Methods of Administration and Calculation

• The right medication
• The right dosage
• The right client
• The right route
• The right time
• The right documentation

This refers to how a medication is administered. Medications come in several forms for administration.

Medication is administered by mouth (e.g., tablets, capsules, caplets, liquid solutions).

Medications are placed under the tongue and designed to be readily absorbed through the blood vessels in this area. They should not be swallowed. Nitroglycerin is an example of a medication commonly administered by this route.

Tablets or capsules release medication into the bloodstream over a period of time at specific intervals. Therefore, these forms of medication should not be opened, chewed or crushed.

Tablets are placed in the mouth against the mucous membranes of the cheek where the medication will dissolve. The medication is absorbed from the blood vessels of the cheek. Clients should be instructed not to cheek or swallow the medication and not take any liquids with it.

Medications are administered by a route other than by mouth or gastrointestinal tract. Parenteral routes include intravenous (IV), intramuscular (IM), subcutaneous (subcut), and intradermal (ID).

Medication is placed into a body cavity, where the medication dissolves at body temperature (e.g. suppositories). Vaginal medications, creams, and tablets may also be inserted by using special applicators provided by the manufacturer.

Medication is introduced in liquid form into a body cavity. It can also include placing an ointment into a body cavity, such as erythromycin eye ointment, which is placed in the conjunctiva of the eye. Nose drops and ear drops are also these types of medications.

Medication is administered into the respiratory tract, for example, through nebulizers used by clients for asthma. Bronchodilators and corticosteroids may be administered by inhalation through the mouth using an aerosolized, pressurized metered-dose inhaler (MDI). In some institutions, these medications are administered to the client with special equipment, such as positive pressure breathing equipment or the aerosol mask. Other medications in this form include pentamidine, which is used to treat Pneumocystis jiroveci, a type of pneumonia found in clients with acquired immunodeficiency syndrome (AIDS). Devices such as “spacers” or “extenders” have been designed for use with inhalers to allow the entire metered dose to be inhaled, particularly in clients who have difficultly using inhalers.

A medicated solution is instilled into the nostrils. This method is used to administer corticosteroids, the antidiuretic hormone vasopressin, and a nasal mist influenza vaccine.

The medication is applied to the external surface of the skin. It can be in the form of lotion, ointment, or paste.

Medications are applied to the skin or mucous membrane for absorption. This includes ointments, powders, and lotions for the skin. The primary advantage is that the action of the drug, in general, is localized to the skin of application.

Medication that is becoming more popular is contained in a patch or disk. Medication is slowly released and absorbed through the skin and enters they systemic circulation. This type of application may be applied for 24 hrs or for as long as 7 days and have systemic effects. Examples include nitroglycerin for chest pain, nicotine transdermal (Nicoderm) for smoking cessation, clonidine for hypertension, fentanyl (Duragesic) for chronic pain and birth control patches.