Preparation &

Administration IM, IV, Subcutaneous

Drugs

Factors Deciding Choice of

Route
Type of described effect, systemic or local
Physiochemical properties, solid or insoluble
Rapidity of effect
Quality of effect
Condition of patient, conscious or unconscious,

vomiting

Drug Administration
Topical/Local
Administration

Mucus
Membrane

Skin

Inhalation

Systemic
Administration

Enteral

Parenteral

Systemic Routes
Enteral through GIT
Orally
Buccal or sublingual
Rectal
Parental
Intravenous (IV)
Intramuscular (IM)
Subcutaneous (SC)

Enteral Route

Oral Administration
Via mouth

Tablets, capsules, powder, syrup, mixture

suspension or emulsion

Advantages of oral route

Convenience and patient comfort

Safety, since medication can be retrieved in case

of error or intentional overdose

Economy, since there are few equipment cost

Disadvantages of oral route

Slower onset of absorption and action

Rate and degree of absorption vary with

gastrointestinal contents and motility

Some drugs destroyed by digestive fluids and
must be administered by injection
Cannot be used with nausea or vomiting
Dangerous to use if patient has dysphagia, due to
the possibility of aspiration
Cannot be used for unconscious patients
Cannot be use for patients who should keep nil
by oral

Absorption from stomach and

upper intestine is affected by: Surface area
Blood flow to site of absorption
Physical state: solid, solution, suspension
Water solubility
Concentration at the site of absorption

Rate of dissolution
Rate of disintegration
Particle size

Via Nasogastric tube/Gastric tube

For the patients unable to swallow

Advantages : ability to bypass mouth and pharynx

when necessary , elimination of numerous

injections
Disadvantages: discomfort specially for the
conscious patients

Buccal or sublingual Route

Buccal medication placed in the pouch between

the cheek and the gum

Sublingual under the tongue
Advantages: directly absorb to the circulation and
rapid action
Disadvantage: misunderstanding of the way of
use

Rectal Route
For the patients having nausea and vomiting or

patients who are unable to swallow

Advantages: bypassing the action of digestive
enzymes
Avoidance of irritation to the upper GI tract

Disadvantages of Rectal route

Many medications are unavailable in suppository

form
Prolonged use of rectal suppositories can cause
rectal irritation
Absorption may be irregular or incomplete if feces
are present
Inconvenient & embarrassing
Rectal inflammation occurs

Parenteral Administration

Parenteral Administration
Intravenous

Intramuscular
Subcutaneous
Intradermal
Intrathecal
Intraarterial
Intra articular

Intravenous Route
Drug administration directly to the vein

Direct injection
Bolus
Infusion

Advantages of Intravenous Route

Immediate effects

Valuable for emergency use

Suitable for large volume
Complete bioavailability

Disadvantages of Intravenous
Route
Not suitable for oily solutions & insoluble

substances
Drug administered cannot be withdrawn
Thrombophlebitis occurs at injection site
Lack of sterility may cause viral hepatitis
or AIDS
Increased risk of adverse drug reactions
Time and skill required for venipuncture
Difficulty of maintaining IV line
Complications of IV therapy bleeding, infection
and fluid overload

Intramuscular Route ( IM)

Injections of drugs into certain muscles

Usually doses 3ml or less

IM injection
Depot preparation

Absorption depends upon rate of blood flow to the

injection site
Rapid action compared to SC route
Slow releasing compared to IV route

 Advantages : can be use to administer solutions or

suspensions
Slow, sustained effect from depot preparation
Disadvantages: incorrect placement of the needle
may damage blood vessels or nerves
Pain
Abscess formation
Avoid during anticoagulant therapy

Subcutaneous Route (SC)

Injection of drugs under the skin

Use for highly soluble, non irritating, small volume

of drug about 1ml or less

Absorption is slower and the drug action is
generally longer with SC injections than with IV or
IM injections
Advantages :Slow absorption and distribution

 Disadvantages: tissue damage, tissue necrosis and

sterile abscess formation

Only nonirritant drugs
Not suitable for large volume

Intraarterial Route
Direct injection into artery

Localization of effect in particular tissue or organ

Advantages: Diagnostics agents
Disadvantages: Reserved route for experts

Intrathecal Route
Injections into cerebrospinal fluid

Blood Brain Barrier & Blood CSF Barrier slow

drug entry into CNS

Used when local and rapid effects of drugs on
the meninges or cerebrospinal axis desired

Intradermal Route
Injection into skin layers

Uses: BCG, Small pox vaccination

Testing drug sensitivity- Penicillin's
Tuberculin test

Intraarticular Route
Drug administration directly to the joint

Usually local effect

Uses: Rheumatology disorders

Topical Application- Mucous

Membrane
Conjunctiva, nasopharynx, oropharynx, vagina,

urethra, urinary bladder, ear, nose, anal canal for

local effects
Ointment, cream, drops, jelly, powder, tablet,
suppository, pessary, sprays, gargles

Topical Application- Skin

Absorption depends on surface area of

application, lipid solubility

Few drugs readily penetrate skin
Burned, denuded, abraded, inflammation
increase systemic absorption
Controlled- release topical patches

 Advantages: Absorption rapid

Only local effect

Disadvantages: Toxicity by highly lipid soluble
substances

Inhalation

Inhalation
Via inhaler

Via nebulizer
Medication directly to the respiratory system

Advantages of Inhalation
Rapid action of the drug, with local effects with in

the respiratory tract

Potent drugs may be given in small amounts,
minimizing the side effects
Convenience and comfort of the patient

Disadvantages of Inhalation
Requires cooperation of the patient in proper

breathing techniques for effectiveness

Adverse systemic side effects may result rapidly
because of extensive absorption capacity of the
lungs
Improperly administered or too frequently
administered, inhalation can lead to irritation of the
trachea or bronchi or bronchospasm
If not clean properly nebulizers can be a source of
infection