Parenteral routes of administration can include




















Insulin is ordered in units. It is important to use the correct syringe and needle for the specific injection. Always examine the measurement scale on the syringe to determine that you have the correct syringe Lynn, Needles are made of stainless steel, are sterile and disposable, and come in various lengths and sizes. The needle is made up of the hub, shaft, and bevel.

The bevel is the tip of the needle that is slanted to create a slit into the skin. The hub fits onto the tip of the syringe. All three parts must remain sterile at all times. The gauge of a needle is the diameter of the needle.

Gauges can vary from very small diameter 25 to 29 gauge to large diameter 18 to 22 gauge. A needle will have its gauge and length marked on the outer packaging; choose the correct gauge and length for the injection ordered Lynn, see Figures 7. Skip to content Chapter 7.

Parenteral Medication Administration. Read this information about ampules to review how to prepare medication from an ampule. Read this information about vials to review how to prepare medication from a vial and reconstitute medication.

Read this information about syringes to review the different types of syringes. What are three strategies that can be implemented to reduce distractions while preparing medication? What are two ways to prevent needle-stick injuries?

Previous: 7. Next: 7. Share This Book Share on Twitter. Safety consideration: Always follow the principles of sterile technique when preparing injections. Perform hand hygiene. Always perform hand hygiene before administration and after removing gloves. For hand hygiene with ABHR, use 1 to 2 pumps of product; this volume requires a minimum of 15 seconds for hands to dry.

Hand hygiene with ABHR. Keep sterile parts of the needle and syringe sterile. Avoid letting the needle touch unsterile surfaces such as the outer edges of the ampule or vial, surface of the needle cap, or counter. Always keep the needle covered with a cap when not in use, and use the scoop-cap method to avoid needle-stick injuries.

Avoid touching the length of the plunger. Keep the tip of the syringe sterile by covering with a cap or needle. Parts of a syringe and needle. Follow agency policy for skin preparation. When using an alcohol swab, use a circular motion to rub the area for 15 seconds, and then let the area dry for 30 seconds. If cleaning a site, move from the centre of the site outward in a 5 cm 2 in.

Do not keep multi-dose vials in patient treatment area. Discard if sterility is compromised or questionable. Do not combine and administer medications from single-dose vials or ampules for later use. Ampules should not sit open and should be used immediately, then discarded appropriately. Use new, sterile sterile equipment with each injection.

Single use syringe and needle must be used with each patient. Always inspect packaging for intactness; inspect for dryness, rips, torn corners and expiry date. If single use equipment is not available, use syringes and needles designed for steam sterilization. Data source: CDC, ; Hutin et al. Safety consideration: Agency policy on medication administration and on the medication administration record MAR may vary.

Avoid distractions. Some agencies have a no-interruption zone NIZ , where health care providers can prepare medications without interruptions.

Always ask patient about allergies, types of reactions, and severity of reactions. Use two patient identifiers at all times. Always follow agency policy for patient identification. Use at least two patient identifiers before administration AND compare against the medication administration record MAR. Assessment comes before medication administration.

All medications require an assessment review of lab values, pain, respiratory or cardiac assessment, etc. Errors in medication calculations have contributed to dosage errors, especially when adjusting or titrating dosages. Avoid reliance on memory; use checklists and memory aids.

Slips in memory are caused by lack of attention, fatigue, and distractions. Routes of Drug Administration It refers to the right path or the required route through which a drug has to be administered into the body to obtain maximum benefit.

Ask your question. Written by Vijayaganesh Kasinathan , B. Pharm, M. Medically Reviewed by Dr. Simi Paknikar, MD. Last Updated on Oct 16, Introduction on Routes of Drug Administration Routes of drug administration refer to the right path or the required route through which a drug has to be administered into the body to obtain maximum benefit.

These include: Drug properties Physical - solid, liquid, and gas. For example, drugs in gas form are given by inhalation. Chemical - solubility, pH, and irritant properties. Site of desired action Localized and approachable: For example, a skin lesion can be treated with local creams so that maximal effect can be obtained and side effects on the other parts of the body can be avoided.

Generalized and non-approachable: For example, oral or injection antibiotics will be required for infections affecting the internal organs of the body. Rate and extent of absorption from the drug administration site: Drugs used in emergencies are usually given intravenously for quick effect.

Effect of digestive juices and first pass metabolism: For example, since nitroglycerine is digested to a large extent when taken orally, it is given by alternate routes. Rapidity of the desired response in case of emergency or in routine treatment. Cases of emergency usually require intravenous injections so that the medication can reach its site of action quickly. Patient condition and compliance pediatric or geriatric patients, or unconscious patients, or any disease conditions.

For example, unconscious patients cannot take drugs orally. Compliance refers to whether the patient follows medical advice correctly or not.

Do you wish to consult a Pharmacologist for your problem? Sushil C. Poulomi Roy Choudhury. View All. Fongitar Zinc Pyrithionone. Drug Side Effects Calculator. The FDA worked on a tip-off that there was a group supplying Codeine containing cough syrups, often seen as a stepping stone to addiction, to school children. Though participants accepted antimalarial drugs, compliance was low as many saved them for future malarial episodes.

Online education that is well-designed provides nurses with tools to communicate the serious need for blood-thinning drugs to patients to prevent blood clots. Drug Abuse - Routes of Administration. The abused substance may be smoked, inhaled, partaken orally or received by a fetus through the mother's blood stream.

Administering medications to children can be challenging for parents. Parents need to use strategies or creative ideas to convince the child to take medicine. View all. Medindia Newsletters. Subscribe to our Free Newsletters! Routes of Drug Administration - Related News. See also Introduction to Administration and Kinetics of Drugs Introduction to Administration and Kinetics of Drugs Drug administration is the giving of a drug by one of several means routes.

Drug kinetics pharmacokinetics describes how the body handles a drug and accounts for the processes of absorption Many drugs can be administered orally as liquids, capsules, tablets, or chewable tablets.

Because the oral route is the most convenient and usually the safest and least expensive, it is the one most often used. However, it has limitations because of the way a drug typically moves through the digestive tract. For drugs administered orally, absorption may begin in the mouth and stomach.

However, most drugs are usually absorbed from the small intestine. The drug passes through the intestinal wall and travels to the liver before being transported via the bloodstream to its target site.

The intestinal wall and liver chemically alter metabolize many drugs, decreasing the amount of drug reaching the bloodstream. Consequently, these drugs are often given in smaller doses when injected intravenously to produce the same effect.

When a drug is taken orally, food and other drugs in the digestive tract may affect how much of and how fast the drug is absorbed. Thus, some drugs should be taken on an empty stomach, others should be taken with food, others should not be taken with certain other drugs, and still others cannot be taken orally at all. Some orally administered drugs irritate the digestive tract. For example, aspirin and most other nonsteroidal anti-inflammatory drugs Nonsteroidal Anti-Inflammatory Drugs In some cases, treating the underlying disorder eliminates or minimizes the pain.

For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain Peptic ulcers can result from Helicobacter pylori Other drugs are absorbed poorly or erratically in the digestive tract or are destroyed by the acid and digestive enzymes in the stomach.

A drug product can be prepared or manufactured in ways that prolong drug absorption from the injection site for hours, days, or longer. Such products do not need to be administered as often as drug products with more rapid absorption. Sometimes a drug is given through the skin—by needle subcutaneous, intramuscular, or intravenous route , by patch transdermal route , or by implantation.

For the subcutaneous route, a needle is inserted into fatty tissue just beneath the skin. After a drug is injected, it then moves into small blood vessels capillaries and is carried away by the bloodstream. Alternatively, a drug reaches the bloodstream through the lymphatic vessels see figure Lymphatic System: Helping Defend Against Infection Lymphatic System: Helping Defend Against Infection Lymphomas are cancers of lymphocytes, which reside in the lymphatic system and in blood-forming organs.

Lymphomas are cancers of a specific type of white blood cells known as lymphocytes. Protein drugs that are large in size, such as insulin, usually reach the bloodstream through the lymphatic vessels because these drugs move slowly from the tissues into capillaries. The subcutaneous route is used for many protein drugs because such drugs would be destroyed in the digestive tract if they were taken orally. Certain drugs such as progestins used for hormonal birth control Hormonal Methods of Contraception Contraceptive hormones can be Taken by mouth oral contraceptives Inserted into the vagina vaginal rings or barrier contraceptives Applied to the skin patch Implanted under the skin read more may be given by inserting plastic capsules under the skin implantation.

Although this route of administration is rarely used, its main advantage is to provide a long-term therapeutic effect for example, etonogestrel that is implanted for contraception may last up to 3 years. The intramuscular route is preferred to the subcutaneous route when larger volumes of a drug product are needed. Because the muscles lie below the skin and fatty tissues, a longer needle is used. Drugs are usually injected into the muscle of the upper arm, thigh, or buttock. How quickly the drug is absorbed into the bloodstream depends, in part, on the blood supply to the muscle: The sparser the blood supply, the longer it takes for the drug to be absorbed.

For the intravenous route, a needle is inserted directly into a vein. A solution containing the drug may be given in a single dose or by continuous infusion. For infusion, the solution is moved by gravity from a collapsible plastic bag or, more commonly, by an infusion pump through thin flexible tubing to a tube catheter inserted in a vein, usually in the forearm. Intravenous administration is the best way to deliver a precise dose quickly and in a well-controlled manner throughout the body.

It is also used for irritating solutions, which would cause pain and damage tissues if given by subcutaneous or intramuscular injection. An intravenous injection can be more difficult to administer than a subcutaneous or intramuscular injection because inserting a needle or catheter into a vein may be difficult, especially if the person is obese.

When given intravenously, a drug is delivered immediately to the bloodstream and tends to take effect more quickly than when given by any other route. Consequently, health care practitioners closely monitor people who receive an intravenous injection for signs that the drug is working or is causing undesired side effects.

Also, the effect of a drug given by this route tends to last for a shorter time. Therefore, some drugs must be given by continuous infusion to keep their effect constant. For the intrathecal route, a needle is inserted between two vertebrae in the lower spine and into the space around the spinal cord. The drug is then injected into the spinal canal. A small amount of local anesthetic is often used to numb the injection site.

This route is used when a drug is needed to produce rapid or local effects on the brain, spinal cord, or the layers of tissue covering them meninges —for example, to treat infections of these structures. Anesthetics and analgesics such as morphine are sometimes given this way. A few drugs are placed under the tongue taken sublingually or between the gums and teeth buccally so that they can dissolve and be absorbed directly into the small blood vessels that lie beneath the tongue.

These drugs are not swallowed. The sublingual route is especially good for nitroglycerin , which is used to relieve angina, because absorption is rapid and the drug immediately enters the bloodstream without first passing through the intestinal wall and liver.

However, most drugs cannot be taken this way because they may be absorbed incompletely or erratically. Many drugs that are administered orally can also be administered rectally as a suppository.



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