Route of administration: Difference between revisions

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:* [[Epidural]] (synonym: peridural) (injection or infusion into the [[epidural space]]), e.g. epidural anesthesia.
:* Intracerebral (into the cerebrum) administration by direct injection into the brain. Used in experimental research of chemicals<ref>{{cite web |url=http://www.neurotransmitter.net/mdmametabolites.html |title=MDMA (ecstasy) metabolites and neurotoxicity: No occurrence of MDMA neurotoxicity from metabolites when injected directly into brain, study shows |publisher=Neurotransmitter.net |access-date=2010-08-19 |archive-url=https://web.archive.org/web/20100807215102/http://www.neurotransmitter.net/mdmametabolites.html |archive-date=2010-08-07 |url-status=live }}</ref> and as a treatment for malignancies of the brain.<ref>{{cite journal|title=A potential application for the intracerebral injection of drugs entrapped within liposomes in the treatment of human cerebral gliomas |date=2010-07-06 |pmc=1028604|last2=Firth|first2=G|last3=Oliver|first3=S|last4=Uttley|first4=D|last5=O'Laoire|first5=S|volume=48|issue=12|pages=1213–1219|journal=Journal of Neurology, Neurosurgery, and Psychiatry|doi=10.1136/jnnp.48.12.1213|pmid=2418156|author=McKeran RO, Firth G, Oliver S, Uttley D, O'Laoire S}}</ref> The intracerebral route can also interrupt the blood brain barrier from holding up against subsequent routes.<ref>{{cite journal|title=Blood–brain barrier changes following intracerebral injection of human recombinant tumor necrosis factor-α in the rat |doi=10.1007/BF01057957 |volume=20 |journal=Journal of Neuro-Oncology |pages=17–25 |year=1994 |author=Wright JL, Merchant RE|issue=1 |pmid=7807180 |s2cid=12445653 }}</ref>
:* [[intracerebroventricular injection|Intracerebroventricular]] (into the cerebral ventricles) administration into the ventricular system of the brain. One use is as a last line of opioid treatment for terminal cancer patients with intractable [[cancer pain]].<ref>{{cite webjournal |url=http://www.anesthesia-analgesia.org/cgi/content/full/89/5/1209 |title=Acute Decreases in Cerebrospinal Fluid Glutathione Levels after Intracerebroventricular Morphine for Cancer Pain |publisher=Anesthesia-analgesia.org |date=1999-06-22 |doi=10.1213/00000539-199911000-00023 |access-date=2010-08-19 |archive-url=https://web.archive.org/web/20060106043224/http://www.anesthesia-analgesia.org/cgi/content/full/89/5/1209 |archive-date=2006-01-06 |url-status=live |last1=Goudas |first1=Leonidas C. |last2=Langlade |first2=Agnes |last3=Serrie |first3=Alain |last4=Matson |first4=Wayne |last5=Milbury |first5=Paul |last6=Thurel |first6=Claude |last7=Sandouk |first7=Pierre |last8=Carr |first8=Daniel B. |journal=Anesthesia & Analgesia |volume=89 |issue=5 |pages=1209–1215 }}</ref>
 
[[File:Applying transdermal patch.jpg|thumb|A transdermal patch which delivers medication is applied to the skin. The patch is labelled with the time and date of administration as well as the administrator's initials.]]
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* [[Intracardiac]] (into the heart), e.g. [[adrenaline]] during [[cardiopulmonary resuscitation]] (no longer commonly performed).
* [[Intracavernous injection]], an injection into the base of the [[penis]].
* [[Intradermal]], (into the skin itself) is used for [[Skin allergy test|skin testing]] some [[allergens]], and also for [[mantoux test]] for [[tuberculosis]].
* Intralesional (into a skin lesion), is used for local skin lesions, e.g. acne medication.
* [[Intramuscular injection|Intramuscular]] (into a [[muscle]]), e.g. many [[vaccine]]s, antibiotics, and long-term psychoactive agents. Recreationally the colloquial term 'muscling' is used.<ref name="Fenway Community Health">{{cite web|url=http://www.fenwayhealth.org/site/PageServer?pagename=CM_efc_effects |website=Fenway Community Health|title = Crystal Meth: The Effects |publisher=[[Fenway Health]] |url-status = dead|archive-url = https://web.archive.org/web/20101210183228/http://www.fenwayhealth.org/site/PageServer?pagename=CM_efc_effects|archive-date = 10 December 2010}}</ref>
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===Desired target effect===
Identical drugs can produce different results depending on the route of administration. For example, some drugs are not significantly absorbed into the bloodstream from the gastrointestinal tract and their action after enteral administration is therefore different from that after parenteral administration. This can be illustrated by the action of [[naloxone]] (Narcan), an antagonist of [[opiate]]s such as [[morphine]]. Naloxone counteracts opiate action in the [[central nervous system]] when given intravenously and is therefore used in the treatment of opiate overdose. The same drug, when swallowed, acts exclusively on the bowels; it is here used to treat constipation under opiate pain therapy and does not affect the pain-reducing effect of the opiate.
 
===Inhalation===
 
====Mouth inhalation====
[[File:Administering inhaled medication.jpg|thumb|A dummy wears a nebulizer mask, used to administer inhaled medications.]]
 
[[File:illu quiz lung05.jpg|thumb|upright=0.8|{{ordered list |[[trachea]] (conducting zone)
|main [[bronchus]] (conducting zone)
|[[lobar bronchus]] (conducting zone)
| [[segmental bronchus]] (conducting zone)
| [[subsegmental bronchus]] (conducting zone)
| conducting [[bronchiole]] (conducting zone)
| [[terminal bronchiole]] (conducting zone)
| [[respiratory bronchiole]] (transitional respiratory zone)
| [[alveolar duct]] (transitional respiratory zone)
| [[alveolar sac]] (transitional respiratory zone)
| [[Pulmonary alveolus|alveolus]] (transitional respiratory zone)}}<ref name="Ali 2010 pp. 209–246">{{cite book | last=Ali | first=Mohammed | title=Handbook of Non-Invasive Drug Delivery Systems | chapter=Pulmonary Drug Delivery | publisher=Elsevier | year=2010 | isbn=978-0-8155-2025-2 | doi=10.1016/b978-0-8155-2025-2.10009-5 | pages=209–246}}</ref><ref name="archive.is 2020">{{cite web | title=Lungs - Anatomy of the Respiratory System | website=archive.is | date=2020-03-29 | url=https://www.brainkart.com/article/Lungs---Anatomy-of-the-Respiratory-System_21915/ | archive-url=https://archive.today/20200329053609/https://www.brainkart.com/article/Lungs---Anatomy-of-the-Respiratory-System_21915/ | url-status=dead | archive-date=2020-03-29 | access-date=2020-03-29}}</ref><ref name="GetBodySmart 2017">{{cite web | title=Major Zones & Divisions | website=GetBodySmart | date=2017-10-30 | url=https://www.getbodysmart.com/respiratory-system/respiratory-system-anatomy | access-date=2020-03-29}}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Conducting-Zone-770x550.png |title=Diagram for conducting zone |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329080819/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Conducting-Zone-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Respiratory-Zone-770x550.png |title=Diagram for respiratory zone |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081010/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Respiratory-Zone-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Upper-tract-770x550.png |title=Diagram for upper respiratory tract |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081203/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Upper-tract-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-lower-tract-770x550.png |title=Diagram for lower respiratory tract |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081254/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-lower-tract-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/10/Test-yourself-with-answers-shown-504x550.png |title=Diagram for majour zones of respiratory system |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081401/https://www.getbodysmart.com/wp-content/uploads/2017/10/Test-yourself-with-answers-shown-504x550.png |url-status=live }}</ref>]]
 
Inhaled medications can be absorbed quickly and act both locally and systemically.<ref name=DDS/> Proper technique with [[inhaler]] devices is necessary to achieve the correct dose. Some medications can have an unpleasant taste or irritate the mouth.<ref name=DDS/>
 
In general, only 20–50% of the pulmonary-delivered dose rendered in powdery particles will be deposited in the lung upon mouth inhalation.<ref name="Tandel Florence Misra 2011 pp. 429–479">{{cite book | last1=Tandel | first1=Hemal | last2=Florence | first2=Kiruba | last3=Misra | first3=Ambikanandan | title=Challenges in Delivery of Therapeutic Genomics and Proteomics | chapter=Protein and Peptide Delivery through Respiratory Pathway | publisher=Elsevier | year=2011 | isbn=978-0-12-384964-9 | doi=10.1016/b978-0-12-384964-9.00009-8 | pages=429–479}}</ref> The remainder of 50-70% undeposited aerosolized particles are cleared out of lung as soon as [[exhalation]].<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
An inhaled powdery particle that is >8 μm is structurally predisposed to depositing in the central and conducting airways ([[conducting zone]]) by inertial impaction.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
An inhaled powdery particle that is between 3 and 8 μm in diameter tend to largely deposit in the [[transitional zone]]s of the lung by sedimentation.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
An inhaled powdery particle that is <3 μm in diameter is structurally predisposed to depositing primarily in the [[respiratory region]]s of the peripheral lung via diffusion.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
Particles that deposit in the upper and central airways are generally absorbed systemically to great extent because they are only partially removed by [[mucociliary]] clearance, which results in orally mediated absorption when the transported mucous is swallowed, and first pass metabolism or incomplete absorption through loss at the fecal route can sometimes reduce the bioavailability.<ref>{{Cite journal|title=Cilia and Mucociliary Clearance|first1=Ximena M.|last1=Bustamante-Marin|first2=Lawrence E.|last2=Ostrowski|date=April 18, 2017|journal=Cold Spring Harbor Perspectives in Biology|volume=9|issue=4|pages=a028241|doi=10.1101/cshperspect.a028241|pmid=27864314|pmc=5378048}}</ref> This should in no way suggest to clinicians or researchers that inhaled particles are not a greater threat than swallowed particles, it merely signifies that a combination of both methods may occur with some particles, no matter the size of or lipo/hydrophilicity of the different particle surfaces.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
{{further|PM 2.5|PM 10}}
 
====Nasal inhalation====
Inhalation by nose of a substance is almost identical to oral inhalation, except that some of the drug is absorbed intranasally instead of in the oral cavity before entering the airways. Both methods can result in varying levels of the substance to be deposited in their respective initial cavities, and the level of mucous in either of these cavities will reflect the amount of substance swallowed. The rate of inhalation will usually determine the amount of the substance which enters the lungs. Faster inhalation results in more rapid absorption because more substance finds the lungs. Substances in a form that resists absorption in the lung will likely resist absorption in the nasal passage, and the oral cavity, and are often even more resistant to absorption after they fail absorption in the former cavities and are swallowed.
 
===Oral===
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====Sublingual====
[[Sublingual administration]] is fulfilled by placing the drug between the tongue and the lower surface of the mouth.<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817"/> The [[sublingual mucosa]] is highly permeable and thereby provides access to the underlying expansive network composed of capillaries, leading to rapid drug absorption.<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817"/>
 
===Intranasal===
Drug administration via the nasal cavity yields rapid drug absorption and therapeutic effects.<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817">{{cite journal | last1=Kaminsky | first1=Bonnie M. | last2=Bostwick | first2=Jolene R. | last3=Guthrie | first3=Sally K. | title=Alternate Routes of Administration of Antidepressant and Antipsychotic Medications | journal=The Annals of Pharmacotherapy | publisher=SAGE Publications | volume=49 | issue=7 | date=2015-04-23 | issn=1060-0280 | pmid=25907529 | doi=10.1177/1060028015583893 | pages=808–817| s2cid=39802797 }}</ref> This is because drug absorption through the nasal passages does not go through the gut before entering [[capillaries]] situated at [[tissue cell]]s and then systemic circulation and such absorption route allows transport of drugs into the [[central nervous system]] via the pathways of [[olfactory]] and [[trigeminal nerve]].<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817"/>
 
Intranasal absorption features low lipophilicity, enzymatic degradation within the nasal cavity, large molecular size, and rapid mucociliary clearance from the nasal passages, which explains the low [[bioavailability|risk of systemic exposure of the administered drug absorbed]] via intranasal.<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817"/>
 
[[File:Capillaries.jpg|thumbnail|upright=2|center|Involved subjects' positions.]]
 
===Local===
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The term injection encompasses [[intravenous]] (IV), [[intramuscular]] (IM), [[subcutaneous injection|subcutaneous]] (SC) and [[Intradermal injection|intradermal]] (ID) administration.<ref>{{cite web|url=http://www.ismp.org/Tools/errorproneabbreviations.pdf|title=List of Error-Prone Abbreviations|website=Institute For Safe Medication Practices|access-date=14 April 2018|archive-url=https://web.archive.org/web/20160222201424/https://www.ismp.org/tools/errorproneabbreviations.pdf|archive-date=22 February 2016|url-status=live}}</ref>
 
Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC.<ref>{{cite web |url=https://www.gov.mb.ca/health/ems/guidelines/docs/A2.08.03.pdf |title=Routes for Drug Administration |date=2003 |work=Emergency Treatment Guidelines Appendix |publisher=Manitoba Health |access-date=April 2, 2013 |archive-url=https://web.archive.org/web/20131001174406/http://www.gov.mb.ca/health/ems/guidelines/docs/A2.08.03.pdf |archive-date=October 1, 2013 |url-status=dead }}</ref> They also have essentially 100% [[bioavailability]] and can be used for drugs that are poorly absorbed or ineffective when they are given orally.<ref name="Nursing Times">{{cite web |url=https://www.nursingtimes.net/clinical-archive/medicine-management/the-administration-of-medicines-19-11-2007/ |title=The Administration of Medicines |date=2007 |work=Nursing Practice Clinical Zones: Prescribing |publisher=NursingTimes.net |access-date=April 2, 2013 |archive-url=https://web.archive.org/web/20200102152352/https://www.nursingtimes.net/clinical-archive/medicine-management/the-administration-of-medicines-19-11-2007/ |archive-date=January 2, 2020 |url-status=live }}</ref> Some medications, such as certain [[antipsychotic]]s, can be administered as [[depot injection|long-acting intramuscular injections]].<ref>Stahl SM, Stahl's Essential Psychopharmacology: Neuroscientific basis and practical applications, New York: Cambridge University Press, 2008</ref> The practice is often carried out through physical force in company of law-enforcement, and often against the will of the patient. However, all doses of long-acting antipsychotics injections are of at extreme risk to the health and well-being of the patient. Extreme ethical concerns should be considered. If the choice is made to use force, care should be taken to use only the smallest dose that is currently scientifically demonstrated to be efficacious for the specific drug. This is because, despite being injected, the drugs are designed with heavy esterifying molecular additions which can cause traces of the drugs to be found in circulation for up to one year. Ongoing [[IV infusion]]s can be used to deliver continuous medication or [[IV fluid|fluids]].<ref>Smeltzer SC Bare BG, Textbook of Medical-Surgical Nursing, 9th ed, Philadelphia: Lippincott, 2000.</ref>
 
Disadvantages of injections include potential pain or discomfort for the patient and the requirement of trained staff using [[aseptic technique]]s for administration.<ref name="Nursing Times"/> However, in some cases, patients are taught to self-inject, such as SC injection of insulin in patients with [[insulin-dependent diabetes mellitus]]. As the drug is delivered to the site of action extremely rapidly with IV injection, there is a risk of [[drug overdose|overdose]] if the dose has been calculated incorrectly, and there is an increased risk of side effects if the drug is administered too rapidly.<ref name="Nursing Times"/>
 
===IntranasalRespiratory tract===
 
====Mouth inhalation====
Drug administration via the nasal cavity yields rapid drug absorption and therapeutic effects.<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817">{{cite journal | last1=Kaminsky | first1=Bonnie M. | last2=Bostwick | first2=Jolene R. | last3=Guthrie | first3=Sally K. | title=Alternate Routes of Administration of Antidepressant and Antipsychotic Medications | journal=The Annals of Pharmacotherapy | publisher=SAGE Publications | volume=49 | issue=7 | date=2015-04-23 | issn=1060-0280 | pmid=25907529 | doi=10.1177/1060028015583893 | pages=808–817| s2cid=39802797 }}</ref> This is because drug absorption through the nasal passages does not go through the gut before entering [[capillaries]] situated at [[tissue cell]]s and then systemic circulation and such absorption route allows transport of drugs into the [[central nervous system]] via the pathways of [[olfactory]] and [[trigeminal nerve]].<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817"/>
[[File:Administering inhaled medication.jpg|thumb|A dummy wears a nebulizer mask, used to administer inhaled medications.]]
 
[[File:illu quiz lung05.jpg|thumb|upright=0.8|{{ordered list |[[trachea]] (conducting zone)
Intranasal absorption features low lipophilicity, enzymatic degradation within the nasal cavity, large molecular size, and rapid mucociliary clearance from the nasal passages, which explains the low [[bioavailability|risk of systemic exposure of the administered drug absorbed]] via intranasal.<ref name="Kaminsky Bostwick Guthrie 2015 pp. 808–817"/>
|main [[bronchus]] (conducting zone)
|[[lobar bronchus]] (conducting zone)
| [[segmental bronchus]] (conducting zone)
| [[subsegmental bronchus]] (conducting zone)
| conducting [[bronchiole]] (conducting zone)
| [[terminal bronchiole]] (conducting zone)
| [[respiratory bronchiole]] (transitional respiratory zone)
| [[alveolar duct]] (transitional respiratory zone)
| [[alveolar sac]] (transitional respiratory zone)
| [[Pulmonary alveolus|alveolus]] (transitional respiratory zone)}}<ref name="Ali 2010 pp. 209–246">{{cite book | last=Ali | first=Mohammed | title=Handbook of Non-Invasive Drug Delivery Systems | chapter=Pulmonary Drug Delivery | publisher=Elsevier | year=2010 | isbn=978-0-8155-2025-2 | doi=10.1016/b978-0-8155-2025-2.10009-5 | pages=209–246}}</ref><ref name="archive.is 2020">{{cite web | title=Lungs - Anatomy of the Respiratory System | website=archive.is | date=2020-03-29 | url=https://www.brainkart.com/article/Lungs---Anatomy-of-the-Respiratory-System_21915/ | archive-url=https://archive.today/20200329053609/https://www.brainkart.com/article/Lungs---Anatomy-of-the-Respiratory-System_21915/ | url-status=dead | archive-date=2020-03-29 | access-date=2020-03-29}}</ref><ref name="GetBodySmart 2017">{{cite web | title=Major Zones & Divisions | website=GetBodySmart | date=2017-10-30 | url=https://www.getbodysmart.com/respiratory-system/respiratory-system-anatomy | access-date=2020-03-29}}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Conducting-Zone-770x550.png |title=Diagram for conducting zone |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329080819/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Conducting-Zone-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Respiratory-Zone-770x550.png |title=Diagram for respiratory zone |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081010/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Respiratory-Zone-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Upper-tract-770x550.png |title=Diagram for upper respiratory tract |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081203/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-Upper-tract-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-lower-tract-770x550.png |title=Diagram for lower respiratory tract |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081254/https://www.getbodysmart.com/wp-content/uploads/2017/09/Respiratory-lower-tract-770x550.png |url-status=live }}</ref><ref>{{Cite web |url=https://www.getbodysmart.com/wp-content/uploads/2017/10/Test-yourself-with-answers-shown-504x550.png |title=Diagram for majour zones of respiratory system |access-date=2020-03-29 |archive-date=2020-03-29 |archive-url=https://archive.today/20200329081401/https://www.getbodysmart.com/wp-content/uploads/2017/10/Test-yourself-with-answers-shown-504x550.png |url-status=live }}</ref>]]
 
Inhaled medications can be absorbed quickly and act both locally and systemically.<ref name=DDS/> Proper technique with [[inhaler]] devices is necessary to achieve the correct dose. Some medications can have an unpleasant taste or irritate the mouth.<ref name=DDS/>
[[File:Capillaries.jpg|thumbnail|upright=2|center|Involved subjects' positions.]]
 
In general, only 20–50% of the pulmonary-delivered dose rendered in powdery particles will be deposited in the lung upon mouth inhalation.<ref name="Tandel Florence Misra 2011 pp. 429–479">{{cite book | last1=Tandel | first1=Hemal | last2=Florence | first2=Kiruba | last3=Misra | first3=Ambikanandan | title=Challenges in Delivery of Therapeutic Genomics and Proteomics | chapter=Protein and Peptide Delivery through Respiratory Pathway | publisher=Elsevier | year=2011 | isbn=978-0-12-384964-9 | doi=10.1016/b978-0-12-384964-9.00009-8 | pages=429–479}}</ref> The remainder of 50-70% undeposited aerosolized particles are cleared out of lung as soon as [[exhalation]].<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
An inhaled powdery particle that is >8 μm is structurally predisposed to depositing in the central and conducting airways ([[conducting zone]]) by inertial impaction.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
An inhaled powdery particle that is between 3 and 8 μm in diameter tend to largely deposit in the [[transitional zone]]s of the lung by sedimentation.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
An inhaled powdery particle that is <3 μm in diameter is structurally predisposed to depositing primarily in the [[respiratory region]]s of the peripheral lung via diffusion.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
Particles that deposit in the upper and central airways are generally absorbed systemically to great extent because they are only partially removed by [[mucociliary]] clearance, which results in orally mediated absorption when the transported mucousmucus is swallowed, and first pass metabolism or incomplete absorption through loss at the fecal route can sometimes reduce the bioavailability.<ref>{{Cite journal|title=Cilia and Mucociliary Clearance|first1=Ximena M.|last1=Bustamante-Marin|first2=Lawrence E.|last2=Ostrowski|date=April 18, 2017|journal=Cold Spring Harbor Perspectives in Biology|volume=9|issue=4|pages=a028241|doi=10.1101/cshperspect.a028241|pmid=27864314|pmc=5378048}}</ref> This should in no way suggest to clinicians or researchers that inhaled particles are not a greater threat than swallowed particles, it merely signifies that a combination of both methods may occur with some particles, no matter the size of or lipo/hydrophilicity of the different particle surfaces.<ref name="Tandel Florence Misra 2011 pp. 429–479"/>
 
{{further|PM 2.5|PM 10}}
 
====Nasal inhalation====
Inhalation by nose of a substance is almost identical to oral inhalation, except that some of the drug is absorbed intranasally instead of in the oral cavity before entering the airways. Both methods can result in varying levels of the substance to be deposited in their respective initial cavities, and the level of mucousmucus in either of these cavities will reflect the amount of substance swallowed. The rate of inhalation will usually determine the amount of the substance which enters the lungs. Faster inhalation results in more rapid absorption because more substance finds the lungs. Substances in a form that resists absorption in the lung will likely resist absorption in the nasal passage, and the oral cavity, and are often even more resistant to absorption after they fail absorption in the former cavities and are swallowed.
 
==Research==
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* [https://www.fda.gov/Drugs/DevelopmentApprovalProcess/FormsSubmissionRequirements/ElectronicSubmissions/DataStandardsManualmonographs/ucm071666.htm FDA Center for Drug Evaluation and Research Data Standards Manual: Dosage Form.]
* [http://www.nutritioncare.org/ A.S.P.E.N. American Society for Parenteral and Enteral Nutrition]
* {{MeshName|As Drug+ Administration+ Routes}}
 
{{Dosage forms|state=expanded}}