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1. Intravenous (IV) route: Advantages : 1- Large volumes can be given via this route. 2- Unconscious patient. 3- Rapid onset of action. 4- Suitable for continuous infusion (for rapidly destroyed drugs) 5- Suitable for too irritant drugs (anticancer drugs). 6- No first pass metabolism.

2. Disadvantages: 1-IV fluid should be aqueous, and (isotonic) 2- Infection and local venous thrombosis. 3-The injected drug cannot be recalled simply in case of toxicity .

3. Intramuscular (IM) route:  Common route, and less affected by peripheral circulatory failure.  isotonicity is not essential except for the comfort of the patient.  Drug can be aqueous or specialized depot preparations.  Sites of injection: the best site is deltoid muscle in the shoulder or the gluteus muscle in femeral and , triceps

4. Advantages: 1-bypasses the first-pass metabolism 2- More rapid than subcutaneous route as the absorption is more rapid. 3- unconscious patient .

5. Disadvantages: 1- not suitable for self administration 2- may be painful. 3- Muscle fibrosis and contracture 4-Abscess at the injection site. 5- nerve injury .

6. Subcutaneous (SC) route:  Injection (1ml or less).  Mechanical pumps (insulin ). Advantage: 1-reliable and acceptable for self administration. 2. It is relatively safer than intravenous and intramuscular routes 3-Absorption is slower thus, it is a good route if a prolonged effect is to be achieved. Disadvantage : 1- skin reaction 2- Poor absorption in case of peripheral circulatory failure.

7. Intraperitoneal (I.P) route: A- Relatively large volume of non-irritant drugs. B- Absorption is faster in the peritoneal cavity than IM or SC .

8. Special ROUTE: 1- Intraspinal (Epidural): administration on or over the dura mater. The drug must be filtered through fat and veins to reach the nervous roots, thus delaying the beginning of the effect. It supports permanent catheter collation. 2- Intrathecal : Direct administration in the cerebrospinal fluid of the subarachnoid space (between pia mater and arachnoid membranes). Immediate effect over nervous roots. It does not support permanent catheter. These routes are used primarily for anesthesia ( e.g. lidocaine, )and pain management ( e.g. opioid analgesic)

9. 3-Intracerebroventricular : Direct administration to the cerebral ventricles. This route, like the previous one, is an option to the IV route in the case of CNS active drugs that are unable to cross the blood brain barrier, when high, localized concentrations are required ( e.g. antibiotics, chemotherapy of gliomas) 4-Intraarterial : Direct administration to an artery. E.g. antineoplastic injected in the surroundings of the tumor, with a decrease of systemic adverse effects . It is also useful for the administration of vasodilators in arterial embolisms or contrast media for arteriography.

10. 5 -Intracardiac : Direct administration into the heart, used only as emergency route during a cardiac arrest (adrenaline injection into cardiac chambers) 6- Intraarticular : Direct administration on a joint, generally for local effects. E.g. anti inflammatory corticosteroids for arthritis . 7- Intraosseous : Direct administration within a long bone medulla by injection through it . It is used to achieve systemic effects since the vascular bed of these bones quickly transports the drug to the rest of the body, and hence is an option when the IV route is not possible, as in pediatric emergencies to administer antibiotics, antiepileptics , etc

11. Inhalation : May be used for a local effect, e.g. bronchodilators. Can be used for systemic effect, e.g. general anesthesia. Rapid absorption by-passing the liver. Advantages: A- Large surface area B- thin membranes separate alveoli from circulation C- high blood flow