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Routes of drug administration

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It will provide you a complete journey through the routes of drug administration, with all the basics covered I hope this presentation will make your fundamentals crystal clear.

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Routes of drug administration

  1. 1. CHANNELS OF DRUG ADMINISTRATIONENTERAL PARENTERAL TOPICAL
  2. 2. ENTERAL ORAL SUBLINGUAL BUCCAL RECTAL
  3. 3. ORAL ROUTE Oral refers to two methods of administration:  applying topically to the mouth  swallowing for absorption along the gastrointestinal (GI) tract into systemic circulation po (from the Latin per os) is the abbreviation used to indicate oral route of medication administration
  4. 4. ORAL Advantages  Convenient - can be self- administered, pain free, easy to take  Absorption - takes place along the whole length of the GI tract  Cheap - compared to most other parenteral routes
  5. 5. ORAL Disadvantages  Sometimes inefficient - only part of the drug may be absorbed  First-pass effect - drugs absorbed orally are initially transported to the liver via the portal vein  irritation to gastric mucosa - nausea and vomiting
  6. 6. ORAL Disadvantages cont.  destruction of drugs by gastric acid and digestive juices  effect too slow for emergencies  unpleasant taste of some drugs  unable to use in unconscious patient
  7. 7. First-pass Effect 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 less the agent will reach the systemic circulation when the agent is administered orally
  8. 8. First-pass Effect
  9. 9. Oral Dosage Forms Common dose forms for oral administration  tablets  capsules  liquids  solutions  suspensions  syrups  elixirs
  10. 10. SUBLINGUAL ROUTE Sublingual administration is where the dosage form is placed under the tongue  rapidlyabsorbed by sublingual mucosa
  11. 11. SUBLINGUAL ROUTE12 ADVANTAGES  ECONOMICAL  QUICK TERMINATION  FIRST-PASS AVOIDED  DRUG ABSORPTION IS QUICK DISADVANTAGES  UNPALATABLE & BITTER DRUGS  IRRITATION OF ORAL MUCOSA  LARGE QUANTITIES NOT GIVEN  FEW DRUGS ARE ABSORBED
  12. 12. BUCCAL ROUTE Buccal administration is where the dosage form is placed between gums and inner lining of the cheek (buccal pouch)  absorbed by buccal mucosa
  13. 13. BUCCAL ROUTEADVANTAGES– Avoid first pass effect– Rapid absorption– Drug stabilityDISADVANTAGES– Inconvenience– advantages lost if swallowed– Small dose limit
  14. 14. RECTAL ROUTE15 ADVANTAGES By Suppository or  USED IN CHILDREN Enema  LITTLE OR NO FIRST PASS EFFECT  USED IN – E.g. aspirin, theophylline, VOMITING/UNCONSCIOUS  HIGHER CONCENTRATIONS RAPIDLY ACHIEVED chlorpromazine DISADVANTAGES  INCONVENIENT  ABSORPTION IS SLOW AND ERRATIC  IRRITATION OR INFLAMMATION OF RECTAL MUCOSA CAN OCCUR
  15. 15. SYSTEMIC-PARENTERAL Parenteral administration is injection or infusion by means of a needle or catheter inserted into the body The term parenteral comes from Greek words  para, meaning outside  enteron, meaning the intestine This route of administration bypasses the alimentary canal
  16. 16. SYSTEMIC-PARENTERAL17  INJECTABLES I. INTRAVENOUS II. INTRAMUSCULAR III. SUBCUTANEOUS IV. INTRA-ARTERIAL V. INTRA-ARTICULAR VI. INTRATHECAL VII. INTRADERMAL  INHALATION - Absorption through the lungs
  17. 17. INTRAVENOUS18 ADVANTAGES  BIOAVAILABILITY 100% DISADVANTAGES  DESIRED BLOOD CONCENTRATIONS ACHIEVED  IRRITATION & CELLULITIS  LARGE QUANTITIES  THROMBOPHELEBITIS  VOMITING & DIARRHEA  REPEATED INJECTIONS NOT  EMERGENCY SITUATIONS ALWAYS FEASIBLE  FIRST PASS AVOIDED  LESS SAFE  GASTRIC MANUPALATION  TECHNICAL ASSISTANCE AVOIDED REQUIRED  DANGER OF INFECTION  EXPENSIVE  LESS CONVENIENT AND PAINFUL
  18. 18. INTRAMUSULAR ROUTE19 ADVANTAGES  ABSORPTION REASONABLY UNIFORM  RAPID ONSET OF ACTION  MILD IRRITANTS CAN BE DISADVANTAGES GIVEN  FIRST PASS AVOIDED  ONLY UPTO 10ML DRUG  GASTRIC FACTORS CAN GIVEN BE AVOIDED  LOCAL PAIN AND ABCESS  EXPENSIVE  INFECTION  NERVE DAMAGE
  19. 19. SUBCUTANEOUS Injected under the skin. Absorption is slow, so action is prolonged.IMPLANT :a tablet or porous capsule is inserted into the loose tissues by incision of the skin, which is then stiched up. example : certain hormonal drugs
  20. 20. INTRA-ARTERIAL Rarely used Anticancer drugs are given for localized effects Drugs used for diagnosis of peripheral vascular diseases
  21. 21. INTRA-ARTICULAR injections of antibiotics and corticosteroids are administered in inflammed joined cavities by experts. example: hydrocortisone in rheumatoid arthritis
  22. 22. INTRADERMAL drug is given within skin layers (dermis) Painful Mainly used for testing sensitivity to drugs. e.g. penicillin, ATS (anti tetanus serum)INOCULATION :administration of vaccine (like small pox vaccine )
  23. 23. Topical Routes of Administration  Topical administration is the application of a drug directly to the surface of the skin  Includes administration of drugs to any mucous membrane  eye – vagina  nose – urethra  ears – colon  lungs
  24. 24. Topical Dosage FormsDose forms for topical administration include: Skin:  creams • Eye or ear:  ointments – solutions  lotions – suspensions  gels – ointments  transdermal patches • Nose and lungs:  disks – sprays and powders
  25. 25. Advantages and Disadvantages of theTopical Route  Local therapeutic effects  Not well absorbed into the deeper layers of the skin or mucous membrane  lower risk of side effects  Transdermal route offers steady level of drug in the system  spraysfor inhalation through the nose may be for local or systemic effects
  26. 26. Transdermalabsorption of drug through skin (systemic action) i. stable blood levelsii. no first pass metabolismiii. drug must be potent or patch becomes too large
  27. 27. Route for administration -Time until effect- intravenous 30-60 seconds intraosseous 30-60 seconds endotracheal 2-3 minutes inhalation 2-3 minutes sublingual 3-5 minutes intramuscular 10-20 minutes subcutaneous 15-30 minutes rectal 5-30 minutes ingestion 30-90 minutes transdermal (topical) variable (minutes to hours)
  28. 28. SELECTION OF ROUTEThe ROA is determined by : the physical characteristics of the drug the speed which the drug is absorbed and/ or released the need to bypass hepatic metabolism to achieve high conc. at particular sites Accuracy of dosage Condition of the patient
  29. 29. Sublingual/Buccal Some drugs are taken as smaller tablets which are held in the mouth or under the tongue.  Advantages  rapidabsorption  drug stability  avoid first-pass effect
  30. 30. Sublingual/Buccal  Disadvantages  inconvenient  smalldoses  unpleasant taste of some drugs
  31. 31. Rectal 1. unconscious patients and children 2. if patient is nauseous or vomiting 3. easy to terminate exposure 4. absorption may be variable 5. good for drugs affecting the bowel such as laxatives 6. irritating drugs contraindicated

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