Travel Reference
In-Depth Information
APPENDIXE
B
THERAPEUTIC PROCEDURES
ADMINISTERING MEDICATIONS
Oral Medications
The oral route is the easiest, most convenient, and safest method for administering drugs
but has two major disadvantages: the time required for a drug to be absorbed, and variations
in the rate and completeness of absorption. Acid and enzymes in the stomach completely
inactivate some therapeutic agents, and they must be given by another route.
Individualswhoarenotfullyconsciousmayaspirateoralmedicationsandmustneverre-
ceive them.
Oral therapy is much less effective for a person who is nauseous or vomiting. Even if the
drugs are not expelled, emptying of the stomach is greatly retarded and the onset of action
by the agent is delayed because orally administered drugs are usually absorbed only in the
small intestine.
With the exception of agents that are irritating to the stomach, such as aspirin or ibupro-
fen,oralmedicationsshouldbetakenatleastthirtyminutesbeforemeals.Thestomachemp-
ties more slowly and irregularly when it is filled with food, which delays onset of the drug's
actions. Food interferes with the absorption of some medications.
Intramuscular Injections
The intramuscular route for administering drugs avoids the vagaries of intestinal absorp-
tion but must be used cautiously because injected medications cannot be retrieved.
Intramuscularinjectionsareassociatedwithaslightriskofinjectingthedrugdirectlyinto
abloodvesselinsidethemuscle,whichwouldproducehigherandmoretoxicbloodconcen-
trations of the agent than the slower absorption from a true intramuscular site.
Intramuscular injections are usually not absorbed well by individuals who are in shock
or are hypothermic. If several injections of an agent were given and the medication was not
absorbed until the person recovered, all would be absorbed at once, producing an overdose
and possibly serious toxicity.
The needle used for an intramuscular injection may injure nerves, blood vessels, or other
structures if the site for the injection is not carefully chosen.
The most common complication of intramuscular injections is an infection produced by
bacteria introduced with the needle. Although the needle may be free of bacteria, the skin
through which it passes cannot be completely sterilized. Cleansing the skin and avoiding
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