1. What is Medication?
• A medication is a substance administered for
the diagnosis, cure, treatment, or relief of a
symptom or for prevention of disease.
• In the health care context, the words
medication and drug are generally used
interchangeably.
Types of Drug Preparations
Aerosol spray
or foam
A liquid, powder, or foam
deposited in a thin layer on the
skin by air pressure
Aqueous
solution
One or more drugs dissolved in
water
Aqueous
suspension
One or more drugs finely
divided in a liquid such as
water
Caplet A solid form, shaped like a
capsule, coated and easily
swallowed
Capsule A gelatinous container to hold a
drug in powder, liquid, or oil
form
Cream A nongreasy, semisolid
preparation used on the skin
Elixir A sweetened and aromatic
solution of alcohol used as a
vehicle for medicinal agents
Extract A concentrated form of a drug
made from vegetables or
animals
Gel or jelly
A clear or translucent semisolid
that liquefies when applied to the
skin
Liniment
A medication mixed with alcohol,
oil, or soapy emollient and
applied to the skin
Lotion
A medication in a liquid
suspension applied to the skin
Lozenge
(troche)
A flat, round, or oval preparation
that dissolves and releases a
drug when held in the mouth
Ointment
(salve,
unction)
A semisolid preparation of one
or more drugs used for
application to the skin and
mucous membrane
Paste
A preparation like an ointment,
but thicker and stiff, that
penetrates the skin less than an
ointment
Pill
One or more drugs mixed with a
cohesive material, in oval, round,
or flattened shapes
Powder
A finely ground drug or drugs;
some are used internally, others
externally
Suppository
One or several drugs mixed with
a firm base such as gelatin and
shaped for insertion into the
body (e.g., the rectum); the base
dissolves gradually at body
temperature, releasing the drug
Syrup
An aqueous solution of sugar
often used to disguise
unpleasant-tasting drugs
Tablet
A powdered drug compressed
into a hard small disk; some are
readily broken along a scored
line; others are enteric coated to
prevent them from dissolving in
the stomach
Tincture
An alcoholic or water-and-
alcohol solution prepared from
drugs derived from plants
Transdermal
patch
A semipermeable membrane
shaped in the form of a disk or
patch that contains a drug to be
absorbed through the skin over a
long period of time
Parenteral
 Subcutaneous
(hypodermic) —into the
subcutaneous tissue, just
below the skin
 Intramuscular (IM) —into a
muscle
 Intradermal (ID) —under
the epidermis (into the
dermis)
 Intravenous (IV) —into a
vein.
Different Route of Administration:
A. Oral
B. Sublingual
C. Suppositories
D. Intradermal
E. Subcutaneous
F. Intramuscular
Rights of Medication
1. RIGHT MEDICATION
- medication given was the medication
ordered.
2. RIGHT DOSE
- dose ordered is appropriate for the client.
- Give special attention if the calculation
indicates multiple pills/ tablets or a large
quantity of a liquid medication. An indication
that the math calculation may be incorrect.
- Double-check calculations that appear
questionable.
- Know the usual dosage range of the
medication.
- Question a dose outside of the usual
dosage range.
3. RIGHT TIME
- Give the medication at the right frequency
and at the time ordered according to agency
policy.
- Medications should be given within the
agency guidelines.

2. 4. RIGHT ROUTE
- Give the medication by the ordered route.
- Make certain that the route is safe and
appropriate for the client.
5. RIGHT CLIENT
- Medication is given to the intended client.
- Check the client’s identification band with
each administration of a medication.
- Know the agency’s name alert procedure
when clients with the same or similar last
names are on the nursing unit.
6. RIGHT CLIENT EDUCATION
- Explain information about the medication to
the client (e.g., why receiving, what to expect,
any precautions).
7. RIGHT DOCUMENTATION
- Document medication administration after
giving it, not before.
- If time of administration differs from
prescribed time, note the time on the MAR
and explain the reason and follow-through
activities (e.g., pharmacy states medication
will be available in 2 hours) in nursing notes.
- If a medication is not given, follow the
agency’s policy for documenting the reason
why.
8. RIGHT TO REFUSE
- Adult clients have the right to refuse any
medication.
- The nurse’s role is to ensure that the client is
fully informed of the potential consequences
of refusal and to communicate the client’s
refusal to the health care provider.
9. RIGHT ASSESSMENT
- Some medications require specific
assessments prior to Administration (e.g.,
apical pulse, blood pressure, lab results).
- Medication orders may include specific
parameters for administration (e.g., do not
give if pulse less than 60 or systolic blood
pressure less than 100).
10. RIGHT EVALUATION
- Conduct appropriate follow-up (e.g., was the
desired effect achieved or not? Did the client
experience any side effects or adverse
reactions?).
DIFFERENT TYPES OF SYRINGES

3. DISPOSAL OF SYRINGES AND NEEDLES
Administering an Intradermal Injection for Skin
Tests
Administering an Intradermal Injection for Skin
Tests
Administering Subcutaneous Injection
Administering Subcutaneous Injection
Administering Subcutaneous Injectio
Administering an
Intramuscular Injection

4. Administering an
Intramuscular Injection
Administering an
Intramuscular Injection
Administering an
Intramuscular Injection
Administering an Ophthalmic
and Otic Drugs

5. BASIC PRINCIPLES TO THE PREPARATION
AND ADMINISTRATION OF MEDICINES
• A physician’s order is required before
administering any drug. A written order is
preferred, but a phone or verbal order maybe
necessary at all times. In this case, the nurse
writes the order and reads to the doctor who
must countersign the order immediately as
possible.
• Nurses administering drugs are responsible for
their actions. Verify all new or questionable
orders on medication chart against the doctors’
orders.
• Students are not allowed to take verbal or phone
order.
• Wash your hands and maintain aseptic
technique before and after preparing medication.
• Prepare medication in quiet environment.
• Collect all necessary equipment including
measuring cups, stethoscope as necessary.
• Be knowledgeable of the drugs you administer.
Review medication chart for each client carefully
to ensure safety. “NOTE MEDICATION,
DOSAGE, ROUTE AND FREQUENCY”
• Research drug compatibilities, action purpose,
contraindications, side effects and appropriate
routes.
• Find medication for individual clients and
calculate dosage accurately.
• Check expiration date on medication and look
for any changes that may indicate
decomposition (color, odor and clarity.
• Compare label three times with medication to
decrease the risk of error:
a. When removing package from drawer
b. Before preparing medication/when pouring
c. After preparing medication/before returning to
the cart or shelf
• Check the need for PRN medication.
• Be sure medications are identified for each
client.
• Check for any allergies before administration.
• Use meds that are in clearly labeled containers
from the pharmacy (don’t give if there is no
label). Keep all narcotics and barbiturates in a
locked place.
• Return to the pharmacy and don’t use liquids
that are discolored or muddy.
• Confirm client’s identity by checking at least 2 of
the 3 possible mechanisms for identification to
ensure safety:
a. Ask client his name
b. Check patient’s ID band
c. Check the bed tag (least reliable method)
• Provide privacy if needed.
• Inform client of any procedure, medication,
technique, purpose and client teaching as
applicable.
• Stay with the client until medication is gone,
don’t leave medication at bedside.
• Assist client as needed and leave position of
comfort.
• Give medication within 30 min. of prescribed
time.
• If the client vomits after taking the medication,
report to the nurse in charge or to the doctor
(same if there’s an adverse effect after taking
the drug).
• Pre-op meds are discontinued post operatively
or after the operation unless it is ordered
continued.
• Liquid medications – all routes of administration
must not be mixed together unless compatibility
is verified.
• Chart administration immediately in ink, marking
your initials in appropriate spaces. Observe for
any reactions.
• Circe initials and document rationale if drug is
not administered. If the medicine is omitted for
any reason, document the fact together with the
reason why it is discontinued.
• If there is a medication error, report at once to
the nurse and physician.
• To ensure safety, do not give a medication that
someone else prepared.
• Observe the 10 rights of drug administration.
Standard timing medicine administration
FREQUENCY HOUR
O.D 8:00
B.I.D
8:00 – 4:00 (Antibiotic)
8:00 – 6:00 (Misc. Drugs)
8:00 – 8:00
(Tranquilizers/sedatives)
T.I.D 8:00 – 1:00 – 6:00
Q.I.D
8:00 – 12:00
4:00 - 8:00
HS 8:00
Q8H 8:00 – 4:00 – 12:00
Stat Immediately
PRN When necessary

6. Computation of Drug Dosages
1. For oral medication in solid form (tablets, caplets,
capsules etc.)
Desired dose = Quantity of drug
Stock dose
(D/S=Q)
EXAMPLE
Give Paracetamol 250mg/tab, 1 tablet every 6
hours for fever.
Desired: Paracetamol 250mg/tab
Stock dose: Paracetamol 500mg/tab
250mg/tab
500mg/tab
Answer =0.5 tablet
You will give 0.5 or half tablet of Paracetamol
500mg to achieve the desired dose of 250 mg.
2. For oral/parenteral medications in liquid form:
Desired dose x dilution =Quantity of drug
Stock dose
(D/S x Dilution=Q)
EXAMPLE
Give Cefuroxime 375mg IV q 8hrs via soluset to run
for 30 minutes.
Desired: Cefuroxime 375 mg
Stock: Cefuroxime 750 mg
Dilution: 10 ml sterile water
Cefuroxime 375mg
Cefuroxime 750mg
=0.5 X 10 ml (dilution)
Answer =5ml
Give 5ml of diluted 750mg Cefuroxime q 8hrs.
Intravenous fluid
These are liquids given to replace water, sugar and
salt that a person may need when he is not able to
do so orally.
Types:
Isotonic Solutions (Balance)
- no concentration gradient across the cell
membrane
- cells neither expand nor shrink in the
presence of an isotonic solution.
- contain an electrolyte balance similar to
that of plasma in the blood stream.
Example: Normal Saline Solution, Lactated
Ringer’s Solution
Hypotonic Solutions (Burst)
- solute concentrations lower than those of
your cells
- water will rush into the cell, causing it to
expand.
Example: 0.45 NaCl Solution, 0.3 NaCl
Solution
Hypertonic Solutions (Shrink)
- have higher solute concentrations than
those of your cells
- Water will flow out of the cell, causing it to
shrink.
Example: D5LR, D10W, D5NSS, D5NM
How to compute IV fluid rate:
A. gtts/min= Volume in cc x drop factor
no. of hours x 60 minutes
B. cc/hr = volume in cc or gtts/min
no. of hours
C. duration in hours= volume in cc
cc/hr
EXAMPLE 1
How long will a 100 ml infusion of Sodium
bicarbonate last if it is running at 42 drops per
minute? DF=20/ml
Drop rate: 42 drops/minute, DF is 20 drops/ml
42/20=2.1 ml/min
100ml/2.1 ml/min
Answer: 47.6 minutes
The infusion will run for 47.6 minutes
EXAMPLE 2
A patient is to be given 1000 ml IV using an
infusion pump with a drip factor of 15 drops/ml.
The infusion starts at 8am. If the drip rate was set
at 25 drops/minute at what time would the infusion
finish?
If we divide 25 drops per minute by 15 drops/ml, we
get 1.67ml/min.
Then we divide 1000ml by 1.67ml/min we get 600
mins.
600mins/ 60min= 10 hours
8 am plus 10 hours= 6pm
Administering Intradermal Injection
PROCEDURE
1. Organize the equipment
2. Wash hands & observe other appropriate
infection control procedure
3. Prepare the medication from the vial or
ampule for drug withdrawal.
4. Prepare the client by checking the ID band
5. Explain to the client that the medication will
produce a small wheal, sometimes called a
bleb or wheal.
6. Provide for client’s privacy
7. Select & clean the site
8. Avoid using sites that are tender, inflamed or
swollen, and those that have lesions
9. Cleanse the skin at the site using firm circular
motion, starting at the center & widening the
circle outward. Allow the area to dry
thoroughly.
10. Prepare the syringe for the injection.
11. Remove the needle cap while waiting for
alcohol or antiseptic to dry.
12. Expel any air bubbles from the syringe
13. Hold the syringe in your dominant hand,
holding it thumb & forefinger
14. Hold the needle almost parallel to the skin
surface, with bevel of the needle up
15. Inject the fluid

7. 16. With the non dominant hand, pull the skin at
the site until it is taut
17. Insert the tip of the needle far enough to the
place bevel through the epidermis into the
dermis
18. The outline of the needle of the bevel should
be visible under the skin surface
19. Stabilize the syringe & needle, and inject the
medication carefully & slowly, so that it
produces small wheal on the skin.
20. Withdraw the needle quickly at the same
angle that is was inserted
21. Do not massage the area
22. Dispose the syringe & needle safely
23. Circle the injection site with ink to observe for
redness or indurations, write name of drug
injected & time due.
24. Document all relevant information
25. Record the testing materials given, the time
dosage, route, site & nursing assessment
Administering Intramuscular Injection
PROCEDURE
1. Organize the equipment
2. Wash hands & observe other appropriate
infection control procedure
3. Prepare the medication from the vial or
ampule for drug withdrawal.
4. Whenever feasible, change the needle on
the syringe before injection
5. Invert the syringe uppermost and expel all
excess air
6. Provide for client’s privacy
7. Prepare the client by checking the ID band
8. Assist the client to a supine, lateral, prone
or sitting position, depending on the chosen
site.
9. Obtain assistance in holding an
uncooperative client
10. Explain the purpose of medication & how it
will help, using language that the client can
understand, include relevant information
about effects of the medication.
11. Select, locate & clean
12. Select the site free of skin lesions,
tenderness, swelling, hardness or localized
inflammation, and one that has been used
frequently.
13. If injections are to be frequent, alternate
sites. Avoid using the same site twice in a
row.
14. Locate the exact site for injection
15. Clean the site with an antiseptic swab or
alcohol. Using a circular motion, start at the
center & move outward about 5cm (2in)
16. Transfer and hold the swab between the 3rd
& 4th
finger of your non dominant hand in
readiness for needle withdrawal, or position
the swab on the client’s skin about the
intended site. Allow skin to dry prior to
injection of medication.
17. Prepare the syringe for injection
18. Remove the needle cover without
contaminating the needle
19. Withdraw unit-dose medication, take caution
to avoid dripping medication on the needle
prior to injection
20. Inject the medication
21. Holding the syringe in a dart like position,
pierce the skin quickly & smoothly at 90
degrees angle & insert the needle into the
muscle
22. Hold the barrel of the syringe steady with
your non dominant hand, aspirate by pulling
back on the plunger with your dominant
hand.
23. If blood appears on the syringe, withdraw
the needle & discard & prepare a new
injection
24. If blood does not appear, inject the
medication steadily & slowly while holding
the syringe steady.
25. After the injection, wait 10 seconds
26. Withdraw the needle smoothly at the same
angle of insertion
27. Applied gentle pressure at the side with a
dry cotton ball
28. If bleeding occurs apply pressure with a dry
cotton ball until it stops
29. Discard the uncapped needle & disposed
syringe into the proper receptacle wash
hands.
30. Document all relevant information such as
time of administration, the drug name, route,
the dose & client’s reaction.