2.4 Explain the different routes of medicine administration

This guide will help you answer 2.4 Explain the different routes of medicine administration.

Medicines can be given to people in several ways. How medicine is given can affect how it works and how quickly it acts. The choice depends on the type of medicine, the person’s needs, and their medical conditions.

Understanding each route gives clear guidance on how to support safe and effective care. Workers must always follow care plans, training, and organisational procedures. The guide covers the main routes of medicine administration you may find in health and social care settings.

Oral Route

The oral route is the most common way to give medicines. “Oral” means any medicine taken by mouth.

Medicines are swallowed and absorbed through the stomach and gut. They then enter the bloodstream.

Medicines can come in several oral forms:

• Tablets
• Capsules
• Liquids
• Chewable tablets
• Lozenges

Points to remember:

• Some medicines should not be chewed or crushed. Extended-release tablets, for example, release medicine slowly. If crushed, they might cause harm.
• Liquids may be used for people who cannot swallow tablets.
• Some tablets can be dissolved in water. Check the prescription or pharmacy label.

Taking medicine with or after food can affect how it works, so follow instructions carefully.

Sublingual and Buccal Routes

Sublingual (Under the Tongue)

A sublingual medicine is placed under the tongue, where it dissolves. It is absorbed directly into the blood vessels under the tongue.

This method is fast. It is used for medicines needing quick action, such as glyceryl trinitrate for chest pain.

Buccal (Inside the Cheek)

A buccal medicine is placed between the gums and cheek. It also dissolves and is absorbed in the mouth lining.

Both sublingual and buccal routes avoid the stomach, giving a quicker effect than swallowing.

Topical Route

Topical medicines are applied directly onto the skin or a mucous membrane.

They can include:

• Creams
• Ointments
• Gels
• Lotions
• Patches (usually called transdermal patches)

Topical medicine acts mainly where applied. Some, like hormone patches, release drug into the bloodstream through the skin.

Points to remember:

• Wash your hands before and after giving topical medicine.
• Apply only to the area prescribed.
• Use gloves if needed, especially for steroids, as these can be absorbed into your own skin.

Transdermal Route

A transdermal patch is a special form of topical medicine. The patch sticks to the skin and releases medicine slowly over time.

Examples include pain relief patches and hormone patches.

Things to think about:

• Place the patch on clean, dry, hairless skin.
• Rotate where you place each new patch to avoid skin irritation.
• Remove old patches before putting on a new one.

Inhalation Route

Some medicines are given as a mist or powder that is breathed in through the mouth or nose.

Examples are:

• Inhalers for asthma (such as salbutamol)
• Nebulisers (machines that turn liquid medicine into a mist)
• Nasal sprays

These medicines act directly on the lungs or nasal passages. Some help prevent flare-ups, others treat acute symptoms.

Top tips:

• Make sure the person knows how to use the device.
• Follow the care plan for cleaning and storing equipment.
• Rinse the mouth after using steroid inhalers to reduce risk of infection.

Rectal and Vaginal Routes

Rectal Route

Medicines may need to be given through the back passage (rectum). Forms include:

• Suppositories
• Enemas

Suppositories are small solid shapes that melt inside the body. Enemas are liquids.

Reasons for using the rectal route:

• The person cannot take medicine by mouth (vomiting, difficulty swallowing)
• The medicine works locally, such as to treat constipation

Considerations:

• Respect privacy and dignity
• Use gloves and explain the process
• Position the person as stated in care plan

Vaginal Route

Some medicines are given into the vagina.

They can include:

• Creams
• Pessaries (solid, oval tablets)

This route is used for local problems such as infections or dryness.

Take care to support dignity, use gloves, and provide explanations. Follow instructions carefully.

Parenteral Routes

Parenteral routes involve giving medicine by injection. This bypasses the digestive system.

Main types are:

Intravenous (IV)

Medicine injected directly into a vein.

• Acts very quickly
• Used in hospitals or specialist care homes

Intramuscular (IM)

Medicine injected into a muscle, often the upper arm or thigh.

• Works quicker than oral but slower than IV

Subcutaneous (Subcut or SC)

Medicine injected into the fatty layer just under the skin, for example, insulin for diabetes.

• Slower release than IV and IM
• Good for medicines needing constant low-level action

Points to note:

• Only staff trained and authorised give injections
• Follow infection prevention standards
• Safe disposal of needles is a must

Intrathecal and Epidural Routes

These are specialist routes, mainly in hospitals.

Intrathecal Route

Medicine is injected into the space around the spinal cord. Used for some pain relief and cancer drugs.

Epidural Route

Medicine delivered into the space just outside the spinal cord. Used mainly for pain control (such as in childbirth).

These are advanced techniques, always handled by trained professionals.

Nasogastric and Gastrostomy Routes

For people unable to take medicine by mouth, medicine can go through a tube direct into the stomach.

Types of feeding tubes:

• Nasogastric (NG): a tube through the nose into the stomach
• Gastrostomy (PEG): a tube placed through the abdomen wall into the stomach

Medicines are given as liquids or dissolved tablets via the tube.

Instructions:

• Check tube placement before giving medication.
• Flush the tube after administration to reduce clogging.
• Only trained staff should use this route.

Ear, Eye, and Nose Routes

Ear Drops

Used to treat ear infections or soften wax.

• Warm the bottle to room temperature (cold drops can feel uncomfortable).
• Ask the person to tilt their head.
• Avoid touching the dropper to the ear.

Eye Drops and Ointments

Treats eye conditions such as infections, dryness or allergies.

• Tilt person’s head back, ask them to look upwards.
• Pull down the lower eyelid to make a pocket for the drops.
• Avoid touching the dropper to the eye or eyelashes.

Nasal Drops and Sprays

Treats congestion or nasal infections.

• Ask person to blow their nose gently before use.
• With sprays, close the opposite nostril.
• With drops, tilt head back or to one side as instructed.

Always allow enough time between different medicines for the same route, such as using different eye drops.

Common Considerations for All Routes

Each route has benefits and downsides. Think about:

• Person’s comfort and dignity
• Speed and duration of action needed
• Safety risks (such as choking or infection)
• Any allergies or sensitivities
• The person’s ability to cooperate or give consent

Record administration accurately. Report and record any side effects or problems straight away.

Training and Authority

You can only give medicines by a route you are trained and authorised for. This protects both you and the person in your care.

Never guess or attempt a new route. Ask your manager or a health professional first.

Final Thoughts

Safe medicine administration is a basic part of health and social care work. Understanding the routes helps you offer person-centred, safe support. Every person is unique, and the best route is chosen for their comfort, health, and personal needs. Always double-check the instructions, support dignity, and act within your competence.

Recording accurately, observing for any side effects, and working closely with others all make a positive difference. Your role in giving medicines is important in keeping people safe and well. If you have any questions about a medicine route, ask a supervisor or qualified health professional. Never guess—a simple question could protect both you and the person you care for.