II. Types: Non-Parenteral

  1. Oral (PO)
    1. Medications formulated to withstand Stomach acidity, intestinal absorption and first pass metabolism
    2. Drug Bioavailability is significantly less than the ingested dose and onset of action is also typically delayed
    3. Innate Immunity of the Stomach and intestinal tract nearly eliminates the infection risk seen with Parenteral agents
  2. Sublingual (SL)
    1. Medications (e.g. Nitroglycerin) with good absorption via the capillary network beneath the Tongue
    2. Results in rapid absorption and activity without navigating the acid Stomach, intestinal tract or first pass metabolism
  3. Per Rectum (PR)
    1. Rapid, but variable absorption
    2. Indicated in unconsious patients (e.g. Valium for Status Epilepticus) or young children (e.g. Acetaminophen)
  4. Inhalational
    1. Rapid absorption of aersolized medications
    2. Medications (e.g. Albuterol, Ipratropium) in Obstructive Lung Disease (Asthma, COPD) are typically delivered via inhalations
    3. Higher doses of some resusitation medications may be delivered via Endotracheal Tube (e.g. Lidocaine, Epinephrine, Atropine, Naloxone)
  5. Transdermal
    1. Patch delivered, slow released drugs delivered over an extended period (typically 12 to 72 hours)
    2. Examples include Fentanyl Patch, Clonidine patch, Contraceptive Patch. Lidocaine Patch
  6. Topical
    1. Includes Skin Preparations (e.g. ointments, creams), vaginal agents, ophthalmic drops or ointments, Otic Solutions and nasal preparations
  7. Intranasal
    1. See Intranasal Drug Delivery Route
    2. Excellent route for Procedural Sedation and Analgesia (e.g. Intranasal Fentanyl, intranasal Midazolam)
    3. Topical agents intended for their intranasal activity (e.g. Intranasal Steroids)

III. Types: Parenteral

  1. See Parenteral Drug Delivery
  2. See Intravenous Access
  3. Background
    1. Term Parenteral is derived from "around the intestinal tract" (i.e. bypassing the intestinal tract)
    2. Parenteral Routes are preferred for conditions in which rapid absorption and consistent drug levels are critical (e.g. Resuscitation, Sepsis)
    3. Parenteral Routes risk infection as well as pain of administration
  4. Intravenous (IV)
    1. Rapid onset of action and consistent and predictable drug levels
    2. Requires sterile, soluble drugs and Intravenous Access
  5. Intramuscular (IM)
    1. See Intramuscular Injection
    2. Drugs (e.g. Epinephrine, Penicillin) injected into large Muscle regions (e.g. Shoulder, thigh, buttock) rely on local capillary absorption
    3. Absorption is dependent on formulations (slow absorption with lipid preparations, faster absorption with aqueous preparations)
  6. Subcutaneous (SQ or SC)
    1. See Subcutaneous Injection
    2. Drugs (e.g. Insulin, Morphine, Enoxaparin) are injected beneath the skin and absorbed via local capillaries

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Ontology: Drug Administration Routes (C0013153)

Definition (HL7V3.0) <p>The path the administered medication takes to get into the body or into contact with the body.</p>
Definition (HL7V3.0) <p>The path the administered medication takes to get into the body or into contact with the body.</p>
Definition (HL7V3.0) <p><b>Description:</b>This describes which path the administered medication takes to get into the body or into contact with the body and constitutes part of the<i>where</i> (the other part being site - see below). It is the<i>way in</i> or the course the medication must take to get to its destination.</p><p>Note that a path is in no sense a description of a<i>final destination</i>; it is a stylized description of the path taken. For example, an oral antibiotic may be used to treat a severe infection on a toe; the oral route is used to get the medicine to be able to reach and treat the infection in the toe. For some specific routes of administration there may be an incidental sense of<i>final destination</i>, for example an ocular administration usually occurs when treatment of an eye condition is required. However, this is in no sense definitional: rectal administration of a medicine may be for a local effect (a steroid foam for treatment of colitis) or for a systemic effect (metronidazole for treatment of infection). The route of administration of a medicine should only be a description of the path taken and not the form.</p><p><b>Examples:</b></p><ul><li><p>oral</p></li><li><p>rectal</p></li><li><p>intravenous (IV)</p></li><li><p>subcutaneous (SC)</p></li><li><p>intramuscular (IM)</p></li></ul>
Definition (NCI) Designation of the part of the body through which or into which, or the way in which, the medicinal product is intended to be introduced. In some cases a medicinal product can be intended for more than one route and/or method of administration.(ICH)
Definition (NCI_CDISC) The course by which a substance was administered in order to reach the site of action in the body.
Definition (MSH) The various ways of administering a drug or other chemical to a site in a patient or animal from where the chemical is absorbed into the blood and delivered to the target tissue.
Definition (CSP) various ways of administering a drug or other chemical to a site in a patient or animal from where the chemical is absorbed and delivered to the target tissue.
Concepts Functional Concept (T169)
MSH D004333
SnomedCT 284009009, 263513008, 103389009, 410675002
HL7 RouteOfAdministration, 2.16.840.1.113883.1.11.14581, 0162
LNC LP40261-7, MTHU008438
English Administration Route, Drug, Administration Routes, Drug, Drug Administration Route, Route, Drug Administration, Routes, Drug Administration, drug administration route, Route administration of drug, Route of administration of drug, Drug Route of Administration, Route of Administration, Route of Drug Administration, Drug Administration Routes, DRUG ADMIN ROUTES, ADMIN ROUTES DRUG, mode of substance administration, route of drug application, route of drug entry, medication route, medication routes, administration drug routes, medicine routes, route of administration, administration route, drug administration routes, route of administration of drug, route administration, route of drug administration, administration drug route, administration routes, administrations of routes, medications routes, RouteOfAdministration, Route of administration (qualifier value), Route of administration of drug (attribute), Medication route, ROUTE, ROUTE OF ADMINISTRATION, Route of administration, NOS, Route of administration, Route of administration values, Route of administration - attribute, Route of administration (attribute), Route of administration value (qualifier value), Route of administration value
Spanish valor de la vía de administración, valor de la vía de administración (calificador), Vías de Administración de Medicamentos, vía de administración, valor (calificador), valor: vía de administración, vía de administración, valor, Route of administration values, vía de administración (calificador), vía de administración del medicamento, vía de administración - atributo, vía de administración del medicamento (atributo), vía de administración, SAI, vía de administración, vía de administración (atributo)
Swedish Läkemedelstillförselsätt
Czech léky - způsoby aplikace
Finnish Lääkkeiden antotavat
Russian LEKARSTV PUTI VVEDENIIA, LEKARSTVA, PUTI VVEDENIIA, ЛЕКАРСТВА, ПУТИ ВВЕДЕНИЯ, ЛЕКАРСТВ ПУТИ ВВЕДЕНИЯ
French Voies d'administration de substances chimiques et des médicaments, Voies d'administration des médicaments et de substances chimiques
Croatian LIJEKOVI, MJESTA DAVANJA
Polish Podawanie leków, Drogi podawania substancji chemicznych, Drogi podawania leków
Japanese 投薬経路, 薬物投与法, 薬物投与経路, 投与法(経路), 投与経路, 薬剤投与経路, 薬剤服用方法(経路), 薬物投与方法(経路)
Norwegian Tilførselsveier for legemiddeladministrering
German Arzneimittelapplikationswege, Arzneimitteldarreichungswege, Medikamentendarreichungswege
Italian Vie di somministrazione farmacologica
Dutch Geneesmiddelenroute, Route, geneesmiddelen-
Portuguese Vias de Administração de Medicamentos