Chapter 53 Administering Oral and Non-Injectable Medications Copyright ©2012 Delmar, Cengage Learning. All rights reserved

Chapter 53

Administering Oral and Non-Injectable Medications

Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Routes of Medication

• Drugs may be administered by many different routes

• Providers select the route based on: – Rate of absorption desired– Distribution– Biotransformation – Elimination


Routes of Administration

• Oral• Buccal • Sublingual• Drops• Inhalation



• Intradermal • Intramuscular• Intranasal • Intraosseous• Intrathecal• Intravenous



• Ophthalmic • Otic • Rectal • Subcutaneous• Topical • Transdermal • Vaginal


Prescriptions

• A written order prepared by a licensed provider authorizing a medication or treatment to be dispensed to the patient for self-administration


Elements of a Prescription

• Provider’s name and address

• Date of issue• Patient’s name and

address• Drug name• Dosage form• Quantity prescribed

• Directions for use• Number of refills• “Dispensed as written”

or if substitutions are permitted

• Manual signature of prescriber


Preparing Prescriptions

• In offices with EHR, prescribers can directly transmit prescriptions directly to the pharmacist

• In offices without EHR, it may be the MA’s responsibility to prepare the handwritten prescription, except for the final review and signature


Preparing Prescriptions

• If MA telephones prescription to the pharmacy: – Provide the pharmacist with ALL the information

contained in the prescription– The pharmacist should repeat back this

information to ensure accuracy


Medication Orders

• Medication orders are direct and complete instructions from the provider for administering medication to a patient while in the office


Elements of a Medication Order

• Full name of the patient• Name of the medication • Dosage• Route of administration• How often, or

frequency, the medication is ordered

• Date and time the order is written

• Specific instructions• Signature of the

prescriber


Seven Rights of Medication Administration

1. Patient2. Medication3. Dose4. Route5. Technique6. Time7. Documentation


Right Patient

• Use TWO identifiers• Ask the patient to cite his or her full name and

another identifier from the chart – Do not ask the patient to reply “yes” or “no”


Right Medication

• Check the medication order and verify the medication at least four times:– When preparing the medication– Upon bringing the medication to administer to the

patient– Prior to administering– Following administration


Medication Errors

• A medication error involves one or more of the following:– Correct drug given to wrong patient– Wrong drug given to the correct patient– Wrong dose administered– Drug given by the wrong route– Drug given at the wrong time


Medication Errors

• NEVER try to cover up a medication error• Notify the provider at once • The provider will to determine what steps

need to be taken


Medication Documentation

• Who, what, where, when, why• Immunization documentation

– Manufacturer– Lot number– Serial number– Container’s expiration date


Using Abbreviations

• There are a number of abbreviations used in the health care office

• Spell out the words if you are unsure of the appropriate abbreviation

• Spell out the words if it could create any confusion as to what is being written


Error-Prone Abbreviations

• Joint Commission’s DO NOT USE list• Institute of Safe Medication Practice’s list of

error-prone abbreviations


Documenting Adverse Reactions

• Document any reaction to medication given, along with corrective actions taken: – Date and time– Type of reaction– Medication administered to reverse the reaction or

restore function– Airway support, when applicable– Level of care– Outcome of interventions– Instructions provided to the patient


Administering Medications

• Oral medications are taken by mouth and intended for absorption through the digestive system

• Other methods are parenteral (intended for absorption outside the digestive system)


Oral Medications

• Oral medications come in a variety of forms: pills, tablets, capsules, caplets, lozenges, syrups, sprays, and other liquids


Oral Medications

• Oral medications have many advantages: – Easily prepared and administered– Easily stored– Generally more economical for the office and

patient– Generally associated with lower risk and less

expense than medication given by injection– Easily for patient to self-administer at home


Sublingual and Buccal Administration

• Sublingual: The medication (usually tiny tablets or spray) is placed under the tongue

• Buccal: The medication is placed or sprayed in the mouth between the gum and the cheek

• The medication is absorbed through the mucous membranes into the bloodstream


Parenteral: Non-injectable

• Routes: inhalation, nasal, ointment, otic, rectal, topical, transdermal, urethral, and vaginal

• Medications given by these routes may be applied directly to the affected body part or inhaled into the lungs


Nasal, Ophthalmic, and Otic

• Usually drops, ointments or salves • Applied directly into the nose, eyes

or ears• Provide immediate relief or direct

absorption by the target tissues


Inhalation

• Medications in the form of gases, sprays, fluids, or powders

• Breathed into the respiratory tract• The patient often self-administers through a

metered inhaler or nebulizer• In the office, oxygen is a form of inhalation

medication


Topical

• Medications in the form of sprays, lotions, creams, ointments, paints, salves, wet dressings, and transdermal patches


Topical

• Used in treating diseases or disorders of the skin or mucous membranes

• Must be applied as prescribed to achieve the desired effect


Rectal

• Most common medication forms are suppositories and enemas


Vaginal

• Medications in the form of creams, suppositories, tablets, douches, foams, ointments, tampons, sprays, and salves

• Patient education is important – Women may be uncomfortable or embarrassed – Vaginal medication should not be used during

menstruation – Advise patients to use disposable panty liners to avoid

medication leaking and staying undergarments or clothes


Documents

Chapter 53 Administering Oral and Non-Injectable Medications Copyright ©2012 Delmar, Cengage Learning. All rights reserved