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    Routes of Administration of Drugs

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    Abrham Belachew
    This document discusses various routes of drug administration including oral, sublingual, buccal, rectal, injections, inhalation, and topical application. The main routes covered are oral, parenteral injections including intravenous, intramuscular, and subcutaneous, and inhalation. For each route, the key merits and demerits are outlined. Oral administration is the most common and convenient route but can be impacted by first pass metabolism and gastrointestinal conditions. Injections allow for precise dosing and rapid onset but require more skill and sterile precautions.

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    Routes of Administration of Drugs

    Uploaded by

    Abrham Belachew
    30 views43 pages
    This document discusses various routes of drug administration including oral, sublingual, buccal, rectal, injections, inhalation, and topical application. The main routes covered are oral, parenteral injections including intravenous, intramuscular, and subcutaneous, and inhalation. For each route, the key merits and demerits are outlined. Oral administration is the most common and convenient route but can be impacted by first pass metabolism and gastrointestinal conditions. Injections allow for precise dosing and rapid onset but require more skill and sterile precautions.

    Original Title

    03.(Lec 3) Routes of Drug Adminstration

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    This document discusses various routes of drug administration including oral, sublingual, buccal, rectal, injections, inhalation, and topical application. The main routes covered are oral, parenteral injections including intravenous, intramuscular, and subcutaneous, and inhalation. For each route, the key merits and demerits are outlined. Oral administration is the most common and convenient route but can be impacted by first pass metabolism and gastrointestinal conditions. Injections allow for precise dosing and rapid onset but require more skill and sterile precautions.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    30 views43 pages

    Routes of Administration of Drugs

    Uploaded by

    Abrham Belachew
    This document discusses various routes of drug administration including oral, sublingual, buccal, rectal, injections, inhalation, and topical application. The main routes covered are oral, parenteral injections including intravenous, intramuscular, and subcutaneous, and inhalation. For each route, the key merits and demerits are outlined. Oral administration is the most common and convenient route but can be impacted by first pass metabolism and gastrointestinal conditions. Injections allow for precise dosing and rapid onset but require more skill and sterile precautions.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 43

    Routes of Administration of drugs

    By.
    Dr.Abdul latif Mahesar
    ROUTES OF ADMINISTRATION

    ►Enteral (Alimentary)

    ► Par - enteral
    ( Other than Alimentary)
    ROUTES OF ADMINISTRATION

    Enteral (Alimentary canal)

     Oral
     Buccal & Sublingual
     Rectal
     Nasogastric
    Par - enteral ( Other than Alimentary)

     Par - enteral injections


    Intravenous , intramuscular, intradermal,
    Subcutaneous, intrarterial, intrarticular, intraperitoneal,
    intrathecal

     Inhalation
     Topical
    ORAL
    MERITS
     Commonest, Safest
     Convenient ,
     No skill required, self medication
     Painless, & acceptable
     Cost effective
     No maximal/strict sterilization required
    ORAL
     MERITS cont’d
     Due to slow rate of absorption adverse effects occurs less and
    slowly as compared to
    parenteral route
     Large volume (doses) can be given

     Systemic / local effects in G.I.T

    For local effect


    e.g.,
    neomycin (an aminoglycoside),
    anthelmintics
    antiamoebic.
    ORAL con’d
    De-merits
     Absorption varies (delay, decrease, or
    increase )
    affected by ---- food or drugs that affect GI
    motility
    e.g. antimuscarinic, opioids )
     (Dose may not accurately be delivered)
     Irritation of gastric mucosa
     Patient compliance not ensured
    ORAL cont’d
    Demerits
     First pass metabolism ( First pass effect,
    Presystemic elimination)
     Metabolism of drug (to inactive form)
    after administration before it reaches the
    systemic circulation Usually with orally
    administered drugs
    ORAL
    De-merits cont’d
     First pass metabolism
    - Orally administered drugs
    - First pass effect in GIT
    - Hepatic first pass metabolism
    during its first passage thru liver

     Greater the first pass effect, lesser will be


    the bioavailability
    BIOAVAILABILITY

    is the fraction of administered drug that


    gain access to the systemic circulation
    (after absorption) in a chemically
    unchanged form
    ORAL cont’d

    Demerits cont’d

    - Drugs with high first pass effect needs


    to be given in high doses

    - Variation in first pass effect


    among individuals cause variation in
    drug response
    ORAL cont’d
    Demerits cont’d
     Not suitable for :
    Unconscious patients
    Vomiting patients
    Emergency --- (Slow onset of action)

     GIT diseases or abnormality may


    affect the absorption of drug
    ORAL cont’d
    Demerits
    - Following drugs can not be given by oral route:
    - Drugs destroyed by Stomach pH
    (some Penicillins e.g., benzyl penicillin)
    - Drugs destroyed by Intestinal enzymes
    (e.g., Insulin, oxytocin)
    - Hydrophilic drugs which can not absorbed
    (e.g., Aminoglycosides, but can be given for
    local effect such as neomycin)
    ORAL cont;d

    Demerits cont’d
    Uneven distribution (for local effect),
    in some diseases of gut whole thickness of wall is
    affected (e.g. severe bacillary dysentery, typhoid)
    & effective blood concentrations ( as well as
    luminal concentrations ) may be needed.
    Drug interaction:
    one drug can affect the absorption of other
    drug e.g., antacids decrease the absorption of
    tetracyclines.
    SUBLINGUAL & BUCCAL
    Merits
     Rapid onset of action
     useful in emergency
    (glyceryl trinitrate, nifedipine & ergotamine),
    especially if tablet is crushed, giving greater
    surface area for solution

     Effect can be terminated by spitting out tablet


    SUBLINGUAL & BUCCAL
    Merits
     No sterilization required
     No skill
     first pass hepatic metabolism is avoided
     Increase in bioavailability
     Not affected by gastric acidity or intestinal enzymes
    SUBLINGUAL & BUCCal

    Demerits
     Inconvenient for frequent use
     Irritation of oral mucosa & excessive
    salivation
     Promotes swallowing, so losing the advantage of
    bypassing the first pass effect
     Patient compliance not ensured
     Not suitable for large doses and vomiting patients

     Bitter, irritant can not be given


    RECTAL

     Dose requirement same or slightly greater than

    oral route
    RECTAL

    Merits
     Can be used for producing both the systemic effects
    and local effects

     Drugs that are irritant to stomach can be given by


    suppository (aminophylline, indomethacin)

     Suitable in unconscious, vomiting , motion


    sickness, migraine or when a patient can not swallow , &
    when cooperation is lacking (sedation in children)
    RECTAL

    Merits
     No sterilization
     No skill
     Avoid 50% first pass hepatic metabolism (from
    lower rectum)
     For local effect e.g. in proctitis or colitis
    RECTAL

    Demerits
     Psychological, patient may be embarrassed and dislike this
    way

     Irritation of mucosa & inflammation may occur


    with repeated use

     Emergency (slow onset of action)

     Absorption unreliable, especially if rectum is full of


    feces
    PAR-ENTERAL INJECTIONS

    Dosage forms:
    Solution,
    Suspension
    PAR-ENTERAL INJECTIONS

    Intravenous ( I / V ),
    Intramuscular ( I / M ),
    Subcutaneous ( S / C )
    Intra dermal
    Intra articular
    Intrathecal
    Intraperitoneal
    I / V INJECTIONS & INFUSIONS
    Merits
     Rapid onset of action
     useful in emergency
     No first pass effect, 100% bioavailability,
     Dose more accurately delivered & give smooth
    effective, & highly predictable blood
    concentration
     Suitable in vomiting , motion sickness, migraine,
    unconscious patients, or when a patient can not
    swallow , & when cooperation is lacking
    - Large volume (doses) of drug can be given
    Intra venous and I.V infusions cont’d

    Merits
     Suitable in vomiting , motion sickness, migraine,
    unconscious patients, or when a patient can not
    swallow , & when cooperation is lacking

     Large volume (doses) of drug can be given


    Intra venous and I.V infusions cont’d

     Following drugs which can not be given by


    oral route, are given intravenously
     Drugs destroyed by stomach pH
    (some Penicillins e.g., benzyl penicillin)
     Drugs destroyed by intestinal enzymes
    (e.g., Insulin)
     Hydrophilic drugs which can not absorbed
    (e.g., Aminoglycosides)
    Intra venous and I.V infusions cont’d
    Merits
    - Drugs that are too irritant (anticancer agents) to be
    given by other routes

    - In I.V. infusion ----Rapid modification of dose and


    immediate cessation of administration if unwanted
    effects occur
    I / V INJECTIONS & INFUSIONS

    De-merits
     Costly
     Inconvenient
     More chances of adverse effects, most
    dangerous
     Maximal Sterilization, chances of infection
    Skill, no self medication
     Local irritation at site of administration
    I / V INJECTIONS & INFUSIONS
    Demerits
     Local venous thrombosis with:
    prolonged infusion
    irritant formulations
    microparticulate components of infusion
    fluids, especially if small veins are used
    Infection of intravenous catheter and small
    thrombi on its tip during prolonged infusions
    PARENTERAL : I / M INJECTIONS
    Merits
     Reliable and suitable for irritant drugs and
    depot preparations (penicillins , neuroleptics,
    medroxyprogesterone) can be used at monthly
    or longer intervals

     Absorption is more rapid than following


    subcutaneous injection or oral route
    (soluble preparations are absorbed within 10 – 30 mins.)
    : I / M INJECTIONS

    De-merits
     Inconvenient
     Painful especially for frequent use
     More chances of adverse effects than oral
    Sterilization,
     Chances of infection
     Skill required
     Local irritation at site of administration
    I / M INJECTIONS

    De-merits
    Not acceptable for self administration

    If any adverse effect occur tha can not be


    removed.
    S / C INJECTIONS

    Merits

     Can be used for local and systemic effects both


     Reliable and acceptable for self administration
    (e.g. diabetic patients taking Insulin)
    For local effect --- e.g. local anesthetics
    S / C INJECTIONS

    De-merits
     Poor absorption in peripheral circulatory
    failure

     repeated injections at one site can cause


    lipodystrophy, resulting in erratic
    absorption (insulin)
    INHALATION

     Can be used for local & systemic effects both

    As a gas, --- e.g. ---- General anaesthetics


    As an aerosol,--- e.g. ---- β2 –adrenoceptor agonist
    bronchodilators
    As a powder, e.g. sodium chromoglycate
    INHALATION
    Merits
     Drugs as gases can be rapidly taken up or eliminated,
    giving the close control that has marked the use of
    this route in general anesthesia

     Self administration is practicable

     Aerosols & powders provide high local concentration


    for action on bronchi, minimizing systemic effects

     Aerosols can also be used for systemic effect, e.g


    ergotamine for migraine
    INHALATION

    De-merits
     Special apparatus is needed

     Drug must be nonirritant.

     If the patient is unconscious


    Obstructed bronchi (mucus plugs in asthma) may
    cause therapy to fail
    TOPICAL application

    For local effect


     Skin
     Mucous membrane (eye, nose , ear , lungs,
    anal canal, rectum, urethra, vagina, etc. )

    For systemic effect ----- Transdermal


    TOPICAL APPLICATION: FOR LOCAL EFFECT
    Dosage forms
    Ointment, lotion, cream, etc

    Merits
    usually high local concentration can be used
    without systemic effect
    TOPICAL APPLICATION: FOR LOCAL EFFECT

    Demerits
    systemic effects can occur especially when there is
    tissue destruction e.g.,
    adrenal steroids & neomycin --- to ---- skin,
    atropine & β-adrenoceptor blocker --- to --- eye
    TOPICAL APPLICATION: FOR SYSTEMIC EFFECT:
    TRANSDERMAL DELIVERY SYSTEM (TDS)

    Dosage form:
     Patches, ointment
    as a sticking plaster (Patch) attached to skin or
    as an ointment
    glyceryl trinitrate
    postmenopausal hormone replacement
    TOPICAL APPLICATION: FOR SYSTEMIC EFFECT
    Merits:
     Used for slow continuous administration for long
    duration

     Fluctuations in plasma concentration are largely


    avoided

     Usually No first pass effect

     Drug can be removed if required


    TOPICAL APPLICATION: FOR SYSTEMIC EFFECT:

    Demerits:
     Only small number of drugs can be used by
    this route
     Slow onset of action
     Local reactions

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