Medication Preparations

and Supplies
Drug form
• Refers to the type of preparation in which the drug is supplied.
• Synonymous to drug preparation.

Common Abbreviations for Drug Administration

DRUG FORMS ROUTES
cap capsule IM intramuscular
elix elixir IV intravenous
gtt drop TOP topical
supp suppository PO, po oral
susp suspension R or PR rectal
tab tablet subcu/sc subcutaneous
DRUG FORMS AND DEVICES
Oral Drug Forms
1. Tablet
• Disks of compressed drug
• Comes in a variety of shapes, colors, and may be coated to enhance swallowing, and may be
scored
2. Enteric-coated tablet
• Tablet with a special coating that resists disintegration by gastric juices
• Some drugs that are irritating to the stomach, such as aspirin, are available in enteric-
coated tablets
3. Capsule
• Drug contained within a gelatin-type container
• Easier to swallow than noncoated tablets
• Double chamber may be pulled apart to add drug powder to soft foods or beverages for
patients who have difficulty swallowing
4. Sustained-release capsule or tablet
• Drug particles that have various coatings that differ in the amount of time required
before the coatings dissolve.
• Designed to deliver a dose of drug over an extended period of time.
• An advantage of taking a drug in the sustained-release form is the decreased frequency
of administration.
• Must not be crushed or mixed with foods unless specifically allowed by the drug
manufacturer.
5. Lozenge (troche)
• Tablet containing palatable flavouring, indicated for a local (often soothing) effect on the
throat or mouth.
• Patient is advised not to swallow a lozenge; should be allowed to slowly dissolve in the
mouth
• Patient is also advised not to drink liquids for approximately 15 minutes after
administration
6. Suspension
• Liquid form of medication that must be shaken well before administration because the drug
particles settle at the bottom of the bottle.
7. Emulsion
• Liquid drug preparation that contains oils and fats in water.
8. Elixir
• Liquid drug forms with alcohol evaporation.
• Should be tightly capped to prevent alcohol evaporation.
• Should not be available to alcoholics. Caution in small children.
9. Syrup
• Sweetened, flavoured liquid drug form.
10. Solution
• Liquid drug form in which the drug is totally and evenly dissolved
• Appearance is clear rather than cloudy or settled.
Oral Drug Forms

Tablets Scored tablets Enteric-coated tablets

Capsules Sustained-release capsules Gelatin capsules

Rectal Drug Forms
1. Suppository
• Drug suspended in a substance, such as cocoa butter, that melts at body temperature.
2. Enema
• Drug may be either a suspension or a solution to be administered as an enema.

Injectable Drug Forms

1. Liquid
• Drug suspended (suspension) or dissolved (solution) in a sterile vehicle.
• Quite often the solution have a sterile water base and are thus referred to as aqueous
(waterlike) solutions.
• Some solutions have an oil base (viscous solutions), which tends to cause a more
prolonged absorption time.
2. Powder
• Dry particles of drugs that must be mixed with a sterile diluting solution to render an
injectable solution (reconstitution)
The various injection routes differ according to the type of tissues into which the drug is
deposited and the rate of absorption.
Intravenous
• Injected directly into a vein.
• Immediate absorption and availability to major organs renders this route a dangerous
one.
• Types of IV injections include the following:
IV push, a small volume of drug (bolus) injected into a peripheral saline lock,
attached to a vein. Can also be injected into a port on a primary (continuous) injection
line.
IV infusion or IV drip, a large volume of fluids, often with drugs added, that infuses
continually into a vein.
IV piggyback (IVPB), a drug diluted in moderate volume (50-100 ml) of fluid for
intermittent infusion at specified intervals.
IV Administration

Peripheral saline lock

IVPB

IV push medication
Intramuscular
• Injected into a muscle by positioning the needle and
syringe at a 90-degree angle from the skin.
• Absorption is fairly rapid due to the vascularity in muscle.

Subcutaneous
• Injected into the fatty layer of tissue below the skin by
positioning the needle and syringe at a 45-degree angle
from the skin.
• Sometimes, especially with self-administration or
a shorter needle, a 90-degree angle is used
Intradermal
• Injected just beneath the skin by positioning the needle bevel up and the syringe at a
15-degree angle from the skin.
• Used primarily for allergy skin testing.
• Tuberculin (TB) skin tests (PPD) are also administered ID, and the site is inspected 48-
72 h later for hardness (induration) and swelling.
Epidural
• Injected into a catheter that has been placed by an anesthesiologist in the epidural space
of the spinal canal.
• Epidurals have become a popular and widely accepted vehicle for the management of
acute postoperative pain.
Intraosseous
• Injected directly into the marrow of long bones.
Intraventricular
• Drugs injected directly into the brain via a catheter (ventriculostomy)
placed in a brain ventricle.
Intraspinal
• Injected into the subarachnoid space, which contains cerebrospinal fluid
that surrounds the spibnal cord.
• Drugs injected by this route are frequently anesthetics, which render a
lack of sensation to those regions of the body distal to the intraspinal
injection.
Intraosseous Intraventricular

Intracapsular (glenoid)
Topical Form
Topical drug forms include drugs for dermal application and drugs for mucosal
application.
1. Cream or Ointment
• A semisolid preparation containing a drug, for external application.
• Creams and ointments are not the same
• Creams are more aqueous in nature and ointments tend to be thicker or more viscous
2. Lotion
• A liquid preparation applied externally for the treatment of skin disorders.
• Should be patted, not rubbed, on the affected skin.
3. Liniment
• Preparation for external use that is rubbed on the skin as a counterirritant.
• The liniment creates a different sensation to mask pain in the skin or muscles.
4. Transdermal patch
• Skin patch containing drug molecules that can be absorbed through the skin at varying
rates to promote a consistent blood level of the drug between application times.
• Advantages of this method of administration include:
- Easy application, with minimal discomfort or undesirable taste
- Effectiveness for long periods of time, hours for some drugs, and days for others
- Consistent blood level of drug because the drug is released at varying rates
rather than all at one time.
5. Mucosal drugs
Eye, ear, and nose drops – Drugs in sterile liquids to be applied by drops.
Eye ointment – Sterile semisolid preparation, often antibiotic in nature, only
for ophthalmic use
Vaginal creams – Medicated creams, often of antibiotic or antifungal
nature, that are to be inserted vaginally with the use of a
special applicator.
Rectal and vaginal suppositories – Drug suspended in a substance, such
as cocoa butter, that melts at body
temperature, for local effect.
Douche solution – Sterile solution, often an antiseptic such as povidone-
iodine solution and sterile water, used to irrigate the
vaginal canal.
Buccal tablet – Tablet that is absorbed via the buccal mucosa in the mouth.
It is to be placed between the cheek and gums.
Sublingual tablet – Tablet that is absorbed via the mucosa under the
tongue.
6. Inhalation Drug Forms
The inhalation route is a very fast acting (second to IV route) and effective
route for delivering humidification and medication directly into the
respiratory system. The inhalation drug forms for the inhalation route
include:
Spray or mist
• In the hospital setting, respiratory therapists instill a liquid into a
chamber of a nebulizer for a patient’s breathing treatment. Often the
liquid contains a bronchodilator, a mucolytic agent, or a sterile saline
solution for moisture.
• In the home, the patient may instill aerosol sprays into the respiratory
system via a small-volume nebulizer (SVN), a metered-dose inhaler
(MDI), or a dry-powdered inhaler.
SVN MDI

DPI
SUPPLIES
Considering the variety of drug forms you may be administering, you must become
familiar with various supplies to be used:
Medicine cup
• Two types of disposable cups are commonly used: paper cups for tablets and capsules,
and plastic medicine cups with measurements for dispensing oral liquid medications.
Pill crusher and pill cutter
Medication for injection is contained in an
ampule, a vial, or a specified syringe
Ampule
• Small glass container that holds a single
dose of sterile solution for injection.
• The ampule must be broken at the neck to
obtain the solution
Vial
• Glass container sealed at the top by a
rubber stopper to enhance sterility of the
contents.
• Contents may be a solution or a powdered
drug that needs to be reconstituted.
Needles
Needles for injections have two measurements that must be noted
• Length varies from short (3/8 inch) to medium (1-1½ inch) for standard
injections. Long needles (5 inch) may be used for intraspinal or
intraosseous routes.
• Gauge is a number that represents the diameter of the needle lumen
(opening). Gauge 16 (largest) to 31 (smallest)

Syringes
The three most common disposable syringes used for parenteral
administration of drugs are:
1. Hypodermic syringe (standard)
• 2-3 mL; usually with a needle attached
2. Insulin syringe
• Used strictly for administering insulin to diabetics.
• Standard insulin syringe has only a 1-mL capacity, which is equivalent to 100
units
3. TB syringe
• Very narrow and is finely calibrated
• Has a total capacity of 1 mL
• Commonly used for newborn and pediatric dosages and for ID skin tests.
4. Oral syringes
• Some oral liquid medications are dispensed from the pharmacy in disposable
plastic syringes with rubber or plastic covers on the tip.
• These syringes are labeled “Not for injection” or “For oral use only.”