routes of administration, frequency, and time of day of administering medicines

Solution Preview

Routes of administration can broadly be divided into:
topical: local effect, substance is applied directly where its action is desired
enteral: desired effect is systemic (non-local), substance is given via the digestive tract
parenteral: desired effect is systemic, substance is given by other routes than the digestive tract
The following is a list of some routes of administration.
Topical
epicutaneous (application onto the skin), e.g. allergy testing, topical local anesthesia
inhalational, e.g. asthma medications
enema, e.g. contrast media for imaging of the bowel
eye drops (onto the conjunctiva), e.g. antibiotics for conjuncitivitis
ear drops - such as antibiotics and corticosteroids for otitis externa
intranasal, e.g. decongestant nasal sprays

Enteral
by mouth (orally), many drugs as tablets, capsules, or drops
by gastric feeding tube, duodenal feeding tube, or gastrostomy, many drugs and enteral nutrition
rectally, various drugs in suppository or enema form

Parenteral by injection or infusion
intravenous (into a vein), e.g. many drugs, total parenteral nutrition
intraarterial (into an artery), e.g. vasodilator drugs in the treatment of vasospasm and thrombolytic drugs for treatment of embolism
intramuscular (into a muscle), e.g. many vaccines
subcutaneous (under the skin), e.g. insulin
intraosseous infusion (into the bone marrow) is, in effect, an indirect intravenous access because the bone marrow drains directly into the venous system. This route is occasionally used for drugs and fluids in emergency medicine and paediatrics when intravenous access is difficult
intradermal, (into the skin itself) is used for skin testing some allergens, and also for tatoos

Parenteral (other than injection or infusion)
transdermal (diffusion through the intact skin), e.g. transdermal opioid patches in pain therapy
transmucosal (diffusion through a mucous membrane), e.g. cocaine snorting, sublingual nitroglycerine
inhalational, e.g. inhalational anesthetics

Other
intraperitoneal (infusion or injection into the peritoneal cavity), e.g. peritoneal dialysis
epidural (synonym: peridural) (injection or infusion into the epidural space), e.g. epidural anesthesia
intrathecal (injection or infusion into the cerebrospinal fluid), e.g. antibiotics, spinal anesthesia

ADMINISTRATION, FREQUENCY AND TIME OF DAY OF ADMINISTRATION
Principles for the administration of medicines
In exercising your professional accountability in the best interests of the patients, the doctor must:
s
know the therapeutic uses of the medicine to be administered, its normal dosage, side effects, precautions and contra-indications

be certain of the identity of the patient to whom the medicine is to be
administered

be aware of the patient's care plan

check that the prescription, or the label on medicine dispensed by a pharmacist,
is clearly written and unambiguous

have considered the dosage, method of administration, route and timing of the
administration in the context of the condition of the patient and co-existing
therapies

check the expiry date of the medicine to be administered

check that the patient is not allergic to the medicine before administering it

contact the prescriber or another authorised prescriber without delay where
contra-indications to the prescribed medicine are discovered, where the patient
develops a reaction to the medicine, or where assessment of the patient indicates
that the medicine is no longer suitable

make a clear, accurate and immediate record of all medicine administered,
intentionally withheld or refused by the patient, ensuring that any written
entries and the signature are clear and legible; it is also your responsibility to
ensure that a record is made when delegating the task of administering.
Some drug administrations can require complex calculations to ensure that the
correct volume or quantity of medication is administered. In these ...