Welcome to our "How to Take Medicine Correctly" Page

Introduction
Aerosol Sprays
Capsules, Tablets & Oral Powders
Eardrops, Eyedrops & Eye Ointments
Liquids
Nose Drops & Nasal Sprays
Rectal Suppositories
Throat Lozenges, Discs and Sprays
Topical Ointments & Creams
Transdermal Patches
Vaginal Ointments, Creams, Tablets & Suppoitories


How to Administer Medication Correctly

Introduction to Administering Medication Correctly

To derive the maximum benefit from your drug therapy, you must use your medicine correctly. If you use drugs improperly, you may not receive their full therapeutic effects. Indeed, improper administration can be dangerous, since some medications may become toxic if used incorrectly.

Before administering medications to older adults (that is, people who are 65 years of age or older) or children, ask your doctor for specific instructions. These groups of patients can be more sensitive to dosage amounts and side effects of medications than young and middle-aged adults.

As a person ages, the function of the kidneys, liver, and other organ systems in the body slows down. Compared with younger adults, people over 65 may have a reduced capacity to break down and remove medicines from their bodies. Therefore, it is sometimes recommended that older people receive lower initial doses of drugs and that drug dosages be increased more slowly.

In other cases, a different drug within the same class of medication may be administered because the side effects from the alternative drug may be less bothersome. For example, in the elderly population with diabetes, the oral antidiabetic agent glyburide may be more appropriate than chlorpropamide (another oral antidiabetic agent), which is associated with an increased chance of dangerously low blood sugar in the elderly. In general, physicians "start low and go slow" when prescribing medications and adjusting dosages for older patients.

Infants and children also differ from adults in how their bodies respond to medication. Depending on age and weight, the best dose of a medicine for a younger patient may be different than an adult dose. Accordingly, children may be given lower dosages of some medications (including antibiotics) and higher dosages of others (including phenytoin, carbamazepine, and phenobarbital).

The following sections will delve into the proper administration of various types of medication, including capsules, eardrops, sprays, patches and more. Let‘s begin with a topical medication - aerosol sprays.

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Administering Aerosol Sprays

Many topical (applied to the skin) medications are packaged as pressurized aerosol sprays. These sprays usually cost more than the cream or ointment form of the same product. 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 have a cooling effect on burns, rashes, and other skin inflammations.

Before using an aerosol spray, shake the container 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 treat part of your face, simply spray the solution onto your hand, then rub it in. Getting the solution in your eyes, nose, or mouth may cause pain and may even damage your eyes.

Aerosol sprays may feel cold when they are first applied. If this sensation bothers you, ask your pharmacist or doctor whether another form of the same

Another option is to find out whether the product comes in the form of a tablet, capsule or oral powder. In the next section, learn how to easily swallow these oral medications and use them properly so you feel their full effect.

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Administering 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 swallow them. Then place the tablet or capsule on the back of your tongue, take a drink, and gulp it down.

If it seems too large to swallow or tends to stick in your throat, there is another possible option: Empty the capsule or crush the tablet in a spoon and mix it with applesauce, soup, or even chocolate syrup. But BE SURE TO CHECK WITH YOUR PHARMACIST BEFOREHAND, since some tablets and capsules must be swallowed whole and should not be crushed or opened. Your pharmacist can tell you which ones can and cannot be taken this way.

If it cannot be crushed or chewed and you prefer to not mix it with food, ask your doctor if the drug can be prescribed in a liquid or chewable tablet form instead.

Occasionally medications come in oral powder form (for example, cholestyramine and colestipol). Such preparations should be carefully mixed with liquids, and then swallowed; they are not meant to be swallowed dry.

Another option is to find out if the medication can be applied through your eyes or ears. In the next section, learn how to correctly administer eardrops, eye drops, and eye ointments, and avoid contaminating the dropper.

Sublingual Tablets

Some drugs, such as nitroglycerin, are prepared as tablets that must be placed under the tongue. Such drugs are more rapidly or 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 it under your tongue, close your mouth, and hold the saliva under your tongue for as long as you can before swallowing to allow the tablet to dissolve. A bitter taste in your mouth five minutes after taking a nitroglycerin tablet indicates that the drug has not yet been completely absorbed. Wait at least five minutes longer before drinking liquids. Drinking too soon may wash the medication into the stomach before it has been completely absorbed. Do not smoke, eat, or chew gum while the medication is dissolving.

Buccal Tablets

A few drugs, including some forms of nitroglycerin, are prepared as tablets that must be place between the lip and gum 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 it between the upper lip and gum. If you eat or drink during the three to five hours it takes for the tablet to dissolve 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.

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Administering Eardrops, Eyedrops, and Eye Ointments

Your ears and eyes are some of the most sensitive parts of your body. Therefore, it‘s important to administer any medications for these areas with care.

Eardrops

Eardrops must be administered so they fill the ear canal. To use eardrops properly, tilt your head to one side, turning the affected ear upward. Grasp the earlobe and gently pull it upward (toward the top of the head) and back to straighten the ear canal.

When administering eardrops to a child younger than three years old, gently pull the child‘s earlobe downward (toward the shoulder) and back. Fill the dropper and place the prescribed number of drops (usually a dropperful) into the ear. Be careful to avoid touching the sides or edge of the ear canal, because the dropper can easily become contaminated by such contact.

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 prevent the medication from seeping out. 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 eardrops, you may warm the drops to body temperature simply by rolling the container back and forth between your hands. Do not place the bottle in boiling water, however: The eardrops may become so hot that they cause pain or damage when placed in the ear. Boiling water can also cause the container‘s label to loosen or peel off and might even ruin the medication.

Eyedrops

Before administering eyedrops or ointments, wash your hands. Then sit or lie 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. Squeeze the prescribed amount of medicine into this pouch and slowly close your eye. Try not to blink. Keep your eye
closed, and use your finger to apply slight pressure at the inner corner of the eye for a minute or two to prevent loss of medication through the duct that drains fluid from the surface of the eye.

If more than one drop per eye is prescribed, wait at least five minutes before administering the next drop. This pause helps ensure that the first drop is not flushed away by the second or that the second is not diluted by tears from the first.

When finished, wipe away any tears or excess solution from the eye area with a clean tissue. Do not wash or wipe the dropper before replacing it in the bottle -- this may contaminate the remaining medication. Close the bottle tightly.

Eye Ointments

To administer an eye ointment, squeeze a line of ointment in the prescribed amount into the pouch formed as just described for eyedrops (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 are intended for use in the eye (all products made for use in the eye must be sterilized to prevent eye infections). And check the expiration date on the label or container. Don‘t use a drug product after the specified date, and never use any eye product that has changed color. If it appears that your medication contains particles that weren‘t visible at the time of purchase, discard it.

If you prefer using liquid medications, the next section will discuss how to properly administer them externally on the skin or internally through your mouth to receive their full therapeutic effects.

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Administering Liquids

Liquid medications are used in several different ways. Some are intended to be used externally on the skin; some are placed in the eye, ear, nose, or throat; still others are taken internally. Before taking or using any liquid medication, carefully read the label for specific directions.

A suspension is a liquid product containing particles that settle to the bottom of the container. It must be shaken before use so each application contains the right proportion of ingredients. If you don‘t shake it well each time, you may not get the correct amount of the active ingredient, and as the amount of liquid remaining in the bottle becomes smaller, the drug could become more concentrated. Thus, you may be getting more of the active ingredient than you need. A dose could even reach toxic levels.

If a liquid medication is for application to the skin, pour a small quantity onto a cotton pad, a piece of gauze, or a cotton-tipped applicator. (Don‘t use a large piece of cotton or gauze, since it will absorb more medication than is needed, resulting in waste.) Don‘t pour the medication into your cupped hand; you may spill some of it. Never dip cotton-tipped applicators, pieces of cotton or gauze, or your fingers directly into the bottle itself, however.

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 ordinary 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; they are well worth their cost in ensuring accurate dosage. Incidentally, while it‘s true that many children balk at medication taken from a teaspoon, they often enjoy taking it from a special spoon.

Another option is to use medication in the form of nose drops or nasal sprays. Since bacteria from your nose can easily enter the container and contaminate the solution, the next section will review how to properly hold and administer these medications.

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Administering Nose Drops and Nasal Sprays

Before using nose drops or nasal 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.

When using a nasal spray, do not tilt your head back. Insert the sprayer into the nose, but try to avoid touching the inner nasal membranes. Sniff and squeeze the sprayer at the same time, according to the product directions. 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 of your nostrils, gently sniff two or three times.

Unless your doctor has told you otherwise, you should not use nose drops or nasal 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 drops or spray for more than a week, purchase a new container. Never allow anyone else to use your nose drops or spray.

Some other types of medication must be administered as a rectal suppository. The next section will review how to properly handle the suppository, especially if it is too soft or if it is painful to insert.

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Administering Rectal Suppositories

Rectal suppositories are used to deliver various types of medication, including laxatives, sleep aids, tranquilizers, and even medications to relieve nausea and vomiting. Regardless of the type of medicine that they are delivering into the body, 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 it in the refrigerator, in a glass of cool water, or under cold running 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 unusually long or 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 quickly feel as if you want to have a bowel movement, but ignore that feeling and lie still for a few minutes. Delay trying to have a bowel movement for at least an hour. If you have trouble inserting a suppository or if the process is painful, coat the suppository with a thin layer of petroleum jelly or mineral oil.

Some manufacturers of suppositories used for hemorrhoids suggest that their product should be stored in the refrigerator. But don‘t assume that this is always the case. Ask your pharmacist for advice about proper storage.

Another option is to use medication in the form of throat lozenges, discs, or sprays. In the next section, learn how to properly use them and to avoid common mistakes such as chewing them or drinking fluids too soon afterward.

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Administering Throat Lozenges, Discs, and Sprays

Learn how to best soothe that sore throat with tips on taking throat lozenges, discs, and sprays.

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 fully and spray the medication as far back as possible. Hold the liquid in your mouth for as long as you can, trying not to swallow, and do not drink any fluids for several minutes. Swallowing a throat spray is not harmful, but if you find that your throat spray upsets your stomach, don‘t swallow it; simply spit it out.

Other medications need to be applied directly to the skin in the form of ointments or creams. Learn how to prep your skin and apply topical medications, with minimal mess, in the next section.

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Administering Topical Ointments and Creams

Most topical (applied to the skin) ointments and creams exert only local effects -- that is, they affect only the area to which they are directly applied. Most creams and ointments are expensive (especially steroid products) and should be applied to the skin in as thin a layer as possible. A thin layer is just as effective as a thick layer but less expensive. Moreover, some steroid-containing creams and ointments can cause toxic side effects if applied too heavily.

Before applying the topical ointment or cream, moisten the skin by immersing it in water or 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 medication disappears.

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; they 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.

If your doctor tells you to place a wrap on the skin after the cream or ointment has been applied, you may use 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 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 for an oozing lesion.

If you need a continuous, controlled release of a medication, then a transdermal patch might be a good option for you. For information on how to properly use the patch with minimal skin irritation, turn to the next section.

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Administering Transdermal Patches

Transdermal patches allow controlled, continuous release of medication. They are convenient and easy to use.

Apply the patch to a hairless or clean-shaven area of skin, avoiding scars and wounds. Choose an area of skin, such as the chest or upper arm, that is not subject to excessive movement. For best results and to minimize skin irritation, each time you replace a patch, apply the new patch to a different area of the body. In the event that a patch falls off, ask your pharmacist or doctor for advice on whether to re-apply the same patch or replace it with a new patch. It is alright to bathe, shower, or swim with a patch in place.

If redness or irritation develops at the application site, consult your physician. Some people are sensitive to the materials used to make patches.

Another option is to administer medication through vaginal ointments, creams, tablets, and suppositories. Learn how to properly use all of these forms in the next section.

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Administering Vaginal Ointments, Creams, Tablets, and Suppositories

Because of this area‘s sensitivity, it‘s important to take special care when administering vaginal medications. Learn how to apply ointments and creams as well as how to use tablets and suppositories.

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 before storing.

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 thoroughly and then let it dry completely before storing.

Unless your doctor has told you otherwise, do not douche for two to three weeks after you use vaginal tablets or suppositories. Be sure to ask your doctor for specific recommendations on douching.

With all the various types of medications available, it can be difficult to know how to administer them properly. Now you have the tools you need to ensure you‘re taking your medications properly, which in turn helps them work most effectively.

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By the editors of Consumer Guide