Ideal administration
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A lubricant can be used to reduce friction against the vaginal mucosa as the medication is administered. Position the patient onto their back with legs bent and feet resting flat on the bed. It is recommended that the patient remains on the side for 5 to 10 minutes unless otherwise specified by the medication’s directions.
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If administering a laxative suppository, the patient will need a bedpan or commode or be placed close to the toilet. A lubricant may be used for the patient’s comfort. Separate the buttocks with the non-dominant gloved hand and gently insert the medicine 2 to 4 cm into the rectum using a dominant hand's gloved index finger. It is recommended to have the patient lie onto the left side with the right knee bent towards the chest as this position enables the medication to flow into the rectum and subsequently to the sigmoid colon by gravity. The injection is usually at an angle if using a needle/syringe or at a perpendicular angle if using an injector pen. It is recommended that instead of using the same site, patients rotate the sites of injection to avoid complications such as lipohypertrophy that can cause incomplete medication absorption. Ī subcutaneous route requires minimal skills and training, and patients can often quickly learn to inject medications to themselves. When injecting to the dorsogluteal site, aspirating for a few seconds is recommended, given its proximity to the gluteal artery. Skin traction and deep pressure to the muscle can help decrease patients' pain and discomfort. Intramuscular injection should be done at a perpendicular angle as it has been shown to be the most effective method for patient comfort, safety, and medication efficacy. In central lines or peripherally inserted central catheter (PICC) lines for the medication administration, ultrasound guidance is often used. However, when used, the tourniquet must be removed before injecting the medication to prevent extravasation. Techniques involved in each route of medication administration are different, and some of the important points are summarized as follows:Ī tourniquet may be used over the site intended for the intravenous medication to make the vein more visible and easier to access. Similarly, an inhaled medication is contraindicated in patients with airflow obstruction. An intranasal medication is contraindicated in patients with nasal trauma, anatomic obstruction, presence of a foreign body, or copious mucous or bleeding. Subcutaneous injection volumes larger than 2 mL are associated with adverse effects, including pain and leakage at the injection site. Doses that require to be injected more than 1.5 mL at once should be avoided. An intramuscular route is contraindicated in an active infection or inflammation at the site of drug administration, myopathies, muscular atrophy, thrombocytopenia, or coagulopathy.Ī subcutaneous route of medication is contraindicated in an actively infectious or inflamed site. A rectal route is contraindicated in patients with active rectal bleeding or diarrhea or after a recent rectal or bowel surgery. An oral medication route is contraindicated for patients who cannot tolerate oral drugs, such as those who have altered mental status or have nausea or vomiting that hinder them from safely ingesting the drug orally. Each medication administration route has unique contraindications, and the healthcare team members need to recognize them.