Routes of medication administration

• Routes of Medication Administration

  • Oral and Topical
• Oral administration


  Medications are given by mouth and swallowed with fluid
• Oral administration


  • Convenient
  • Comfortable
  • Economical
  • Easy to administer
  • Often produce local or systemic effects
  • Rarely cause anxiety for patient
• Oral administration


  • 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
• Oral route


  Is the easiest and the most commonly used route of medication administration
• Oral medications


  Have a slower onset of action and a more prolonged effect than parenteral medications
• Sublingual route


  Medications are placed under the tongue
• Buccal route


  Involves placing the solid medication in the mouth against the mucous membranes of the cheek until it dissolves
• Oral drug forms


  • Capsules
  • Lozenges
  • Pills
  • Syrups
  • Tablets
  • Elixirs
  • Emulsions
  • Suspensions
• Medicine pot


  Allows a dosage form to be taken from its original container for immediate administration to a patient
• Tablet splitter


  Increases the accuracy of tablet splitting
• Tablet crusher


  Can be used when a patient has swallowing difficulties and no alternative dosage form exists
• 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
• Oral route nursing responsibilities

  • Protect patients from aspiration
  • Allow patient to self-administer medications if possible
  • Know signs of dysphagia (difficulty swallowing)
  • Position the patient in an upright seated position at a 90-degree angle
  • Administer pills one at a time, ensuring that each medication is properly swallowed before next one is introduced
  • Refer to a medication reference to identify medications that are safe to crush
• Topical administration


  Medications are applied to the skin
• Topical administration


  • Local effect
  • Painless
  • Limited side effects
• Topical administration


  • Patients with skin abrasions are at risk for rapid medication absorption and systemic effects
  • Medications are absorbed through skin slowly
• Topical drug forms


  • Ointment
  • Liniment
  • Lotion
  • Paste
  • Transdermal disk or patch
• Topical route nursing responsibilities

  • Assess the condition of the affected site for altered skin integrity
  • Wash and dry the affected area before applying the topical medicines where appropriate, unless the prescription directs otherwise
  • Expose the area that requires the lotion and where necessary cover the patient with a towel or sheet
  • If the medication is to be rubbed into the skin, the preparation should be placed on a sterile topical swab
  • Educate the patient to inform the nurse if there is any itching, skin colour change or signs of a rash following application
• Transdermal administration


  Medications are absorbed through the skin slowly over a long period of time
• Transdermal administration


  • Prolonged systemic effects
  • Medication leaves oily or pasty substance on skin and sometimes soils clothing
• 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 delivered via transdermal patch

  • Fentanyl
  • Hyoscine
  • Nicotine
  • Oestradiol
• Types of transdermal patch

  • Simply designed patches which consist of a drug-containing adhesive and a backing material
  • Layered patches which consist of a drug-containing matrix, an adhesive and a backing material