Nonparenteral Medications

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Nonparenteral Medications

• Unit 13

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Objectives

• List several advantages and disadvantages of the
  oral route of drug administration.
• Describe a transdermal system.
• Describe inhalation and give three uses of
  inhalation therapy.
• Give the MAs responsibility with regard to
  oxygen administration.
• Describe oxygen safety precautions.

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Nonparenteral Medications

• Administered by any route other than by
  injection.
• Examples
• Oral
• Ophthalmic
• Otic
• Nasal
• Inhalation
• Administration of oxygen

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Oral Medications

• Benefits of using oral route
• Safe
• Most convenient
• Most economical
• Solid forms tablets, capsules, caplets
• Liquid forms solutions, suspensions, syrup
• Other forms sublingual, buccal

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Units of Measurement

• Weight (dosage) micrograms, milligrams, grams,
  grains, milliequivalents, units
• Volume milliliters, cubic centimeters, drams,
  ounces, teaspoons
• Amount given is based upon the age and weight of
  the patient (average 20-60 y.o. and 150 lbs)

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Disadvantages of the Oral Route

• Objectionable odor
• Objectionable taste
• Cause discoloration of teeth, mouth, and tongue
• Irritate the gastric mucosa
• Poor absorption
• Too large to swallow

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Equipment and Supplies

• Medicine cup
• Water cup (3 oz)
• Medicine dropper
• Selection of container depends upon
• Physical structure of medication
• Amount of medication prescribed
• Size and calibrations on container

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Oral Medication Procedure

• Verify physicians order
• Follow the 6 rights
• Wash hands
• Assemble equipment and supplies
• Obtain the correct medication
• Check the medication card
• Calculate dosage

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Oral Medication Procedure

• Correctly prepare medication
• Check label with medicine card
• Identify patient
• Explain procedure
• Provide water, milk, juice
• Administer medication
• Observe patient for adverse reactions

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Crushed Medications

• Guidelines
• 1. Ask before attempting to crush (most tablets
  can be crushed)
• 2. Buccal, sublingual, sustained-release, or
  enteric coated tablets should NOT be crushed
• Unit dose medications should be crushed in the
  wrapper prior to opening

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Crushing Methods

• Tablet crusher
• Mortar and pestle
• Spoons
• Incorporate into small amounts of food

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Ophthalmic Medications

• Administered by instillation slowing pouring or
  dropping a liquid into a cavity or onto a surface

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Eye Instillation Procedure

• 1. Explain procedure to the patient. Inform
  patient they may experience blurred vision
  temporarily.
• 2. Position the patient in a sitting or lying
  position.
• 3. Instruct patient to stare at a fixed spot
  during instillation.

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Eye Instillation Procedure

• 4. Prepare medication
• 5. Have patiene look up at the ceiling.
• 6. Gently pull lower lid down.
• 7. Place drops/ointment in the lower surface of
  the eyelid.
• 8. Have patient close their eyes and blink to
  distribute medication.

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Otic Medications

• Administered by instillation
• Performed to treat
• 1. Treat infection/inflammation
• 2. Soften ear cerumen
• 3. Local anesthetic effect
• 4. Immobilize a trapped insect

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Otic Medication Procedure

• Position patient to either lie on unaffected side
  or sitting position with head tilted toward
  unaffected ear.
• Pull the top of the ear upward and back (adult)
  or pull earlobe downward and backward (child)
• Instill drops into affected ear
• Maintain position for 5 minutes

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Nasal Medications

• Administered by
• Instillation, spray, nasal inhaler
• Used to treat symptoms of
• Seasonal rhinitis, nasal congestion
• Best administered by the patient!

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Rectal Medications

• Administered by instillation/insertion
• Types
• Suppository, ointment, enema

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Suppositories

• Uses include
• Laxative
• Narcotic analgesic
• Local anesthetic
• Anti-inflammatory agent
• Antipyretic agent
• Antiemetic

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Enemas

• Delivering a solution or medication into the
  rectum and colon
• Uses cleanse the colon for surgery

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Ointments

• Drug combined with a base of petroleum jelly or
  lanolin
• Ex. Preparation H

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Special Delivery Medications

• Transdermal system adhesive patch that my be
  applied to the body near the treatment site
• 4 layers include
• 1. Impermeable back keep drug in
• 2. Reservoir containing the drug
• 3. Porous membrane (controlled release)
• 4. Adhesive layer keeps patch in place

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Inhalation Drugs

• Providing cold or warm air, in the form of
  medicated steam or aerosol therapy for the
  patient to breathe
• Used in the treatment of
• Local treatment of infections
• Serious respiratory infections
• Supply medication absorbed through the lungs

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Administration of Oxygen

• With an inadequate supply, the body enters a
  state of hypoxemia.
• Normal range for oxygen in the arterial blood is
  80-100 mm Hg

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Hypoxemia

• Symptoms include
• Anxiety
• Cyanosis
• Dyspnea
• Tachycardia
• Increased blood pressure
• Confusion

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Conditions/Diseases

• Apnea
• Carbon monoxide poisoning
• Congestive heart failure (CHF)
• COPD
• Myocardial infarction
• Pulmonary edema
• Shock

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Oxygen Dosage

• Dosage is based on individual needs
• Physician will prescribe
• Flow rate
• Concentration
• Method of delivery
• Length of time for administration
• Ordered as L/minute and of conc.

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Oxygen Toxicity

• Develops when 100 oxygen is breathed over a
  prolonged period
• The higher the dose, the shorter time required to
  develop toxicity
• Symptoms include nausea, vomiting, fatigue,
  numbness, tingling of extremities

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Methods of Oxygen Delivery

• Methods of delivery include
• Nasal Cannulas
• Masks
• Nasal catheters
• Isolettes
• Hoods
• Tents
• Portable oxygen tanks

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Nasal Cannula

• Use when a low concentration of oxygen is desired
• Most convenient method
• Can dry out the nasal passages may require
  humidification

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Oxygen Masks

• Use when patient requires high humidity and a
  precise amount of oxygen flow

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Oxygen Precautions

• Oxygen supports combustion!
• Do not use around electrical appliances
• Use suction machines, x-ray and EKG equipment
  with caution while oxygen is being administered