McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach,
12th Edition
Chapter 10: Drug Administration
Key Points
Nurses have a significant responsibility in preparing, administering, teaching, and
evaluating patients’ responses to the medications they administer.
Patients must receive adequate training from the nurse to self-administer medications
upon discharge.
Nurses share their knowledge about the many aspects of drug administration including
drug interactions, safety practices, side effects, and dosage calculations.
A variety of forms and routes are used for the administration of drugs, including
sublingual, buccal, oral (tablets, capsules, liquids, suspensions, elixirs), transdermal,
topical, instillation (drops and sprays), inhalation, nasogastric and gastrostomy tubes,
suppositories, and parenteral.
Oral medications are not given to patients who are vomiting, lack a gag reflex, or to those
who are comatose.
Enteric-coated and timed-release capsules must be swallowed whole to maintain a
therapeutic drug level, so the drug is released gradually. If crushed, the initial excessive
drug release poses a risk of toxicity such that it could lead to a potentially fatal overdose.
Administer irritating drugs with food to decrease gastrointestinal (GI) discomfort.
Drugs given via sublingual (under the tongue) or buccal (between the cheek and gum)
routes remain in place until fully absorbed; therefore, no food or fluid should be taken
while the medication is in place.
Elixirs are sweetened, hydro-alcoholic liquids used in the preparation of oral liquid
medications.
Emulsions are a mixture of two liquids that are not mutually soluble.
Suspensions are liquids in which particles are mixed but not dissolved.
Transdermal medication is stored in a patch placed on the skin and absorbed through
skin, having a systemic effect.
Topical medications are most frequently applied to the skin by painting or spreading the
medication over an area and applying a moist dressing or leaving the area exposed to air.
Instillations are liquid medications usually administered as drops, ointment, or sprays.
Metered-dose inhalers (MDIs) are handheld devices used to deliver a number of
commonly prescribed asthma and bronchitis drugs to the lower respiratory tract via
inhalation.
Spacers are devices used to enhance the delivery of medications from the MDI.
A nebulizer is a device that changes a liquid medication into a fine mist or aerosol and
has the ability to reach the lower, smaller airways.
Check for proper tube placement before administering medications via nasogastric and
gastrostomy tubes.
o Place patient in a high Fowler position or elevate the head of bed at least 30
degrees to avoid aspiration.
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Key Points 10-2
o Make sure the drug is crushable. If it is a capsule, assess whether it can be opened
to be administered through the tube.
o The crushed drug should be placed into a plastic dosing cup. A small amount of
water is added to liquify the dry medication.
Medications administered as suppositories or enemas can be given rectally for local and
systemic absorption.
Vaginal drugs are available as suppositories, foams, jellies, or creams.
o Advise patients to remain lying for a time sufficient to allow medication
absorption; times vary depending on the medication.
Methods of parenteral administration include intradermal, subcutaneous, intramuscular,
Z-track technique, and intravenous administration.
Anticipate pediatric patients’ developmental needs.
Copyright © 2026 Elsevier, Inc. All rights are reserved, including those for text and data mining, AI training, and
similar technologies.