Drug Administration Routes and Dosage Forms

Routes of Drug Administration and

Dosage Formulations

Created by Jennifer Majeske, Mineral Area

College



Differentiate between the terms

 route of

administration, dosage form, 

and 

drug

delivery system

.



Explain the properties of oral, topical, and

parenteral dosage forms.



Identify inactive ingredients and the various

coatings of tablets and their functions.



Differentiate between a suspension and an

emulsion liquid dosage form.



Identify dosage formulations utilizing the

transmucosal route of administration.

Created by Jennifer Majeske, Mineral Area College



Define the emulsion characteristics of topical

products such as ointments, creams, lotions,

and gels.



Explain the advantages and disadvantages of

oral, topical, and parenteral dosage

formulations.



Discuss the importance of syringe selection

for a diabetic patient.



Contrast the advantages and disadvantages

for insulin in multi-dose vials and prefilled

insulin syringes.

Created by Jennifer Majeske, Mineral Area College



Understand the stability and expiration dates

of insulin at room and refrigerated

temperatures.



Demonstrate correct techniques for

administration of eyedrops, eardrops,

metered-dose inhalers, and various

parenteral injections.



Differentiate among enteric-coated,

sustained-release, and extended-release

dosage formulations.

Created by Jennifer Majeske, Mineral Area College



There exists many pharmacological agents with a

variety dosage forms available to customize

patient treatment.



Pharmaceutics

 – the study of the release

characteristics of various dosage forms or drug

formulations.



Medications can be taken: orally, inhaled,

injected, inserted, applied to the skin, and each

route affects the drugs’ onset and duration of

action.



Pharmacokinetics

 – the study of how drugs are

absorbed, distributed, metabolized, and

eliminated.

Created by Jennifer Majeske, Mineral Area College



Route of administration

 – a way to get a

drug into or onto the body.



What are the major routes of administration?



Dosage form

 – the physical manifestation of

a drug – such as a tablet, capsule,

suspension, ointment, cream, patch or

injection – that is designed to deliver the

medication by one or more routes of

administration.



Systemic effect

 – the series of steps to get a

drug into the bloodstream to exert its

therapeutic effect.

Created by Jennifer Majeske, Mineral Area College



Delayed systemic effect:



Tablets, capsules, and oral liquids



Immediate systemic effect:



Parenteral injections, IV bolus and infusions



Localized effect

 – when a drug exerts its

pharmacological action at or near the site of

administration.



Drugs administered by the transmucosal,

topical and inhalation route



Example: eardrop in the ear

Created by Jennifer Majeske, Mineral Area College



Oral route of administration

 – medication

administered for absorption along the

gastrointestinal (GI) tract into the systemic

circulation.



Oral 

can also refer to applying medication to

the mouth.



The abbreviation 

po

 – from the Latin term

per os

, meaning “by mouth”, is used to

indicate the oral route of medication on a

prescription.

Created by Jennifer Majeske, Mineral Area College



Tablets, capsules, solutions, suspensions,

syrups and elixirs.



Tablets and capsules are the two most

common types and are inexpensive to

manufacturer.



The active ingredient in many tablets,

capsules and suspensions are sometimes

powders or 

granules

.



Drugs available in salt forms add shelf life to

the product and/or to affect the release

characteristics of the drug.

Created by Jennifer Majeske, Mineral Area College



Tablet

 – a solid dosage form produced by

compression.



Tablets contain one or more active ingredient

along with inert or inactive ingredients

(

excipients

).



Tablets are available in a variety of shapes,

sizes, surface markings and coatings.

Created by Jennifer Majeske, Mineral Area College



Tablets can be designed to be easy to

swallow, mask taste or exert an immediate

pharmacological effect.



Compression tablets

 are the most

inexpensive and common dosage form.



Acetaminophen (Tylenol)



Multiple compression tablet (MCT)

 is made

by multiple compression cycles and is a

tablet on top of a tablet or a tablet within a

tablet.



Caplet

 – a hybrid of a capsule and tablet;

shaped like a tablet, coated like a capsule.

Created by Jennifer Majeske, Mineral Area College



Most compression tablets are not coated.



Coatings improve flavor, appearance, or ease of

swallowing.



Sugar-coated tablet (SCT) 

– contains an outside layer

of sugar that protects the medication and improves

appearance and flavor.



Sugar coating makes tablets larger and heavier thus

more difficult to swallow.



Film-coated tablet (FCT)

 – contains a thin outer layer

of a polymer that can either be soluble or insoluble.



Film coating are colored for an attractive

appearance; taste-masking benefits can be lost if

crushed.

Created by Jennifer Majeske, Mineral Area College



Most tablets are designed to be swallowed

whole and dissolve in the GI tract.



Chewable tablet

 – contains a base that is

flavored and/or colored. It is designed to be

chewed (masticated) and absorbed quickly for

slightly faster onset.



Oral disintegrating tablet (ODT)

 – designed to

melt in your mouth. ODT’s are useful for

pediatric and geriatric patients who may have

difficulty swallowing or for patients with nausea.

Created by Jennifer Majeske, Mineral Area College



The active ingredient of a 

capsule

 is in the

form of a granular powder (liquid gel)

enclosed by a gelatin shell.



The body and cap may be sealed to prevent

tampering.



Diluent

 – pharmacologically inert filler used

in capsules.



Some capsule formulations are designed to

provide better absorption of drugs, with less

side effects.



Some medications that come in capsule form

are substitutable with a tablet, others are

not.

Created by Jennifer Majeske, Mineral Area College



Powders and effervescent salts are used less

frequently by patients, but offer some

advantages over tablets and capsules.



Powders

 – preparations in the form of fine

particles.



Goody’s headache powders



Effervescent salts

 – granules or coarse

powders containing one or more medicinal

agents, as well as some combination of

sodium bicarbonate with citric acid, tartaric

acid or sodium bisphosphate.



Alka-Seltzer

Created by Jennifer Majeske, Mineral Area College



Liquids

 – consist of one or more active

ingredient in a liquid vehicle such as a

solution or suspension.



Most liquids are commercially available as

solutions (elixirs and syrups), suspensions or

emulsions.

Created by Jennifer Majeske, Mineral Area College



Solution

 – a liquid in which the active

ingredients are completely dissolved in a

liquid vehicle.



Solutions can be classified as aqueous,

alcoholic, or hydroalcoholic.



Solvent

 – the vehicle that makes up the

greater part of the solution.



Solute 

– the ingredient dissolved in a

solution.

Created by Jennifer Majeske, Mineral Area College



Solutions are often classified by their

ingredients; elixirs and syrups are the most

common dosage forms of solutions.



Elixir

 – a clear, sweetened, flavored solution

containing water and ethanol.



Syrup 

– an aqueous solution thickened with a

large amount of sugar – sucrose – or sugar

substitute.



Syrups can contain additional flavors, colors

or aromatics.



Most pediatric formulations are syrups or

elixirs.

Created by Jennifer Majeske, Mineral Area College



Aromatic water

 – a solution of water containing

oils or other substitutes that have a pungent,

and usually pleasing smell.



Extract 

– potent dosage form derived from plant

or animal sources which most or all of the

solvent has evaporated to produce a powder, an

ointment like form, or a solid.



Fluidextract 

– a liquid dosage form prepared by

extraction from plant sources and commonly

used in the formulation of syrups.



Tincture

 – alcoholic or hydroalcoholic solution of

extractions from plants.



Spirit

 – alcoholic or hydroalcoholic solution

containing volatile, aromatic ingredients.

Created by Jennifer Majeske, Mineral Area College



Suspension

 – the state of a substance when

its solid particles are mixed with but

undissolved

 in a liquid.



Dispersion

 – the medication is simply

dispersed or distributed throughout the

vehicle, creating an incomplete mixture of

solid and liquid.



Suspensions contain inactive ingredients such

as colorings, flavorings and coatings.



Some suspensions are commercially

available, others come in the form of

powders that must be reconstituted prior to

dispensing.

Created by Jennifer Majeske, Mineral Area College



Emulsion

 – another type of dispersion; a

mixture of two immiscible or unblendable

substances.



What is an example of an emulsion?



Emulsions contain an emulsifying agent that

renders the emulsion stable and less prone to

separate.

Created by Jennifer Majeske, Mineral Area College



Colloid

 – a mixture having physical properties

between those of a solution and a fine

suspension.



Magma

 – or milk like liquid, is an example of

a dispersion containing ultrafine colloidal

particles that remain distinct in a two-phase

system.



Microemulsion

 – another type of colloidal

dispersion; a liquid that is dispersed in

another.

Created by Jennifer Majeske, Mineral Area College



What are some common advantages and

disadvantages to administering a drug using

the oral route?



Tablets



Capsules



Liquids

Created by Jennifer Majeske, Mineral Area College



Patients should be counseled by the

pharmacist what drinks and foods to take or

not take with medications.



Patients should be counseled by the

pharmacist on behaviors to avoid while

taking medications.



Auxiliary labels are affixed to drug

containers to ensure that patients are taking

medications in the correct manner.



Patients should be reminded of proper

storage conditions.

Created by Jennifer Majeske, Mineral Area College



Oral syringe

 – measures and delivers oral

liquid medications to pediatric patients.



This type of syringe is a calibrated device

consisting of a plunger and cannula, and is

used without a needle to administer

medications to the mouth.



Oral syringes can be used to slowly

administer liquid medications.



Very small doses (less than 1 mL) can be

administered with a tuberculin syringe

(without a needle).

Created by Jennifer Majeske, Mineral Area College



Manufacturers often provide a medication cup

for OTC liquids.



These are plastic cups that contain specific dose

demarcations in different units of measure.



Droppers offer the ability to deliver the correct

dosage of smaller volumes of medication.



Dropper

 – contains a small squeezable bulb at

one end and a hollow glass or plastic tube with a

tapering point.



Viscosity

 – the thickness and flow characteristics

of fluids.

Created by Jennifer Majeske, Mineral Area College



Transmucosal route of administration

 –

allows the drug to be absorbed through or

across the “sieve-like” or permeable mucous

membranes of the mouth, eyes, ears, nose,

rectum, vagina and urethra.



What advantages are there to using a

transmucosal route of administration?



Transmucosal dosage forms include: tablets,

gum, and lozenges (sublingual); ointments,

solutions, suspensions, and sprays (eyes,

ears, and nose); suppositories and solutions

(rectum, urethra, and vagina).

Created by Jennifer Majeske, Mineral Area College



Sublingual route of administration

 – 

sub

meaning “under” and 

lingua

 meaning

“tongue”; the tablet is placed under the

tongue, where it is rapidly absorbed by blood

vessels.

Created by Jennifer Majeske, Mineral Area College



Buccal route of administration

 – a drug

absorbed by the blood vessels in the lining of

the mouth.



What are some examples of drugs

administered via this route?



Lozenge

 – 

troche,

 solid dosage form

containing active ingredients and flavorings,

that are dissolved in the mouth.

Created by Jennifer Majeske, Mineral Area College



All can be delivered to a specific site with a

minimum of systemic side effects.



Irrigating solution

 – a solution for cleansing

or bathing an area of the body, can be used

both topically as well as instilled.



Ophthalmics



Ocular route of administration

 – application of a

drug into the eye.



Conjunctival route of administration – 

the

application of a drug to the conjunctival mucosa.

Created by Jennifer Majeske, Mineral Area College



Otics



Otic route of administration

 – the application of

a drug into the ear canal.



Eardrops can never be used in the eye, but

eyedrops can be used in the ear.



Nasal sprays/solutions



Intranasal route of administration

 – the

application of a drug into the passages of the

nasal cavity.



Spray

 – a dosage form that consists of a

container having a valve assembly unit, when

activated, emits a fine dispersion of liquid.

Created by Jennifer Majeske, Mineral Area College



Suppository

 – an example of a semisolid

dosage form that is created from an inactive

ingredient and formulated to melt at body

temperature and release an active drug.

Created by Jennifer Majeske, Mineral Area College



Rectal suppositories/solutions



Rectal route of administration

 – used to deliver

drugs into the rectum.



Enema

 – a water-based solution administered

rectally for cleansing or evacuating the bowel

before a GI procedure.



Vaginal suppositories/solutions



Vaginal route of administration

 – the application

of any drug within the vagina.



Urethral suppositories/solutions



Urethral route of administration

 – the

application of a drug within the urethra.

Created by Jennifer Majeske, Mineral Area College



Sublingual medications



Advantage: rapid onset



Disadvantage: short duration



Buccal medications



Advantage: faster onset



Disadvantage: “dose dumping”



Ophthalmics, otics, and nasal

sprays/solutions



Advantage: fast onset



Disadvantage:

Created by Jennifer Majeske, Mineral Area College



Suppositories and Solutions



Rectal suppositories/solutions



Advantage: used in both old and young



Disadvantage: patient inconvenience



Vaginal suppositories/solutions



Advantage: self-treatment



Disadvantage:

Created by Jennifer Majeske, Mineral Area College



Sublingual medications – storage

requirements; nitroglycerin.



Buccal medications – chewing differences

between regular gum and nicotine gum



Ophthalmics, otics, and nasal

sprays/solutions



Ophthalmics

 – administered at or near room

temperature; Fig. 4.2



Otic

 – store at room temperature; Fig. 4.3



Nasal medications

 – used for relief of nasal

congestion or prevention of allergy symptoms

Created by Jennifer Majeske, Mineral Area College



Suppositories and solutions – certain

preparatory steps and administrative

techniques



Rectal medications

 – proper storage and

administration



Vaginal medications

 – use medication for

prescribed time period; Table 4.4 Proper

Technique for Administration of Vaginal

Medications, pg. 126

Created by Jennifer Majeske, Mineral Area College



Topical route of administration

 – application

of a drug directly to the surface of the skin;

exert local effects; side effects are minimal.



Ointments, pastes, and plasters



Ointment

 – a dosage form that is a 

water-in-oil

(W/O) emulsion

 – a formulation that contains a

small amount of water dispersed in oil.



Liniment

 – a medicated topical preparation



Paste

 – like an ointment that contains more solid

materials, creating a dense consistency.



Plaster

 – a solid or semisolid that adheres to the

body and contains backing material such as

paper, cotton, linen, silk, moleskin, or plastic.

Created by Jennifer Majeske, Mineral Area College



Creams, lotions, and gels



Cream

 – 

an oil-in-water (O/W) emulsion 

– a small

amount of oil dispersed in water.



Lotion

 – another O/W emulsion for topical

application.



Gel

 – contains solid particles in a liquid, but the

particles are fine or ultrafine.



Jelly

 – 

a gel that contains a higher portion of water in

combination with a drub substance and a thickening

agent.



Glycerogelatin 

– a topical preparation made with

gelatin, glycerin, water, and medicinal substances.



Colloid

 – a mixture with physical properties that fall

between a solution and a fine suspension.



Irrigating solutions – 

douche

, is often

reconstituted from a powder and introduced into

the vaginal cavity for local cleansing.

Created by Jennifer Majeske, Mineral Area College



Major advantage of topicals is they have a

fast onset of action with relatively few

systemic side effects.



Ointments



Advantage: especially good for extremely dry

areas of skin



Disadvantage: appearance and greasy residue



Creams, lotions and gels



Advantage: apply more smoothly to the skin and

leave a very thin film



Disadvantage:

Created by Jennifer Majeske, Mineral Area College



Ointments – risk of increased absorption;

careful application of topical medications;

nitroglycerin; corticosteroid ointments.



Creams, lotions, and gels – specific

precautions that patients should follow

during application.

Created by Jennifer Majeske, Mineral Area College



Inhalation route of administration

 – the

application of a drug through inhalation into

the lungs, typically through the mouth.



Inhalation Dosage Forms:



Aerosols and MDIs



Aerosol

 – a spray in a pressurized metered-dose

container that contains a propellant



Metered-dose inhaler (MDI) 

– a handheld,

propellant-driven device, an MDI provides a

specific measured amount of medication with

compressed gas.

Created by Jennifer Majeske, Mineral Area College



Sterile Solutions and Nebulizers



Nebulizer

 – atomizing machine that delivers

medication as a mist



Volatile Medications and Vaporizers



Used to deliver moisture to the air for relief of

cold systems



Micronized Powders and Nonaerosolized

Inhalers



Breath-activated powder for inhalation to avoid

propellants



Administers a higher concentration of drug as a

micronized powder into the lungs

Created by Jennifer Majeske, Mineral Area College



Major advantage of inhalation dosage forms

is the rapid onset of action, which is only

second to the IV route of administration.



Major disadvantage is poor inhalation

technique, with all MDIs; higher risk of side

effects with larger amounts of medication.

Created by Jennifer Majeske, Mineral Area College



The more immediate-acting drug when using

multiple MDIs should be used first, followed

by the second 5-10 minutes later.



Table 4.5 Proper Technique for

Administration of an MDI, pg. 132



Spacer device

 – the medication is released

into a “storage chamber” where it can be

more easily inhaled by the patient.



The patient should be sure to rinse their

mouth after administration of an MDI to

prevent an oral fungal infection.

Created by Jennifer Majeske, Mineral Area College



Parenteral solution

 – a sterile or microbial-free

solution (w/ or w/o medication) that is

administered via a hollow needle or catheter

inserted through one or more layers of skin.



Parenteral 

comes from the Greek roots 

para

meaning “beside” and 

enteron 

meaning

“intestine.”



This route bypasses – or goes “beside” rather

than through – the alimentary canal or GI tract.



Parenteral route of administration

 – the

injection of any drug or fluid into the

bloodstream, muscle, or skin.

Created by Jennifer Majeske, Mineral Area College



IV Route – one of the more common

parenteral routes of drug and fluid

administration.



Intravenous (IV) infusion

 – a method for

delivering a large amount of fluid and/or high

concentration of medication directly into the

bloodstream over a prolonged period and at a

slow, steady rate.



IM Route – used to administer antibiotics,

narcotics, medications for migraine

headaches…and vaccines.



Injection

 – administration of a parenteral

medication into the bloodstream, muscle or skin

Created by Jennifer Majeske, Mineral Area College



Subcutaneous route – administer medications

below the skin into the subcutaneous tissue.



What are some common medications

administered subcutaneously?



ID route – used for diagnostic and allergy skin

testing, local anesthesia, and various

diagnostic tests and immunizations.



What ID administrations mentioned in your

text?

Created by Jennifer Majeske, Mineral Area College



The parenteral route is used for medications

that contain molecules that are unstable, to

large for absorption, or broken down to

quickly in the stomach or liver.



IV route – preferred route of administration

in an emergency situation; rapid action to

control and treat symptoms.



IV bolus injection

 – administration of a drug

all at once.



IV infusion

 – continuous amount of needed

medication over a given period.

Created by Jennifer Majeske, Mineral Area College



Pyrogens

 – fever-producing by-products of

microbial metabolism.



Embolism –

 blockage of a vessel.



Phlebitis

 – a severe painful reaction at the

injection site.



IM route – offers a more convenient way to

deliver injectable medications; slower onset

than IV administration; duration of action is

much longer, making it more practical for use

outside of a hospital setting; unpredictable

rate of absorption.

Created by Jennifer Majeske, Mineral Area College



Parenteral preparations contain ingredients

that are dissolved or reconstituted with

solutions.



Most parenteral preparations are made up of

ingredients place in a sterile water medium.



Administration of IV, IM, subcutaneous or ID

must be sterile because they introduce

medication directly into the body.



Only trained professionals and healthcare

providers are legally allowed to give

parenteral injections.

Created by Jennifer Majeske, Mineral Area College



Parenteral injections are administered via a

syringe and/or needle.



Syringe

 – a calibrated device used to accurately

draw up, measure, and deliver medication to a

patient through a needle.



Common syringes



Insulin syringe



Tuberculin syringe



Cannula

 – bore area inside the syringe



Hypodermic syringe



Needle

 – attached to the tip of a syringe and is

used to either draw fluid into or push fluid out of

the syringe; the larger the gauge the smaller the

opening.

Created by Jennifer Majeske, Mineral Area College



IV Route – IV medications can be

administered via two routes: IV bolus and IV

infusions.



Patient-controlled analgesia (PCA) infusion

device

 – a programmable machine that

delivers a small amount of painkillers upon

patient demand.

Created by Jennifer Majeske, Mineral Area College



IM Route – IM injection doesn’t work as fast

as an IV injection

infusion, but the

pharmacological effect

will last longer.



Subcutaneous Route –

injections

typically

administered on the

outside of the upper arm, top of the

thigh, or lower portion of each

side of the abdomen.

Created by Jennifer Majeske, Mineral Area College



Administration of Insulin

 – most commonly used

medication that is administered subcutaneously

is insulin.



Insulin Product Selection

 – syringe size, needle

length and needle gauge. Insulin vials are 10mL

(containing 1,000 units of insulin); prefilled

syringes contain 3mL.



Insulin vials

 – Syringes sizes 0.3mL, 0.5mL, 1mL;

size is determined by dose of insulin; insulin vials

should 

never

 be shaken.



Insulin Pens

 – a portable device in which the

prescribed dose of medication is “dialed up” to

administer insulin.

Created by Jennifer Majeske, Mineral Area College



What are some of the advantages of the insulin

pens? Disadvantages?



Storage of insulin

 – insulin must be protected

against extreme temperatures. Open vials and

pens can be stored at room temperature and

discarded after one month. Unopened vials and

pens should remain refrigerated.



Insulin Coverage for Insulin Supplies

 – insurance

companies require a prescription for coverage of

diabetic supplies.



ID Route – ID injections are given into the

capillary-rich skin layer just below the

epidermis.

Created by Jennifer Majeske, Mineral Area College



Drug delivery system

 – a design feature of a

dosage form that modifies the release of a drug

by one or more pharmacokinetic parameters of

the drug.



Improved efficacy and safety is a result of

formulating medications based on the

pharmacokinetic process.



Tablets or capsules have coatings to delay

release and protect the stomach or extend their

release.



Transdermal patches release medication slowly

over a certain period of time.



Vaginal rings and intrauterine devices are

inserted vaginally to prevent pregnancy.

Created by Jennifer Majeske, Mineral Area College



Most tablets and capsules are “immediate-

release,” the medication is designed to

activated or released shortly after the drug is

taken.



Alphabet of release formulations: DR, CR,

CD, XR, SR, XT, and XL.



Delayed-release (DR) formulations

 – have a

special coating designed to delay absorption

of the medication and to resist breakdown by

acidic gastric fluids.



Enteric-coated tablet (ECT)

 – delay-release

formulation.

Created by Jennifer Majeske, Mineral Area College



Extended-release (XL) formulations

 – allow

a reduced frequency of dosing as compared

with immediate-release medications.



Sustained-release (SR) formulations: two doses

every 8-12 hours.



Controlled-release (CR) formulations: one dose

Created by Jennifer Majeske, Mineral Area College



New drug delivery systems employ scientific and

biotechnologic processes to design medications

to produce long-term effects.



Matrix-controlled release formulations

 – a

reservoir-controlled release utilizing an osmotic

pressure principle or an ion exchange resin.



OxyContin (matrix-controlled release)



Tussionex (ion exchange resin)



Wax matrix systems

 – the drug is embedded in a

polymer matrix, release takes place by

partitioning of the drug into the polymer matrix

and surrounding medium.

Created by Jennifer Majeske, Mineral Area College



Osmotic pressure system

 – the drug is

delivered to the body by slowly being

“pushed out” into the bloodstream.



Target drug delivery systems

 – a drug is

“carried” by a liposome, and released at a

targeted organ site; increasing availability in

the near future.

Created by Jennifer Majeske, Mineral Area College



Transdermal dosage form

 – designed to

deliver a drug contained within a patch or

disk to the bloodstream via absorption

through the skin.



Therapeutic uses – effects last 24 hours to 1

week.



Administration – transdermal patches should

be applied to a relatively hair-free area;

localized heat speeds up the movement from

the patch into the body.

Created by Jennifer Majeske, Mineral Area College



Vaginal ring delivery system and intrauterine

device continually deliver hormones to a

female’s reproductive tract.



NuvaRing



Intrauterine device (IUD)

 – another way to

prevent conception via a drug delivery

device.

Created by Jennifer Majeske, Mineral Area College

Created by Jennifer Majeske, Mineral Area College



This workforce solution was funded by a grant awarded by

the U.S. Department of Labor’s Employment and Training

Administration. The solution was created by the grantee and

does not necessarily reflect the official position of the U.S.

Department of Labor. The Department of Labor makes not

guarantees, warranties, or assurances of any kind, express

or implied, with respect to such information, including any

information on linked sites and including, but not limited

to, accuracy of the information or tis completeness,

timeliness, usefulness, adequacy, continued availability, or

ownership.

This work by Mineral Area College is licensed under the

Creative Commons Attribution 4.0 International License.



Picture on slide 15



Capsule

 by 

Pixabay

 is licensed under 

CC BY



Picture on slide 24



Female lips

 by 

Pixabay

 is licensed under 

CC BY



Picture on slide 29



Human head anatomy with external and internal

carotid arteries

 by 

Patrick J. Lynch

 licensed under 

CC

BY



Picture on slide 33



Suppository

 by 

Eric Schulz

 licensed under 

CC BY



Picture on slide 64



Vaginal ring

 by 

Victor byckttor

 licensed under 

CC BY

Created by Jennifer Majeske, Mineral Area College