# Medication Administration --- **Medication administration** is one of the tasks central to [[nursing]]. It is very important to be careful, because otherwise you're at risk of making a [[medication error]], which can be fatal. The [[rights of medication administration]] are a bunch of checks to run through during every medication administration to make sure you're doing it right. Know the medication's: - Actions - Special nursing considerations - Safe dose range - Purpose of administration - Adverse effects - Appropriateness for the patient ## Route There are many different routes of medication administration, broadly divided into **enteral** (without needles) and **parenteral** (with needles). ### Enteral **Enteral** routs of med administration do not go through the skin, such as pills. Basically anything that doesn't use a needle is enteral. #### Oral **Oral** or **PO** (Latin: *per os*) meds are pills or liquids that you swallow, and they are the most common route for medication administration. It's the safest, most convenient and least expensive method. Oral meds typically take about 60 minutes to kick in, and are generally the easiest to take. One thing to be on the lookout for is any pill that is labeled DO NOT CRUSH, which are enteric-coated or sustained-release tablets. **Enteric coating** makes it easier to absorb, and is less uncomfortable or painful for the patient (i.e. their stomachs), and **sustained-release** tablets are made to be long-lasting. #### Sublingual **Sublingual** or **SL** meds are pills that are held under the tongue until they dissolve. This is a very fast route of administration, and the onset can be anywhere from immediate to 15 minutes. (A similar route is **buccal**, which is held in the cheek, but you rarely see them these days). #### Topical **Topical** or **transdermal** meds are in the form of patches or creams that are applied to this skin. They are long, slow and steady meds, and can be a form of [[medicine|local drug]]. The rate of absorption depends on the vascularity of the site, but this is not usually too much of a problem. Rotating site placement is generally a good idea to avoid irritation, and also be sure to take off the old patches if you're applying them regularly, because even if they're "used up" they still do have some effect. Note! Be sure to wear gloves when applying patches, because the stuff is formulated to enter the body through the skin and it *will* absorb through your hands. ### Ophthalmic **Ophthalmic** meds are **eye drops** which are generally [[medicine|local meds]] used to treat eye irritation, infection or [[glaucoma]]. ### Otic **Otic** meds are **ear drops** which are generally [[medicine|local meds]] used to treat infections, soften [[ceruminous glands|ear wax]] or sometimes kill a bug that's trapped in the ear canal. ### Inhaled **Inhaled** medications enter the body through the respiratory tract, through the nasal or oral passages, or even an endotracheal or tracheostomy tube. It's good practices to listen to [[lung sounds]] before and after administration. ### Intranasal **Nasal medications** are **nose sprays** used to treat congestion. They can be used in excess, and they can increase heartrate or even cause rebound congestion. ### Vaginal **Vaginal medications** are creams, foams, tablets, liquids, suppositories, or gels that are administered vaginally. Sometimes they require a special applicator. This can be sensitive to administer to someone, so consider a chaperone and not doing it alone. ### Rectal **Rectal medications** are medications meant to melt at body temperature, inserted into the rectum, or an [[enema]]. ## Parenteral Meds **Parenteral** routes of medication that do break the skin, or anything delivered with a needle. - [[intramuscular injection|Intramuscular injections]] are delivered into the muscle tissue. - [[subcutaneous injection|Subcutaneous injections]] are delivered into the subcutaneous tissue. - [[intravenous injection|Intravenous injections]] are delivered straight into the bloodstream. - **Intradermal** injections are delivered into the dermis. This is only ever used to administer a [[tuberculin skin test]], so you don't see it that often. >[!health] The Benefit Outweighs the Harm The skin is not meant to be pierced. That's it's main job, to protect from that sort of thing. However, in medicine it's impossible to give anything other than oral medicine into the body without piercing it, and in order to do any labs on the blood we need to access a vein by piercing the skin. This is why it is important to use sterile needles, avoid contaminating the medicine, and thoroughly disinfect the injection site prior to injection. ### Syringes & Needles **Syringes** are the tube part that hold the medicine and the **needles** are hollow metal pointy tubes that pierce the skin and allow the medicine in. Sometimes they come as one piece, but a lot of the time you attach the needle to the syringe yourself. There are three common types of syringes: standard, tuberculin, and insulin. Needles are identified by their length and gauge. The bigger the number of the gauge, the smaller the diameter of the needle. A needle gauge used is based on: - The viscosity of the medicine - The route of administration - The patient's size/musculature/age ![[syringe and needle sizes.png]] ___