PHARM CAL LAB for the weak, elderly, small children, infants; no
coordination required
MAJOR ROUTES OF ADMINISTRATION:
1. ENTERAL- drugs taken orally or sublingually
2. PARENTERAL- delivers drug to systemic
circulation
3. TRANSDERMAL
4. INHALATION
5. PHARYNGEAL
6. TOPICAL
7. RECTAL
8. VAGINAL
9. NASAL
10. EYE OR EAR DROPS
11. INTRASPINAL
TRANSDERMAL PATCH- contains medication;
applied to skin for slow, systemic absorption (24
hours); avoids gastrointestinal problems and
provides a more consistent drug level in the blood
 DURGESIC- 3 days absorption
 CATAPRES- 7 days absorption
 CONTRACEPTIVE DRUGS- 1 month absorption
METHOD:
1. Remove existing patch while wearing gloves,
cleanse and dry the area (avoid hair)
2. Label patch with date, time, initials
3. Remove transparent cover inside the patch
4. Apply the patch with dull plastic side up
5. Document location
INHALERS- absorbed rapidly by mucosal lining of
respiratory tract
 BRONCHODILATORS- dilate bronchial tubes
 GLUCOCORTICOIDS- anti-inflammatory agent
 MUCOLYTICS- liquefy bronchial secretions
1. METERED-DOSE INHALERS (MDIs)
a. STANDARD- pressurized gas that expels
medication; press canister while inhaling
fully
b. BREATH-ACTIVATED- triggered by inhaling
through mouthpiece; less coordination
c. WITH SPACERS- reservoir to hold
medication until inhaled; has a one-way
valve to prevent aerosol from escaping
2. DRY POWDER INHALERS- small amounts of
medication that must be strongly inhaled for it
to get to the lungs; difficult for <6 year old
children
METHOD (MDI):
1. Insert medication canister to plastic holder, test
spray.
2. Shake well and remove cap from mouthpiece.
3. Breathe through mouth, expel air.
4. Hold inhaler upright, keep lips securely around
mouthpiece
5. Inhale while pushing top of medication canister
once
6. Hold breath for a few seconds and remove
mouthpiece, exhale slowly.
METHOD (WITH SPACER):
1. Inhale as soon as canister is depressed.
2. Check if valve opens or closes with each breath.
NEBULIZERS- convert medication into fine mist;
prescribed in a prefilled dosette in a nebulizer that is
connected to a small compressor which aerolizes
medication; inhaled via mouthpiece or face mask;
NASAL SPRAY AND DROPS- relieves nasal
congestion caused by upper respiratory tract
infections; shrinks swollen nasal membranes
 GLUCOCORTICOIDS
 VASOCONSTRICTORS
METHOD (NASAL SPRAY):
1. Tilt head slightly back or forward.
2. Insert tip into one, occlude the other.
3. Inhale as the container is squeezed.
4. Remain tilted for several minutes, do not blow
nose.
5. Drink plenty of fluids to avoid microbial
overgrowth.
METHOD (NASAL DROP):
1. Tilt head back, insert tip without touching nasal
membranes and instill number of drops.
2. Remain tilted for 5 minutes; breathe with mouth.
3. Cleanse the dropper.
4. For frontal and maxillary sinuses: slowly
alternate head tilt side to side while in supine
(lying down) position
For ethmoidal and sphenoidal sinuses: lean
forward with head towards the knees
EYE DROPS AND OINTMENT- for various eye
disorders, allergies, eye examination, eye surgery
METHOD (EYE DROP):
1. Tilt head back and look up towards ceiling.
2. Pull down lower lid of eye, place drops into lower
conjunctival sac, DO NOT TOUCH DROPPER
TO EYE OR EYELASHES
3. Press gently on the medial nasolacrimal canthus
(side closer to nose) with tissue to prevent
systemic absorption
4. Blink then keep eyes closed for several minutes.
5. Wait 5 minutes between medications (if more
than 1).
METHOD (EYE OINTMENT):
1. Tilt head back and pull down lower lid of eye
2. Apply about ¼ inch long ointment to
conjunctival sac
3. Keep eyes closed for 2-3 mintues; expect
blurred vision for a short time after application
EAR DROPS- to soften and loosen cerumen (wax)
in the ear canal; anesthetic effect; immobilize
insects in the ear canal; treat infection
METHOD:
1. Lie down or tilt head toward unaffected side.
2. For Adult: pull auricle up and back
For children: pull auricle down and back until
age 3
3. Instill number of drops
4. Remain in this position for 2-5 minutes.
PHARYNGEAL SPRAY, MOUTHWASH, LOZENGE-
to reduce throat infection; anesthetic and antiseptic
effects; for local effect on the throat
METHOD:
1. Sit upright.
2. Spray: place tongue blade over tongue, hold
nozzle outside the mouth and directly spray to
back of throat
 Mouthwash: swish solution around mouth,
spit onto emesis basin or sink
Lozenge: place lozenge in the mouth and
suck until dissolved, do not chew or swallow
TOPICAL PREPARATIONS: LOTION, CREAM,
OINTMENT- protect skin, prevent dryness, treat
itching, relieve pain
METHOD (TOPICAL LOTION):
1. Cleanse skin area and dry
2. Shake lotion container and rub lotion thoroughly.
METHOD (TOPICAL CREAM/OINTMENT):
1. Cleanse skin area and dry.
2. Use a sterile tongue blade or gauze for
application of long, smooth strokes.
OR
Squeeze line of tube onto gloved finger from tip
to tirst skin crease (finger unit or FTU, weighs
0.5g), apply.
RECTAL SUPPOSITORY- torpedo-shaped; relieve
vomiting when unable to take oral medication,
relieve pain and anxiety, promotes defecation,
destroyable by digestive enzymes
METHOD:
1. Sims position.
2. Expose anus by lifting the upper portion of the
buttock.
3. Lubricate suppository with water-soluble
lubricant.
4. Insert narrow end past anal sphincter and into
rectum, 3 inches or 7-8 cm.
5. Remain in supine or sims position for 5-10
minutes.
VAGINAL SUPPOSITORY- “pessaries”; cone-
shaped; treat vaginal infection and inflammation
METHOD:
1. Lithotomy position (feet on table or bed).
2. Place suppository at the tip of applicator.
3. Lubricate suppository with water-soluble
lubricant.
4. Insert applicator downward then upward and
backward 3-4 inches or 8-10 cm.
5. Remain lying down for 5-15 minutes.
METHODS OF DRUG CALCULATION
2. Determine drug dose per body weight;
drug dose X body weight X frequency (per
day)
3. Choose one of the four drug calculation
methods for the amount of drug to be given
 BODY SURFACE AREA- estimated
mathematical function of height and weight;
most accurate way to calculate drug dosage;
correct dosage is proportional to surface area;
chemotherapy and rug dosages for infants and
children
RECONTSITUTION- the process of restoring
something dried to its original state by adding
water to it; front line pharmacist may do this
1. Lightly shake powder before adding water
to prevent it from sticking to the bottom or
side of bottle
2. Use distilled, sterile, or bottled water to
retard development of bacterial growth.
REFRIGERATE.
3. Pour total amount of water in graduated
cylinder,
4. Pour half into antibiotic, replace lid and
shake
5. Shake for 30 seconds to 1 minutes only,
inspect bottom every after shaking. Never
use a tool to mix, instead tap the bottle or
to the edge of the counter.
6. Repeat for second half until no powder
remains.
7. Expiry date is 14 days
8. Rinse out graduated cylinder to avoid
allergic reactions, store upside down or
covered.
ORAL ADMINISTRATION- most convenient and
economical method to give medications;
absorbed by gastrointestinal tract mainly the
small intestine
ENTERAL FEEDING- tube feeding; unable to take
nourishment by mouth; costs much less than
intravenous therapy
 neurological deficits who can’t swallow
 debilitated
 burns and malnutrition disorders
 upper gastric obstructions
 radical heads and neck surgery

BASIC FORMULA- calculate drug dosages Medications in time-release, enteric-coated,

D(desired dose) sublingual, or bulk-forming laxatives cannot be
×V ( vehicle )=(X ) amount ¿ give administered enterally.
H ( on−hand dose )
RATIO AND PROPORTION
H : V :: D : X

FRACTIONAL EQUATION
H D
=
V X
DIMENSIONAL ANALYSIS- factor labelling or label
factor method
 DRUG LABEL FACTOR: V with equivalence in
units (H)
 CONVERSION FACTOR
 DRUG ORDER FACTOR: dosage desired (D)
V ×C × H × D
V=
H ×C × D ×1

INDIVIDUALIZED DRUG DOSING

 BODY WEIGHT(kg)- primary way of

medication for adults and children
1. Convert pounds to kg; 1kg=2.2lb