Transcript Chapter_8
Chapter 8 Routes of Drug Administration Types Oral Route – Safest, most economical and most convenient way of giving medication. – Preferred route – Drug effects are slower and less efficient – Easier retrieval of a drug in overdose They may have an objectionable odor or taste or to bulky to swallow They may harm or discolor the teeth They may irritate the gastric mucosa, causing nausea and vomiting They may be aspirated by a seriously ill or uncooperative individual They may be destroyed by digestive enzymes They may be inappropriate for some patients Sublingual and Buccal Routes Sublingual: under the tongue: thin epithelium and network of capillaries under the tongue – enhances drug absorption and enhancement. Buccal: in the cheek for local dissolution and absorption. Topical Route Application of a drug directly onto the skin or mucous membrane – Astringent: used as a vasoconstrictor, tissue contraction – Antiseptic or bacteriostatic: inhibit growth of microorganisms – Emollient: soothing and softening – Anesthetic: remove the sensation of pain – Antihistamine: used due to allergic reaction. Rectal Route Convenient, safe when the oral method is unsuitable Avoids irritation of the UGI tract Drug can be released in a slow but steady rate. Disadvantages: retention, absorption into the portal circulation where metabolism can be extensive. Parenteral Route Intradermal or intracutaneous injection Injection is made into the upper layers of the skin almost parallel to the skin surface. The amount of drug is small, absorption is slow. Used to test for allergic reaction Subcutaneous (SC) Method Beneath the layers of skin, yet above the muscle Massaging the part after injection tends to increase the rate of absorption Intramuscular Method: Deeper injection are made into muscular tissue, through the skin and subcutaneous tissue. Larger doses can be given over the subcutaneous method. May be given using an aqueous solution, an aqueous suspension or a solution of suspension of oil. Suspensions form a supply of drug in the tissue and result in slow, gradual absorption. Areas given: gluteal region, deltoid area, anterio-lateral thigh. Injection Pain Contrary to belief, needle puncture does not usually cause the discomfort associated with injections. – The diameter will cause pain – Stretching of tissue (pain receptors in the skin) – Volume of the drug: irritation – Poor injector technique Intravenous Method When immediate results are needed. Antecubital space is the most common. ROCM administered this way. Venipuncture Introduce yourself Wash hands/consent Explain procedure/gloves Find site/clean site Tourniquet Insert at 15-20 degree angle Look for backflow Risks Infection Extravasation/infiltration Charting name of drug dose of drug route time injection site Lines Chest tubes and lines CV lines Pulmonary arterial lines General Administration Guidelines Five – – – – – Rights of Drug Administration Right patient Right drug Right amount Right time Right route