The WHO states that aspirin, the first synthetic medication, was introduced in 1897. It is remarkable that since then there have been immense advancements in many drug treatments for a wide range of health problems such as diseases, mental health and other conditions. Many drugs today can prevent, treat and alleviate diseases that would have been fatal just a few generations ago.

Over time, the process of providing medications has undergone various changes, keeping in step with progress in medicine and technology. It is essential to know the different ways in which drugs can be administered to enhance safe and efficient treatment. Let’s dig deeper into this in this blog.

Historical Routes of Administration

Ancient civilizations wisely used the healing forces of nature. Their medical practices included the ingesting, topical application of concoctions and inhalation of aroma therapies. They demonstrated their deep knowledge using infusions, poultices and compresses which are traditional herbal remedies for holistic well-being.

Modern Routes of Administration

The mode of introduction of the drug within the body is of great importance in medication. Nowadays, modern medicine has several ways of administration with each route having its benefits and drawbacks. To ensure the effective delivery of medicines, healthcare professionals and patients must understand these routes.

1. Oral Administration

Oral administration is probably the most popular and common method for delivering drugs. This procedure involves taking drugs into the body via the mouth usually as pills, capsules, or liquids. It is a convenient, easy, and patient-compliant form of many medications.

Advantages of Oral Administration:

➔ Convenience: Oral administration is non-invasive and can be self-administered by patients without special skills.

➔ Patient Compliance: Taking medications orally is more acceptable by many patients resulting in higher adherence to prescribed regimens.

➔ Variety of Formulations: The formulation of medications into different forms like tablets, capsules, liquids and suspensions provides flexibility in drug delivery.

Disadvantages of Oral Administration :

➔ Variable Absorption: The process of absorption of drugs through the gastrointestinal tract may be unpredictable and is affected by variables like gastric emptying time and food interactions.

➔ First-Pass Metabolism: Absorbed drugs through the digestive system enter the liver and the systemic circulation in which there is a potential for metabolism and reduced bioavailability.

➔ Delayed Onset of Action: Oral absorption, for instance, takes longer to produce curative effects compared to other quick absorption routes.

Mechanism of Absorption

Knowing the mechanism of absorption when oral administration is done is the first step towards understanding the body’s response to drugs. The medication becomes susceptible to breakdown after it is ingested and meets the acidic environment of the stomach. Absorption mainly takes place in the small intestine, especially the upper part.

At this crucial phase, the dissolved medication crosses the intestinal lining and gets into the blood, which travels to different parts of the body. Then commences the medication action, during which the medication is absorbed into the tissues to set the stage for therapy. Nevertheless, the type of drug, food interactions, and individual variation may determine the absorption rate and efficiency.

2. Topical Administration

Topical administration is defined as applying medications on the skin surface. It is selected when the local effects are intended, and it is the non-invasive way to administer drugs for various therapeutic purposes. Topical medicines involve transdermal patches, creams and ointments each having a specific role in drug delivery.

(i) Transdermal Patches

Transdermal patches are patches that are adhesive and contain medications. These patches are meant to stick to the skin’s surface and deliver a controlled release of the drug for days and weeks. The drug reaches the body through the layers of the skin and has an overall effect. For example, nicotine replacement therapy, pain management, or hormonal treatments are commonly administered using transdermal patches.

Some of the benefits of transdermal patches include the steady release of drugs, avoidance of gastrointestinal side effects, and increased patient compliance. The patches employ specific membranes for drug delivery thereby delivering a standardized therapeutic response. Although they are good for some medicines, not all drugs can be delivered through this method of administration due to their molecular size and properties.

(ii) Creams and Ointments

Topical formulations include creams and ointments applied to the skin directly. This includes a mixture of active and inactive compounds. Creams usually have a light texture and are water-based. This makes it possible for such creams to penetrate the skin easily. However, ointments are more oil-based have a thicker consistency and form a protective barrier on the skin.

Creams and ointments as versatile topical formulations applicable to many skin conditions. Creams are preferred for their ease of use, rapid absorption, and non-oily feeling. They are appropriate for the administration of drugs with a balanced water or oil ratio. Ointments have oil-based compositions, which are more occlusive. The two formulations are important in dermatological treatments and the choice is made according to the needs of the patient.

3. Respiratory Administration

Administration of drug inhalation involves the direct introduction of these drugs into the respiratory system. This is usually the preferable technique because it can deliver medications to the lungs and systemic circulation. Inhalation is a common method that is administered with the use of inhalers or nebulizers, which provides several advantages over other routes.

(i) Inhalers

Such handheld devices provide a metered dose in the form of the aerosol which can be inhaled by patients. Examples of these include pressurized metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs). pMDIs deliver a predetermined dose upon each actuation, whereas DPIs depend on the patient’s breath to disperse the powdered medicine.

(ii) Nebulizers

Nebulizers are instruments that convert the liquid drug into small droplets that are inhaled from a mask or mouthpiece. This is especially helpful for young children suffering from respiratory disorders and those who find it difficult to use inhalers.

Benefits of Respiratory Administration:

➔ Rapid Onset of Action: Inhalation provides immediate action because the drug enters the bloodstream via the capillary network of the lungs. In particular, in emergencies, this speed is very important.

➔ Targeted Delivery: Respiratory administration ensures that a given drug is delivered to act directly on the respiratory system. Such precision minimizes systemic adverse events and increases organ-directed efficacy.

➔ Lower Dosage Requirement: In most cases, inhalation requires smaller dosages of medication than oral administration to produce a similar therapeutic effect. As a result, this reduces the likelihood of occurrence of certain side effects.

➔ Improved Patient Compliance: Inhalers and nebulizers give patients convenience and ease, which in turn increases compliance with the prescribed therapies. This can especially be beneficial for people suffering from chronic respiratory conditions.

4. Injections

Injection is a medical procedure during which a substance is injected into the body using a syringe or hypodermic needle. This allows for the fast and exact delivery of drugs, vaccines or other treatment agents. There are different types of injections, each for the administration of specific substances. They include intramuscular (IM), subcutaneous (SC), and intravenous (IV) injections, which have their unique advantages.

(i) Intramuscular Injection:

Intramuscular injections are used to deliver a substance directly into the muscle system. This is a common approach for slow-release drugs. Injection is usually done into the deltoid muscle of the upper arm or the gluteal muscles in the buttocks. These Injections are preferred for drugs which demand long-term effects and are normally used for vaccines, antibiotics and some painkillers.

(ii) Subcutaneous Injection:

In subcutaneous injections, a substance gets to the subcutaneous layer. It is used for medicines which are absorbed slower than the intramuscular injections. Injection usually takes place in the abdominal section, upper arm or thigh. Insulin, certain vaccines, and anticoagulants are well suited to subcutaneous injections. Subcutaneous tissue makes it possible to provide a steady intake of the medication into the blood.

(iii) Intravenous Injection:

Intravenous injection is a process where substances are directly introduced into the bloodstream through injection into a vein. This is because the medication can be administered directly into the systemic circulation hence taking the shortest and most straightforward path to systemic circulation.

These injections are used to give medicines that need very quick action, or precise dosage control. It is common to administer fluids, chemotherapy drugs, and emergency medications. The intravenous route provides for rapid onset and enables the adjustment of the dose during administration.

Sublingual Route of Administration

Sublingual administration is a unique and useful approach to administering drugs where they are placed under the tongue. Unlike other routes of administration such as swallow or injection, sublingual has the advantage, over other methods of administration.

The medication delivery method involves placing medication under the tongue, where it is absorbed by the large network of blood vessels, facilitating rapid absorption. This is a straightforward method of transporting substances directly into the bloodstream, without the need for a digestion process or injection.

The tissue below the tongue is very vascularized that is, it is composed of many blood vessels. The active ingredients of the medication are absorbed directly through the blood vessels when the medication is placed sublingually, the medication quickly dissolves. This goes around the digestive system and the liver first-pass metabolism leading to a straight systemic circulation.

Benefits of Sublingual Administration

1. Rapid Absorption:

Sublingual administration is putting medication at the bottom of the tongue, which allows it to pass directly into the bloodstream. The high number of blood vessels beneath the tongue enhances quick absorption, thereby promoting rapid onset of action as compared to oral administration. This is highly advantageous, especially in emergency cases or where immediate release is paramount.

2. Bypassing First-Pass Metabolism:

Sublingual administration skips the liver’s first-pass metabolism and is different compared to oral ingestion. This is because the drug concentration in systemic circulation will be much higher, maximizing its therapeutic effects. The liver’s metabolic processes tend to lower the bioavailability of drugs in an oral dose, hence sublingual administration is a better option than oral administration.

3. Improved Bioavailability:

Sublingual administration increases bioavailability (The ability of a drug or other substance to be absorbed and used by the body) since the drug enters directly into the bloodstream without passing through gastrointestinal degradation. As a result, more of the administered dose arrives at the target tissues, enhancing the efficacy.

4. Ease of Administration:

Sublingual administration is normally well-tolerated and does not need swallowing which makes it convenient for the patients who have difficulty in swallowing pills or liquids. This makes it much easier to administer, thereby improving patient compliance, particularly among children and the elderly.

5. Reduced Side Effects:

Sublingual administration avoids the gastrointestinal tract and, therefore, is less likely to cause nausea or stomach upset. This is especially beneficial for people who have sensitive stomachs and those who often suffer from digestive problems.

6. Flexibility in Dosage Adjustment:

Through such administration, dosage can be controlled with precision. This flexibility is not always achieved with other routes because individuals can easily adjust their dosage by simply changing the number of sublingual administrations.

7. Convenience and Portability:

Sublingual medication is an excellent choice since it is easy to administer especially when the traditional administration may be impractical. Most sublingual medications are portable and do not require special storage conditions.

8. Suitability for Certain Medications:

Certain drugs are particularly compatible with sublingual dosage. Examples of such drugs include rapidly absorbed drugs, have a narrow therapeutic window, or undergo high first-pass metabolism.

Conclusion

It is important to understand the multiple routes of medication administration in making informed healthcare decisions. Each method provides unique strengths and weaknesses, from oral ingestion to inhalation and injection. Sublingual administration is where medicine is placed under the tongue and rapidly absorbed into the bloodstream.

The use of sublingual administration gives it an edge in the wellness industry. Nutritional Health Supplements using sublingual delivery methods allows the medicines/supplements to have a better absorption and improved impact.