How can medications be administered

It is the manner in which a medicine is administered that will determine to some extent whether or not the patient gains any clinical benefit, and whether they suffer any adverse effect from their medicines. For example, intravenous IV furosemide administered too quickly can cause deafness; oral penicillin V given with food will not be well absorbed; over-application of topical steroids will cause thinning of the skin and may lead to systemic side-effects.

Two main factors determine whether or not a drug will reach its intended site of action in the body:. Bioavailability is the proportion of an administered drug that reaches the systemic circulation and is therefore available for distribution to the intended site of action.

Some drugs that are particularly well absorbed by the gastrointestinal mucosa may have bioavailability comparable to that of an IV dose — for example the antibiotic ciprofloxacin.

Most drugs do not have this availability by the oral route so the dose given orally is usually higher than that given parenterally. For example, the beta-blocker propranolol when given orally is administered in doses of 40mg and above.

The equivalent IV dose is 1mg. The route of administration and its formulation tablet, capsule, liquid can clearly influence the bioavailability of a drug. There are various routes of administration available, each of which has associated advantages and disadvantages. This is the most frequently used route of drug administration and is the most convenient and economic.

Solid dose forms such as tablets and capsules have a high degree of drug stability and provide accurate dosage. The oral route is nevertheless problematic because of the unpredictable nature of gastro-intestinal drug absorption. For example the presence of food in the gastrointestinal tract may alter the gut pH, gastric motility and emptying time, as well as the rate and extent of drug absorption. The extent to which patients can tolerate solid dose forms also varies, particularly in very young and older patients.

In such cases the use of liquids or soluble formulations may be helpful. Many drugs, however, are not stable in solution for liquid formulation and in such cases careful consideration should be given to the option of switching to alternative drug treatment. Difficulties frequently arise with patients who are prescribed modified-release preparations as these must not be crushed or broken at the point of administration. Modified-release formulations can delay, prolong or target drug delivery.

The aim is to maintain plasma drug concentrations for extended periods above the minimum effective concentration. For patients, their main advantage is that doses usually only need to be taken once or twice daily. Damage to the release controlling mechanism, for example by chewing or crushing, can result in the full dose of drug being released at once rather than over a number of hours.

This may then be absorbed leading to toxicity or may not be absorbed at all leading to sub optimal treatment. Nurses should seek advice from a pharmacist or the prescribing doctor if they are uncertain about a formulation of solid dose forms and whether or not they are suitable for crushing. The sublingual mucosa offers a rich supply of blood vessels through which drugs can be absorbed.

This is not a common route of administration but it offers rapid absorption into the systemic circulation. The most common example of sublingual administration is glyceryl trinitrate in the treatment of acute angina. These are aimed at particular markets where taking tablets may be problematic, such as the treatment of migraine rizatriptan where symptoms of nausea may deter patients from taking oral treatments.

The formulation is also used to treat conditions where compliance with prescribed drug regimens may be problematic, for example, olanzapine used to treat schizophrenia can be administered by the sublingual route.

The rectal route has considerable disadvantages in terms of patient acceptability in the UK at least and unpredictable drug absorption but it does offer a number of benefits. Liquid waste should be disposed of in a specialist bin, they should never be put down the toilet or sinks.

Transdermal patches must be folded in half before being disposed as this renders them ineffective. It is important to provide dignity and privacy when administering medication. This helps to make the patient feel comfortable, especially if administering medication means the patient having to take some of their clothes off, or having medication administered rectally or vaginally.

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In this article. Oral medication includes:. Tablets Capsules Liquids Mixtures. The injection goes straight to the vein and is absorbed through the body quickly. Transdermal Administration. Rectal Administration. Vaginal Administration.

Storing medication. Disposing of medication. Intradermal injections are made at a 10 to degree angle to the skin to administer medicine just under the epidermis. Subcutaneous Administration — injects medicine to the deepest layers of the skin at a 45 to degree angle into subcutaneous tissue, just under the dermis.

Intramuscular Administration — injection delivers medication into specific muscles at a degree angle. Medicine injected into the muscle moves quickly into the blood vessels and produces a quick response. Injection sites must be located away from bones, large blood vessels, and nerves. Intravenous Administration — enables administration of medicine and fluids directly into the bloodstream for the body to use immediately.

Although the IV route is the fastest way to inject medicine it is also the most dangerous. Pharmacokinetics focuses on how drugs move within the body once administered. The movement of drugs involves four processes which include absorption, distribution, metabolism, and excretion. Absorption - The first step in how the body handles a drug. Absorption involves the movement of a substance from the location of administration across one or more body membranes.

Drugs may be absorbed into the skin or the membranes that line blood vessels. Distribution — the process of how the drugs are transported after they are absorbed or administered into the bloodstream. There are many factors that affect the movement of a drug from the injection site to the target tissue, they include:.

Metabolism — the total of all chemical reactions in the body, that occurs in almost every cell and organ in the body. Age, kidney and liver disease, genetics and other factors can affect the metabolism. Excretion — most substances that enter the body are removed by urination, exhalation, defecation or sweating. Drugs are removed from the body by the kidneys, the respiratory tract, bile or glandular activity.

The amount of drug removed per unit of time from the body by normal body processes. The elimination rate is an indicator of how long a drug will produce its effect. Interested in learning more about administration of drugs to patients as a nurse? Ready to learn about pharmacokinetics and the rate of drug elimination in the body? As a successful graduate with a nursing degree, you may be prepared to work as a beginning professional nurse in hospitals, physicians' offices, nursing and residential facilities, and home health care centers.

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