• Paclitaxel releasing stents in coronary
angioplasty
 Computerized miniature pumps
• Insulin
 Conclusion
• Entral • Parentral
• Oral- PCM • IV- Dopamine
• Sublingual- Nitroglycerine • IM- Adrenaline
• Buccal- Nitroglycerine • SC- Insulin
• Rectal- Diazepam • ID- BCG vaccine
• Intraarterial- Anticancer
drug
• Intraarticular-
Hydrocortisone
• Intrathecal- lignocaine
• Oral cavity: lignocaine – anaesthesia
• GI tract : neomycin – sterilization of gut before
surgery
• Rectum : soap water enema,
Methylprednisolone in ulcerative colitis
Bisacodyl suppository
• Eye, ear, nose: Gentamicin- infection
• Bronchi: Salbutamol – asthma
• Vagina: tablet, cream, Pessary
• Urethra: Lignocaine jel
• Skin: Clotrimazole - candidiasis
 Special drug delivery system
• Ocusert- Pilocarpine
• Progestasert- Progesterone
• Liposomes- Amphotericine B
• Monoclonal antibody- Anticancer drugs
• Drug eluting stents- Paclitaxel
• Computerized miniature pumps- Insulin