Drug administration is a core nursing duty that requires an understanding of how medications are formulated. A dosage form is the physical presentation of a drug product, designed to ensure the active pharmaceutical ingredient is delivered safely and effectively to the site of action in the human body. Manufacturers create different forms based on chemical stability, target absorption sites, and patient convenience. Nurses must recognize that changing a dosage form—such as crushing a tablet meant to be swallowed whole—can alter pharmacokinetics and harm the patient.
Oral solids are the most common and convenient drug preparations used in clinical practice.
Never crush enteric-coated or sustained-release tablets, because doing so destroys the protective coating, leading to rapid, potentially toxic drug absorption or stomach irritation.
Liquids provide rapid absorption because the active drug is already dissolved. Oral solutions, syrups, and elixirs must be measured using accurate devices like oral syringes, never ordinary household spoons. Parenteral solutions—such as intravenous and intramuscular injections—bypass the digestive tract entirely. Nurses must inspect all liquid solutions for clarity, precipitation, or discoloration prior to administration to prevent adverse reactions.
Topical medications deliver active ingredients directly to the skin or mucous membranes for local or systemic effects.
| Preparation | Base Type | Clinical Use |
|---|---|---|
| Lotions | Aqueous suspension | Hairy areas, cooling effect |
| Creams | Water-in-oil or oil-in-water | Moist lesions, easy to wash off |
| Ointments | Grease or oil base | Dry, thick, scaly skin lesions |
Always wear gloves when applying medicated topical agents to prevent self-absorption of the drug through the nurse's skin.
Inhalers, transdermal patches, and suppositories represent specialized delivery routes. Metered-dose inhalers deliver medications directly to the respiratory tree, requiring good hand-breath coordination or a spacer device. Transdermal patches release drugs slowly through the skin into the systemic circulation over hours or days. Nurses must remember to remove old transdermal patches before applying a new one to prevent dangerous drug accumulation and overdose.
Safe medication administration relies on strict adherence to core clinical principles. Nurses must master the rights of medication administration—checking the right patient, drug, dose, route, time, and documentation. Clinical vigilance requires assessing allergies, checking renal and hepatic function, and monitoring the patient for therapeutic and adverse responses after administration. Never administer a drug that you did not prepare yourself, and always clarify any ambiguous order with the prescriber.