Parenteral route of administration

Route of administration that delivers the

drug directly into blood or tissue without
having to cross the intestinal mucosa
 Different types of parenteral
routes

• Intradermal
• Subcutaneous
• Intramuscular
• Intravenous
• Intrathecal
• Inhalational
• Transdermal
 General rules for injecting
• Use aseptic technique
– Washing hands
– Disinfecting skin at site of injection
– Protective cover on the needle

• Check label of drug before injecting

• Two needle technique- One for filling, another for injecting

• No air bubbles in the solution

• Proper disposal of used syringe &needles

 Advantages
 Faster action
 No gastric irritation or vomiting
 Useful in unconscious, uncooperative or patients
with vomiting
 First pass metabolism bypassed
 No interference by food or digestive juices

Disadvantages

 Invasive procedure
 Sterile precautions to be maintained
 Less convenient and expensive
 Parenteral Dosage Forms
• Solutions
• Suspensions
• Dry powder with water for
reconstitution
Containers
• Ampoules
• Vials
• Infusion bottles
 Aspirating from ampoules

 Wash your hands

 Choose a syringe twice the volume
required
 Fix the needle on the syringe
 File around the neck of ampoule
 If glass ampoule, protect your fingers
 Plastic ampoules – twist the top
 Aspirate fluid from ampoule
 Remove air from syringe before injecting
Aspirating from ampoules
 Aspirating from vials
 Wash your hands
 Disinfect the top of vial
 Fix the needle on the syringe
 Suck air equal to the amount of solution
to be aspirated
 Insert needle into vial & turn upside – down
 Pump air into vial
 Aspirate a little more than required amount of solution
 Pull the needle out of the vial
 Remove air from syringe before injecting
Aspirating from vials
 Subcutaneous injection
 Wash hands
 Reassure the patient & explain procedure
 Disinfect the skin
 “Pinch” fold of the skin
 Insert needle in the base of skin fold at an angle of 45°
 Aspirate briefly to check that the needle is not in a blood
vessel
 Inject & Withdraw needle
 Press sterile cotton wool
 Clean up & dispose
Subcutaneous injection
 Intramuscular injection
 Wash hands
 Reassure patient & explain procedure
 Disinfect the skin
 Insert needle at an angle of 90° deep into the muscle
 Aspirate briefly to check that the needle is not in a blood
vessel
 Inject slowly (less painful)
 Withdraw needle
 Press sterile cotton wool
 Clean up & dispose
Intramuscular injection
 Z-Track technique of IM injection

Used for drugs that stain or

irritate subcutaneous tissue
1. Skin is laterally displaced
away from injection site
2. IM injection is given at 90
degree
3. Skin is released only after
needle has been withdrawn
so that the track is sealed
 Intravenous injection

 Wash your hands

 Reassure patient & explain procedure
 Uncover arm, apply tourniquet & look
for suitable vein
 Disinfect the skin
 Stabilize vein by pulling skin taut in longitudinal
direction of vein by other hand
 Insert needle at an angle of around 30°
 Puncture the skin & move needle into vein
 Aspirate briefly to check whether the needle is in vessel
 Loosen tourniquet & inject slowly
 Withdraw needle swiftly & press sterile cotton
 Clean up & dispose
Intravenous injection
 Intradermal injection

• Drug is injected into layers of skin

• Injection is given at an angle of 15 degrees
• Small thin bore needle( 25-27 G, ½ inch) used
• Volume given is small & thus given by small 1 ml
syringe
• Site: Inner aspect of arm, deltoid area
Examples:
– BCG vaccine
– Small pox vaccination
– Testing drug sensitivity
Intradermal injection
 Intrathecal Injection

• This route is used when local & rapid effect on

the meninges or cerebrospinal axis is desired
• Lumber puncture needle is used to inject drug
into spinal subarachnoid space

Examples:
– Spinal anesthesia
– Acute CNS infections
Intrathecal Injection
 Transdermal Route
• Transdermal route is used for percutaneous
drug absorption

• It comprises a drug impregnated adhesive patch

which can be applied over skin

• The patch delivers drug at a constant rate

• Absorption occurs via skin by diffusion

Transdermal patches
Transdermal patches
• Sites for application:
Chest, abdomen, upper arm,
lower back, mastoid region

• Examples:
– Hyoscine: Motion sickness
– Nitroglycerine: Angina
– Estrogens: HRT
Tables and Diagrams

Parenteral Dosage Forms

 Tables and Diagrams

• Make these tables and diagrams on left

side page of your practical note book

• Use lead pencil

• Make these at appropriate place facing the

text

• Label the diagrams appropriately

 Needle selection
Injection Type Gauge Length Volume
(Inches) injected
(ml)
Intradermal 25-27 3/8 - ½ 0.01 – 0.1

Subcutaneous 25-27 ½-1 0.5 – 2

Intramuscular 20-24 1-2 0.5-5

Intravenous 15-22 ½-1 Large

volumes
 Checklist before injection

• Whether the label has all the necessary

information
• Name of preparation ( generic / trade name)
• Constituents and their strengths
• Intactness of package
• Colour changes or impurities
• Date of expiry
• Method of reconstitution, if needed
• Route of administration
Injectable routes
Subcutaneous injection
Z- Track Technique Of IM injection

Step 1

Step 3

Step 2
Step 1 Step 2

Step 3 Step 4

Intravenous injection
Intravenous injection
 Drug matrix

Transdermal patch