Routes of drug administration

Dr. Rathnakar U.P.

MD.DIH.PGDHM

Associate Professor Department of Pharmacology Kasturba Medical College, Mangalore www.scribd.com 03 August 2013

Routes of Drug Administration

Route of administration is the path by which a drug, is brought into contact with the body

Routes of administration
Oral Enteral Route Sublingual [Systemic/ Local] Rectal Inhalation Topical -Application to

Injection
Intradermal Subcutaneous Intramuscular Intravenous Intra arterial Intrathecal Intravitreal.

other epithelial surfaces (e.g. skin, cornea, vagina and nasal mucosa)

Transdermal Nasal

Others [Local/ Systemic Action]

Parenteral Route [Systemic/ Local]

Intrarticular

Oral [Tablets, Capsules, liquids]

Advantages Safer, convenient, Self administration Does not need assistance, Noninvasive, Painless, Need not be sterile Cheaper. Solid and liquid dosage forms Disadvantages
Slower action not for emergencies. Bitter drugs (chloramphenicol) difficult to administer[Cap] Nausea and vomiting Cannot be used in uncooperative/unconscious/ vomiting patient. Drugs may not absorbed (streptomycin) May be destroyed by digestive juices or liver [First pass metabolism].

Mostly systemic action Rarely for local action. Eg. Peptic ulcer, ulcerative colitis

First-pass metabolism
[Metabolism before the drug reaches systemic circulation]

Injections

Metabolism [First pass]

Portal circulation

Oral

Sub-lingual
[Tablet placed under tongue/spray]

Advantages Absorption is rapid-action can be produced in minutes. One can spit the drug after the desired effect [Convenient??] Liver is by passed[Nitrates] Eg. GTN, buprenorphine, desaminooxytocin

Disadvantages Only lipid soluble Only non-irritating drugs

Mostly systemic action

Rectal

Rectal
[Enema, suppositories]

Enema Evacuant enema[Liquid] Eg: Soap & water enema , AIM:-to remove fecal matter & flatus Retention Enema [Suppositories] Local action:- Eg: Prednisolone enema in ulcerative colitis.

Systemic action [Transrectal] [Suppositories] MgSO4 to ICT. Diazepam in epilepsy Indomethacin, Ergotamine

Mostly Local action Rarely for systemic action.

Rectal
[Enema, suppositories]

Advantages Irritant and unpleasant drugs When the patient is having recurrent vomiting Unconscious Children 50% bypasses liver

Disadvantages Inconvenient Embarrassing; Absorption is slower, irregular, unpredictable [Diazepam fast] Local irritation

Cutaneous/mucus membrane
Topical: Local action Ointments, powders, eye drops, nasal drops, paints, lozenges, unabsorbable drugs, Inhalers for asthma

Transdermal Therapeutic System

[A transdermal patch is a special medicated adhesive patch that is placed on the skin to deliver a medication through the skin and into the bloodstream.]

Occlusive backing film Drug reservoir Rate controlling micropore membrane Adhesive impregnated with priming dose of the drug Protective film

TTS
Drug is released slowly without fluctuations Chest, abdomen/ upper arm, lower back, buttock or mastoid region are utilized. GTN, fentanyl, nicotine and estradiol are available in India, [isosorbide dinitrate, hyoscine, and clonidine -other countries.]

TTS
Advantages Convenient Better compliance Long duration No fluctuations in plasma cocn. Minimizes inter-individual variations By passes of liver Disadvantages Expensive Only lipid soluble drugs Local irritation May fall off

Inhalation
Systemic action [GA, oxygen] Local action [Bronchial asthma.Eg??] Absorption takes place from the vast surface of alveoli Controlled administration is possible with moment to moment adjustment Irritant vapors (ether) cause inflammation of respiratory tract and increase secretion Require special equipment

Nasal
Local action[decongestants] Systemic [GnRH agonists, desmopressin]