I.

ROUTE OF ADMINISTRATION
II. INTERVAL OF ADMINISTRATION
III. TIME OF ADMINISTRATION
IV. DURATION OF THERAPHY
V. TECHNIQUE OF ADMINISTRATION

The reasons :
1. Most Convenience (oral)
2. To maximize concentration at the site of action
3. Minimize it else where (topical)
4. To prolong the duration of drug absorption
5. Avoid the first pass effect
6. Economical
7. Safest

Dose of
Drug

I
N
P
U
T

Drug in Blood

D
I
S
T
R
I
B
U
T
I
O
N

Drug in General
Circulation
Drug at sites
of Action
Pharmacologic Effect
Clinical Effect

Toxicity

Efficacy
Utility

L
O
S
S

Classification Of Route Of Drug Administration

- Enteral route : Oral Route
Sublingual Route
Buccal Route
Rectal Route
- Parenteral route

: Intravenous bolus (I.V.)

Intravenous Infusion (I.V.inf)
Intramuscular (I.M.)
Subcutaneous (S.C.)
etc

- Other route

: Transdermal
Inhalation
Topical
etc

Oral route
Drug administered orally pass through various part of
GIT/oral cavity
- the most commonly used route of administration
- convenient for self administration
- effective for most drug
except : rapidly in activated by gastric or intestinal
secretion or by passage via hepatic portal circulation
through the liver
- unsuitable for surgical patients, unconscious, vomiting and
malabsorption state patients

Sublingual Route
Bucal route
useful for self-administered drugs
to overcome some of the problems of the oral route (avoiding
immediate inactivation by the liver)
may also be used in the unconscious patient

Rectal Route
- Drugs

are absorbed mainly into the systemic circulation,

some entry into the hepatic portal circulation
- Absorbtion from the rectal mucose is less predictable than
from the small intestine
- Use for drugs know to cause G.I irritation or to a patient who
is unconscious or vomiting
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Parenteral Route
Drugs may be administered directly into circulation by the intravenous route

- Distribution of the drug throughout the circulatory system is

rapid and bypasses many biological membranes which may
delay absorption into the circulation
- The dose volume of an intravenous injection many vary from a
fraction of millilitre given as a bolus injection to 500 ml or more
given as a slow infusion
- Intra-arterial injections used mainly for diagnostic purposes
- Rapid absorption in aqueous solution
- Intramuscular route slower than intravenous (i.v), and follow
subcutaneous tissues (s.c)
9

Transdermal Route
Drugs applied to the skin surface absorbed slowly into the systemic
circulation
Use for : - drugs with a short duration of action
- rapidly metabolized by the liver
- may provide sustained concentration of the drug in the circulation

Inhalation Route
The high blood flow through the lungs and the large surface area of the
alveolar membrane provide a route for rapid absorption of drugs into the
general circulation
Anaesthetic gases, volatile liquid and drugs that can be dispersed in an
aerosol form may be administered by inhalation in order to produce a
systemic effect. The nasal mucosa may also be used as route of systemic
administration.

10

Topical Route
Application of dosage form to the epithelium covering one of the body
surfaces to exert a local effect at the site of application
Example : - skin
- the cornea of eyes
- the nasal
- rectal
- vagina/urethra mucosa

Oral Route for Local Effect

Dosage form of absorbents, antimicrobial compound, antacid
Designed to exert a local effect within the G.I.T after oral administration

11

Some Cracteristics of Common Routes of Drug

Administration
ROUTE
Enteral Routes
Oral (PO)

BIOAVAILABILITY

ADVANTAGES

DISADVANTAGES

Absorption may vary.

Generally slower
absorption rate
compared to IV bolus
or IM injection.

Safest and easiest

route of drug
administration.
May use immediaterelease and
modified-release
drug products.

Some drugs may have

erratic absorption, be
unstable in the gastro in
testinal tract or be
metabolized by liver
prior to systemic
absorption.

No first-pass effect.

Some drugs may be

Rapid absorption
Buccal or
sublingual (SL) from lipid-soluble

swallowed.
Not for most drugs or

drugs.

drugs with high doses

Rectal (PR)

Absorption may vary

from suppository.
More reliable
absorption from
enema (solution).

Useful when patient

can not swallow
medication.
Used for local and
systemic effects.

Absorption may be
erratic.
Suppository may migrate
different position.
Some patient discomfort.
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ROUTE

BIOAVAILABILITY

ADVANTAGES

DISADVANTAGES

Drug is given for

immediate
effect.

Increase chance for

adverse
reaction.
Possible
anaphylaxis.

Intravenous Complete (100%)

infusion (IV systemic drug
inf)
absorption.
Rate of drug
absorption
controlled by
infusion pump.

Plasma drug levels

more
precisely
controlled.

Requires skill in
insertion of
infusion set.
Tissue damage at
site of

Intramuscul
ar
injection
(IM)

Easier to inject
than
intravenous
injection.
Large volumes may
be used
compared to

Parenteral
Routes
Complete (100%)
Intravenous systemic
(IV)
drug absorption.
.

Rapid from aqueous

solution.
Slow absorption
from
nonaqueous (oil)
solution.

May inject large

fluid volumes.
injection may
May use drugs with accort.
poor lipid
solubility and/or
irritating
drug.

Irritating drugs may

be very
painful.
Different rates of
13
absorption
depending upon

ROUTE
Other Routes
Transdermal.

BIOAVAILABILITY

ADVANTAGES

DISADVANTAGES

Slow absorption,
rate may vary.

Transdermal
delivery system
(patch) is easy to
use.
Used for lipidsoluble drugs with
low dose.

Some irritation by
patch of drug.
Permeability of skin
variable with condition,
anatomic site, age,and
gender.
Type of cream or
ointment base affects
drug-release and

Increased
absorption with
occlusive dressing.

absorption.
Inhalation

Rapid absorption.
Total dose
absorbed is variable.

May be used for

Local or systemic
effects.

Particle size of drug

determines anatomic
placement in
respiratory tract.
May stimulate cough
reflex.
Some drug may be
swallowed.
14

SITE OF ROUTE ADMINISTRATION

RODA
SITES
- Oral
- Peroral (per os)
- Sublingual
- Parenteral
* Intravenous
* Intraarterial
* Intracardiac
* Intraspinal/intrathecal
* Intraosseous
* Intraarticular
* Intrasynovial
* Intracoutaneus/Intradermal
* Subcutaneous
* Intramuscular
- Epicutaneous (Topical)
- Transdermal
- Conjunctival
- Intraoccular
- Intranasal
- Aural
- Intrarespiratory

- Mouth
- GI tract system via mouth
- Under the tongue
- Other sites than GI tract (by injection)
* Into vena
* Into artery
* Into the heart
* Into spine
* Into bone
* Into joint
* Synovial fluid cavity
* Into skin
* Under skin
* Into muscle
- Skin surface
- Skin surface
- Conjunctiva
- Eye globe
- Nose
- Ear
- Lung

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THE USAGE OF DOSAGE FORMS

Route Of Drug Administration
Oral
Sublingual
Parenteral
Epicutaneous/Transdermal
Rectal
Conjunctival
Intraoccular/Intraaural
Intranasal
Intrarespiratory
Vaginal
Urethral

Dosage Form
Solid and Liquid dosage form
Tablet, trochition and lozenges
Solution, suspension
Ointment, Cream, Paste, Powder, Aerosol,
Lotion,Transdermal, Disc, and Solution
Attachment
Solution, Ointment, Suppositoria
Ointment
Solution, Ointment
Solution, Spray, Inhalant, Ointment
Aerosol
Solution, Ointment, Emulsified foam,
Tablet, Insert, Suppositoria, Sponge
Solution, Suppositoria

DRUGS THAT ARE USED SPECIFICALLY

1. SUBLINGUAL TABLET
For cardiac diseases : angina/asthma (nitroglycerin, isoprenalin)
2. CHEWING TABLET
Drugs for gastritis
3. LOZENGES
Mouth freshener (anti inflammation)
4. TABLET
Tablets that are destroyed in intestine :
* Unchawed tablet
* Without milk, alkaline drinks, or antacid
5. DRUG THAT NEED EXCESSIVE DRINK (200 ml 300 ml)

Sulfa group

Metronidazol

Erythromycin

Amoxicillin

Aspirin

6. DRUGS THAT ARE WITHOUT EXCESSIVE DRINK

Anti gastritis drug/antacid suspension
7. DRUGS THAT ARE TAKEN WITHOUT MILK
- Vitamin C+ Ferrous
- Antienteretis
- Enteric coated tablet
- Tetracycline
8. PEDIATRIC DRUG ADMINISTRATION
Tablet / powder dissolved into:
- Honey
- Sugar water
- Jelly
- Corn oil

Determined by: Half life time ( t ) of drugs

a. Ultra fast

b. Fast
c. Slow
d. Very slow

Amoxicillin, Cloxacillin, Flurosemide,

Penicillin
Paracetamol, Ampicillin, Hydrocortison
Doxicillin, Griseo fluvine, Proctolal
Barbiturate, Diazepam, Digitoxin
Phenilbutazon

STANDARD ADMINISTRATION TIMES

DAILY
.. times a day
Once
: 10.00 (morning)/22.00 (night)
Twice
: 10.00 , 14.00
Three times : 10.00 , 14.00, 18.00
Four times : 10.00, 14.00, 18.00, 22.00
EVERY
Every .. hours
12-hourly : 10.00, 22.00
8-hourly : 06.00, 14.00, 22.00
6-hourly : 06.00, 12.00, 18.00, 24.00
4-hourly : 06.00, 10.00, 14.00, 18.00. 22.00, 02.00

Base on :
1. Chemical properties of drugs
Exp : Anticholinergic drugs reduce secretion and peristaltic of intestinal.
These drugs should be taken one hour before meal.

2. Physiological properties of G.I.T.

Exp : Gastric pH
absorption
G.I. Mortility absorption

3. Possible interaction :
Interaction between drug
Exp : Drug that interact with antacid in stomach
Amoxicillin, Ampicillin, Cloxacillin, Nitrofurantoin
Interaction Drug and Food
Exp : Drug interferred by gastric chyme
Ampicillin, Amoxicillin, Erythromycin, Lincomycin
These drugs should be taken during empty stomach

4. Drugs that synchronized with chyme (food)

Exp : Doxycycline, Doxycycline hyclate, Erthromycin, ethylsuccinate,
Griseofulvin.
These drugs should be taken with meals

5. Stomach-irritating drugs
Exp : Aminophylline, Acetyl salicilic acid, Codein, Phenylbutazon
EXAMPLE OF ADMINISTRATION TIME OF THE INTERACTIVE
DRUGS
R/

Ampicillin 500 mg cap No. XV

S 3. dd.cap.I (1) hac ------- 1 hour before meal
-------------------------------------#-------------------------------------------R/
Antacid tab No.XX
S3.dd.tab.I (1) hpc ------- 1 hour after meal
-------------------------------------#-------------------------------------------22

Standard administration times

Abbreviation

qd* = quaque die = each day

bid* = bis in die = twice a day
tid* = ter in die = three times a day
qid* = quater in die = four times a day
hs = hora somni = at bed time
q12h = quaque duodecin hora = each twice hours
q8h = quaque octo hora = each eight hours
q6h = quaque six = each six hours
q4h = quaque quattour = each four hours
q3h = quaque tres = each three hours
ac
pc

= ante cibos
= past cibos

Administration times

Usually accepted to mean 10:00 AM

10:00 AM, 2:00 PM
10:00 AM, 2:00 PM, and 6:00 PM
10:00 AM, 2:00 PM, 6:00 PM, and 10:00 PM
Usually accepted to mean 10:00 PM
10:00 AM and 10:00 PM
6:00 AM, 2:00 PM, and 10:00 PM
6:00 AM, 12:00 AM, 6:00 PM, and 12:00 PM
6:00 AM, 10:00 AM, 2:00 PM, 6:00 PM, 10:00 PM,
and 2:00 AM
3:00 AM, 6:00 AM, 9:00 AM, 12:00 AM, 3:00 PM,
6:00 PM, 9:00 PM, and 12:00 PM
before meals (approximately 30 45 minutes)
after meals (approximately 1 hour)

* Exceptions:
1.

Steroids perhaps should be administered near 7:00 or 8:00 AM when on a qd schedule.

2.

Oral hypoglycemic agents and insulin (7:00 AM and/or 4:30 PM) when ordered bid.

3.

Antibiotics should be spread evenly over 24 hours. An approximate schedule to avoid meals might be 4:0
AM, 10:00 AM, 4:00 PM, and 10:00 PM.

4.

Antihypertensive agents should be spread over the 24 hour period

5.

Anticoagulants should be scheduled so as to follow measurement of the patients clotting time.

FIX TIME OF ADMINISTRATION

- In the morning

: Steroid
Diureticum
Antihypertensi

- In the night

: Contraceptive agent
Hypnotic agent

- During meal

: Drug irritating stomach

Drug that sensitive to gastric pH
Drug absorption increase

- During episode

: Antiasthmatic drug
Drug for migraine
Angina pectoris drugs

- Empty stomach

: 1 hour before meal 1h.a.c

2 hour after meal 2h.p.c
24

Duration of therapy :
Symptomatic therapy : three days, < or > than three days
Causative therapy :
* eliminate the cause of the case
* antimicrobial agent eradicate all infecting organism
oral administration : 5 7 days or < if given high dose

25

Depend on :
DRUG DOSAGE FORMS
ROUTE OF ADMINISTRATION
SPECIFIC- DRUG MEDICATION

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