When it comes to taking medications, there are two categories of people. The first category would be people who love oral medications and detest injections. The second set would prefer you give them injections over swallowing drugs for any ailment, including a headache. So, to what category do you belong?

Let us begin with the following illustrations.

Imagine you wake up to find a paralyzed mosquito just by your pillow, and instead of killing it with your hand or tissue paper, you decide to use the hammer for hanging up pictures to kill the helpless creature.

Will the mosquito die? Absolutely.

Was the hammer necessary? Not at all.

This illustrates what happens in your body when you insist on being given an injection when the doctor has prescribed simple tablets or syrup to make you feel better.

Imagine you are asked to kill a goat by cutting its neck, and a cutlass is provided for this job. However, you decide to use a penknife for this task. What will be the outcome of such a decision? The goat may die but after much stress and effort from you.

This scenario illustrates what happens when the doctor says your case needs injectables, but you insist on tablets or other oral medication because of your fear of the needle. Unfortunately, such actions will cause a much slower response to treatment and, in some severe cases, treatment failure, meaning the drug won't work.

This article aims to give answers to the following questions; Why are drugs produced as injectables and oral medications? Why do prescribers pick injectables over tablets or vice versa when certain situations present themselves?

Different Routes of Drug Administration

Before differentiating orals from injectables, let us define a term; Route of Administration. It is the pathway by which a drug is introduced into the body. There are three primary routes of drug administration; the oral route, the parenteral route, and the topical route.

1. Oral Medications: They refer to drugs taken through the oral route, i.e., medicines delivered by the mouth through the alimentary canal. They could be in the form of tablets, capsules, powders, syrups, suspensions, etc.

2. Parenteral Medications: These are administered through injections with syringes and needles. Injections are given through five significant routes. They include the Subcutaneous (SC) route, Intradermal (ID) route, Intraperitoneal (IP) route, Intravenous (IV) route, and Intramuscular (IM) route.

3. Topical Medications: Topicals are administered through the topical route. They include all medications applied to the skin and mucous membrane, e.g., pain relief gels/creams, rectal suppositories, vaginal pessaries, etc.

4. Intravenous Injections: Intravenous injection involves injecting the medication through the vein directly into the bloodstream.

5. Intramuscular Injections: They involve injecting the drug into the muscles. They are usually given on the buttocks, hips, thighs, and upper arm.

In this article, injectables would refer to the most common two, i.e., the intravenous and intramuscular routes.

Advantages of Oral Medications

So, what are the benefits of oral medications?

1. They are less invasive. You won't need to expose body parts you don't want anyone else to see. The only parts of your body required to take oral drugs are your hands and mouth.

2. Oral medications are generally safer to consume. That's because the drug passes through certain stages before getting into systemic circulation through the blood. It is easier to reverse the effects of orals on the body in case of drug overdose or adverse drug reaction, i.e., when the patient reacts negatively to the drug given.

3. They are very convenient to take. You don't need anyone to help you with administering oral medicines. You don't need to leave your house or drive to the hospital. Hence it improves your ability to take drugs as prescribed.

Disadvantages of Oral Medications

1. Oral medications pass through the Gastrointestinal tract (GIT).** So, food digestion and other GIT factors may reduce their concentration. In addition, the liver also leads to the loss of some concentrations of oral drugs. All these may cause an unpredictable treatment outcome as the drug concentration which enters the bloodstream may be below what is needed to bring about an action.

2. Oral medications are unsuitable for emergency cases as they take longer to enter the bloodstream and act on the disease pathogen.

3. Their unpleasant taste and odour affect patient compliance. Many people do not complete their dosage simply because they hate the drug's smell or taste. For instance, people usually complain of the foul odour of B-complex tablets and calcium tablets and the bitter taste of antimalarials.

Advantages of Injectables

For team "Please give me an injection," here are some advantages of your preferred route.

1. Injectables are delivered at a precise dose; whatever is injected into the body is what the body gets. The first-pass effect (a case by which the drug ingested reduces concentration before reaching systemic circulation) is of no consequence here.

2. Injectables bring about a very rapid treatment response. They have a fast onset of action, as drugs go directly into the bloodstream.

3. The intramuscular and subcutaneous routes may serve as depots, slowing drug release over time.

Disadvantages of Injectables

1. Once a drug has been injected, it is difficult to revert its action. Remember, when injected, the drug moves directly to the bloodstream. Hence, injectables make drug overdose and adverse reactions more challenging to handle.

2. There is also the risk of developing an infection or swelling at the point of injection due to unsafe injection practices.

3. Injections may be invasive. Many times, the nurses will administer them on the buttocks.

4. It is inconvenient as you'll need to visit a health personnel to administer your injectables repeatedly.

5. They are usually painful to receive, but some people would rather bear the pain from needles than take tablets.

Factors that Determine Your Doctor's Prescription

Even with the advantages and disadvantages spelt out clearly, some people will still say, "I still prefer injections" or "I still prefer tablets." Some, like you, will shout, "The doctor should just give me what I want."

However, you must understand that some factors determine your doctor's decision on the prescription and route of administration to use per time. They include:

1. The Nature of the Drug

A drug's physical and chemical properties determine whether it will come as an oral medication or an injectable. It is important to note that though some medicines may come in both oral and injectable forms (e.g., Paracetamol, Diclofenac, Ciprofloxacin, Omeprazole, etc.), other drugs exist only as injectables (e.g., Pentazocine, Insulin, Gentamycin) or as orals, (e.g., Metformin, Glibenclamide, Liquid Paraffin, etc.)

Therefore, your doctor can only prescribe what is available for such drugs. So no matter your dislike for injections, you cannot take insulin orally, and no matter your love for injectables, metformin cannot be given to you as an injection.

2. The Patient's Condition and Speed of Clinical Outcome Required

The urgency of your treatment is crucial in the decision-making process. For example, intravenous paracetamol or diclofenac is given instead of tablets in emergencies where your temperature needs to be lowered within minutes. Doctors would always treat severe malaria with injectables to arrest the situation before using orals to maintain or extend drug action to the post-treatment period.

3. The Body Part Where the Drug is Needed

For instance, injections are administered directly to the spinal cord to relieve pain in that area. Locally acting anaesthetics are also given as injections to produce numbness to a particular body site. This specificity cannot be attained using oral medications.

So yes, that sting from the injection may be what you need to feel better. Likewise, the bitter taste of that medication may work wonders for your ailment.

Conclusion

In summary, trust your doctors to give you what is best for you and adhere to their instructions. Do you have questions about your health, or do you currently feel unwell? You do not have to book an appointment or wait in a queue at the clinic to get the help you need. Click here to speak to a doctor now.