Different medications must be absorbed to be effective. For absorption, the drug must be administered in proper manner. To choose a route of administration we need to relate the dosage form, the advantages and disadvantages etc.

1. DRUG
ADMINISTRATION

2. INTRODUCTION
Different medications must be absorbed
to be effective. For absorption, the drug
must be administered in proper manner. To
choose a route of administration
we need to relate the
dosage form, the
advantages and
disadvantages etc.

3. ROUTES OF ADMINISTRATION
Definition
It is the way of getting a drug onto or into
the body. It is chosen based on the effect
upon the speed and efficiency with the drug
action.

4. CLASSIFICATION
1. Enteral
 Oral
 Rectal
2. Topical
 Otic
 Nasal
 Ophthalmic
3. Parenteral
 Intravascular
 Intramuscular
 Subcutaneous
 Inhalation

5. ENTERAL
Desired effect is nonlocal, it is
systemic
Substance is given via digestive
tract

6. It is supplied in many forms as :
 Liquids
 Powders
 Tablets
 Capsules
The equipments used are:
 Medicine cup
 Spoon
 Plastic oral syringe
 Dropper
 Nipple without bottle

7. TABLETS & CAPSULES
PROCEDURE
• Crush the tablet (for children under 5-6 years)
• Mix with pleasant tasting liquid
• Never mix tablet with food
FOR AN OLDER CHILD
• Place tablet at the back of tongue
• Tell child if there is medicine in food

8. LIQUIDS
It should be given with proper equipment
as mentioned in packet. Drop size may vary
from one to another. Do not use syringe for
parental administration.
PROCEDURE
• Shake well before use
• While using dropper direct liquid directly to
posterior side of mouth
• Slowly in small amounts
• Allow child to swallow

9. In case of nipple without bottle:
• Fill nipple by keeping medication directly
• Place infant in upright position
In case of tube feeding:
• Medicine should be in liquid form
• Check tube placement before and after
administration
• Flush tube before and after to maintain
patency

10. ADVANTAGES
• Most convenient and commonly
used route
• Ease and safety of administration
• Active ingredient is in powder or
granule form which dissolve in GI
tract
• Sub linguinal administration has
rapid onset (< 5 minutes)

11. DISADVANTAGES
• Delayed onset
• Destruction of drug by GI fluids, food
or drink in stomach
• Not indicated in patients with
nausea, sedated or unable to
swallow

12. RECTAL ADMINISTRATION
It is not a preferred route for
administration in children as it may be
irritating and unpredictable. Method is
invasive and upsetting. It is used when
child is vomiting or receiving nothing by
mouth.
Suppositories and enemas are two
types of rectal administration of
medication

13. SUPPOSITORY
This drug delivery system is inserted into
rectum, vagina or urethra where it dissolves or
melts. Suppositories are inserted as solids it
dissolves to deliver medicine which is received
later by blood vessels.
Example :
glycerin
paracetamol
diclofenac

14. PROCEDURES
 Ensure the child in side lying position
 Insert suppository into the rectum quickly
but gently
 Insert suppository above anal sphincter
 Use index finger for insertion
FOR AN INFANT OR CHILD UNDER 3
YEAR OF AGE
 Use fifth finger for insertion
 To prevent expulsion of suppository, hold
buttocks together for several minutes

15. ENEMAS
Usually used for cleaning
the bowel, it has laxative action.
In the case of diseases, drug is
administered as enema.

16. ADVANTAGES
Could be administered in unconscious
patients and children.
Useful for nauseous patient and
children
Easy to terminate exposure
Relieve constipation or hemorrhoids

17. DISADVANTAGES
Absorption is slow and
unpredictable in effectiveness
Irregular drug absorption
Inconvenience.

18. TOPICAL
It is the application of the drug directly to the
surface of skin. it includes administration of drugs to
any mucous membrane. In this type of
administration, the desired effect is local.
 Eye
 Nose
 Ear
 Lungs
 Urethra
 Colon

19. The dosage forms include:
 Creams
 Solutions
 Ointments
 Lotions
 Gels
 Tran dermal patches
 Sprays
 powders

20. OPHTHALMIC MEDICATION
 They are supplied in the forms of drops or ointments
 Ensure medication is at room temperature
 administer when child is not crying..
PROCEDURE
 place child in supine position
 Slightly hyperextend neck with head lower
than body
 Rest the heel of your hand to stabilize on child’s
forehead
 Retract the lower eyelid & place medication in
conjunctival sac.

21.  For ointment, apply medication on a thin
ribbon from inner canthus outward without
touching eye or eyelash
 For an older child, we should instruct child
to gently close the eyes to allow medication
to be dispersed.

22. OTIC MEDICATIONS
Typically they are in the form of drops.
This root is upsetting because child cannot see
the procedure..
• Ensure that medication is at room temperature.
• Cold ear drops cause pain & vertigo
PROCEDURE
• Place child in supine or side lying position with
affected ear exposed.
• Pull pinna downward & back in children under
3 years.
• Pull pinna upward and back in children over 3
years.

23. •Instill medication using dropper
•Have the child remain in the same
position for several minutes.
•Massage the area anterior to promote
passage of medication

24. NASAL ADMINISTRATION
These medications are typically drops & sprays
Additional help may be needed to keep child’s
position.
PROCEDURE
• Position child in supine position with hyper
extended head to ensure that the drops will flow
back to nares.
• A pillow or folded towel can be used to facilitate
the hyper extension.
• Place thee tip of the dropper just at or inside
nasal opening

25. • Bottle should not touch the nares
• After installations, maintain child’s head
in hyperextension for 1 minute.
FOR NASAL SPRAYS
• Position the child upright
• Place tip of spray bottle just inside nasal
opening and tilted to back.
• Squeeze the container for instillation

26. ADVANTAGES
• Local therapeutic effects
• Lower risk of side effects
• It offer steady level of drug in the system
DISAVANTAGES
• Messiness
• Irregular drug absorption
• Improper technique leads to risk of side effects
• Alter drug efficacy

27. It is an infusion by means of needle
or catheter inserted into the body.
Any method of administration that
does not involve passage through the
digestive tract is called parenteral .
Intra muscular
Intra venous
Intra-arterial
Intra-cardiac

28.  Intra-thecal
 Intraosseous- into bone marrow
 Intrapleural
 Intraperitoneal
 Intra-articular
 Intradermal (Intracutaneous)
 Subcutaneous route (Hypodermic)

30. It is placing the drug
directly into blood
stream. It would be
intravenous or intra
arterial. It is used
when we need a rapid
response.
For administration in
pediatrics an IV
device should be
inserted peripherally
or centrally. Insertion
is traumatic but it is
less compared to the
pain of multiple
injections.

31.  Peripheral Sites:
-vein in hand or forearm
-scalp vein or foot vein in infant
(possible but central IV site preferred in
neonates)
 Central IV Sites: subclavian vein into
superior vena cava
-central line inserted peripherally
-umbilical vein in neonates

33. Different methods could be
taken for administration
including :
 large volume infusion
pumps
 syringe pumps are accurate
for small volume delivery
 volumetric infusion devices
(Buretrol) used for small
total fluid requirements and
slow rates of administration

34.  Place the child in supine position
 Seek the help of other nurses to hold the
child
 Check the patency of IV line
 Choose the area for IV administration
(Scalp vein is best for infant & toddler. Others
sites are hand, foot antecubital fossa)
 Meditation should be diluted appropriately
 It should be given at the rate of over 2 – 3
minutes
 Watch for irritation to small veins or any
adverse reactions.

35. ADVANTAGES
 Complete and rapid drug absorption with
rapid onset of action
 Immediate access to cardiovascular
system
 Useful in neonates with little muscle
mass
 Less painful route for frequent injections
 Administer drugs which cannot be given
by another route

36. DISADVANTAGES
 Rapid drug/fluid delivery means
immediate onset of adverse reactions
 inability to withdraw infused solutions
 Risk infusion of
air, microorganisms, pyrogens and
particulate matter
 Risk sepsis (infection), phlebitis (venous
irritation), extravasations/infiltration
(leaking outside of the vein)

37. INTRAMUSCULAR INJECTIONS
Here the drug is administered directly
into skeletal muscle. For children it
is given into deltoid muscles of
shoulders.
 Typical needle is 22- to 25-gauge
½- to 1-inch needle
 Intramuscular (IM) injections are
administered at a 90-degree
angle.
 volume limited to less than 3 mL

38.  Fewer medications are given by this route due to
potential for pain.
 Medications typically given IM
Newborn—Vitamin K
Immunizations
At times antibiotics
 Vastus Lateralis muscle for newborns, infants and
young children (Rectus femoris muscle is an
alternative)
 Dorso gluteal site is not used until the child has been
walking ( atleast 1 year)

39. SITES

41. PROCEDURE
 Select the needle size and gauge based
on size of child’s muscle.
 Position the child with proper assistance
 Deltiod – 1 finger below acromion
process
 Vastus lateralis – lateral aspect of thigh
(one handbreadth from greater
trochanter and one handbreadth above
femoral condyle in the lateral aspect)

42.  Rectus femoris – lies over the femur
(one handbreadth from greater
trochanter and one handbreadth above
femoral condyle in the anterior aspect)
 Spread the skin apart
 Insert needle at a 90 degree angle.
 Aspirate for blood and administer.
 If it is an infant or a child with small
muscle mass, 45 degree angle is
preferred

43. ADVANTAGES
 convenient ways to deliver medications
 Compared with the IV route:
 onset of response of the medication is slower
 duration of action is much longer
 Practical for use outside the hospital
 Used for drugs which are not active orally
 Absorption is rapid than subcutaneous route.
 Oily preparations can be used.
 Irritative substances might be given

44. DISADVANTAGES
Neurovascular damage
Bleeding (eg anticoagulant therapy)
Pain
Infection
Delayed absorption in shock

45. SUBCUTANEOUS
Here we administer medications below the
skin into the subcutaneous fat
outside of the upper arm
top of the thigh
lower portion of each side of the abdomen
not into grossly
adipose, hardened, inflamed, or swollen
tissue

46. SITE
Given at a 45-
degree angle
25- or 26-gauge
needle, 3/8 to
5/8 inch length

47. SITES
Abdominal wall
Thigh
Deltoid area

48. PROCEDURE
Position the baby with proper
assistance
Select the site and clean the area
Pinch skin together and insert
needle in 45 degree angle
Aspirate for blood and administer

49. ADVANTAGES
 slow and constant absorption
 Often have a longer onset of action and a longer
duration of action
 compared with IM or IV injection
DISADVANTAGES
 absorption is limited by blood flow , affected if
circulatory problems exist
 concurrent administration of vasoconstrictor will slow
absorption

50. Inhalation may be the route of choice to avoid
the systemic effects. In this way drugs can pass
directly to the lungs. Drugs used involve volatile
drugs and gases. Examples include aerosols like
salbutamol; steam inhalations include tincture
and Benzoin.
solids and liquids are excluded if larger than 20
micron. the particles impact in the mouth and
throat. Smaller than 0.5 micron , they aren't
retained.

51. Medications can be administered directly into
the respiratory tree in cases of respiratory
distress resulting from reversible airway
disease including asthma and certain types of
chronic obstructive pulmonary disease.These
medications are usually nebulized into a
water vapor and breathed with normal
respiration.

52.  Shake canister well
 “Prime” by pressing down
and activating a practice
dose.
 Insert canister into a mouthpiece or spacer to
reduce the amount of drug deposited on the back
of the throat.
 Breathe out and hold spacer between lips making
a seal
 Activate & take a deep slow inhalation.
 Hold breath briefly &slowly exhale through nose

53.  Rapid absorption takes place.
 Rapid onset of action takes place.
 This route has minimum side
effects.
 No first pass effect takes place
 This method is easy.
 Fewer doses is required

54.  Special apparatus is
required.
 Irritation of the respiratory
tract may take place.
 Cooperation of the patient is
required.
 Airway must be patent.