Pharmacokinetics and Route Admnistration

Front

Back

What are the 4 main routes of medication administration?

Oral/enteral, topical, inhalation, and parenteral.

What routes are included under oral/enteral administration?

Tablets, capsules, liquids, suspensions, elixirs, lozenges, sublingual, buccal, nasogastric tubes, and gastrostomy tubes.

What routes are included under topical administration?

Transdermal, eye, ear, nose, rectal suppositories, and vaginal.

What routes are included under inhalation administration?

Metered-dose inhalers (MDI) and dry-powder inhalers (DPI).

What routes are included under parenteral administration?

Intradermal, subcutaneous, intramuscular, intravenous, and epidural.

What are contraindications for oral medication administration?

Vomiting, decreased GI motility, absent gag reflex, difficulty swallowing, and decreased level of consciousness.

What position should a client be in for oral medication administration?

Sitting upright to help swallowing.

Why might analgesics be given with small amounts of food?

Because analgesics can irritate the stomach.

What food/beverage should be avoided with some oral medications?

Grapefruit juice because it can interact with medications.

Which oral medications should not be crushed?

Enteric-coated, time-release, extended-release, and fluid-filled medications.

What should be done before giving liquid suspensions or elixirs?

Shake them if needed, dilute if ordered, and measure on a flat surface.

What are advantages of oral medications?

They are safe, inexpensive, easy, and convenient.

What are disadvantages of oral medications?

Variable absorption, possible GI/first-pass inactivation, and the client must be conscious and cooperative.

What does sublingual mean?

Medication placed under the tongue.

What does buccal mean?

Medication placed between the cheek and gum.

Why do sublingual and buccal medications work quickly?

They absorb through vascular mucous membranes and bypass the liver.

What should clients avoid while sublingual/buccal medication dissolves?

Do not eat or drink until it completely dissolves.

Can sublingual medication be given through an NG tube?

No. It should be given under the tongue.

What form of medication is preferred for NG or gastrostomy tubes?

Liquid medications, after provider approval.

Should medications be mixed with enteral feedings?

No. Do not mix medications with enteral feedings.

How should multiple medications be given through an NG/gastrostomy tube?

Give each medication separately.

How much sterile water is used to dissolve crushed tablets/capsule contents?

15 to 30 mL of sterile water.

What must be verified before giving medication through a tube?

Proper tube placement.

Why flush tubing before and after tube medications?

To prevent clogging.

What are topical medications?

Medications applied directly to the skin.

What are examples of topical medication forms?

Powders, sprays, creams, ointments, pastes, oils, and suspension-based lotions.

What are advantages of topical medications?

They are painless and usually have limited adverse effects.

What must nurses wear when applying topical medications?

Gloves; never apply with bare hands.

How should skin be prepared before topical medication?

Wash with soap and water, then pat dry.

When is surgical asepsis needed for topical medications?

When applying medication to open wounds.

What is a transdermal medication?

A medication patch absorbed through the skin for systemic effects.

Where should transdermal patches be placed?

On a clean, dry, hairless area.

Why rotate transdermal patch sites?

To prevent skin irritation.

How should a client be positioned for eye drops?

Sit upright, tilt head slightly, and look up.

Where should eye ointment be applied?

As a thin ribbon along the lower eyelid from inner to outer canthus.

How long should you wait between two eye medications in the same eye?

At least 5 minutes.

How should an adult ear canal be straightened before ear drops?

Pull the auricle upward and outward.

How long should a client remain side-lying after ear drops?

2 to 3 minutes.

Why warm ear drops with the hands?

Cold drops can cause dizziness.

What position is used for nasal drops?

Supine position so medication enters properly.

What should clients do while receiving nasal drops?

Breathe through the mouth.

How long should clients avoid blowing their nose after nasal drops?

At least 5 minutes.

What should be done before using nasal spray?

Prime the spray.

Where should the nasal spray nozzle point?

Away from the center of the nose.

What position is used for rectal suppositories?

Left lateral or lateral semi-prone recumbent position.

Where should a rectal suppository be inserted?

Beyond the internal sphincter.

How long should clients stay flat after rectal suppository insertion?

At least 5 minutes.

What position is used for vaginal medication insertion?

Supine with knees bent and feet flat near the hips.

What should be done before vaginal medication if needed?

Provide perineal care.

How long should clients remain supine after vaginal medication?

At least 5 minutes.

What does MDI stand for?

Metered-dose inhaler.

What does DPI stand for?

Dry-powder inhaler.

What is the first step when using an MDI?

Shake the inhaler.

How should a client inhale when using an MDI?

Begin slow and deep inhalation while pressing the inhaler.

How long should the client hold their breath after using an MDI?

10 seconds.

How long should the client wait between MDI inhalations?

At least 1 minute.

Why rinse the mouth after corticosteroid inhalers?

To reduce the risk of oral infection.

Should a DPI be shaken?

No. Do not shake a DPI.

What should clients follow when preparing a DPI?

The manufacturer’s directions, such as loading the medication pellet.

What are general nursing actions for parenteral medications?

Use correct needle size/length, match syringe size to volume, rotate sites, document sites, and avoid inflamed/scarred areas.

Where should sharps be discarded?

In puncture-proof sharps containers.

What should nurses monitor after IV medication administration?

Therapeutic and adverse effects immediately.

What is key technique for intradermal injections?

Insert needle bevel up and create a small bleb.

Should an intradermal injection site be massaged?

No.

What medications are commonly given subcutaneously?

Small doses of nonirritating, water-soluble medications like insulin and heparin.

What are common subcutaneous sites?

Abdomen, upper hips, lateral upper arms, and thighs.

When are intramuscular injections used?

For irritating medications, oil-based solutions, and aqueous suspensions.

What are advantages of subcutaneous and intramuscular injections?

Useful for poorly soluble medications and slow absorption over time.

What are disadvantages of injections?

Cost, inconvenience, pain, tissue/nerve damage risk, and infection risk.

What IV sites are preferred in adults?

Peripheral veins in the arm or hand.

What IV sites may be used in newborns?

Veins in the head, lower legs, and feet.

What are advantages of IV medication administration?

Rapid onset, immediate absorption, precise control, and ability to give large fluid volumes.

What is a major danger of IV medications?

Wrong dose or wrong medication acts immediately and can be dangerous.

What is the epidural route used for in the slides?

IV opioid analgesia such as morphine or fentanyl.

What is pharmacokinetics?

How medications travel through the body.

What does ADME stand for?

Absorption, distribution, metabolism, and excretion.

What is absorption?

Movement of medication from the administration site into the bloodstream.

What affects medication absorption?

Route, site, solubility, pH, food, GI emptying, other medications, and medication form.

What does rate of absorption determine?

How soon the medication takes effect.

What does amount absorbed determine?

The intensity of the medication’s effect.

What does enteral mean?

Through the GI tract, such as oral administration.

What does parenteral mean?

By injection.

Which route has no absorption barrier?

Intravenous.

What is oral absorption affected by?

GI epithelial barrier, medication stability/solubility, pH, emptying time, food, other meds, and drug form.

What can reduce sublingual/buccal absorption?

Swallowing before dissolution, because gastric pH can inactivate the medication.

What is the absorption pattern for sublingual/buccal medications?

Quick systemic absorption through highly vascular mucous membranes.

What can limit rectal/vaginal absorption?

Stool in the rectum or infectious material in the vagina.

What is the absorption pattern for rectal/vaginal medications?

Easy absorption with local and systemic effects.

What can limit inhalation absorption?

Poor inspiratory effort.

What is the absorption pattern for inhaled medications?

Rapid absorption through alveolar capillary networks.

What is the absorption pattern for intradermal/topical medications?

Slow, gradual absorption, usually local but can be systemic.

Why can lipid-soluble topical medications have systemic effects?

They can pass through subcutaneous fatty tissue.

What affects subcutaneous/intramuscular absorption?

Medication solubility and blood perfusion at the injection site.

How fast do highly water-soluble SC/IM meds absorb?

Rapidly, about 10 to 30 minutes.

What happens at highly perfused injection sites?

Medication absorbs faster.

What is IV absorption like?

Immediate and complete because medication enters directly into the blood.

What is distribution?

Transportation of medications to sites of action by body fluids.

What factors influence distribution?

Circulation, cell membrane permeability, and plasma protein binding.

How can poor circulation affect distribution?

It can delay medication distribution.