itz just a short study on routes of drug administration that will b helpful to all nursing proffesional students...

1. PRESENTED BY
-VINU VARGHESE KIRIYANTHAN
2ND YEAR BSc.

3. Definition:
A route of administration is the path by which a drug,
fluid, poison or other substance is brought into
contact with the body.

5.  Medications are available in a variety of forms and
preparations
 The form of the medication will determine its
route of administration
 Composition of medicine is designed to enhance
its absorption & metabolism
 Many medications are available in several forms

6.  Tablet
 Capsule
 Elixir
 Enteric-coated
 Suppository
 Suspension
 Transdermal patch

7. • Check the “10 rights”
• Standard Precautions: Wash your hands!
• Double-check if unsure about anything
• Check for drug allergies
• Prepare drugs for one patient at a time
• Check three times

8. • Check expiration dates
• Check the patient’s identification
• Give medications on time
• Explain medications to the patient
• Open the medications at the bedside
• Document the medications given before going to the next
patient

9. • A drug’s route of administration affects the rate and
extent of absorption of that drug
• Route can be broadly divided into:
– Enteral (GI tract)
– Parenteral
– Topical

10. • It is the most common oldest and safe route
• Drug is absorbed into the systemic circulation through
the oral or gastric mucosa, the small intestine, or
rectum
– Oral
– Sublingual
– Buccal
– Rectal

11. ADVANTAGES
 Safest route
 Most convenient
 Self administrable
 Non invasive route

12. DISADVANTAGES
 Slow onset
 Some may be irritant and unpalatable
 Some may not absorb
 Irritation may induce vomiting
 Irregularities in absorption
 Cannot gave to unconscious patients
 Some may undergo extensive first pass effect in liver

13. - The first pass effect is the term used for the hepatic
metabolism of a pharmacological agent when it is
absorbed from the gut and delivered to the liver via the
portal circulation.
- The greater the first pass effect, the lower the
bioavailability of the drug(the rate and extent of the
drug reaching systemic circulation).

14. First pass effect

15. - By swallowing.
- It is intended for systemic effects resulting from drug absorption
through the various epithelia and mucosa of the gastrointestinal
tract.

16.  These are tablets coated with substance like cellulose
acetate, phthalate, gluten etc. which are not digested
by the gastric acid but get disintegrated in the alkaline
juices of the intestine

18.  Some drugs are taken as smaller tablets which are
held in the mouth (buccal tablet) or under the
tongue (sublingual tablet).
 Buccal tablets are often harder tablets [4 hour
disintegration time], designed to dissolve slowly.
 E.g Nitroglycerin, as a softer sublingual tablet [2
min disintegration time], may be used for the
rapid relief of angina.

20.  Route of administration other than the enteral route
are known as parenteral route.
 Drugs are directly delivered into tissue fluid or blood.
 It includes:
injections
inhalations
transdermal route
transmucosal route

21. ADVANTAGES
 Action is rapid
 Administered even in unconscious patients
 Gastric irritant can be given parenterally
 Used in patients who are unable to swallow

22. DISADVANTAGES
 Asepsis must be maintained
 Injection may be painful
 more expensive, less safe and inconvenient
 Injury to nerve may occur

23. • Intradermal
• Subcutaneous
• Intramuscular
• Intravenous
• Intraperitoneal
• Intrathecal
• Intraarticular
• Intra arterial
• Intra medullary

24. • Intradermal into the dermal layer of the skin
• Subcutaneous into the subcutaneous layer of the skin
• Intramuscular into the muscle
• Intravenous (fastest delivery into the blood
circulation) into the vein
• Intraperitoneal into the peritoneum

25. • Intrathecal into the subarachnoid space (used for
anesthesia)
• Intraarticular into a joint
 Intra arterial into arteries
 Intra medullary into bone marrow

26. Drug is injected into the layers of skin by;
• Raising a bleb. Eg, BCG vaccine test for allergy
• by multiplying punctures of epidermis through a drop
of drug, eg, smallpox vaccine
only a small dose can be administered and it
may be painful

27. drug is injected under the skin
e.g. insulin.

28. SITES OF
SUBCUTANEOUS
INJECTION
 Gluteal
 Thigh
 Shoulder
 Back…

29.  Drug can be administered subcutaneously as ;
1, dermojet
2, pellet implantation
3, sialistic implants

30. Injecting medication into large skeletal muscle
deltoid, gluteus or rectus femoris

31. SITES OF INTRAMUSCULAR INJECTIONS
– Ventrogluteal site (preferred)
– Vastus lateralis site
– Dorsogluteal site
– Deltoid site

32. Advantages
suitable for injection of drug in aqueous solution
(rapid action) and drug in suspension or emulsion
(sustained release).
Disadvantages
Pain at injection sites for certain drugs.

34. - Placing a drug directly into blood stream.
- -May be - Intravenous (into a vein)
- intraarterial (into an artery).

35. DRUGS CAN BE GIVEN IV AS;
1, bolus
2, slowly
3, slow infusion…

37. Advantages
precise, accurate and immediate onset of action,
100% bioavailability.
Disadvantages
risk of embolism.
high concentrations attained rapidly leading to
greater risk of adverse effects.

38. ADMINISRATION OF IV FLUIDS
 Maintain strict asepsis
 Port of iv line flushed with saline before infusion
 Watch for sign of extravascation
 Make sure that there are no air bubbles
 Carry a sterile container to place components while iv
cannulisation

40.  (infusion or injection into the peritoneum) e.g.
peritoneal dialysis in case of renal insuffeciency

41.  Drug injected into the spinal canal) is most
commonly used for spinal anesthesia .

42.  Drugs injected directly into joint for treating arthritis
& other diseases of joint

43.  Injection into a bone marrow

44. • Skin (including transdermal patches)
• Eyes
• Ears
• Nose
• Lungs (inhalation)
• Vagina

45.  Highly lipid soluble
drug can be applied over
skin for slow and
prolonged absorption
Eg, nitroglycerine
ointment in angina
pectoris
• Administering
medications to the skin
– Lotions, creams,
ointments, powders
– Transdermal patches

46. Used for gaseous and volatile agents and aerosols.
.
Advantages
A- Large surface area
B- thin membranes separate
alveoli from circulation
C- high blood flow
-As result of that a rapid onset
of action due to rapid access to
circulation

47. .
Disadvantages
1- Most addictive route of
administration because it hits
the brain so quickly.
2- Difficulties in regulating the
exact amount of dosage.
3- Sometimes patient having
difficulties in giving
themselves a drug by inhaler

48. • NASAL DRUGS
– Drops
– Spray

49. • EAR DROPS
– Adults
– Infant or child younger than
3 years of age

50. • EYE MEDICATIONS
–Drops
–Ointments

51. • RECTAL DRUGS
• Most commonly by suppository or enema.
Advantages
 By-pass liver - Some of the veins draining the rectum
lead directly to the general circulation, thus by-passing
the liver. Reduced first-pass effect.
 Useful - This route may be most useful for patients
unable to take drugs orally (unconscious patients) or
with younger children. if patient is nauseous or
vomiting

52. • RECTAL DRUGS
• Most commonly by
suppository or enema.
Disadvantages
Erratic absorption -
Absorption is often incomplete
and erratic.
Not well accepted

53.  Ocusert
 Progestasert
 Prodrug
 Osmotic pumps
 Computerized miniature pumps
 Monoclonal antibodies
 Liposomes

54.  Ensure that correct drug is administered by right route
and in the right dose
 History of allergy should be taken particularly before
parenteral administration of drugs
 Monitor the adverse effects
 Drugs should be kept in a safe place
 Check the prescription, drug label and the patients
name before the administration of drugs

57. THANK YOU……