$Unique_ID{BRK01802}
$Pretitle{}
$Title{Administering Medication Correctly}
$Subject{}
$Volume{}
$Log{}

Copyright (C) 1991 Publications International, Ltd.


Administering Medication Correctly
------------------------------------------------------------------------------

     You must use medicine correctly to obtain its full benefit.  If you
administer drugs improperly, you may not receive their full therapeutic
effects.  Furthermore, improper administration can be dangerous.  Some drugs
may become toxic if used incorrectly.
     Before administering medications to children or elderly patients, ask
your doctor for instructions.  Children and older patients can be more
sensitive to dosage amounts and side effects of medications.

LIQUIDS

     Liquid medications are used in several different ways.  Some are intended
to be used externally on the skin; some are placed into the eye, ear, nose, or
throat; still others may be taken internally.  Before taking or using any
liquid medication, look at the label to see if there are specific directions.
     A suspension is a liquid product that contains particles that settle to
the bottom of the container.  It must be shaken before you use the medicine.
If you don't shake it well each time, you may not get the correct amount of
the active ingredient--as the amount of liquid remaining in the bottle becomes
smaller, the drug becomes more concentrated.  You will be getting more of the
active ingredient with each dose.  It may even reach toxic levels.
     When opening the bottle, point it away from you.  Some liquid medications
build up pressure inside the bottle; the liquid could spurt out and stain your
clothing.  If the medication is for application to the skin, pour a small
quantity onto a cotton pad or a piece of gauze.  Do not use a large piece of
cotton or gauze, since it will absorb the liquid and much will be wasted.
Don't pour the medication into your cupped hand; you may spill some of it.  If
you're using it on only a small area, you can spread the medication with your
finger or a cotton-tipped applicator.  Never dip cotton-tipped applicators or
pieces of cotton or gauze into the bottle; since this might contaminate the
rest of the medication.
     Liquid medications that are to be swallowed must be measured accurately.
When your doctor prescribes one teaspoonful of medication, he or she is
thinking of a 5-milliliter (ml) medical spoon.  The teaspoons you have at home
can hold anywhere from 2 to 10 ml of liquid.  If you use one of these to
measure your medication, you may get too little or too much drug with each
dose.  Ask your pharmacist for a medical teaspoon or one of the other plastic
devices for accurately measuring liquid medications.  Most of these cost only
a few cents and are well worth their cost in ensuring accurate dosage.  In
addition, while many children balk at medication taken from a teaspoon, they
often enjoy taking it from a "special" spoon.

CAPSULES, TABLETS, AND ORAL POWDERS

     Many people find it hard to swallow a tablet or capsule.  If tablets or
capsules tend to catch in your throat, rinse your mouth with water, or at
least wet your mouth, before attempting to take a tablet or capsule.  Place
the tablet or capsule on the back of your tongue, take a drink, and swallow.
If it is too large, or still "sticks" in your throat, empty the capsule or
crush the tablet into a spoon and mix it with applesauce, soup, or even
chocolate syrup.  But BE SURE TO CHECK WITH YOUR PHARMACIST BEFORE YOU DO SO.
Some tablets and capsules should not be crushed or opened and must be
swallowed whole--your pharmacist can tell you which ones they are.
     If you have trouble swallowing a tablet or capsule and do not wish to mix
the medication with food, ask your doctor to prescribe a liquid drug
preparation or a chewable tablet instead, if one is available.
     Occasionally, medications come in oral powder form (for example,
cholestyramine and colestipol).  Such medications should be carefully mixed
with liquids, then swallowed.  These medications should NOT be swallowed dry.

SUBLINGUAL TABLETS

     Some drugs, such as nitroglycerin, are prepared as tablets that must be
placed under the tongue.  Such medications are more rapidly or more completely
absorbed into the bloodstream from the lining of the mouth than they are from
the stomach and intestinal tract.
     To take a sublingual tablet properly, place the tablet under your tongue,
close your mouth, and hold the saliva in your mouth and under your tongue as
long as you can before swallowing (to allow the tablet to completely
dissolve).  If you have a bitter taste in your mouth after five minutes, the
drug has not been completely absorbed.  Wait at least five more minutes before
drinking water.  Drinking too soon may wash the medication into the stomach
before it has been absorbed thoroughly.  Do not smoke, eat, or chew gum while
the medication is dissolving.

BUCCAL TABLETS

     Some drugs, such as nitroglycerin, are prepared as tablets that must be
placed under the lip or in the cheek.  These products are designed to release
a dose of the drug over a period of time.
     To take a buccal tablet properly, place the tablet between the upper lip
and gum (above the front teeth) or between the cheek and gum.  If you eat or
drink during the three to five hours that it takes for the tablet to dissolve,
place the tablet between the upper lip and gum.  Do not go to sleep with a
tablet in your mouth because it could slip down your throat and cause choking.
Do not use chewing tobacco when a tablet is in place.

EYE DROPS AND EYE OINTMENTS

     Before administering eye drops or ointments, wash your hands.  Then lie
down or sit down, and tilt your head back.  Using your thumb and forefinger,
gently and carefully pull your lower eyelid down to form a pouch.  Hold the
dropper close to your eyelid without touching it.  Drop the prescribed amount
of medicine into this pouch and slowly close your eyes.  Try not to blink.
Keep your eyes closed, and place one finger at the corner of the eye next to
your nose for a minute or two, applying slight pressure (this is done to
prevent loss of medication through the duct that drains fluid from the surface
of the eye into the nose and throat).  Then wipe away any excess with a clean
tissue.  Do not wash or wipe the dropper before replacing it in the
bottle--you might accidentally contaminate the rest of the medication.  Close
the bottle tightly to keep out moisture.
     To administer an eye ointment, squeeze a line of ointment in the
prescribed amount into the pouch formed as for administering eye drops (avoid
touching the tube to your eyelid), and close your eye.  Roll your eye a few
times to spread the ointment.
     Be sure the drops or ointments you use are intended for use in the eye
(all products manufactured for use in the eye must be sterilized to prevent
eye infections).  Also, check the expiration date on the label or container of
the medication.  Don't use a drug product after the specified date, and never
use any eye product that has changed color.  If you find that the medication
contains particles that weren't there when you bought it, don't use it.

EAR DROPS

     Ear drops must be administered so that they fill the ear canal.  To
administer ear drops properly, tilt your head to one side, turning the
affected ear upward.  Grasp the earlobe and gently pull it upward and back to
straighten the ear canal.  When administering ear drops to a child, GENTLY
pull the child's earlobe downward and back.  Fill the dropper and place the
prescribed number of drops (usually a dropperful) into the ear, but be careful
to avoid touching the sides or edge of the ear canal.  The dropper can easily
become contaminated by contact with the ear canal.
     Keep the ear tilted upward for five to ten seconds while continuing to
hold the earlobe.  Your doctor may want you to gently insert a small wad of
clean cotton into the ear to ensure that the drops do not escape.  Do not wash
or wipe the dropper after use; replace it in the bottle and tightly close the
bottle to keep out moisture.
     Before administering the medication, you may warm the bottle of ear drops
by rolling the bottle back and forth between your hands to bring the solution
to body temperature.  DO NOT place the bottle in boiling water.  The ear drops
may become so hot that they will cause pain when placed in the ear.  Also,
boiling water can loosen or peel off the label and might even destroy the
medication.

NOSE DROPS AND SPRAYS

     Before using nose drops or sprays, gently blow your nose if you can.  To
administer nose drops, fill the dropper, tilt your head back, and place the
prescribed number of drops into your nose.  To prevent contamination of the
rest of the medicine do not touch the dropper to the nasal membranes.  Keep
your head tilted for five to ten seconds, and sniff gently two or three times.
     Do not tilt your head back when using a nasal spray.  Insert the sprayer
into the nose, but try to avoid touching the inner nasal membranes.  Sniff and
squeeze the sprayer at the same time.  Do not release your grip on the sprayer
until you have withdrawn it from your nose (to prevent nasal mucus and
bacteria from entering the plastic bottle and contaminating its contents).
After you have sprayed the prescribed number of times in one or both nostrils,
gently sniff two or three times.
     Unless your doctor has told you otherwise, you should not use nose drops
or sprays for more than two or three days at a time.  If they have been
prescribed for a longer period, do not administer nose drops or sprays from
the same container for more than one week.  Bacteria from your nose can easily
enter the container and contaminate the solution.  If you must take medication
for more than a week, purchase a new container.  NEVER allow anyone else to
use your nose drops or spray.

RECTAL SUPPOSITORIES

     Rectal suppositories are used to deliver various types of medication.
They may be used as laxatives, sleeping aids, or tranquilizers or as
preparations that are used to relieve the itching, swelling, and pain of
hemorrhoids.  Regardless of the reason for their use, all rectal suppositories
are inserted in the same way.
     In extremely hot weather, a suppository may become too soft to handle
properly.  If this happens, place the suppository in the refrigerator, in a
glass of cool water, or under running cold water until it becomes firm.  A few
minutes is usually sufficient.  Before inserting a suppository, remove any
aluminum wrappings.  Rubber finger coverings or disposable rubber gloves may
be worn when inserting a suppository, but they are not necessary unless your
fingernails are extremely long and sharp.
     To insert a suppository, lie on your left side with your right knee bent.
Push the suppository, pointed end first, into the rectum as far as is
comfortable.  You may feel like defecating, but lie still for a few minutes
and try not to have a bowel movement for at least an hour.  If you cannot
insert a suppository, or if the process is painful, you can coat the
suppository with a thin layer of petroleum jelly or mineral oil to make
insertion easier.
     Manufacturers of many suppositories that are used in the treatment of
hemorrhoids suggest that the suppositories be stored in the refrigerator.  Be
sure to ask your pharmacist if the suppositories you have purchased should be
stored in the refrigerator.

VAGINAL OINTMENTS AND CREAMS

     Most vaginal products are packaged with complete instructions for use.
If a woman is not sure how to administer vaginal medication, she should ask
her pharmacist.
     Before using any vaginal ointment or cream, read the directions.  They
will probably tell you to attach the applicator to the top of the tube and to
squeeze the tube from the bottom until the applicator is completely filled.
Then lie on your back with your knees drawn up.  Hold the applicator
horizontally or pointed slightly downward, and insert it into the vagina as
far as it will go comfortably.  Press the plunger down to empty the cream or
ointment into the vagina.  Withdraw the plunger and wash it in warm, soapy
water.  Rinse it thoroughly and allow it to dry completely.  When the plunger
is dry, return it to its original package.

VAGINAL TABLETS AND SUPPOSITORIES

     Most packages of vaginal tablets or suppositories include complete
directions for use, but you may wish to review these general instructions.
     Remove any foil wrapping.  Place the tablet or suppository in the
applicator that is provided.  Lie on your back with your knees drawn up.  Hold
the applicator horizontally or tilted slightly downward, and insert it into
the vagina as far as it will comfortably go.  Depress the plunger slowly to
release the tablet or suppository into the vagina.  Withdraw the applicator
and wash it in warm, soapy water.  Rinse it and let it dry completely.  When
the applicator is dry, return it to its package.
     Unless your doctor has told you otherwise, do not douche two to three
weeks before or after you use vaginal tablets or suppositories.  Be sure to
ask your doctor for specific recommendations on douching.

THROAT LOZENGES AND DISCS

     Both lozenges and discs contain medication that is released in the mouth
to soothe a sore throat, to reduce coughing, or to treat laryngitis.  Neither
should be chewed; they should be allowed to dissolve in the mouth.  After the
lozenge or disc has dissolved, try not to swallow or drink any fluids for a
while.

THROAT SPRAYS

     To administer a throat spray, open your mouth wide and spray the
medication as far back as possible.  Try not to swallow--hold the spray in
your mouth as long as you can, and do not drink any fluids for several
minutes.  This gives the medication a greater opportunity to work.  Swallowing
a throat spray is not harmful, but if you find that your throat spray upsets
your stomach, don't swallow it; simply spit the throat spray out.

TOPICAL OINTMENTS AND CREAMS

     Most topical (used on the skin) ointments and creams exert only local
effects--that is, they affect only the area on which they are applied.  Most
creams and ointments are expensive (especially steroid products, such as
betamethasone valerate, fluocinolone, fluocinonide, hydrocortisone, and
triamcinolone) and should be applied to the skin as thinly as possible.  A
thin layer is as effective as (but less costly than) a thick layer.
Furthermore, some steroid-containing creams and ointments can cause toxic side
effects if applied too heavily.
     Before applying the medication, moisten the skin by immersing it in water
or by dabbing the area with a clean, wet cloth.  Blot the skin almost dry and
apply the medication as directed.  Gently massage it into the skin until the
cream or ointment disappears.  You should feel no greasiness after applying a
cream.  After an ointment is applied, the skin will feel slightly greasy.
     If your doctor has not indicated whether you should receive a cream or an
ointment, ask your pharmacist for the one you prefer.  Creams are greaseless
and do not stain your clothing.  Creams are best to use on the scalp or other
hairy areas of the body.  However, if your skin is dry, ask for an ointment.
Ointments help keep skin soft for a longer period.
     If your doctor tells you to place a wrap on top of the skin after the
cream or ointment has been applied, you may use a wrap of transparent plastic
film like that used for wrapping food.  A wrap holds the medication close to
the skin and helps to keep the skin moist so that the drug can be absorbed.
To use a wrap correctly, apply the cream or ointment as directed, then wrap
the area with a layer of transparent plastic film.  Follow your doctor's
directions EXACTLY, and keep the wrap in place only as long as you are told to
do so.  If you keep a wrap on the skin too long, too much of the drug may be
absorbed, which may lead to increased side effects.  Do not use a wrap without
your doctor's approval, and never use one on an oozing lesion.

AEROSOL SPRAYS

     Many topical (applied to the skin) items are packaged as pressurized
aerosol sprays.  These sprays usually cost more than the cream or ointment
form of the same medication.  They are especially useful on very tender or
hairy areas of the body, where it is difficult to apply a cream or ointment.
Aerosols can provide a cooling effect on burns or rashes.
     Before using an aerosol, shake the can to evenly disperse the particles
of medication.  Hold the container upright four to six inches from the skin.
Press the nozzle for a few seconds, then release.
     Never use an aerosol around the face or eyes.  If your doctor tells you
to use the spray on a part of your face, apply it to your hand and then rub it
into the area.  If you get it into your eyes or on a mucous membrane, it can
be very painful; and it may even damage the eyes.
     Aerosol sprays may feel cold when they are applied.  If this sensation
bothers you, ask your pharmacist or doctor whether another form of the same
product is available.

TRANSDERMAL PATCHES

     Transdermal patches allow controlled, continuous release of medication.
They are convenient and easy to use.  For best results, apply the patch to a
hairless or clean-shaven area of skin, avoiding scars and wounds.  Choose a
site (such as the chest or upper arm) that is not subject to excessive
movement.  It is all right to bathe or shower with a patch in place.  In the
event that the patch becomes dislodged, discard and replace it.  Replace a
patch by applying a new unit in another spot.  By doing this, you allow for
uninterrupted drug therapy and minimal skin irritation.
     If redness or irritation develops at the application site, consult your
physician.  Some people are sensitive to the materials used to make the
patches.

----------------

The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
