ROUTES OF MEDICATION ADMINISTRATION

Oral

In the mouth; tablet, capsule or liquid

--Safest of all routes--Usually takes 30-60 minutes

for absorption phase--Some meds will irritate GI

track if not taken with food/liquid

Sublingual

- Under the tongue– pill, gel

- Quickly absorbs

- Rapid onset of action

- E.g. Nitroglycerin

Buccal

Between gum and cheek- tablet, capsule

• Slower absorption than sublingual– but onset is to rapid

• Avoids GI (stomach and small intestine) involvement.

• e.g. fentanyl buccal lozenges and tablets

Nasal

In the nares

• Usually works quickly• Often for respiratory tract

issues• e.g. Decongestants and

antihistamines

Topical

• Placement on the skin--creams, ointments, irrigations, inhalation in to respiratory tract

• Usually works within a 1-5 minutes

Opthalmic

• Into the eye- drops, ointments, cream, an ointment, or a liquid drop

Otic

• Into the ear - eardrops, irrigations

• Antibiotics, anti-inflammatories

• Onset of action will vary with medication- some unknown

Transdermal

Patch placed on skinMust remove old patch before placing new patch. If this is not done then toxic levels can occur!!

Intradermal

Into the dermal layer , e.g. PPD• These medications are given intradermally because they are very potent.

• Since the dermis has a reduced blood supply the medication absorption is slower thus reducing the risk of an anaphylactic reaction.

SubQ, SC, Subcutaneous Injection

• Injection into the subcutaneous layer, e.g. insulin, anticoagulants

• Used for drug that are inactivated in GI tract

• Onset of action depends on medication e.g. some insulin meds work within 5 minutes

Intramuscular

• Into the muscle- with a needle e.g. narcotics, vaccines

• Onset of action usually in a few minutes

• Absorption faster than subq

IV Intravenous Infusion

Medications and fluids administered directly into the bloodstream for immediate availability

They are parenteral- they do not go down the GI track

• Review terms: gtt/min (drops per minute)mL/hr (milliliters per hour)IV- intravenousIVPB- intravenous piggy backIVP- Intravenous push - very rapid infusion! Caution with many drugs!!!

Rectal

• Into the rectum e.g. laxative suppositories & enemas

• Onset of action usually within 15-30 minutes

Gastrostomy tube– Tube placed within the

stomach

– Only crushable pills that can be liquefied, or liquid solutions, or powders that can be removed from capsules

– Not all pills can be crushed!- Must check 1st!!

– Never crush an enteric coated or sustained release

• As you can see there are numerous routes of medication administration.

• Many have not been mentioned in this segment.

• As a healthcare provider you will be required to become familiar with the various forms of medications and the routes of administration.

Question

You give the med as ordered-

Now what do you do?

You ensure the patient is safe before leaving the room and

then Document.

If it’s not documented it wasn’t done!!