Introduction to practical pharmacology(part2) Routes of administration of drugs

1. Routes of
Drugs Administration
By Sameh AM. Abdel-Ghany

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Routes of Drug administration
Other routes
Parenteral routes
Enteral routes

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A- Enteral routes
Oral Sublingual Rectal

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I- Oral route
 Forms used
 Requirements needed
 Advantages
 Disadvantages
N.B. Gastric gavage-Gastric lavage

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Forms used

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Advantages
osafe
o easy
o selfuse
o no need for sterilization

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Disadvantages
o Maybe inefficient - high dose, low
solubility
o First-pass effect – GIT enzymes
o Food Interaction
o Local effect - GI flora
o Unconscious patient - not able to
swallow

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II- Sublingual route
 Forms used
 Requirements needed
 Advantages
 Disadvantages

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Forms used

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Advantages
oAvoid first pass effect
oRapid absorption
oDrug stability
oAvoid GIT problems
oCan remove medicine

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Disadvantages
oInconvenience
oadvantages lost if swallowed
oSmall dose limit

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III- Rectal route
 Forms used:
a- suppository
b- enema
 Requirements needed
 Advantages
 Disadvantages

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a- supppsitory

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b- Enema

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Advantages
oBy pass liver – GIT enzymes
oUseful – children
oadministration of large volume of
fluids (enema)

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Disadvantages
oIrregular absorption
omay cause irritation of the rectal
mucosa

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B- Parentral route
1
Injections 2
Inhalation
3
Transdermal
delivery
system

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I- Injections
 Definition
 Forms used
 Requirements needed
 Advantages
 Disadvantages
 Indications

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Forms used

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Advantages
oRapid effect.
oNo destruction of drug by G.I.
enzymes & no local action on
G.I.T.
ouseful in coma and convulsions

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Disadvantages
oneeds trained person.
oneeds aseptic precautions.
oPain at site of injection.
oDanger of infection.

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Indications
oThe drug is ineffective by other routes
oThe drug has intense local irritant.
oa high concentration of the drug is
required very rapidly.
oIn emergencies and in unconscious
patients.

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www.themegallery.com
Types of
injections
Intradermal
Subcutaneous
Intramuscular
Intracardiac
Intraperitoneal
Intrathecal
Intravenous
Intrarterial
Intra-articular

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a- Intradermal route
 Definition
 Requirements needed
 Advantages
 Disadvantages

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b- Subcutaneous route
 Definition
 Requirements needed
 Sites
 Advantages
 Disadvantages

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Sites

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Advantages
oCan be given by the patient
oSlow but generally complete
oabsorption

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Disadvantages
oPainful
oTissue damage from irritant drugs
oMaximum of 2 ml injection.

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c- Intramuscular route
 Requirements needed
 Sites
 Advantages
 Disadvantages

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Sites

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Advantages
o injection of moderately irritant drugs.
o injection of large amount of fluid than
S.C..
o suitable for solutions or suspensions of
insoluble drugs in water or oil.

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Disadvantages
oTrained personnel
oAbsorption may be incomplete
oAvoid in patients with bleeding
tendency

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d- Intravenous route
 Forms used
 Intravenous infusion
 Requirements needed
 Sites
 Advantages
 Disadvantages
 Precautions

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Forms

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Intravenous infusion

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Sites

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Advantages
o rapid (used in emergency).
o avoid rapid chemical decomposition
o very irritant drugs can be given
o Large amount of fluids can be given by
I.V. infusion and for nutrition.
o Immediate cessation of administration is
possible of unwanted effects occur
during drug administration.

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Disadvantages
oPyrogenic reactions and
anaphylactoid reactions
oExtravasation
oNot suitable for drugs in an oily
vehicle or those that hemolyse
RBcs.

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Precautions
o must be performed slowly.
o Not add more than one drug to one infusion.
o Saline is generally suitable for infusing many drugs.
o Fresh preparation
o Change the infusion set whenever clear fluids are to follow blood proteins or
amino acids.
o Do not add drugs to blood, amino acid solutions or fat emulsion.
o Do not add aminophylline, hydrocortisone or erythromycin to dextrose
solution.
o Do not add corticotrophin, tertracyclines, suxamethonium or metaraminol to
any strength of mannitol.
o Do not add tetracyclines, calcium salts, corticotrophin, hydrocortisone or
insulin or methicillin to sodium bicarbonate.
o Heparin and aminophylline must not be added to acidic solutions.
o Insulin must not be added to strongly alkaline solutions

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e- Intra-arterial route
oDefinition
oUses
i. Diagnstic
ii. Therapeutic

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f- Intracardiac route
oDefinition
oUses

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g- Intraperitoneal route
oDefinition
oUses

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h- Intrathecal route
o Definition
o Uses:
i. Diagnstic
ii. Therapeutic

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i- Intra-articular route
o Definition
o Uses

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II- Inhalation
 Definition
 Preparation
 Advantages

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Preparations
o Gases
o Vapours
o Steam inhalation
o Inhalers:
i. Aerosols e.g MDI - Nebulizer
ii. Dry powder inhalers e.g spinhaler

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NebulizerSpinhalerMDI(metered
dose inhaler)

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Advantages
orapid
oavoid GIT problems like first
pass effect
oMinimize side effects if used
locally
oAbsorption of gases efficient
and rapid

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III- Transdermal delivery system
 Definition
 Forms used
 Advantages

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Administration for local use
Topical
Injections
Inhalation

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a- Topical
 Skin :
i. Ointment
ii. Cream
iii. Liniment
iv. Lotions
v. Powder

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Cont.
 Mouth: washes – gargles
 Eye : drops – solution
 Nose – Ear: drops
 Vagina: douches

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b- injections:
i. infiltration anaesthesia
ii. nerve block
iii. intra-articular
c- Inhalation

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C- Other routes
B- InsufflationA- Diadermal
administration
(Iontophoresis)
Other routes

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Contact informations
 Facebook: Dr-Sameh Abdel-Ghany
www.facebook.com/samghany
 Tel: 01003798288
 Email:
dr.samghany@gmail.com