2.3 Drug Administration Routes, Preparation, and Administration
3 min read•june 18, 2024
Drug administration routes are crucial in determining how medications work in the body. From oral pills to injections, each method has unique advantages and considerations. Understanding these routes helps healthcare providers choose the most effective way to deliver medications for optimal patient outcomes.
Proper technique is essential for safe and effective drug administration. Whether it's giving an injection, applying a topical cream, or using an inhaler, following correct procedures ensures patients receive the right dose and experience minimal discomfort. Nurses play a key role in administering medications and educating patients about their treatments.
Drug Administration Routes
Drug administration routes
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- convenient non-invasive cost-effective suitable for self-administration
- Slower onset of action compared to routes
- Potential for reduces of certain medications (propranolol, lidocaine)
- May be affected by food or other medications altering (tetracyclines, bisphosphonates)
- bypasses gastrointestinal tract delivers medication directly into body tissues or circulation
- (SC) injection into fatty tissue beneath skin suitable for small volumes non-irritating medications (insulin, heparin)
- (IM) injection into muscle tissue faster absorption than SC route accommodates larger volumes oil-based medications (vaccines, antibiotics)
- (IV) direct injection into vein fastest onset of action precise dosing titration risks include infection
- applies medication directly to skin or mucous membranes for localized effect minimal systemic absorption
- Examples include creams ointments patches ( fentanyl) eye drops (antibiotics, glaucoma medications)
- delivers medication directly to lungs via inhalation rapid onset of action targets respiratory system
- Examples include (albuterol) (ipratropium) (fluticasone)
- Various affect absorption and administration route choice
Sites for parenteral therapy
- (SC) injection sites outer aspect of upper arm anterior abdomen upper back anterior thigh
- Intramuscular (IM) injection sites muscle (upper arm) site (hip) (lateral thigh) site (buttocks) less preferred due to risk of sciatic nerve injury
- Factors affecting site selection
- Absorption rate muscle tissue has more blood supply than subcutaneous tissue leading to faster absorption
- Patient comfort rotate injection sites to minimize discomfort tissue damage
- Medication properties certain medications may require specific administration routes (insulin typically given SC)
- Patient's age mobility body composition consider ease of access amount of subcutaneous or muscle tissue available
Plan for effective drug administration
- Patient assessment review medication order verify patient identity assess allergies contraindications vital signs evaluate appropriateness of medication dose route timing
- Medication preparation gather necessary supplies equipment perform hand hygiene use personal protective equipment (PPE) follow double-check medication label dose expiration date
- Post-administration monitoring assess patient's response to medication monitor for adverse reactions or side effects document administration including time dose route relevant observations
- Provide on medication purpose, expected effects, and potential side effects
Techniques for medication delivery
- ensure upright position offer water or liquids to aid swallowing observe to confirm medication swallowed
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- Subcutaneous use new sterile needle syringe clean injection site with alcohol swab using circular motion stretch or pinch skin insert needle at 90-degree angle (SC) or appropriate angle (IM) aspirate to check for blood return (IM only) inject medication slowly steadily apply gentle pressure with gauze after removing needle
- Intravenous administration use aseptic technique when preparing administering IV medications assess IV site for patency signs of phlebitis use appropriate equipment (pumps tubing filters) flush IV line with saline before and after medication administration
- Topical administration wear gloves to prevent contamination protect healthcare provider apply medication evenly to affected area following package instructions cover with dressing if needed
- Inhalation administration ensure upright position instruct patient to exhale fully before inhaling place inhaler mouthpiece in mouth seal lips coordinate actuation with inhalation hold breath for 5-10 seconds after inhalation rinse mouth with water after using corticosteroid inhalers to prevent oral thrush ()
Medication Safety and Pharmacokinetics
- Understanding helps predict drug behavior and optimize dosing
- Be aware of potential that may affect efficacy or safety
- Implement strategies to prevent , such as double-checking orders and using barcode scanning
- Monitor for and report them promptly to ensure patient safety
Key Terms to Review (58)
Absorption: Absorption is the process by which a substance, such as a drug or nutrient, is taken up from the site of administration and enters the bloodstream or lymphatic system, making it available for distribution throughout the body. This term is crucial in understanding the pharmacokinetics and pharmacodynamics of drugs, as well as the functioning of the gastrointestinal system and the administration of various medications.
Adverse effects: Adverse effects are unintended and harmful outcomes resulting from medication or other interventions. They can range from mild to severe and may require medical attention.
Adverse Effects: Adverse effects, also known as side effects, are unintended and undesirable consequences that can occur during or after the use of a drug or medication. These effects can range from mild discomfort to serious and potentially life-threatening conditions, and they are an important consideration in the context of drug classifications, pharmacokinetics, pharmacodynamics, drug administration, and the use of specific drug classes like angiotensin II receptor blockers (ARBs).
Aseptic Technique: Aseptic technique is a set of practices and procedures designed to prevent the introduction of harmful microorganisms into sterile or clean environments, particularly during medical procedures and drug administration. It is a crucial aspect of maintaining sterility and preventing the spread of infections.
Bioavailability: Bioavailability refers to the degree and rate at which a drug or other substance is absorbed and becomes available at the site of action in the body. It is a crucial pharmacokinetic property that determines the effectiveness and safety of a medication.
Candidiasis: Candidiasis is a fungal infection caused by the Candida species of yeast, most commonly Candida albicans. It can affect various parts of the body, including the mouth, throat, skin, and genitals, and is particularly prevalent in individuals with weakened immune systems or certain medical conditions.
Cutaneous: Relating to or affecting the skin. Cutaneous administration involves applying drugs directly onto the skin's surface.
Cutaneous Administration: Cutaneous administration involves the application of a drug directly onto the skin for localized or systemic effects. It includes methods such as creams, ointments, patches, and gels.
Deltoid: The deltoid is a large, triangular muscle covering the shoulder joint. It is commonly used as an injection site for intramuscular (IM) drug administration.
Donepezil transdermal: Donepezil transdermal is a medication used to manage symptoms of Alzheimer's disease by delivering the drug through a skin patch. It inhibits acetylcholinesterase, thereby increasing acetylcholine levels in the brain.
Dorsogluteal: The dorsogluteal site refers to the upper outer quadrant of the buttocks, specifically the area over the gluteal muscle. This site is commonly used for intramuscular (IM) drug administration due to the presence of a large muscle mass and minimal risk of hitting major nerves or blood vessels.
Dosage Forms: Dosage forms refer to the physical appearance and composition of a drug product that determines how it is administered to the patient. They are designed to optimize the delivery of the active pharmaceutical ingredient (API) to the desired site of action in the body, ensuring the intended therapeutic effect.
Drug Interactions: Drug interactions occur when the effects of one drug are altered by the presence of another drug, food, or other substance in the body. These interactions can lead to changes in the drug's intended therapeutic effects, side effects, or both, potentially impacting the overall safety and efficacy of the medication regimen.
Dry Powder Inhalers: Dry powder inhalers (DPIs) are a type of inhaler device used to deliver medication in the form of a fine, dry powder directly to the lungs. They are designed to efficiently disperse and deliver the medication to the targeted areas of the respiratory system, providing a convenient and effective way to manage various respiratory conditions.
Enteral: Enteral drug administration involves delivering medication directly into the gastrointestinal (GI) tract. Common methods include oral, sublingual, and rectal routes.
Enteral administration: Enteral administration involves delivering medication directly into the gastrointestinal (GI) tract, typically through oral or feeding tube methods. It is a common route for systemic drug delivery.
Enteral Administration: Enteral administration refers to the delivery of medications, nutrients, or other substances directly into the gastrointestinal tract, typically through the mouth, nose, or a feeding tube. This method of administration is used to provide essential nutrients and medications to patients who cannot or should not receive them orally or by other routes.
Extravasation: Extravasation refers to the unintentional leakage or escape of a substance, such as a medication or intravenous (IV) fluid, from the intended blood vessel or administration site into the surrounding tissue. This can occur during various drug administration routes, chemotherapeutic drug infusions, and the administration of certain cardiac emergency or shock drugs.
First-Pass Metabolism: First-pass metabolism refers to the process where a drug is metabolized, or broken down, by the liver and other organs before it reaches the systemic circulation and becomes available to the rest of the body. This phenomenon is particularly important when considering the bioavailability and pharmacokinetics of drugs administered through certain routes.
Forms of medication: Forms of medication refer to the physical form in which a drug is produced and administered, such as tablets, capsules, liquids, or injections. The form affects how the drug is absorbed and utilized by the body.
Infiltration: Infiltration refers to the unintended leakage or accumulation of a drug or fluid into the tissues surrounding the intended site of administration. This can occur during various drug administration routes and preparation procedures, and it is an important consideration in the context of 2.3 Drug Administration Routes, Preparation, and Administration.
Inhalation Administration: Inhalation administration is a route of drug delivery where the medication is administered directly into the respiratory system, typically through the nose or mouth. This method allows for rapid absorption of the drug into the bloodstream and is particularly effective for treating conditions affecting the lungs and airways.
Intramuscular: Intramuscular (IM) refers to the administration of a medication or substance directly into the muscle tissue. This route of administration is commonly used for vaccines, certain medications, and hormonal therapies, as it allows for efficient absorption and targeted delivery of the substance into the body.
Intramuscular injections: Intramuscular injections involve administering medication directly into a muscle, allowing for rapid absorption into the bloodstream. Common sites include the deltoid, vastus lateralis, and gluteal muscles.
Intravenous: Intravenous (IV) administration involves delivering medication directly into a vein using a needle or catheter. It ensures rapid drug absorption and immediate effect.
Intravenous: Intravenous (IV) refers to the administration of a drug or fluid directly into a vein, bypassing the digestive system. This route of drug delivery provides rapid absorption and ensures the medication reaches the systemic circulation immediately.
Intravenous medications: Intravenous medications are drugs administered directly into a vein for immediate effect. This route allows for rapid onset and precise control of drug levels in the bloodstream.
Medication Errors: Medication errors are any preventable events that may cause or lead to inappropriate medication use or patient harm. These errors can occur during any stage of the medication management process, including prescribing, transcribing, dispensing, administering, or monitoring the medication.
Medication reconciliation: Medication reconciliation is the process of creating an accurate list of all medications a patient is taking to ensure consistency and safety in drug administration. This includes prescription drugs, over-the-counter medications, and supplements.
Medication Reconciliation: Medication reconciliation is the process of creating the most accurate list of a patient's current medications and comparing that list to the medications ordered for the patient to ensure accuracy, identify and resolve any discrepancies, and provide the correct medications to the patient at all transition points of care.
Medication safety: Medication safety involves practices and protocols that ensure the correct administration of medications to patients, minimizing errors and adverse effects. It encompasses proper drug storage, preparation, administration, and monitoring.
Metered-Dose Inhalers: Metered-dose inhalers (MDIs) are a type of inhaler device used to deliver aerosolized medication directly to the lungs. They provide a pre-measured dose of medication with each actuation, allowing for precise and controlled drug delivery for the treatment of respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD).
Nasal sprays: Nasal sprays are liquid medications delivered through the nostrils to treat conditions such as allergies, congestion, and infections. They provide localized treatment and can have systemic effects depending on the drug used.
Nebulizers: Nebulizers are medical devices that convert liquid medications into a fine mist, allowing patients to inhale the medication directly into the lungs. They are commonly used to administer respiratory medications for conditions such as asthma, COPD, and cystic fibrosis.
Needle Disposal: Needle disposal involves the proper discarding of used needles to prevent injuries and the spread of infections. It is a crucial aspect of healthcare practice to ensure safety and hygiene.
Oral administration: Oral administration is the process of taking medications by mouth, where they are swallowed and absorbed through the digestive system. It is one of the most common and convenient routes for drug delivery.
Oral Administration: Oral administration refers to the delivery of a drug or medication through the mouth, where it is absorbed into the bloodstream from the gastrointestinal tract. This is one of the most common and convenient routes of drug administration, allowing for easy self-administration by the patient.
Parenteral: Parenteral administration involves delivering medications by injection through routes such as intravenous, intramuscular, or subcutaneous. It bypasses the gastrointestinal tract for quicker absorption and effect.
Parenteral administration: Parenteral administration is the delivery of medications by injection through routes such as intravenous (IV), intramuscular (IM), and subcutaneous (SC). It bypasses the gastrointestinal tract, allowing for faster absorption and onset of action.
Parenteral Administration: Parenteral administration refers to the delivery of medications or fluids directly into the body through routes other than the gastrointestinal tract. This method of drug delivery bypasses the digestive system and allows for rapid absorption and distribution of the active substances throughout the body.
Parenteral medication: Parenteral medication is a route of drug administration that bypasses the gastrointestinal tract, typically via injection. Common methods include intravenous, intramuscular, and subcutaneous routes.
Patient Education: Patient education is the process of providing patients with the knowledge, skills, and resources necessary to actively participate in their own healthcare. It empowers patients to make informed decisions, manage their conditions, and maintain optimal health. This term is particularly relevant in the context of drug administration, medication management, and the treatment of various medical conditions.
Percutaneous administration: Percutaneous administration involves delivering drugs through the skin or mucous membranes. It aims for localized or systemic effects depending on the drug formulation.
Pharmacokinetics: Pharmacokinetics is the study of how the body affects a drug, including the processes of absorption, distribution, metabolism, and elimination. It examines the movement of drugs within the body and how these processes impact the drug's concentration and duration of action.
Phlebitis: Phlebitis is the inflammation of a vein, typically caused by irritation or infection. It is an important consideration in the context of drug administration routes, preparation, and administration as it can occur as a complication of intravenous (IV) therapy.
Rectal administration: Rectal administration is the insertion of medication into the rectum for absorption through the rectal mucosa. It is often used when oral administration is not possible.
Subcutaneous: Subcutaneous refers to the administration of medication or fluids into the tissue layer between the skin and muscle. This route is often used for drugs that require slow, sustained absorption.
Subcutaneous: Subcutaneous refers to the layer of tissue located just beneath the skin, composed of fat, connective tissue, and blood vessels. This term is particularly relevant in the context of drug administration, vaccine delivery, and dosage calculations.
Subcutaneous injections: Subcutaneous injections involve administering medication into the layer of fat below the skin using a short needle. This route is commonly used for vaccines and medications that need to be absorbed slowly.
Sublingual and buccal administration: Sublingual and buccal administration are methods of delivering medication by placing it under the tongue (sublingual) or between the gum and cheek (buccal). These routes allow for direct absorption into the bloodstream, bypassing the digestive system.
Suppositories: Suppositories are solid medical preparations designed for insertion into body cavities, where they dissolve or melt to exert local or systemic effects. Common sites of administration include the rectum and vagina.
Topical Administration: Topical administration refers to the application of a drug or medication directly to a specific area of the body, such as the skin, eyes, ears, or mucous membranes, for localized treatment. This method of drug delivery is particularly useful for addressing conditions that affect the surface of the body or specific organs.
Transdermal: Transdermal refers to the administration of medication through the skin, allowing the active ingredients to be absorbed into the bloodstream. This method of drug delivery bypasses the gastrointestinal tract and liver, providing a direct route for the drug to reach the systemic circulation.
Vaginal medications: Vaginal medications are drugs administered through the vagina for local or systemic effects. They can come in forms such as creams, gels, tablets, or suppositories.
Vastus Lateralis: The vastus lateralis is one of the four muscles that make up the quadriceps femoris, the large muscle group on the front of the thigh. It is the largest and most lateral of the quadriceps muscles and plays a crucial role in the administration and preparation of certain drug delivery routes.
Ventrogluteal: The ventrogluteal site is an injection area located on the hip, specifically in the gluteus medius muscle. It is often used for intramuscular injections due to its safety and low risk of complications.
Ventrogluteal: The ventrogluteal site is a location on the body used for intramuscular (IM) injections. It is situated on the posterior aspect of the hip, in the gluteal region, and is a safe and effective alternative to the dorsogluteal (upper outer quadrant of the buttocks) injection site.
Z-track method: The Z-track method is a technique used for intramuscular injections to prevent medication from leaking back along the needle track and into subcutaneous tissue. It involves displacing the skin and tissue before needle insertion.