Routes of Drug Administration

Dr. Devendra Paraz

Definitions
 A route of administration is the path by which a drug/ fluid/ poison/
other substance is brought into contact with the body

 Dosage forms are the products designed to administer drugs to the patients by
various routes for diagnostic, prophylactic or therapeutic purposes
Why we need dosage forms?

1. Drug safety
2. Patient safety
Classification of dosage forms

Based on route of administration Based on physical form

Enteral
Parenteral Solid
Semisolid Liquid
Gases
I. ENTERAL ROUTE
Used for systemic (non local) effect, substance is given via the digestive tract.

Oral

Sublingual
Enteral
Buccal

Rectal
a. ORAL ROUTE
 By swallowing- it is intended for systemic effects
resulting from drug absorption through the various
epithelia and mucosa of the gastrointestinal tract
 oldest and commonest mode of drug
administration

 It is safer, more convenient and often

painless

 Both solid & liquid dosage forms can be given

orally

 Action of drug is slower

First pass
metabolism/effect
 The first pass effect is the term used
for the hepatic metabolism of a
pharmacological agent when it is
absorbed from the gut and delivered
to the liver via the portal circulation.

 The greater the first pass effect, the

less the agent will reach the systemic
circulation when the agent is
administered orally.
ORAL DOSAGE FORMS
 Tablets
 Capsules
 Liquids
 Solutions
 Suspensions
 Syrups
 Elixirs
ORAL ROUTE
Merits
• Easy administration
• Painless procedure
• No skilled person required
• Most widely & acceptable route
• Self medication is possible
• Cheap as compared to other routes
Demerits
• An objectionable odour or taste
• Damage or discoloration of teeth
• Irritation of gastric mucosa causing
nausea & vomiting
• Not useful in unconscious states.
It is not suitable for/in:
1. For emergency as onset of action is slow.
2. Unpalatable and highly irritant drugs
3. Unabsorbable drugs (aminoglycosides)
4. Drugs destroyed by digestive juices (insulin)
b. SUBLINGUAL ROUTE
Sublingual administration is where the dosage form is placed under the tongue and
is rapidly absorbed by sublingual mucosa.

Eg: nitroglycerin for acute anginal attack

SUBLINGUAL ROUTE

Merits Demerits
• Economical • Unpalatable/ bitter drugs cannot be
• Action can be terminated by spatting given
out tablet • Irritation of oral mucosa
• First pass effect is avoided • Large quantities cannot be given
• Drug absorption is quick • Few drugs are absorbed by SL route
c. RECTAL ROUTE
Drugs can be given in the form of solid or
liquid through rectum.

a. Suppository: solid dosage form used for

local effect as well as systemic effects.
Eg. Diazepam

b. Enema : injection of fluid into lower

bowel. Used more frequently to relieve
constipation.
RECTAL
ROUTE
Merits Demerits
• Used in children • Inconvenient
• Little or no first pass effect • Absorption is slow and erratic
• Used in vomiting/unconscious • Irritation or inflammation of rectal
patients mucosa can occur
• Higher concentrations rapidly
achieved
II. PARENTERAL
ROUTE
Parenteral administration is injection or infusion by means of a needle or a catheter
inserted into the body.

This route of administration bypasses the alimentary canal.

Parenteral route of
administration
1. INJECTIONS

2. INHALATION (PULMONARY OR INTRA RESPIRATORY)

3. NASAL

4. ENDOTRACHEAL

5. TRANSDERMAL

6. TOPICAL
 INTRAVENOUS

INTRAMUSCULAR

INTRAARTICULAR

INJECTIONS
INTRAARTERIAL

INTRADERMAL

SUBCUTANEOUS
 a. INTRAVENOUS ROUTE(IV)
The drug is injected into the vein.

Merits:
 Bioavailability is 100%.

 Quick onset of action; therefore route of choice in

emergencies.

 Large volumes of fluids can be administered.

Eg. IV fluids in patients with severe dehydration.

Highly irritant drugs can be given. Eg. Anticancer drugs

 Hypertonic solution can be infused by IV route. Eg. 20%

mannitol in cerebral edema.
Demerits:
 Local irritation may cause phlebitis.
 Self medication not possible.
 Once the drug is injected, its action cannot be halted.
 Strict aseptic conditions are necessary.
b. INTRA MUSCULAR ROUTE
(IM)
The drug is injected into the muscles of the buttocks
and upper arm.

Merits:
 Absorption is more rapid as compared to oral
route.
 Mild irritants, depot injections, soluble
substances and suspensions can be given by this
route.
INTRA MUSCULAR
ROUTE
Demerits:
 Aseptic conditions are needed.
 Intramuscular injections are painful and may cause abscess.
 Self administration not possible.
 Chances of nerve injuries.
c. SUBCUTANEOUS
ROUTE (SC)

The drug is injected into the subcutaneous tissues

of the thigh, abdomen and arm.
Eg. Adrenaline, insulin
SUBCUTANEOUS
ROUTE
Merits:
 Self administration is possible (eg insulin).
 Depot preparations can be inserted into the SC tissue (eg Norplant for
contraception).

Demerits:
 It is suitable only for non irritant drugs.
 Drug absorption is slow; not suitable for emergencies.
d. INTRA
ARTERIAL
Injection is administered directly into an artery.

 Not used frequently.

 Anticancer drugs are given for localized effects.
 Drugs used for diagnosis of peripheral vascular diseases.
e. INTRA
ARTICULAR
Injections of antibiotics and corticosteroids are
administered in inflamed joints cavities.
Eg. Hydrocortisone in arthritis.
f. INTRA
DERMAL
Drug is given within layers of skin (dermis).

 Painful injection.
 Mainly used for testing sensitivity to drugs. Eg. penicillin, ATS (anti tetanus
serum).
 Inoculation: administration of vaccine like small pox vaccine.
INHALATION (PULMONARY OR INTRA
RESPIRATORY)
By this route, drug particles are deposited directly into
the lungs.
Used for gaseous and volatile agents and aerosols.

Merits:
 Large surface area for absorption.
 Thin membranes separate alveoli from circulation.
 High blood flow.
As a result of that, rapid onset of action due to rapid
access to circulation.
Demerits:
 Difficulty in regulating the dose.
 Drugs can cause inflammation of respiratory tract.
 Overdose due to excessive self medication.
 Obstruction of bronchi due to mucus plugs may cause failure of therapy.
TRANSDERMAL
ROUTE
Absorption of drug through skin (systemic action).

Merits:
 Rate of delivery is steady without any peaks
and troughs.
 No first pass metabolism
 Duration of action is prolonged.
 Convenient administration of drugs with
short
half life.
Demerits:
• High blood levels are not easily achieved.
• Contact dermatitis chances.
• Relatively expensive.
TOPICAL ROUTE
Topical administration is the application of a drug directly to the surface of the
skin/mucous membranes for local effect.

Includes administration of drugs into:

 Eye
 Nose
 Ear
 Vagina
 Urethra
 Oropharynx
 Anorectal
TOPICAL DOSAGE FORMS
• Skin: creams, ointments, lotions, gels.

• Eye or ear: solutions, suspensions, ointments.

• Nose and lungs: sprays and powders.

NEWER DRUG DELIVERY
SYSTEMS
1. Intraocular
a. Ocusert: this device is placed directly under the eyelid.
b. Hydrophilic contact lenses.
c. Intravitreal device

2. Intravaginal
a. Contraceptive ring for oestrogen/progestins.
3. Intrauterine devices
a. Progestasert

4. Subcutaneous delivery systems

a. Insulin sc pumps
Advantages of dosage
forms:
1.Safe and convenient delivery of accurate dosage.
Eg: tablets, syrups

2. Protection of drug substances from atmospheric oxygen/moisture as well as

from gastric acid after oral administration.
Eg: capsules, sealed ampules, enteric coated tablets

3. Liquid preparation of drug that is insoluble/unstable in the desired vehicle.

Eg: suspension
4.Liquid dosage forms of substances soluble in desired vehicle.
Eg: solution

5.Optional drug action from tropical administration sites.

Eg: ointment, cream, ear and nasal preparations

6.Optimal drug action through inhalational therapy.

Eg: inhalants
7.Extended drug action through controlled release mechanisms.
Eg: Controlled release tablets, capsules

8.Insertion of drug into one of the body orifices.

Eg: Rectal and vaginal suppositories

9.Placement of drugs within body tissues.

Eg: Implants

10.Conceal bitter taste or odour of a drug substance.

Eg: Capsules, coated tablets, flavoured syrups
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