Routes of

administration of
drugs
BY
Dr ABDEL BASET TAHER
Professor of pharmacology &
therapeutics
2020
MBBS-Y1, Sem2,

Prof. Dr Abdel Baset Taher 1

−Learning Objectives
− Classify routes of administration of drugs for
both local and systemic effects
− Illustrate advantages and disadvantages of
oral administration
− Describe advantages of sublingual and rectal
administration
− Discuss types, advantages and
disadvantages of parenteral administration

Prof. Dr Abdel Baset Taher 2

I) administration for local effects
1. topical application
– drug is applied directly to skin or mucous membrane
– e.g. powder, ointment, lotions, eye drops
2. injections
– the drugs are injected around sensory nerve terminals
(infiltration anaesthesia) or nerve trunck (nerve block)
or in the joints (intra – articular injection of
corticosteroid in rheumatoid arthritis)
3. inhalation
– e.g. disodium chromoglycate (intal) in prophylaxis
against bronchial asthma or salbutamol in treatment of
acute bronchial asthma.
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II) administration for systemic effects
1. GIT : oral – sublingual- rectal
2. parenteral
3. inhalation
4. skin
5. eye

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1. GIT:
Oral administration
– Drug should be palatable, stable at PH of intestinal
tract, not affected by digestive enzymes, should be
absorbed to produce systemic effect.
Advantages:
– economic, easy

Prof. Dr Abdel Baset Taher 5

Prof. Dr Abdel Baset Taher 6
Disadvantages
– Delayed onset
– Irritant drugs e.g. tarter emetic cannot be administered.
– Impractical in unconscious or uncooperative patient or
in GIT disturbances.
– Drugs destroyed by digestive enzymes (insulin) or by
gastric acidity (benzyl penicillin) cannot be
administered orally.
– Some drugs are not absorbed from the gut
(aminoglycoside antibiotics e.g. streptomycin)
– Some drugs are absorbed from gut but inactivated in
liver before reaching general circulation
(testosterone)
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First pass effect:
– loss of drug activity through its first passage in
liver. Examples of drugs which are subjected to
significant first pass effect: Propranolol,
nitroglycerin, morphine

N.B. in order to avoid gastric irritation or destruction

by gastric juices, drugs may be enteric coated with a
film resistant to dissolution in the stomach, but
soluble in the intestinal PH.

Prof. Dr Abdel Baset Taher 8

Sublingual administration
– The drug is readily absorbed through sublingual
mucosa and passes directly to general circulation
avoiding initial passage through liver.
– Examples: nitroglycerine, isoprenaline

The drug should be:

– Given in the form of a small tablet or pellet placed
beneath the tongue.
– Palatable, soluble, effective in a small dose.
– N.B. It is unsuitable for drugs that cause
vasoconstriction of sublingual mucosa.

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Rectal administration
– Rectal route can be used for drugs that can be readily
absorbed from rectal mucosa.
– It may be resorted to when oral administration is
impractical.
– Examples: suppository or enema

Advantages:
1. Drugs irritant to stomach can be given by suppository.
2. Can be used when cooperation is lacking (as in
children).
3. Effect of digestive enzymes can be avoided.
4. Drugs liable to extensive first pass effect may be given
in this way.
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2. Parenteral administration:
Definition:
– it's any route of administration of a drug which
does not make use of GIT, eye, respiratory
tract or skin
– i.e. the drugs are given by subcutaneous
implantation or by injection.
i. Subcutaneous implantation:
– implantation of pellets under the skin allows
release of drug over a period of several
weeks or months (steroid hormones).

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ii. injection:
• It involves introducing a drug by means of a syringe
into the required site. Strict aseptic precautions must
be observed
• It's usually employed in the following conditions:
1. When the drug is ineffective by other routes.
2. When the drug possesses severe local irritant actions.
3. When it's necessary to raise the concentration of the
drug in the body very rapidly.
4. In emergencies e.g. unconscious patient or in cases of
circulatory failure.

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• It's made in the following sites:

i) Intradermal:
– Injection is made into the skin.
– It's used for sensitivity tests and infiltration anesthesia.
ii) Subcutaneous:
– Absorption is more rapid and complete than after oral
administration.
– It's suitable for non-irritant drugs which may be either
in aqueous solution or in the form of fine suspension
designed to be slowly dissolved and hence to prolong
their absorption and activity .

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iii) Intramuscular:
− Absorption is greater than subcutaneous due to
greater muscle vascularity, muscles are less sensitive
to pain than SC tissues → it's more suitable for
injecting moderately irritant drugs, it's also suitable for
solutions or suspensions of insoluble drugs in water or
oil.

iv) Intravenous:
− it's usually given in superficial veins e.g. cubital
− only aqueous, pyrogen free solutions can be
employed

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Advantages:
– Immediate effect.
– Drug avoid chemical decomposition.
– It's the only channel by which very irritant drugs
can be given (walls of blood vessels are
insensitive to pain).
Disadvantages:
– Anaphylactoid reaction.
– Pyrogenic reactions.
– Phlebitis, thrombophlebitis.
– Leakage of irritant drug outside vein → severe
reaction.
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v) Bone marrow injection:
– It's made in the sternum in adults or tibia in children
vi) Intra-arterial:
– Only used for experimental purposes or arteriogram
vii) Intracardiac:
– Sometimes used to resuscitate the patient in emergencies.
viii) Intrathecal:
– It's made in subarachnoid space (spinal anesthesia, X-ray
contrast media)
ix) intra-articular
x) intraperitoneal:
– Used for experimental animals
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3. Inhalation:
– Gaseous (nitrous oxide) and volatile (halothane)
anesthetics.
– Drugs intended to produce local effect in the
lung e.g. salbutamol (a bronchodilator) or
disodium chromoglycate.
– Absorption from alveolar membrane is very
rapid because of its thinness, extensive surface
area and its rich blood supply.

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4. Skin:
– Absorption from skin can be achieved by
iontophoresis of water soluble drugs. Iontophoresis
is the passage of drugs through the skin by means of
galvanic current passed through it.
– Drugs applied to the skin are intended to produce
local effect. In some instances, they may be
absorbed through the skin and produce systemic
effect e.g. corticosteroids applied topically in
children.
– Certain drugs e.g. nitroglycerin may be applied to
skin in the form of plasters or adhesive discs to
allow for graded absorption over a prolonged time
and avoiding extensive first-pass effect.
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5. Eye:
– Drugs may be given to produce local effect
e.g. decongestion or to treat glaucoma in the
form of eye drops
– Antihistaminic (for allergy) and antibiotics may
be applied as ointments.

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 Thank you

Prof. Dr Abel Baset Taher 20