Route of Medication Administration: Oral and Topical PDF

Route of Medication Administration: Oral and Topical Carreon, Emily Jane F., RN, MAN  ROUTES OF ADMINISTRATION ORAL ADMINISTRATION ORAL, BUCCAL, SUBLINGUAL ADVANTAGES: Convenient Comfortable Economical Easy to...

Route of Medication Administration: Oral and Topical Carreon, Emily Jane F., RN, MAN  ROUTES OF ADMINISTRATION ORAL ADMINISTRATION ORAL, BUCCAL, SUBLINGUAL ADVANTAGES: Convenient Comfortable Economical Easy to administer Often produce local or systemic effects Rarely cause anxiety for patient  ROUTES OF ADMINISTRATION ORAL ADMINISTRATION ORAL, BUCCAL, SUBLINGUAL DISADVANTAGES: Oral route is avoided when patients has alterations in gastrointestinal function, reduced GI motility , surgical resection of the GI tract Oral administration is contraindicated in patients who are unable to swallow Oral administration is contraindicated in patients who are unconscious, confused Oral medications sometimes irritate lining of GI tract, discolor teeth or have unpleasant taste Gastric secretions destroy some medications  ROUTES OF ADMINISTRATION Is the easiest and the most commonly used route of medication administration. Medications are given by mouth and swallowed with Oral Route fluid. Oral medications have a slower onset of action and a more prolonged effect than parenteral medications. Medications are placed under the tongue Sublingual Instruct patients not to swallow a medication given by the sublingual route or drink anything until the Route medication is completely dissolved to ensure that the medication will have the desired effect. Involves placing the solid medication in the mouth against the mucous membranes of the cheek until it dissolves Buccal Route Teach patients to alternate cheeks with each subsequent dose to avoid mucosal irritation. Do not chew. Do not swallow ROUTES OF ADMINISTRATION  ROUTES OF ADMINISTRATION ORAL ROUTE Oral Drug Forms Capsules are small, cylindrical, gelatin containers that hold dry powder or liquid medicinal agents Lozenges are flat disks that contain a medicinal agent in a suitably flavored base. The base may be a hard sugar candy or a combination of sugar with sufficient gelatinous substances to give it form. Lozenges are held in the mouth to dissolve slowly, thereby releasing the therapeutic ingredients. Pills are an obsolete dose form that is no longer manufactured because of the development of capsules and compressed tablets. However, the term is still used to refer to tablets and capsules. ROUTES OF ADMINISTRATION ORAL ROUTE Oral Drug Forms Syrups contain medicinal agents that have been dissolved in a concentrated solution of sugar (usually sucrose) and water. Syrups are particularly effective for masking the bitter taste of a drug. Tablets are dried powdered drugs that have been compressed into small disks..  ROUTES OF ADMINISTRATION METHODS OF ENTERAL ADMINISTRATION  ROUTES OF ADMINISTRATION ORAL ROUTE Oral Drug Forms Elixirs are clear liquids that are composed of drugs that have been dissolved in alcohol and water. Elixirs are used primarily when the drug will not dissolve in water alone. Emulsions are dispersions of small droplets of water in oil or small droplets of oil in water. The dispersion is maintained by an emulsifying agent such as sodium lauryl sulfate, gelatin, or acacia. Suspensions are liquid dose forms that contain solid, insoluble drug particles dispersed in a liquid base. All suspensions should be shaken well before administration to ensure the thorough mixing of the particles.  ROUTES OF ADMINISTRATION METHODS OF ENTERAL ADMINISTRATION Oral Route- Equipment Medicine Pot allow a dosage form to be taken from its original container for immediate administration to a patient.  ROUTES OF ADMINISTRATION METHODS OF ENTERAL ADMINISTRATION Oral Route- Equipment Tablet Splitter increase the accuracy of tablet splitting  ROUTES OF ADMINISTRATION METHODS OF ENTERAL ADMINISTRATION Oral Route- Equipment Tablet Crusher can be used when a patient has swallowing difficulties and no alternative dosage form exists.  ROUTES OF ADMINISTRATION METHODS OF ENTERAL ADMINISTRATION Oral Route- Equipment Oral Syringe if a syringe is needed to measure and administer an oral dose, an oral syringe that cannot be attached to intravenous catheters or ports should be used  ROUTES OF ADMINISTRATION METHODS OF ENTERAL ADMINISTRATION Oral Route- Equipment  ROUTES OF ADMINISTRATION METHODS OF ENTERAL ADMINISTRATION Oral Route- Equipment  ROUTES OF ADMINISTRATION Oral Route- Nursing Responsibilities An important precaution to take when administering any oral preparation is to Position the patient in an upright seated protect patients from aspiration. position at a 90-degree angle Allow patient to self-administer medications Administer pills one at a time, ensuring that if possible. each medication is properly swallowed before next one is introduced. Know signs of dysphagia (difficulty swallowing): cough, change invoice tone or quality after Refer to a medication reference to identify swallowing, delayed swallowing, medications that are safe to crush.  ROUTES OF ADMINISTRATION TOPICAL ADMINISTRATION SKIN ADVANTAGES: Local Effect Painless Limited side effects DISADVANTAGES: Patients with skin abrasions are at risk for rapid medication absorption and systemic effects Medications are absorbed through skin slowly  ROUTES OF ADMINISTRATION TOPICAL ROUTE Topical Drug Forms Ointment – semisolid, externally applied preparation, usually containing one or more medication Liniment-usually contains alcohol, oil, or soapy emollient applied to skin Lotion- semiliquid suspension that usually protects, cools or cleanses skin  ROUTES OF ADMINISTRATION TOPICAL ROUTE Topical Drug Forms Paste- medication preparation that is thicker than an ointment; absorbed through skin more slowly than ointment; often use for skin protection Transdermal disk or patch- medicated disk or patch absorbed through the skin slowly over long period of time  ROUTES OF ADMINISTRATION Topical Route- Nursing Responsibilities The condition of the affected site should be assessed for altered skin integrity If the medication is to be rubbed into the skin, the preparation should be placed on a sterile topical swab. The affected area must be washed and dried before applying the topical medicines where appropriate, unless the prescription directs otherwise. Educate the patient to inform the nurse if there is any itching, skin colour change or signs of a rash following application. Expose the area that requires the lotion and where necessary cover the patient with a towel or sheet.  ROUTES OF ADMINISTRATION TOPICAL ADMINISTRATION TRANSDERMAL ADVANTAGE: Prolonged systemic effects DISADVANTAGE: Medication leaves oily or pasty substance on skin and sometimes soils clothing  ROUTES OF ADMINISTRATION TOPICAL ADMINISTRATION TRANSDERMAL - A transdermal patch contains a certain amount of drug and delivers it in a quantity which is sufficient to cause the desired pharmacological effect when it crosses the skin and into the systemic system. - Drugs which can be delivered in a transdermal system include fentanyl, hyoscine, nicotine and oestradiol  ROUTES OF ADMINISTRATION TOPICAL ADMINISTRATION TRANSDERMAL Three types of transdermal patch are available: Adhesive These are simply designed patches which consist of a drug-containing adhesive and a backing material. Layered or matrix Layered patches consist of a drug-containing matrix, an adhesive layer and a backing material. patches The drug-containing matrix controls the release of drug from the system Reservoir Reservoir patches consist of an enclosed reservoir of drug, a membrane layer, an adhesive layer and a backing material.  ROUTES OF ADMINISTRATION Transdermal- Nursing Responsibilities The condition of the affected site should be Patches should not be trimmed or cut. assessed for altered skin integrity. The affected area must be washed and dried before Where necessary, remove the used patch and fold applying the patch, which should be attached to it in half, adhesive side inwards, place in the hairless areas of skin. original sachet and dispose into clinical waste. The upper chest, upper arms and upper back Remove any drug residue from the former site are recommended sites and the distal areas before placing the next patch. of extremities should be avoided ROUTES OF ADMINISTRATION Transdermal- Nursing Responsibilities Carefully remove the patch from its protective cover and hold it by the edge without touching the adhesive edges. Apply the patch immediately, pressing firmly with the palm of the hand for up to 10 seconds. Date and initial the patch. A different skin site should be used each time to avoid skin irritation References Berman, A., Snyder, S. J., & Frandsen, G. (2016). Kozier and Erb's Fundamentals of Nursing (Concepts, Process and Practice) 10th edition. USA: Pearson Education Inc. Potter, P. A., Perry, A., Stockert, P. A., & Hall, A. M. (2021). Fundamentals of Nursing 10th Edition. USA: Elsevier Inc. The Royal Marsden Manual of Clinical Nursing Procedures McCuistion, L. , Vuljoin-Dimaggio, K., Winton, M. and Yeager, J., (2018), Pharmacology: A Patient Centered Nursing Approach 9th edition. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.thehealthsite.com%2Fnews%2Fthroat-lozenges-for-sore-throat-do- they-work- 247425%2F&psig=AOvVaw1vcsWdUt_Pp0Ybd504ve_Z&ust=1611440964513000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCID wtNTLsO4CFQAAAAAdAAAAABAVhttps://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.thehealthsite.com%2Fnews%2Fth roat-lozenges-for-sore-throat-do-they-work- 247425%2F&psig=AOvVaw1vcsWdUt_Pp0Ybd504ve_Z&ust=1611440964513000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCID wtNTLsO4CFQAAAAAdAAAAABAV https://www.google.com/url?sa=i&url=https%3A%2F%2Fdifference.guru%2Fdifference-between-capsules-and- tablets%2F&psig=AOvVaw2jYr4Ld76PftXISKHmKaY8&ust=1611440892740000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCMCx 4pjMsO4CFQAAAAAdAAAAABAD https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.vicks.com.au%2Fen-au%2Fbrowse-products%2Fcough-and- cold%2Fvicks-chesty-cough-syrup-for-children&psig=AOvVaw0RySHPizk3CK- 9nKZnDBjB&ust=1611441279453000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCMCVw93MsO4CFQAAAAAdAAAAABAD https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.indiamart.com%2Fproddetail%2Frunner-veterinary-tablet- 9782300948.html&psig=AOvVaw2Wkp2QNq4RrdThCOBYc5lb&ust=1611441365574000&source=images&cd=vfe&ved=0CAIQjRxqF woTCKiH7YnNsO4CFQAAAAAdAAAAABAD References https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.info.gov.hk%2Fgia%2Fgeneral%2F201111%2F24%2FP20111124038 5_photo_1033469.htm&psig=AOvVaw2QuIkn1ScEQ5098qorG0sC&ust=1611441466124000&source=images&cd=vfe&ved=0CAIQj RxqFwoTCPDwr7nNsO4CFQAAAAAdAAAAABAD https://www.google.com/url?sa=i&url=http%3A%2F%2Fmtoto6.blogspot.com%2F2017%2F04%2Fpreservation-of- emulsions.html&psig=AOvVaw0q72rr_9WwkWOq7QElaDHz&ust=1611441572634000&source=images&cd=vfe&ved=0CAIQjRxqFw oTCKDyw-jNsO4CFQAAAAAdAAAAABAh https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.healthhub.sg%2Fa-z%2Fmedications%2F61%2FMixing-Powdered- Medication-Into- Suspensions&psig=AOvVaw3lPGfJsUbKRmTs7Qvg57qj&ust=1611442171554000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCJj9 6ofQsO4CFQAAAAAdAAAAABAD https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.pharmaguideline.com%2F2015%2F01%2Fmanufacturing- procedure-of- ointment.html&psig=AOvVaw2XjrMr2IX1JT8t6mBKWKP4&ust=1611469331662000&source=images&cd=vfe&ved=0CAIQjRxqFwoT COCG85-1se4CFQAAAAAdAAAAABAD https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.amazon.com%2FWatkins-Wht-Cream-Liniment- 11oz%2Fdp%2FB00SPTP5JO&psig=AOvVaw29HY1c-wfWLhMzMkApYk- U&ust=1611469409753000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCPDP38K1se4CFQAAAAAdAAAAABAD https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.cetaphil.com%2Fus%2Fproduct%2Fmoisturizing- lotion&psig=AOvVaw0ITZdg4GFE5jatr9Myo9jO&ust=1611469529835000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCLDhw_q1 se4CFQAAAAAdAAAAABAD References https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.webmd.com%2Fdrugs%2F2%2Fdrug-75280%2Ftriamcinolone- acetonide- dental%2Fdetails&psig=AOvVaw1N0Auu4z2Nk2FSAK_bz1Gx&ust=1611469590104000&source=images&cd=vfe&ved=0CAIQjRxqFw oTCNjhqpi2se4CFQAAAAAdAAAAABAD https://www.google.com/imgres?imgurl=https%3A%2F%2Fars.els-cdn.com%2Fcontent%2Fimage%2F3-s2.0- B9781907568527500132-f13-07- 9781907568527.jpg&imgrefurl=https%3A%2F%2Fwww.sciencedirect.com%2Ftopics%2Fpharmacology-toxicology-and- pharmaceutical-science%2Ftransdermal- patch&tbnid=Kokl84muiqkNfM&vet=12ahUKEwiZy4i0trHuAhWBzYsBHUKMCPoQMygUegUIARD- AQ..i&docid=Ct9cSocb6RM5nM&w=471&h=165&q=transdermal%20patch&ved=2ahUKEwiZy4i0trHuAhWBzYsBHUKMCPoQMygUe gUIARD-AQ