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Why is route of administration important?
What is a route of administration?
What is a medication administration route?
When are other routes of administration required?
Aug 23, 2023 · Documenting the route of administration is crucial for accurate patient record-keeping, as it communicates to all care team members how the patient is getting their drug therapy, which may affect many pharmacokinetic and pharmacodynamic parameters, including dosing, half-life, and other factors.
- Jean Kim, Orlando De Jesus
- 2023/02/12
- 2021
- Overview
- What are the drug routes of administration?
- Oral drug administration
- Intravenous and intramuscular administration
- Nasal drug administration
- Sublingual and buccal administration
- Transdermal and subcutaneous
- Vaginal drug administration
- Enteral drug administration
- Summary
A route of administration is a way that a drug can enter the body. There are many drug routes of administration, each suited to different situations.
Each route has its benefits and potential risks. The most common route is through the mouth. Drugs can also enter the body through the skin, gums, veins, nose, and many more.
There are many different drug routes of administration. Some are commonly used, while others are rare. Drug administration can be:
•oral, which is when a person swallows a drug
•intraocular, or into the eye
•intraotic, or into the ear
•nasal, or through the nose
•sublingual, or under the tongue
Oral drug administration involves a person putting a drug into their mouth and swallowing it. It is one of the most common routes of drug administration, and it is convenient for many as it does not require special equipment. People can use oral administration for a range of medication types, such as pills, capsules, and liquids.
However, one of the downsides of oral administration is that it can be inefficient. The digestive system and liver start to break down drugs via this route before they reach the bloodstream, meaning the concentration significantly reduces. This is known as the “first pass effect.”
The intravenous (IV) administration route involves using a needle to inject a drug directly into a vein. The intramuscular route is similar but involves an injection into a muscle instead.
IV administration is suitable for many drugs, particularly in situations where a person needs an urgent, high, or consistent dose, such as during a severe infection. This is because IV drugs bypass the digestive system and take effect quickly.
Intramuscular administration also bypasses the digestive system, allowing the body to get a more potent dose of a drug. Some vaccines and hormone drugs have intramuscular administration options.
The downside of these methods is that they can cause pain, swelling, or irritation around the injection site. For people with needle phobias, they can be distressing. There is also a risk of complications, such as infection, nerve injury, hematoma, and accidental puncturing of a blood vessel.
The nasal administration route involves spraying or sniffing a drug through the nose, where it quickly absorbs into the bloodstream.
This is a route of administration for drugs that work directly on nasal and sinus conditions, such as decongestant sprays. However, doctors can also prescribe it for other types of medical treatment. For example, some vaccines come in nasal forms.
The benefits of administering medications via the nose are that it is painless, delivers a high concentration of the drug, and allows drugs to take effect quickly.
However, only certain drugs work via nasal administration. Additionally, the dose and effect size may have limitations depending on the size and features of a person’s nasal cavity and how they administer it. People may also make more mistakes with dosing nasal administration, affecting the dose they receive.
The sublingual administration route is when a person places the drug under the tongue, where it absorbs into the bloodstream. The buccal administration route works in a similar way, but a person places the drug between the gum and the inside of their cheek instead.
Both of these routes are typically simple and painless. The drugs absorb quickly, meaning a medication can start working quickly. They can be good alternatives to oral administration for people who have difficulty swallowing or with digestion.
Sublingual and buccal administration can be difficult if the drug tastes unpleasant. There are also relatively few drugs that are available with this route of administration, and if a person does not allow the drug to dissolve fully, it will affect their dose.
Some people take certain vitamins sublingually. This method can also be useful for delivering immunotherapy for allergies. Buccal administration is the method of delivery for some nicotine replacement products and strong pain medications, such as fentanyl.
Transdermal administration is when a drug enters the body through the skin, such as via a cream, gel, ointment, or patch. Subcutaneous administration is when a person uses a needle to inject the drug underneath the outer layers of the skin.
Transdermal administration is simple, noninvasive, and painless. Uses include nicotine replacement therapy, hormonal medications, and hormonal contraceptives.
However, the downside of this route is that transdermal application can irritate the skin, and not all drugs absorb effectively this way. Additionally, the condition of the skin may affect absorption. For example, if it is dry or has open cuts, it may absorb too much or too little.
Subcutaneous administration is typical for insulin and the anaphylaxis medication known as epinephrine. Because this level of the skin has few blood vessels, this option allows for a slow release of drugs. However, it is invasive and can be painful.
The vaginal administration route involves inserting a drug into the vagina, where it gradually absorbs into the bloodstream. The drug may come in the form of a suppository, cream, gel, or capsule.
Vaginal administration can be useful for medications that act locally, such as antibiotic or antifungal medications for infections or hormone treatments for vaginal dryness or atrophy. It is also a route for some systemic drugs that affect the whole body.
Enteral drug administration refers to any method that delivers a medication to the intestines. This includes oral administration, but also other approaches, such as:
•through the nose and into the stomach via a nasogastric (NG) tube
•through the nose into the intestines via a nasointestinal (NI) tube
•through the skin into the stomach via a percutaneous endoscopic gastrostomy (PEG) tube
Another method of enteral administration is inserting a drug into the rectum, such as via a suppository or enema.
Each of these methods has its own uses and risks. NG, NI, and PEG tubes can be essential for drug administration in situations where a person cannot eat, as it allows doctors to deliver oral medications directly into the stomach or intestines.
There are many routes of drug administration, each with unique benefits and drawbacks that make them suitable for different situations.
Doctors will weigh up the best options to prescribe depending on a person’s unique circumstances and tolerance. Where one route is not available, it may be possible to prescribe another route of administration instead.
Mar 28, 2019 · Medication Administration: Why It’s Important to Take Drugs the Right Way. Routes. Training. Dosage and timing. Potential problems. Takeaway. Introduction. We take medications to diagnose, treat,...
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- Oral route. Many drugs can be administered orally as liquids, capsules, tablets, or chewable tablets. Because the oral route is the most convenient and usually the safest and least expensive, it is the one most often used.
- Injection routes. Administration by injection (parenteral administration) includes the following routes: Subcutaneous (under the skin) Intramuscular (in a muscle)
- Sublingual and buccal routes. A few drugs are placed under the tongue (taken sublingually) or between the gums and teeth (buccally) so that they can dissolve and be absorbed directly into the small blood vessels that lie beneath the tongue.
- Rectal route. Many drugs that are administered orally can also be administered rectally as a suppository. In this form, a drug is mixed with a waxy substance that dissolves or liquefies after it is inserted into the rectum.
Apr 8, 2022 · It is important to choose the appropriate route of administration to maximize therapeutic effects of the drugs and improve patient outcomes. This chapter provides information on all the major route of administration and the situation when a particular route is preferred.
Jan 24, 2023 · Understanding medication routes of administration and common errors in medication use can help improve medication safety. The 5 rights. Routes of administration. Medication administration tips. Common mistakes. Bottom line. References. SDI Productions/E+ via Getty Images. For many people, taking medications is a necessary part of life.
Abstract Medicines administration is a core responsibility of registered nurses in healthcare settings and is increasingly being undertaken by nursing.
