We take medications to diagnose, treat, or prevent illness. Drugs are potentially dangerous, even if they are meant to improve our health. It is important that you take any and all medications correctly, always following your doctor's instructions. Always take all of your medication, and at the amounts and times the instructions say.
If you are unable to give yourself a required medication, a nurse may help you. This may happen if you are in a healthcare facility, or if the medication is very difficult to take by yourself. Medications have different ways they need to be taken in order to work properly. Not all of these can be done at home or without special training.
Medications need to be safe and effective. Doctors, nurses, nurse practitioners and a few other professionals are trained in how to safely give you medication. Administration of medications requires understanding how the medication is entering your body. It also requires knowledge of when the medication needs to be administered, possible side effects, and toxicity. Training for professionals also includes proper storage, handling, and disposal of medications.
Medication error due to the wrong drug, the wrong dose, the wrong timing of administration, or the wrong route of administration accounts for 1.3 million injuries each year in the U.S., according to the Food and Drug Administration (FDA).
Medication can be given many different ways. Some examples include:
- oral route: swallowed by mouth as a pill, liquid, tablet or lozenge
- rectal route: suppository inserted into the rectum
- intravenous route: injected into vein with a syringe or into intravenous (IV) line
- infusion: injected into a vein with an IV line and slowly dripped in over time
- intramuscular route: injected into muscle through skin with a syringe
- topical route: applied to skin
- enteric: delivered directly into the stomach with a G-tube or J-tube
- nasal: sprays or pumps that deliver drug into the nose
- inhaled: inhaled through a tube or mask (e.g. lung medications)
- otic: drops into the ear
- ophthalmic: drops, gel or ointment for the eye
- sublingual: under the tongue
- buccal: held inside the cheek
- transdermal: a patch on the skin
- subcutaneous: injected just under the skin
Some routes may not be safe or effective. This can be due to certain health conditions, dehydration, an inability to swallow, or other factors. Proper preparation must be taken to prevent complications from the route of administration. For example, cleaning the skin and using sterile syringes when injecting via the intravenous or intramuscular routes is important for preventing infection.
Any prescription or instructions state how often and how much of a medication should be given. Calculating the correct dosage for some medications can be very precise, and should only be done by professionals. Only that dose stated in the prescription or instructions should be taken.
Sometimes it is very tricky to find the right dose of a sensitive medication. For example, thyroid medications and blood thinners require frequent blood tests to find if the right dose is being given. Dosage is affected by age, weight, kidney and liver health, and other health conditions.
Timing is also important in medication administration. Some medications need to reach a consistent level in your bloodstream in order to be effective. This means that your medications need to be administered at the right times to keep that level of drug in your system.
Usually your liver or kidneys will remove the medication from your blood. High levels of the drug can build up in your system and lead to toxicity if you take the dose too soon. If you miss a dose or wait too long between doses, there may not be enough drug in your body to work properly.
Common Latin abbreviations used in prescriptions include:
p.o. - by mouth
p.c. - after meals
a.c. - before meals
b.i.d. - twice a day
t.i.d. - three times a day
q.i.d. - four times a day
q.o.d. - every other day
qAM - in the morning
q4h - evry four hours
h.s. - at bedtime
ad lib. - as desired
prn - as needed
gtt. - drops
Medication administration is not just giving a medication to a patient. It also involves observation of what happens afterward. Professionals are trained to know how medications move through the body, what the effect of the medication is, and what adverse effects may occur.
Adverse effects may include overdose of the drug, allergic reactions to the drug, and drug interactions between multiple drugs. You must tell your healthcare provider about any other medications you may be taking, or any times you've had an allergy to drugs or foods.
Tolerance is another risk with certain medications. Over time, you may need to take more of a medication as your body becomes used to the original dose. Only change the dose of medication you are taking after speaking with your doctor.