A drug is a substance used in the diagnosis, treatment, or prevention of health problems. A drug is a chemical substance derived from different sources –living or non living , which alter or change the function of cells, by reacting with them. A route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body.

1. Administration of medication

2. Introduction
• A drug is a substance used in the diagnosis,
treatment, or prevention of health problems.
• A drug is a chemical substance derived from
different sources –living or non living , which
alter or change the function of cells, by reacting
with them.

3. • Medication or drug is a substance that
modified body function when taken into the
living organism.
• Administration of the medication is a basic
nursing function that involves skillful
technique and consideration of the patient
progress and safety.

4. Purposes of medication
• To diagnose a disease
• To treat a disease
• To promote health status
• To relieve pain or discomfort

5. Terms: abbreviations used when
administration of drugs
• AC-before meals
• PC-after meals
• AM-In the morning
• PM- afternoon/Evening
• OD-Once a day
• BD-twice a day
• TDS/TID-three times a day
• QID-every 6 hours (4 times
a day)
• HS-At bed time
• PRN-when required
• SOS- If necessary
• Stat-immediately
• QH-Hourly

6. • Q: every
• Q2h-every 2 hours
• Q4h-every 4 hours
• Q6h-every 6 hours
• Q8h-every 8 hours
• Q12h-every 12 hours
• NPO-nothing per oral

7. Regarding Route
PO-Per oral
IM-intramuscular
IV-Intravenous
ID- Intradermal
SC-Subcutaneous
PV-Per vaginal
NG-Nasogastric
PR-by rectum
SL-sublingual

8. • NEB:Nebuliser
• TOP:topical/skin
• VAG:vaginal
• BUC:inside cheek
• TPN: total parental
nutrition
• Supp: suppository
• s.i.d.: (semel in die)
(once a day)

9. Routes of Medication
• Oral
–Tablets, capsules, elixirs or suspensions
• Topical
–Skin, eyes, ears, nose
• Inhaled
–Mouth or nose

10. Regarding the preparation of drugs
• Mist-Mixture
• Tr./Tinct.- Tincture
• Syp-Syrup
• Sp-spirit
• Lot.-Lotion
• Liq-Liquid
• Inf.-Infusion
• FL.-Fluid

11. Regarding Amount
• Grg-Gargle
• Kg-kilogram
• O-Pint
• mg-milligram
• Mcg-microgram
• O2-Ounce
• Mg-milligram
• mL-milliliter
• Cap-capsule
• Gtt-drop
• Tsp-teaspoon
• Tbs- Tablespoonful
• Tab-tablet

12. About teaspoon, tablespoon, cc, and ml.
• 1 teaspoon (tsp.) = 5 mls
• 1 Tablespoon (Tbs.) = 15 mls
• One ounce = 30mls
• 1 cc = 1 ml

13. Routes of administration
• A route of administration is the path by which
a drug, fluid, poison or other substance is
brought into contact with the body.

14. Reasons for Different Routes of
Administration
• Ease of administration
– Convenience/Compliance
• Rate of onset
– Rapid/slow onset of action desired
• Duration of action
– Rapid/Prolong the duration of action
• Site of action
– Target drug delivery to a specific site
• Preferred route is unavailable
• The physical characteristics of the drug
• Condition of the patient

15. Purpose of medication adinistration
Drugs can be administered for these
purposes:
• Diagnostic purposes. e.g. assessment of liver
function.
• Prophylaxis .e.g. heparin to prevent
thrombosis or antibiotics to prevent infection.
• Therapeutic purposes. e.g. replacement of
fluids or vitamins, supportive purposes (to
enable other treatments, such as anesthesia),
palliation of pain and cure (as in the case of
antibiotics).

16. ENTERAL ROUTE
ORAL ROUTE
• Oral refers to administrating of medication by mouth
• 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.

17. • This is the most frequently used route of drug
administration and is the most safest,
convenient and economic.
• Oral drugs are available in many forms of
tablets, capsules or granules, or liquids such as
syrups, or suspensions.
• Solid dose forms such as tablets and capsules
have a high degree of drug stability and
provide accurate dosage.

18. 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.

19. 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
– 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.

20. 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.

21. SUBLINGUAL ROUTE
• Sublingual
administration is where
the dosage form is placed
under the tongue
–rapidly absorbed by
sublingual mucosa

22. SUBLINGUAL ROUTE
ADVANTAGES
• Economical
• Quick termination
• Bypass first-pass effect
• Bioavaibility good
• Drug absorption is quick
DISADVANTAGES
• Unpalatable & bitter drugs
• Irritation of oral mucosa
• Large quantities not given
• Few drugs are absorbed 22

23. 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

24. BUCCAL ROUTE
ADVANTAGES
– bypass first pass effect
– Rapid absorption
– Drug stability
DISADVANTAGES
– Inconvenience
– advantages lost if
swallowed
– Small dose limit

25. Rectal route
• A rectal route is another enteral route of
medication administration, and it allows for rapid
and effective absorption of medications via the
highly vascularized rectal mucosa.
• Similar to sublingual and buccal routes, rectally
administered medications undergo passive
diffusion and partially bypass the first-pass
metabolism.

26. RECTAL ROUTE
Advantages
 Used in children
 Used in
Vomiting/unconscious
 Higher concentrations rapidly achieved
Disadvantages
 Inconvenient
 Absorption is slow and erratic
 Irritation or inflammation of rectal mucosa can occur
26
By Suppository or Enema
– E.g. aspirin,
theophylline,
chlorpromazine

27. PARENTERAL ADMINISTRATION

28. 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
• The term parenteral is used when drug is
administered through other than enteral
route and systemic action is required.
• Desired effect is systemic, substance is
given by routes other than the digestive
tract or topical application.

29. • Parenteral drug administration can be taken
literally to mean any non-oral means of drug
administration,
• but it is generally interpreted as relating to
injection directly into the body, by-passing the
skin and mucous membranes.
• The common routes of parenteral
administration are intramuscular (IM),
subcutaneous (SQ) and Intravenous (IV).

30. Types of Parenteral Routes
INJECTABLES
1) Intravenous
2) Intramuscular
3) Subcutaneous
4) Intra-arterial
5) Intra-articular
6) Intrathecal
7) Intradermal
30

31. 1. INTRAVENOUS
• Intravenous also popularly known as
I.V. which is given directly into a vein with
injection.
• As the drug direclty goes in to the systemic
circulation, the rapidly reaches to the site of
action and the onset of action is quick (within
minuets) e.g. many drugs, total parenteral
nutrition.

32. • The upper extremity is usually the preferred
site for intravenous medication as it has a
lower incidence of thrombophlebitis and
thrombosis than the lower limbs. The median
basilic or cephalic veins of the arm or the
metacarpal veins on the hand's dorsum are
commonly used. In the lower extremity, the
dorsal venous plexus of the foot can be used.

33. Advantages
• Bioavailability 100%
• Desired blood
concentrations achieved
• Large quantities
• Emergency situations
• First pass (metabolism by
the liver) avoided
• Gastric manipalation
avoided
Disadvantages
• Irritation & cellulitis
• Thrombophelebitis
• Repeated injections not
always feasible
• Less safe
• Technical assistance
required
• Danger of infection
• Expensive
• Less convenient and painful
33

34. 2. INTRAMUSULAR ROUTE
• Drugs administered via the IM route are deposited
deep into the muscle tissue.
• An intramuscular medication route can be
administered in different body muscles, including
deltoid, dorsogluteal, ventrogluteal, rectus femoris, or
vastus lateralis muscles.
• This may be done because the substance is not
tolerated or is altered by the upper gastrointestinal
tract, or when other routes may be contraindicated,
• such as the oral route in patients who can receive nil
orally, or for some medications where intravenous
access is difficult.

35. COMMON INTRAMUSCULAR
INJECTION SITES AND MUSCLES
Site
• Dorsogluteal
• Ventrogluteal
• Anterolateral
aspect of thigh
• Upper arm
Muscle
• Gluteus maximus
• Gluteus medius
• Vastus lateralis
• Deltoid

36. Effectiveness
• Muscles with high blood flows (e.g., deltoid)
provide faster absorption rates than muscles with
lesser flows (e.g., gluteus maximus).
• Generally, 5 to 30 minutes is required for the
onset of drug effect, but this period can be
controlled to some extent.
• Exercise markedly speeds absorption by
stimulating local circulation.
• Conversely, uptake may be minimized by the
application of ice packs or (in an emergency)
tourniquets.

37. • Ventrogleutal site is the preferred and safe site for adults,
children and infants. The location is lateral (ventral) side
of the hip. This involves the Gluteus medius and
minimus muscles in the hip area. This site offers a large
muscle mass that is relatively free from major nerves and
blood vessels and fat. It is considered the safest and least
painful site for delivering IM injection
• Although the dorsogluteal site, or the buttock's upper
outer quadrant, is a common site chosen traditionally for
intramuscular injections by healthcare professionals, it
poses a potential risk of injury to the superior gluteal
artery and sciatic nerve

38. Remember
• The nurse should avoid using the deltoid and
dorsogluteal sites in infants and children. There is
a risk of striking the sciatic nerve when using the
dorsogluteal site. The deltoid muscle is not well
developed in infants and children.
• The primary site for administering an IM injection
in clients over 7 months old is the ventrogluteal
(VG) site. The gluteus medius is a well-developed
muscle, free of major nerves and large blood
vessels.

39. Advantages
• Absorption reasonably
uniform
• Rapid onset of action
• Mild irritants can be
given
• First pass avoided
• Gastric factors can be
avoided
Disadvantages
• Only up to 10ml drug
given
• Local pain and abscess
• Expensive
• Infection
• Nerve damage 39

40. Z-track technique
• It reduces leakage of medication through subcutaneous tissue. So,
the patient gets the full dose of medication.
• It doesn’t hurt patients quite as much as a regular I.M. injection.
• Skin is pulled downwards and laterally(2.5 to 3.5cm) before
injection
• Then leave the skin after withdrawing the needle.
• This leaves a Zigzag path that seals the needle tract where tissue
planes slide across each other. The medication cannot escape from
the muscle tissue.
40

41. 3.SUBCUTANEOUS
• The subcutaneous (SC, SQ) route is one of the
most versatile routes of administration in that
it can be used for both short term and very
long term therapies.
• Up to 2 ml of a drug solution can be injected
directly beneath the skin. The drug becomes
effective within 20 to 30 minutes.

42. Subcutaneous injections
• Small amounts of medication (0.2–2 ml) are given
into the subcutaneous tissue to allow a slow,
sustained absorption of medication. It is an ideal
route for insulin, which requires frequent injections,
but is also used regularly for heparin.
• SC injections place the medication into the
subcutaneous tissue, between the dermis and the
muscle. Clients who administer frequent
subcutaneous injections should rotate sites
regularly.

44. Common sites
• Common sites for SC injections are
–the abdomen,
–the lateral and anterior aspects of the
upper arm or thigh,
–the scapular area on the back, and
–upper ventrodorsal gluteal areas.

45. Purpose
• To obtain quicker absorption than oral
administration
• When it is impossible to give medication orally
• To administer vaccination (measles)
• To administer smaller doses
• To obtain a prompt action that is not obtained
by other route.

46. 4. INTRA-ARTERIAL
• Intra-arterial is given into an artery through injection,
e.g. vasodilator drugs in the treatment
of vasospasm and thrombolytic drugs for treatment
of embolism. (Drugs used for diagnosis of peripheral
vascular diseases.)
• The onset of action is similar to IV route.
• Rarely used.
• Anticancer drugs are given for localized effects.
• The method is considered more dangerous
than intravenous administration and should be reserved
to experts.

47. 5. INTRA-ARTICULAR
• An injection administered
directly into a joint.
• The medication is
actually injected into the
joint space for the
purpose of relieving joint
pain.
• Corticosteroids (steroids)
were the first commonly-
used substances injected
into painful joints.
example: hydrocortisone
in rheumatoid arthritis

48. 6. Intrathecal
Intrathecal administration is a route of
administration for drugs via an injection into
the spinal canal, or into the subarachnoid space
so that it reaches the cerebrospinal fluid
(CSF) and is useful in spinal anesthesia,
chemotherapy, or pain management
applications.

49. 7. INTRADERMAL
• Intradermal literally means “between the skin
layers” and injection is administered just under
the epidermis.
• The useful sites for intradermal injection are
upper arm, inner aspect of forearm and upper
back beneath scapula
• Small volumes, usually 0.01 to 0.05 mL, are
injected because of the small tissue space.
• Syringe used is 1ml tuberculin syringe
• Syringe is positioned at15˚ angle

50. Purposes
• To perform sensitivity test
• To perform tuberculin test
• To administer vaccination
• To obtain a local effect at the site of injection
of local anesthesia such as xylocaine
4/28/2019 prepared by sapana

51. 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 – rectum

52. Topical administration
• Topical administration is the application of
medication directly to the surface of the skin.
• Most topical drugs are given to deliver a drug
at, or immediately beneath, the point of
application.
• Drugs directly applied to the skin are absorbed
through the epidermal layer into the dermis,
where they create local effects or are
absorbed into the bloodstream.

53. • Some topical drugs, such as eye and nasal
drops and vaginal and rectal suppositories,
can be applied directly to the mucous
membranes.
• These drugs are absorbed quickly into the
bloodstream, and, depending on the drug’s
dose (strength and quantity), may cause
systemic effects

54. Topical Dosage Forms
Dose forms for topical administration include:
• Skin:
– Creams
– Ointments
– Lotions
– Gels
– Transdermal patches
• Eye or ear:
– Solutions
– Suspensions
– Ointments
• Nose and lungs:
– Sprays and Powders

55. Advantages of the Topical Route
• Local therapeutic effects
• Not well absorbed into the deeper layers of the
skin or mucous membrane
• lower risk of side effects

56. Disadvantages
• sprays for inhalation through the nose may be
for local or systemic effects

57. • The end