6.1 Introduction

This chapter describes nursing responsibilities in relation to the administration of medications given orally (including NG, G tube, J tube), rectally, vaginally, via eyes, ears, and nose, inhaled and topically. Drugs often require a specific preparation when used for a particular route. For example suppositories have medication dispersed in a fat or wax, which when inserted rectally melt and are absorbed into the intestinal mucosa. Medications for a particular route are often available in a variety of forms. For example oral medications might be a liquid, a suspension, capsule, or a scored tablet. Some oral medications are enteric coated (EC); others are sustained release (SR). Knowing the unique characteristics of these and the accompanying nursing considerations is important for safe medication administration.

Although not in the scope of this textbook, nurses require a working knowledge of pharmacokinetics (absorption, distribution, metabolism, and excretion) and the ability to apply this understanding to unique patient situations. Nurses also require knowledge about the intended action of the drug on the body (pharmacodynamics) in order to determine if medications are working and/or if adverse events are apparent. Every medication has the potential to harm a patient, and as such a nurse can assume that:

• No medication is completely safe and absolutely free of non-therapeutic effects.
• Medication interactions are common in individuals taking many medications.
• When one medication modifies the action of another, a medication interaction occurs (Perry, Potter, & Ostendorf, 2018; Lilley, Rainforth Collins, Snyder, & Swart, 2016).