Question 1

Enteral routes

Accepted Answer

involve drug delivery through the 
gastrointestinal tract and include oral, sublingual, buccal, and 
rectal administration.

Question 2

Drugs are contained in dosing units called

Accepted Answer

formulations or dosage forms.

Question 3

A route of administration is a way of getting a drug onto or into the body.

Accepted Answer

ENTERAL, PARENTERAL

Question 4

ENTERAL: refers to anything involving the stomach from the mouth to the 
rectum. There are four enteral routes of administration:

Accepted Answer

■ Oral
■ Sublingual
■ Buccal
■ Rectal

Question 5

○ PARENTERAL:

Accepted Answer

Routes other than enteral

Question 6

Drugs come in many different forms and many factors determine the choice of

Accepted Answer

route of administration

Question 7

Oral

Accepted Answer

Tablets

Question 8

Oral

Accepted Answer

Capsules

Question 9

Oral

Accepted Answer

Bulk powders

Question 10

Oral

Accepted Answer

Solutions

Question 11

Oral

Accepted Answer

Suspensions

Question 12

Oral

Accepted Answer

Elixirs

Question 13

Oral

Accepted Answer

Syrups

Question 14

Oral

Accepted Answer

Emulsions

Question 15

Oral

Accepted Answer

Tablets
Capsules
Bulk powders
Solutions
Suspensions
Elixirs
Syrups
Emulsions

Question 16

Buccal

Accepted Answer

Tablets

Question 17

Buccal

Accepted Answer

Solutions

Question 18

Buccal

Accepted Answer

Tablets
Solutions

Question 19

Sublingual

Accepted Answer

Tablets
Lozenges

Question 20

Sublingual

Accepted Answer

Tablets

Question 21

Sublinqual

Accepted Answer

Lozenges

Question 22

Rectal

Accepted Answer

Solutions
Ointments
Suppositores

Question 23

Rectal

Accepted Answer

Solutions

Question 24

Rectal

Accepted Answer

Ointments

Question 25

Rectal

Accepted Answer

Suppositories

Question 26

Factor Affecting Selection of Route 
of Administration

Accepted Answer

Ease of administration
Site of action
■ Onset of action
■ Duration of action
■ Quantity of drug administered
Liver or kidney diseases

Question 27

Onset of action

Accepted Answer

Factor Affecting Selection of Route 
of Administration
Site of action
■ ------
■ Duration of action
■ Quantity of drug administered
Liver or kidney diseases

Question 28

Duration of action

Accepted Answer

Factor Affecting Selection of Route 
of Administration
Site of action
■ Onset of Action
■ ------
■ Quantity of drug administered
Liver or kidney diseases

Question 29

■ Quantity of drug administered
Liver or kidney diseases

Accepted Answer

Ease of administration
Site of action
■ Onset of action
■ Duration of action
------

Question 30

Site of Action

Accepted Answer

Local Effect, Systematic Effect

Question 31

A Local Effect:

Accepted Answer

occurs when the drug activity is at the site of 
administration (e.g. eyes, ears, nose, skin).

Question 32

A Systemic Effect:

Accepted Answer

occurs when the drug is introduced into the 
circulatory system by any route of administration and carried by the blood to the site of action.

Question 33

Onset of Action:

Accepted Answer

Oral medications for systemic use must proceed through a series of steps before they exert their therapeutic effect ● Liquid solutions or suspensions work faster than oral tablets or capsules

Question 34

Oral medications for systemic use must proceed through a series of 
steps before they exert their ----

Accepted Answer

therapeutic effect

Question 35

● Liquid solutions or suspensions

Accepted Answer

work faster than oral tablets or capsules.

Question 36

Tablets

Accepted Answer

placed under tongue or between cheek and gums work quickly.

Question 37

Drugs

Accepted Answer

injected/infused directly into bloodstream are carried immediately throughout 
the body.

Question 38

Topical medications work quickly.
● Localized therapeutic effects, especially those

Accepted Answer

○ applied to the skin
○ inhaled into the lungs
○ instilled into the eye.

Question 39

The duration of action

Accepted Answer

● The length of time a drug gives the desired response or is at the therapeutic level 
(duration of time the drug continues to work).

Question 40

Controlled- /extended-release tablet

Accepted Answer

● May last for 12 to 24 hours compared with 4 to 6 hours for same drug in 
immediate-release formulation.

Question 41

Transdermal patches

Accepted Answer

● Delivers small amounts of a drug steadily over many hours or even days.

Question 42

Sustained-duration effect can be achieved by means of intravenous (IV) infusion.

Accepted Answer

● Injections into the muscle and skin last longer than injections directly into the bloodstream.

Question 43

Sometimes route of administration is chosen because of the 
amount of a drug.

Accepted Answer

● A tablet containing a lot of filler (diluent) might be preferred 
for a drug containing a very small amount of active ingredient.

Question 44

IV infusion is an excellent method for systemic delivery of
large quantities of material.

Accepted Answer

● Rapidly diluted in the bloodstream.

Question 45

IV injections and infusions can deliver a higher dose of 
medication to the target site.

Accepted Answer

● Important in serious illnesses.

Question 46

Metabolism by the Liver

Accepted Answer

or
Excretion by the Kidney

Question 47

Liver metabolism

Accepted Answer

breaks down active drug to inactive metabolites 
for elimination and to prevent drug accumulation

Question 48

The first-pass effect

Accepted Answer

is the extent to which a drug is metabolized 
by the liver before reaching systemic circulation.

Question 49

Age-related (old age) or disease-related changes in liver or kidney 
disease can cause:

Accepted Answer

● Drug accumulation
● and thus toxicity.

Question 50

Disintegration

Accepted Answer

The breaking apart of a tablet into smaller 
pieces.

Question 51

Dissolution

Accepted Answer

When the smaller pieces of a disintegrated 
tablet dissolve in solution.

Question 52

Inactive Ingredient
● Include binders, lubricants, fillers, 
diluents, and disintegrates.

Accepted Answer

● Added to help manufacture the 
formulation and to help the dosage 
form disintegrate and dissolve when 
administered.

Question 53

● The most frequently used route of administration.

Accepted Answer

Oral Route

Question 54

● per os)

Accepted Answer

is the abbreviation used to indicate oral route of medication 
administration.

Question 55

Oral Dose Forms

Accepted Answer

Tablets, Capsules, Bulk Powders

Question 56

Bulk powders (e.g., Goody's BC powders)

Accepted Answer

contain the active drug in a small powder paper or 
foil envelope. The patient empties the envelope 
into a glass of water or juice and drinks the 
contents.

Question 57

Chewable tablets

Accepted Answer

have a flavored and/or 
colored base designed to be masticated (chewed)

Question 58

Effervescent tablets

Accepted Answer

are granular salts that 
release gas dispense active ingredients into 
solution when placed in water or juice

Question 59

A capsule is a solid dose form consisting of a 
gelatin shell that encloses the drug

Accepted Answer

usually swallowed whole
○ tasteless and are easier to swallow than 
tablets

Question 60

Capsules

Accepted Answer

Contains powders, granules, liquids, or some 
combination with one or more active 
ingredients

Question 61

Since a ---- is enclosed, flavorings are not 
common for this dose form

Accepted Answer

capsule

Question 62

Buccal tablets (and gum) are placed in the buccal pouch

Accepted Answer

○ Between the cheek and the gum.
○ Dissolved and absorbed by the buccal mucosa.

Question 63

A delayed-release dose

Accepted Answer

form does not release the active drug 
immediately after administration.

Question 64

● An  ----- form allows reduced frequency of dosing.

Accepted Answer

extended-release dose

Question	Answer
Enteral routes	involve drug delivery through the gastrointestinal tract and include oral, sublingual, buccal, and rectal administration.
Drugs are contained in dosing units called	formulations or dosage forms.
A route of administration is a way of getting a drug onto or into the body.	ENTERAL, PARENTERAL
ENTERAL: refers to anything involving the stomach from the mouth to the rectum. There are four enteral routes of administration:	■ Oral ■ Sublingual ■ Buccal ■ Rectal
○ PARENTERAL:	Routes other than enteral
Drugs come in many different forms and many factors determine the choice of	route of administration
Oral	Tablets
Oral	Capsules
Oral	Bulk powders
Oral	Solutions
Oral	Suspensions
Oral	Elixirs
Oral	Syrups
Oral	Emulsions
Oral	Tablets Capsules Bulk powders Solutions Suspensions Elixirs Syrups Emulsions
Buccal	Tablets
Buccal	Solutions
Buccal	Tablets Solutions
Sublingual	Tablets Lozenges
Sublingual	Tablets
Sublinqual	Lozenges
Rectal	Solutions Ointments Suppositores
Rectal	Solutions
Rectal	Ointments
Rectal	Suppositories
Factor Affecting Selection of Route of Administration	Ease of administration Site of action ■ Onset of action ■ Duration of action ■ Quantity of drug administered Liver or kidney diseases
Onset of action	Factor Affecting Selection of Route of Administration Site of action ■ ------ ■ Duration of action ■ Quantity of drug administered Liver or kidney diseases
Duration of action	Factor Affecting Selection of Route of Administration Site of action ■ Onset of Action ■ ------ ■ Quantity of drug administered Liver or kidney diseases
■ Quantity of drug administered Liver or kidney diseases	Ease of administration Site of action ■ Onset of action ■ Duration of action ------
Site of Action	Local Effect, Systematic Effect
A Local Effect:	occurs when the drug activity is at the site of administration (e.g. eyes, ears, nose, skin).
A Systemic Effect:	occurs when the drug is introduced into the circulatory system by any route of administration and carried by the blood to the site of action.
Onset of Action:	Oral medications for systemic use must proceed through a series of steps before they exert their therapeutic effect ● Liquid solutions or suspensions work faster than oral tablets or capsules
Oral medications for systemic use must proceed through a series of steps before they exert their ----	therapeutic effect
● Liquid solutions or suspensions	work faster than oral tablets or capsules.
Tablets	placed under tongue or between cheek and gums work quickly.
Drugs	injected/infused directly into bloodstream are carried immediately throughout the body.
Topical medications work quickly. ● Localized therapeutic effects, especially those	○ applied to the skin ○ inhaled into the lungs ○ instilled into the eye.
The duration of action	● The length of time a drug gives the desired response or is at the therapeutic level (duration of time the drug continues to work).
Controlled- /extended-release tablet	● May last for 12 to 24 hours compared with 4 to 6 hours for same drug in immediate-release formulation.
Transdermal patches	● Delivers small amounts of a drug steadily over many hours or even days.
Sustained-duration effect can be achieved by means of intravenous (IV) infusion.	● Injections into the muscle and skin last longer than injections directly into the bloodstream.
Sometimes route of administration is chosen because of the amount of a drug.	● A tablet containing a lot of filler (diluent) might be preferred for a drug containing a very small amount of active ingredient.
IV infusion is an excellent method for systemic delivery of large quantities of material.	● Rapidly diluted in the bloodstream.
IV injections and infusions can deliver a higher dose of medication to the target site.	● Important in serious illnesses.
Metabolism by the Liver	or Excretion by the Kidney
Liver metabolism	breaks down active drug to inactive metabolites for elimination and to prevent drug accumulation
The first-pass effect	is the extent to which a drug is metabolized by the liver before reaching systemic circulation.
Age-related (old age) or disease-related changes in liver or kidney disease can cause:	● Drug accumulation ● and thus toxicity.
Disintegration	The breaking apart of a tablet into smaller pieces.
Dissolution	When the smaller pieces of a disintegrated tablet dissolve in solution.
Inactive Ingredient ● Include binders, lubricants, fillers, diluents, and disintegrates.	● Added to help manufacture the formulation and to help the dosage form disintegrate and dissolve when administered.
● The most frequently used route of administration.	Oral Route
● per os)	is the abbreviation used to indicate oral route of medication administration.
Oral Dose Forms	Tablets, Capsules, Bulk Powders
Bulk powders (e.g., Goody's BC powders)	contain the active drug in a small powder paper or foil envelope. The patient empties the envelope into a glass of water or juice and drinks the contents.
Chewable tablets	have a flavored and/or colored base designed to be masticated (chewed)
Effervescent tablets	are granular salts that release gas dispense active ingredients into solution when placed in water or juice
A capsule is a solid dose form consisting of a gelatin shell that encloses the drug	usually swallowed whole ○ tasteless and are easier to swallow than tablets
Capsules	Contains powders, granules, liquids, or some combination with one or more active ingredients
Since a ---- is enclosed, flavorings are not common for this dose form	capsule
Buccal tablets (and gum) are placed in the buccal pouch	○ Between the cheek and the gum. ○ Dissolved and absorbed by the buccal mucosa.
A delayed-release dose	form does not release the active drug immediately after administration.
● An ----- form allows reduced frequency of dosing.	extended-release dose
Delayed-release medication	Delayed-release medication is NOT the same as extended- or controlled-release medication of the same drug.
● Controlled-release	dose forms should NOT be split.
Soft or Soft-gel	are capsules that contain liquid instead of powders inside the gelatin shell.
Oral Dose Forms: Other formulations	Also called long-acting, timed-release, and sustained-release dose forms.
Oral Dose Forms: Other formulations	● Sustained Release (SR)
Oral Dose Forms: Other formulations	● Extended Release (XR, ER)
Oral Dose Forms: Other formulations	● Continuous Release (CR)
Oral Dose Forms: Other formulations	● Long acting (LA)
Solutions	is a clear liquid (not necessarily colorless).
A ---- is a liquid that can dissolve another substance to form a solution.	solvent
● Aqueous solution	= water is the solvent.
Suspensions:	are formulations in which the drug does not completely dissolve in the liquid.
Suspensions:	● They should be shaken well before administration.
Syrups:	concentrated (saturated) solutions of sucrose (sugar) in water – are more thicker (viscous) than water.
Liquid Formulations Nonaqueous Solutions	Solutions that contain solvent other than water (mostly alcohol).
Elixirs are sweetened liquids that contain alcohol (5- 40%).	○ They are less sweet and less effective in masking taste than syrup.
Spirits	are alcoholic solutions that contain volatile oils (alcohol 62-85%).
Tincture	are alcoholic solutions (like Spirits) but of nonvolatile substances.
Liquid Formulations Nonaqueous Solutions	Spirits, Elixers, Tincture
Liquid Formulations (Emulsions)	are solutions of oil and water based substances.
Emulsifier	is a substance that disperses the oil in to water (o/w emulsion) or water into oil (w/o emulsion).
Creaming	occurs when dispersed droplets merge together; can be dispersed by shaking.
● Coalescence	is irreversible separation of the dispersed phase.
Liquid Formulations - Emulsions	Emulsifier, Creaming, Coalescence
Liquid Formulations -Gels - Made using a substance called gelling agents. e.g.	○ Carbopols® 934P, methylcellulose, hydroxy-propylmethyl-cellusose, and sodium carboxy-methyl- cellulose are recommended for oral administration.
Liquid Formulations -Gels - Made using a substance called gelling agents. e.g.	● Usually take 12-24 hours to reach maximum viscosity.
Liquid Formulations -Gels - Made using a substance called gelling agents. e.g.	● Add the active drug before the gel is formed.
Unit dose disposable syringes	are prefilled syringes that contain a single pre measured dose of medication and are thrown away after use.
An oral syringe	is a device without a needle to administer medication to pediatric or elderly patients unable to swallow tablets or capsules.
Effervescent salts	are granules or coarse powders containing one or more medicinal agents.
Effervescent salts	■ Contains some combination of sodium bicarbonate with citric acid, tartaric acid, or sodium biphosphate.
Effervescent salts	■ Release carbon dioxide gas when dissolved.
Lozenges	are dose forms containing active ingredients and flavorings that are dissolved in the mouth
Lozenges	■ Also known as troches or pastilles.
Lozenges	■ Generally have local effects.
A ----- uses a bulb to create a vacuum for drawing up a liquid.	dropper
dropper	Contains a small, squeezable bulb at one end and a hollow glass or plastic tube with a tapering point.
dropper	■ May be incorporated into the cap of a vial or other container .
gtt	is an abbreviation for unit of pharmaceutical measurement for droppers and IV infusions indicating drops.
gtt	Due to the differing viscosities of fluids, the size of a drop varies considerably from medication to medication.
Droppers	are often used for otic or ophthalmic administration, as well as for oral medications.
Sublingual Administration	Designed to be dissolved under the tongue. ○ Medication dissolved under the tongue is absorbed very quickly.
Nitroglycerine	is the best known example of sublingual formulation (for chest pain
Sublingual Administration	Advise patients to take a sip of water first and not to eat food or beverages until the drug is fully absorbed.
Capsules	are preferred over tablets for patients with difficulty swallowing.
■ Water	preferred over beverages to aid in swallowing
Some dose forms are designed to be ---- when swallowing a solid is difficult.	sprinkled on food
Liquid doses	are swallowed more easily and are suitable for ■ Patients with swallowing difficulties. ■ Small children
Advantages of the Oral Route	Ease and safety of administration.
Advantages of the Oral Route	Active ingredient is generally contained in powders or granules which dissolve in GI tract.
Advantages of the Oral Route	Sublingual (and buccal) administration has a rapid onset (less than 5 minutes).
Delayed onset	■ Dose form must disintegrate before absorption.
Destruction or dilution of drug by	GI fluids and acid. ■ Food or drink in stomach or intestines.
Destruction or dilution	Not indicated in patients who: ■ Have nausea or vomiting. ■ Are comatose, sedated, or otherwise unable to swallow Unpleasant taste
patients who of some liquid dose forms	■ Must be masked by flavorings to promote compliance.
Sublingual (and buccal) administration has a short duration of action.	■ Less than 30 to 60 minutes. ■ Not appropriate for routine delivery of medication.
Buccal route may have	■ Medicinal taste. ■ Local mouth irritation.
Patients need instruction on proper storage of ----.	nitroglycerin
Sublingual nitroglycerin tablets should be stored in their original container (brown glass bottle).	■ Lid screwed on tightly to prevent sunlight and air from causing potency loss. ■ Pillboxes are not recommended. ■ Refill nitroglycerin with a fresh bottle every 6 months.
Rectal Medications-Suppository	Remove suppository from its package.
Rectal Medications-Suppository	Insert small tapered end first with index finger for the full length of the finger.
Rectal Medications-Suppository	May need to be lubricated with a water-soluble gel to ease insertion. ■
Rectal Medications-Suppository	■ Refrigeration may make insertion of rectal medications easier in warm climates.
Enemas	create an urge to defecate due to the placement of fluid into the rectum.
■ A cleansing enema	uses water or a cleansing solution.
A retention enema	uses an oil that is held in the rectum to soften the stool.
Enema	Frequent use of ----- is discouraged as it can have significant adverse effects.
Rectal administration	is a preferred method when:
Rectal administration is a preferred method when:	■ An oral drug might be destroyed or diluted by acidic fluids in the stomach.
Rectal administration is a preferred method when:	■ An oral drug might be too readily metabolized by the liver and eliminated from the body.
Rectal administration is a preferred method when:	The patient is unconscious and needs medication.
Rectal administration is a preferred method when:	Nausea and vomiting or severe acute illness in the GI tract make patient unable to take oral drugs.

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