3.2 Describe the different routes for the administration of medication

This guide will help you answer 3.2 Describe the different routes for the administration of medication.

Medication can be given to people in health and social care settings in different ways. These ways are known as ‘routes of administration’. Each route suits different medicines, care needs, and individual preferences. Knowing the routes and how they work helps you give medicine safely and effectively.

This guide sets out the main routes for the administration of medication.

Oral Route

Oral means giving medicine through the mouth. This is the most common way to take medicine. Most tablets, capsules, liquids, and some powders are meant to be swallowed.

How it works

When someone swallows medicine, it travels down the oesophagus (food pipe) to the stomach. It is then digested and absorbed into the blood through the lining of the stomach or intestines.

Examples of medicines

• Paracetamol tablets for pain or fever
• Antibiotic capsules for infections
• Liquid antacids for indigestion

Points to remember

• Some people might struggle to swallow tablets or capsules. Liquid forms or dissolvable tablets can help.
• The person needs to be able to sit upright. This prevents choking.
• Medicines given this way take time to work. The medicine needs to reach the intestine before it gets absorbed.
• Food can affect how well the medicine works. Some have to be taken on an empty stomach, others with food.

Sublingual Route

“Sublingual” means “under the tongue”. The medicine is placed under the tongue to dissolve. It gets absorbed straight into the blood vessels there.

How it works

The mouth has many small blood vessels under the tongue. When medicine sits here, it is quickly absorbed into the blood. It acts faster than medicine swallowed.

Examples of medicines

• Glyceryl trinitrate (GTN) tablets or sprays for angina (chest pain)

Points to remember

• The person should not eat, drink or swallow until the medicine fully dissolves.
• Sublingual medicines act very fast.
• This route is used in emergencies or for quick relief.

Buccal Route

“Buccal” refers to the cheek area. Medicine is placed between the gum and cheek and left to dissolve.

How it works

The mucous membrane inside the cheek absorbs the medicine directly into the bloodstream. This avoids the digestive system.

Examples of medicines

• Some hormone medicines
• Some anti-nausea medicines

Points to remember

• The person must not chew or swallow the medicine.
• It may cause mild discomfort in the cheek.

Topical Route

“Topical” means applied directly to the surface of the body – usually the skin. These medicines are creams, gels, ointments, or lotions.

How it works

Medicine is absorbed through the skin and works at the site where applied. Sometimes, it goes deeper into body tissues, or even into the bloodstream.

Examples of medicines

• Hydrocortisone cream for eczema
• Antibiotic ointment for infected cuts
• Pain relief gels for sore muscles

Points to remember

• Always wear gloves to protect yourself and other residents.
• Avoid touching your eyes or mouth after applying medicine.
• Only apply to the area stated on the prescription.

Transdermal Route

“Transdermal” means “through the skin”. Medicine is usually in the form of a patch stuck to the skin. Patches release the medicine slowly over several hours or days.

How it works

The patch is placed on the skin. Medicine travels through the skin into the bloodstream for a steady effect.

Examples of medicines

• Nicotine patches for stopping smoking
• Pain relief patches (e.g., fentanyl)
• Hormone patches (e.g., HRT)

Points to remember

• Use a new patch each time. Remove the old one.
• Rotate the site to prevent skin irritation.
• Do not cut patches unless advised.
• Wash hands after handling.

Inhaled Route

“Inhaled” means breathing in medicine through the mouth or nose. Devices such as inhalers or nebulisers turn medicine into a mist or fine powder.

How it works

When breathed in, medicine goes straight to the lungs. This is useful for breathing problems like asthma.

Examples of medicines

• Salbutamol inhalers for asthma
• Steroid inhalers for chronic obstructive pulmonary disease (COPD)
• Nebuliser solutions

Points to remember

• The person must use proper technique.
• Spacers can help deliver inhaled medicine more effectively.
• Rinse the mouth after steroid inhalers to prevent thrush (a fungal infection).

Nasal Route

“Nasal” means through the nose. Medicines are sprayed or dropped into the nostrils.

How it works

Medicine coats the lining of the nose and gets absorbed. It can act locally (in the nose) or travel into the bloodstream.

Examples of medicines

• Decongestant sprays for blocked nose
• Nasal steroid sprays
• Some emergency medicines, such as naloxone (for opioid overdose)

Points to remember

• Avoid blowing the nose straight after administration.
• Overuse of sprays can damage nasal tissue.
• Keep the spray tip clean.

Rectal Route

“Rectal” means into the rectum (back passage). Suppositories (solid, bullet-shaped medicines) or liquids can be inserted here.

How it works

The medicine melts or dissolves and is absorbed into the blood through the rectal wall.

Examples of medicines

• Paracetamol suppositories (for pain or fever)
• Anti-nausea suppositories
• Some laxatives (for constipation)

Points to remember

• Useful if the person is vomiting or unable to swallow.
• The person may feel embarrassment. Maintain dignity and privacy.
• Lubricate suppositories for comfort.

Vaginal Route

“Vaginal” means into the vagina. This route is usually for women or people assigned female at birth.

How it works

Medicines come as pessaries (similar to suppositories), creams, or gels. They are inserted into the vagina, where they dissolve.

Examples of medicines

• Anti-fungal pessaries for thrush
• Hormone creams

Points to remember

• Used for local treatment.
• Hands should be washed before and after administration.
• A plastic applicator might be supplied for inserting the medicine.

Parenteral Routes

“Parenteral” means giving medicines by injection, outside the digestive system. This is usually done by a nurse or trained professional. There are several forms:

Subcutaneous (Subcut) Route

Given into the layer of fat just under the skin using a small needle.

Examples

• Insulin for diabetes
• Some blood-thinning injections

Points to remember

• Change injection site to prevent damage to skin.
• Small volume of medicine only.

Intramuscular (IM) Route

Given deep into a muscle, usually in the upper arm, thigh, or buttocks.

Examples

• Vaccines
• Pain relief (e.g., morphine)

Points to remember

• Only a trained person should give IM injections.
• The medicine acts quickly, as muscles have a good blood supply.

Intravenous (IV) Route

Given directly into a vein using a needle or cannula.

Examples

• Antibiotics in hospital
• Fluids for dehydration
• Chemotherapy drugs

Points to remember

• Carried out by skilled staff in clinical settings.
• The fastest way for medicine to reach the bloodstream.
• May cause bruising or soreness at the site.

Other Routes

Sometimes medicine is given in specialist ways:

• Ophthalmic: into the eyes (as drops, gels, or ointments). Used for eye infections or conditions like glaucoma.
• Otic: into the ears (as drops). Used for ear infections.
• Intra-arterial: into an artery, used rarely for special treatments.
• Intra-articular: directly into a joint, for example, steroid injections for arthritis.

Factors Affecting the Choice of Route

Choosing the correct route depends on several things:

• The person’s needs and abilities (e.g., can they swallow?)
• How quickly the medicine needs to act
• Where the medicine needs to work (local or whole body)
• The form in which the medicine comes (e.g., some come only as injections)
• Safety (some medicines damage the stomach if taken by mouth)

Safe Practice

Whichever route is used, safety is the top priority. Always:

• Follow the prescribed instructions exactly
• Use protective equipment (e.g., gloves for creams or suppositories)
• Record the time, dose, route, and any reaction in the care records
• Respect the dignity and privacy of the person
• Explain what you are doing before you start
• Check for allergies or previous reactions

Final Thoughts

There are many routes for administering medication. Some are simple, like swallowing a tablet. Others require training and special care, such as injections. The right route depends on the person’s needs, the purpose of the medicine, and how fast it needs to work.

By using the correct routes, explaining what you are doing, and following safety steps, you help the person get the most benefit from their treatment. If you have questions or concerns about the best route for a medicine, always check with a nurse, pharmacist, or doctor.