In this article, routes of drug administration, local route and systemic route is covered in very easiest way.
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ROUTES OF DRUG ADMINISTRATION
Most of drugs can be administered by different routes.
Drug and patient related factors determine the selection of routes.
The factors are.
[1] Characteristics of drug
[2] Emergency use
[3] Condition of patient
[4] Age
[5] Associated disease
[6] Sometimes patient's and doctor's choice.
ROUTES
1. LOCAL
2. SYSTEMIC
LOCAL ROUTE
It is the simplest mode of administration of drug at the site where the desired action is required.
[1] Topical - This refers to external application of drug to the surface of localised action.
The drug can be delivered to -
a) Oral cavity : e.g. nystatin, clotrimazole.
b) GI tract : e.g. neomycin.
c) Rectum and anal canal
d) Eye, ear, nose : e.g. ointments, sprays.
e) Bronchi : e.g. salbutamol, ipratropium bromide
f) Vagina : e.g. pessaries.
g) Urethra : e.g. lignocaine.
[2] Deeper tissues - Deep areas can be approached by using syringes, needles but the drug should be in such a form that systemic absorption is slow, e.g. intra-articular injection (hydrocortisone acetate), infiltration around nerve (lidocaine).
[3] Arterial supply - Close intra-arterial injection is used for contrast media in angiography.
SYSTEMIC ROUTE
The drug administered through systemic route is intended to be absorbed into the blood stream and distributed all over, including site of action through circulation.
[1] Oral - Old and commonest method of drug administration. Both solid dosage form (powders, tablets, capsules, spansules, dragees) and liquid dosage form (elixers, syrup, emulsion, mixtures) can be administered orally.
[2] Sublingual/buccal - Tablet containing drug placed under tongue or crushed in mouth and spread over the buccal mucosa.
[3] Rectal - Irritant and unpleasant drugs can be put into rectum as suppositories.
Diazepam, indomethacin, ergotamine, paracetamol and few other drugs given by this route.
[4] Cutaneous - Highly lipid soluble drugs can be applied on skin for slow and prolonged absorption. Absorption of drug can be increased by rubbing the preparation.
[5] Inhalation - Volatile liquid and gases are given by inhalation for systemic action, e.g. general anesthetics. Absorption takes place from the surface of alveoli, action is very rapid.
[6] Nasal - This route is specially used for drugs like insulin, as well as to bypass the BBB.
[7] Parentral - It refers to injection of drug which takes the drug directly into tissue fluid and blood without having to cross the enteral mucosa.
The important parentral routes are -
a) Subcutaneous - The drug is delivered into loose subcutaneous tissue which is richly supplied by nerves.
b) Intramuscular - The drug is injected in one of the muscle like deltoids, triceps, glutes, rectus femoris, etc.
c) Intravenous - The drug is infused slowly in one of superficial veins, the drug is directly reaches to blood stream and produces effect immediately.
d) Intradermal - The drug is injected into the skin raising a bleb (e.g. BCG vaccine, sensitivity testing). This route is employed for specific purpose only.
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