Oral Sublingual Buccal Drugs Chapter 10 Oral Administration

Oral, Sublingual & Buccal Drugs Chapter 10

Oral Administration (By Mouth, Orally, Per Os, PO) • Most common form of administration – Advantages: • Most drugs have oral dose • Easy to administer – Non-Invasive • Drug can be easily retrieved from stomach to lessen adverse drug events, if necessary – Disadvantages: • • • Slowest rate of absorption Some can harm or discolor the teeth Some taste or smell bad Some cause nausea Cannot be administered if: – – – Is vomiting Has gastric or intestinal suction Is at risk of aspiration Is unconscious or comatose Cannot swallow

Oral Dose Forms • Capsule: – Gelatin container that holds drug in dry powder or liquid form – Used for drugs that have an unpleasant odor or taste • Time released capsules: – Contain granules that dissolve at different rates • Tablet – Dried powdered drug compressed into a small disk • Scored: Grooved for use in dividing • Layer-Coated: Contain layers, so more than one drug can be administered simultaneously • Enteric-Coated: Special coating that prevents from dissolving in the stomach. Dissolves in small intestine • Lozenges: – Flat disk containing a medicinal agent with a flavored base – Held in mouth or sucked to slowly dissolve

Oral Dose Forms (continued) • Elixirs: – Clear liquid made up of a drug dissolved in alcohol and water. Flavor is added to improve taste • Emulsions: – Contains small droplets of water-in-oil or oil-in-water • Used to mask bitter tastes or to increase the ability to dissolve • Suspensions: – Liquid containing solid drug particles. • Prior to administration , bottle must be shaken thoroughly • Syrups: – Contains drugs dissolved in sugar. • Sugars help to mask bitter tastes

Insert Photos of Orals

Equipment for Oral Medications • Souffle Cup: – Small paper or plastic cup used for solid drug forms (tablets or capsules) • Medicine Cups: – Plastic container with measurement scales • Not accurate for doses smaller than 1 tsp – For small doses, use an oral syringe • Medicine Droppers: – Small glass or plastic tube with a hollow rubber ball at one end • Measurements are marked on the tube • Drops will vary from dropper to dropper – Use only the dropper supplied by manufacturer

Equipment (continued) • Teaspoon: – Many liquid drug doses are ordered in teaspoons • In hospitals & nursing centers, the teaspoon is converted into a metric measure – 1 tsp = 5 m. L • Oral Syringes: – Plastic measure device with 3 parts—tip, barrel & plunger

Giving Oral Drugs • Always practice medication safety: – Follow the SIX Rights of Drug Administration – Prevent Drug Errors – Prevent Infection – Follow Procedure

Rules for Giving Oral Drugs • • • Give the most important drug first Give solid drugs first Do not mix solid drugs with liquids Stay with the person while they take the drug Do not the container touch any part of the souffle cup, medicine cup of measuring spoon

Rules (continued) • Use the same souffle or medicine cup for all person’s tablets & capsules with the nurse’ approval – Use separate cups for drugs affecting the heart or blood pressure • • • Check with nurse prior to crushing tablets or opening capsules Check with nurse prior to cutting a scored tablet Do not mix drugs with food unless directed Do not give drugs with food unless ordered Allow person to drink water before and after taking the drug – Encourage the person to drink a full glass of fluid after swallowing drug. • Do not dilute liquid medications • Do not mix liquids medications • Give cough syrup last if more than one liquid – Coats & soothes throat

Measurement Equivalents Found on page 132 in textbook: Household 2 Tbsp 1 Tbsp 2 tsp 1 tsp Apothecary 1 oz ½ oz ⅓ oz ⅙ oz Metric 30 m. L 15 m. L 10 m. L 5 m. L

Crushing Meds

Delegation Guidelines • Follow the information from the nurse, the care plan and the MAR: – – Which drugs to give first Which tablets are crushed for a person Which capsules are opened for a person What to use to give crushed tablets or open capsules • Ex. Applesauce, pudding, custard, etc. – If sitting or Fowler’s position is allowed. If not, how to position – When to report observations • What specific patient or resident concerns to report at once.

Administering Meds • Oral—Solid Form – Review page 134 -135 • Oral—Liquid Form – Review page 136 -137

Sublingual & Buccal Drugs • Sublingual: – Under the tongue • Tablets are placed under the tongue where they are dissolved & absorbed • Buccal: – Inside the cheek • Tablets are placed between the cheek and the molar teeth

Administering Sublingual & Buccal Medications 1. Wear gloves 2. Placement – Sublingual: Place tablet under tongue – Buccal: Place tablet between upper molar & cheek 3. Do not provide water 4. Encourage person to: – Allow the drug to dissolve – Hold saliva in mouth until tablet is dissolved 5. Remove and discard glove 6. Wash hands