TYPES OF DRUG PREPARATION :

1. Aqueous Solution- one or more drug dissolve in water. Ex. Ampicillin/ cloxacillin.
2. Aerosol Spray or Foam- a liquid powder, or foam deposited in a thin layer of the skin by air pressure.
3. Aqueous Suspension- one or more drugs finely divide in a liquid. Ex. Water.
4. Capsule- a gelatinous container to hold a drug in powder or liquid or oil form.
5. Cream- a non-greasy, semisolid preparation used on the skin.
6. Extract- a concentrated form of the drug made from vegetables or animals.
7. Elixir- a sweetened or aromatic solution of alcohol used as a vehicle for medical agents. Ex. Cough
medication.
8. Fluid with extract- a concentrated form of a drug made from vegetables sources: the most concentrated of
all fluid preparation.
9. Syrup- an aqueous solution of sugar often to disguise unpleasant testing drugs.
10. Pill- one or more drug with cohesive material in oval, round, or flattened shape.
11. Tablets- a powdered drug compressed into hard small disc; some are readily broken along a scored line;
others are enteric coated to prevent them from dissolving in the stomach.
12. Lozenges(troches)- a flat, round or oral preparation that dissolves and releases a drug when held in the
mouth.
13. Powder- finely ground drug(s) either for internal or external use. Ex. Paper tab
14. Liniment- oily liquid used for the skin.
15. Ointment- a semisolid preparation of one or more drugs used for application to skin mucous
membrane.
16. Paste- like ointment but thicker and stiffer that penetrates the skin less than an ointment. Ex. Nitrol paste
17. Spirit- a concentrated alcohol solution of volatile substance. Ex. Spirit of ammonia.
18. Suppository- one or more several drugs mixed with a firm base such as gelatin and shaped for insertion
into the body; the base dissolves gradually at body temperature, releasing the drug.
19. Tincture- an alcoholic or water and alcohol solution prepared from drugs.
20. Gel or jelly- a clear transparent semisolid that liquefies when applied to the skin.
21. Spansule- beads or tiny particles, variably coated of the active ingredients of a substance that permit
gradual release in a gastrointestinal tract.

FORMS AND ROUTES OF DRUG ADMINISTRATION :

1. Tablets and Capsules

 Oral medications are NOT given to clients who are vomiting, lack gag reflex or are comatose.
 Enteric coated and time-release capsules must be swallowed whole to be effective.
 Administer irritating drugs with food to decrease GI discomfort.
 Administer drug with an empty stomach if food interferes with drug absorption.
 Drugs administered sublingually or bucally remain in place until they are fully absorbed and food
should be withheld while medication is in place.

2. Liquids ( elixirs, emulsions and suspensions )

  Read labels to determine if dilution or shaking is required.
 The meniscus is at the line of desired dose.
 Many liquids require refrigeration once reconstituted.

3. Transdermal

 Placed on the skin and absorbed through the skin having systemic effect.
 Provides more consistent blood levels and avoids GI absorption problems.

4. Topical

 Apply topical medications with gloved hand, tongue blade or cotton-tipped applicator to clean, dry skin
 Do not contaminate medication in container.
 Observe sterile technique when skin is broken.
 Take precaution to avoid medication stain, and use firm strokes if medication is to be rubbed in.

5. Instillations

 Liquid medications administered as drops.

 Eye drop – pull lower lid down or pinch away from eye to form pouch, avoid contaminating container.
 Eye ointment – gently pull down lower lid to form pouch, apply ointment from inner to outer canthus.
If vision becomes blurred, instruct client not to do any task.
 Ear drops – for adult, pull pinna of ear up and backward. In children, pinna should be pulled down and
back. Client should remain in the same position for about 5 minutes.

6. Suppositories

 Rectal – medications administered as suppositories or enemas can be given rectally for both local and
system absorption.
 Numerous, small capillaries in the rectal area promote absorption
 Suppositories should be lubricated before insertion
 Suppositories tend to soften at room temperature, it needs to be refrigerated
 Always provide privacy and explain procedure
 Use gloves for insertion and instruct client to breath through mouth to relax sphincter.
 Instruct client to lie on his left side, apply a small amount of water to the tip of unwrapped suppository
and gently insert it beyond the anal sphincter
 Have client remain on his side for 20 min. after insertion
 Vagina – generally inserted with an applicator, wear gloves

7. Nasogastric and gastrostomy tubes

 Check proper placement of tube. Pour drug into syringe without plunger or bulb then release clamp to
allow medication to flow in properly.
 Flush tubing with 50 ml of water (refer to agency policy). Clamp tube then remove syringe.
8. Nose drops and sprays

 Have the client blow his/her nose. Administer prescribed number of drops.
 Have client keep head tilted backward for 5 minutes after instillation.

9. Aerosols (inhalations)

 Hand held nebulizers, position in semi or high-Fowler’s then teach client to correct usage of
equipment.

10. Parenteral

 Intradermal ( ID ) – into the dermal layer under the epidermis

 Subcutaneous ( SC ) – into the subcutaneous tissue
 Intramuscular ( IM ) – into muscle
 Intravenous ( IV ) – into the vein
 Intraarterial – into the artery
 Intraosseous –into the bone

A. Intradermal

 Sites include the inner lower arm, upper chest and back beneath the scapulae
 Indicated for allergy, tuberculin testing and vaccination
 Use left arm for tuberculin test, use right arm for all other test
 Use needle gauge 25 – 27; needle length 3/8”, 5/8”, or ½
 Needle at 10-15 degree angle, bevel up
 Inject a small amount of drug slowly over 3-5 seconds to form a wheal or bleb
 Do not massage the site of injection, to prevent irritation of the site and absorption into subcutaneous

B. Subcutaneous

 Drugs administered are vaccines, preoperative medications, narcotics, insulin, heparin

 Sites are outer aspect of the upper arms, anterior aspect of the thighs, abdomen, scapular areas of the
upper back, and ventrogluteal and dorsogluteal areas
 Only small doses of medication should be injected via SC route (0.5 to 1 ml)
 Rotate site of injection to minimize tissue damage
 Needle length and gauge are the same as ID injections
 Use 5/8 needle for adults when the injection is administered at 45 degree angle; ½ is used at 90 degree
angle
 For thin clients – 45 degree angle of needle; for obese – 90 degree angle of needle
 For heparin injection – do not aspirate, do not massage injection site to prevent hematoma formation
 For insulin injection – do not massage to prevent rapid absorption which may result to hypoglycemia
reaction.
  Always inject insulin at 90 degree angle to administer the medication in the packet between the SC and
muscle layer. Adjust length of needle depending on the size of the client.
 For other medications aspirate before injecting to check if blood vessel had been hit, if so, remove the
needle and discard the medication and equipment.

INTRAMUSCULAR INJECTION

 Needle length is 1”, 1 1/2 “, 2” to reach the muscular layer

 Use needle gauge 20-23 depending on the viscosity of the medication
 Clean the injection site using cotton ball with alcohol. To reduce microorganism in the area
 Inject the medication slowly to allow the tissues to accommodate volume.
 Sites : Ventrogluteal site (von Hochteter’s site), dorsogluteal site, vastus lateralis, rectus femoris,
deltoid site

1. Ventrogluteal site

 Uses gluteus medius; area contains no large nerves, or blood vessels and less fat. It is farther from
rectal area, so less contaminated.
 Position client prone or side-lying. When prone position, curl toes inward. When side-lying, flex the
knee and hip. These ensures relaxation of gluteus muscles and minimize discomfort during injection.
 To locate the site, place the heel of the hand over the greater trochanter, point the index finger
towards anterior superior iliac spine, then abduct the middle (third) finger. The triangle formed by the
index finger, the third finger and the crest of the ileum is the site.

2. Dorsogluteal site

 Uses the gluteus medius muscle

 Position of the client is similar to ventrogluteal site
 The site should not be used for infants under 3 years because the gluteal muscles are not well
developed yet
 To locate the site, the nurse draws an imaginary line from the greater trochanter to the posterior
superior iliac spine. The injection site is lateral and superior to this line.
 Another method is to imaginary divide the buttocks into four quadrants. The upper outer quadrant is
the site of injection. Palpate the crest of the ilium to ensure that the site is high enough.

3. Vastus lateralis

 Recommended site of injection for infants

 Located at the middle third of the anterior lateral aspect of the thigh
 Assume back-lying or sitting positions

4. Rectus Femoris

 Located at the middle third, anterior aspect of the thigh

5. Deltoid site

 Not used often for IM injection because it is relatively small muscle and very close to the radial nerve
and radial artery
 Approximately 5 cm (2 inches) or 2-3 fingerbreadths below the acromion process
 Z-tract techniques – used for parenteral iron preparations, to seal the drug deep into the muscle and
prevent permanent staining of the skin
 Retract the skin laterally, inject medication slowly, hold retraction of the the skin until the needle is
withdrawn
 Do not massage the site of injection to prevent leakage into subcutaneous area.