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Routes Of Drugs 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.
1. ORAL ROUTE:- This is taking drugs by the month. The drugs given through this route include mixtures or suspensions, pills, tablets, and capsules.
2. RECTAL ROUTE:- This is introducing drugs 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 gastric juice. To give an injection to patients, the nurse must:
- Ensure that the injection is the prescribed one and that the name of the drug is written on the ampoule on the label placed on the ampoule.
- Use a drug file to scratch the neck of the ampoule and then protecting the fingers with 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, but it also causes some of the broken bottles to be scattered all over the injection room thereby endangering patients who by chance do not wear shoes.
- 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 sequel. Care should be taken when expelling the air so that the drug does not spill and contaminate the nurse as this may cause allergic skin reactions.
The following are routes of giving injections
- Intramuscular
- into a muscle
- Intravenous
- into a vein
- Subcutaneous
- under the dermis
- Intra arterial
- into an artery
- Intrathecal
- into tri? subarachnoid space
- Intra atrium
- into the atrium of the heart.
The nurse is concerned only with the first three routes. In public hospitals, the nurse is not allowed to give intravenous injections but it is necessary that they know how to give them.
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 are 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 vain. If it is in the vein, blood will enter 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 is applied firmly at the point.
Giving injections through the intravenous route requires extra care:
- Identify a straight vein.
- Tie a tourniquet above the point the needle will be inserted and clean the vein with a wet spirit swab.
- 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.
- Remove the tourniquet and inject the drug either slowly or as a bolus depending on the type of drug.
- Remove the syringe and needle and use a dry swab to apply
- gentle pressure on the site.
- It should be emphasized that not all drugs are given
intravenously. Always follow the doctor’s prescription and cross-check with him or her if you are not too sure of what is written.
OTHER METHODS OF DRUG ADMINISTRATION:
- INUNCTION:- Here the drug is introduced by rubbing it into the skin. An example of such a drug is ointment and balms.
- INHALATION: This is the inhaling of vapor into the respiratory tract from a container or from a piece of material where the drug Is dropped. An example is Vicks vapor rub used in catarrh and Ventolin Inhaler used by asthmatics.
- INSTALLATION – 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 eye drops and ear. drops, and nasal drops,
- 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 off the power into a cavity or on to mucus membrane. An example is insufflating cicatrix 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.
- IONTOPHORESIS:- Introducing drugs into the tissue by means of electric current. It is commonly used in physiotherapy clinics. An example is infrared rays.
THE ROLE OF A NURSE IN DRUG ADMINISTRATION
1. She should educate the patient on the action and side effects of the drugs.
2. She should ensure patient compliance.
3. She should note any effects-therapeutics adverse and side effects of specific drugs and report the same to the doctor.
4. Should administer only the drug prescribed, noting 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 an inadequately labeled drug.
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