ROUTES OF DRUG ADMINISTRATION

There are various routes through which drugs can be administered to a patient. The route depends on the type of drug to be given. The three most commonly used routes are orally, rectally and injections.

 

  ROUTES OF DRUG ADMINISTRATION 

  There are various routes through which drugs can be administered to a patient. The route depends on the type of drug to be given. The three most commonly used routes are orally, rectally and injections. READ everything about route of drug administration here.

1. Oral route :-This is taking drugs by mouth. The drugs given through this route include mixtures or suspensions, pills, tablets and capsules.

2. Rectal Route :-This is introducing drug through the rectum. Such drugs include Suppositories and Enema.

3. Injections :-This route is used when fairly quick action is required and when the drug would be altered by gastricjuice. To give injection to patients, the nurse must :

(a) Ensure that the injection is the prescribed one and that the name of the drug is written on the ampoule or on the label placed on the ampoule.

(b) Use a drug file to scratch the neck of the ampoule and then protecting the fingers with a cotton wool or wool gauze, break the ampoule at the neck. The practice where nurse uses artery forceps
to break the neck of the ampoule is highly condemned. It not only causes some of the drugs to spill, it also causes some of the broken bottle to be scattered all over the injection room thereby endangering
patients who by chance do not wear shoes.

(C) After drawing up the drug into a sterile syringe, usually disposable, ensure that air bubbles are expelled, if any, before injection. This will prevent air embolism and its dangerous sequele.

(D) Care should be taken when expeling the air so that the drug does not spill and contaminate the nurse as this may cause allergic skin reaction.

The following are routes of giving injections

Intramuscular               =into a muscle
Intravenous                    = into a vein
Subcutaneous                  =under the dermis
Intra arterial                    = into an artery
Intra thecal                        =into the subarachnoid space
Intra atrium                       =into the atrium of the heart.

 The nurse is concerned only with the first three routes.  But it is necessary that they know how to give it.

    The intramuscular route is the most commonly used. It is usually given in the gluteal muscle, of the buttocks or in the thigh. In using the gluteal muscle, care must be taken to avoid injury to the sciatic.
Nerve and the superior gluteal artery. For safety, the buttocks is divided into four quadrants. inject only in the upper outer quadrant.
The nursing sister in charge is advised to demonstrate this to the students.
    The needle is inserted vertically into the muscle, then the piston is slightly withdrawn to ensure that the needle is not in vein. If it is in the vein, blood will enter into the syringe and the nurse is advised to remove the needle and try another point. If it is not in the vein, the drug is injected. The needle is quickly removed and a dry swab applied firmly at the point.

Giving injections through the intravenous route require extra care :

1. Identify a straight vein.

2. Tie a tournique above the point the needle will be inserted and clean the vein with a wet spirit swab.

3. Insert the needle of the syringe containing the drug to be injected, and slightly withdraw the piston. If blood enters the syringe, then it is inside the vein.

4. Remove the tournique and inject the drug either slowly or as a bolus depending on the type of drug.

5. Remove the syringe and needle and use a dry swab to apply a gentle pressure on the site.

It should be emphasized that not all drugs are given intravenously. Always follow doctor's prescription and crosscheck with him or her if you are not too sure of what is written.

OTHER METHODS OF DRUG ADMINISTRATION :

1. Inunction :-Here the drug is introduced by rubbing it into the skin. Example of such a drug is the ointment and balms.

2. Inhalation :-This is the inhaling of vapour into the respiratory tract from a container or from a piece of material where the drug ls dropped. Example is vicks vapour rub used in catarrh and ventolin Inhaler used by asthmatic.

3. Instillation :-A few drops of the drug may for instance be introduced into the eye or the ear by a pipette or by using a special dropper. Examples of such drugs are the eye drops, ear drops, and nasal drop.

Insertion :-The drug administrated through this route are made of gelatin base. Such drugs include pessaries and bougies that can be introduced into the vagina or urethra.

Insufflation :-This is blowing of a power into a cavity or on to mucus membrane. An example is insufflating cicatrin powder or penicillin powder into a wound. A special appliance called an insufflator is used. Such powders are supplied in plastic containers which, when squeezed, act as an insufflator.

Implantation :-Drug here is placed under the skin and is slowly absorbed.

lontophoresis :-Introducing drugs into the tissue by means of electric current. It is commonly used in physiotherapy clinics. Example is infra red rays.

THE ROLE OF A NURSE IN DRUG ADMINISTRATION 

1. She should educate the patient on the action and side effect of the drugs.

2. She should ensure patient's compliance.

3. She should note any effects-theraprutic adverse and side effects of specific drugs and report same to the doctor.

4. Should administer only the drug prescribed, nothing but the correct dosage, right time, specified route and to the right patient.

5. She is encouraged to question any prescription which appears doubtful, illegible or out of date.

6. She should not use expired drugs, a leaking sterile syringe or Infusion set or inadequately labelled drug.

READ ALSO: GUIDELINES FOR SAFE AND EFFECTIVE DRUG USE