Types of Medical Drug Intake

Not all medical drugs intake are in pill format. There are practically 9 types of medical drug intake which I'd like to share step by step instruction of how to consume them.

How, when, and with what other substances you use your medicine can have a significant impact on your response to many drugs.

Compare your routines with the recommended medication administration methods described below.

EyeDrops

Steps by step instructions

Wash your hands thoroughly with soap and water.
Gently clean your ear with a damp facecloth and then dry your ear.
Warm the drops to near body temperature by holding the container in your hand for a few minutes.
If the drops are a cloudy suspension, shake the bottle well for 10 seconds.
Check the dropper tip to make sure that it is not chipped or cracked.
Draw the medication into the dropper, or hold the dropper-top bottle with the dropper tip down.
Tilt the affected ear up or lie on your side.
Avoid touching the dropper tip against your ear or anything else. Eardrops and the dropper must be kept clean.
Place the correct amount in your ear. Then tug gently on your ear to allow the drops to run in.
Keep your ear tilted up for a few minutes or insert a soft cotton plug in your ear, whichever method has been recommended by your pharmacist or doctor.
Replace and tighten the cap or dropper right away.
Wash your hands to remove any medication.
REMEMBER:

Follow directions carefully
Do not miss doses
Store medications out of reach of children

Adapted from the Michigan Pharmacists Association's Patient Education Program.

Additional Tips for Using Ear Drops

Follow directions carefully.
Do not miss doses.
Store medications out of reach of children.
Do not touch dropper tip to ear.
If more than one type of ear drops is being used, wait at least 2 minutes before instilling the next ear drop.
Let the ear drops drain in for at least 2 minutes before moving head from tilted position.

Eye Ointments/Gels

Steps by step instructions

Wash your hands thoroughly with soap and water.
Avoid touching the tip of the tube against your eye or anything else - the medication and its container must be kept clean.
Holding the tube between your thumb and forefinger, place it as near to your eyelid as possible without touching it.
Brace the remaining fingers of that hand against your face.
Tilt your head forward slightly.
With your index finger, pull the lower eyelid down to form a pocket.
Squeeze a ribbon of ointment or gel into the pocket made by the lower eyelid.
Blink your eye gently; then close your eye for 1 to 2 minutes.
With a tissue, wipe any excess ointment or gel from the eyelids and lashes. With another clean tissue, wipe the tip of the tube clean.
Replace and tighten the cap right away.
Wash your hands to remove any medication.
REMEMBER:

Follow directions carefully
Do not miss doses
Your eyesight may be cloudy after using the ointment or gel Store medications out of reach of children

Adapted from the Michigan Pharmacists Association's Patient Education Program. Illustration reproduced, with permission, from the Atlas of Primary Eyecare Procedures, Appleton Lange, Norwalk, CT, 1997.

EyeDrops

Steps by step instructions

Wash your hands thoroughly with soap and water.
Check the dropper tip to make sure that it is not chipped or cracked.
Avoid touching the dropper tip against your eye or anything else. Eye drops and droppers must be kept clean.
While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket (see figure).
Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
Brace the remaining fingers of that hand against your face.
Gently squeeze the dropper so that the correct number of drops falls into the pocket made by the lower eyelid.
Close your eye for 2 to 3 minutes.
Place one finger at the corner of the eye near the nose and apply gentle pressure. This will prevent the medication from draining out of the eye. Wipe any excess liquid from your face with a tissue.
Replace and tighten the cap right away. Do not wipe or rinse the dropper tip.
Wash your hands to remove any medication.
REMEMBER:

Follow instructions carefully
Do not miss doses
Use the exact number of drops recommended
Store medications out of reach of children
If more than one type of eye drop is being used, wait at least 10 minutes before using the next eye drop.
If soft contact lenses are used, remove them before administering the medication and wait at least 15 minutes before reinserting them.

Additional Tips for Using Eye Drops

Follow label instructions carefully.
Do not miss doses.
Use the exact number of drops recommended by your doctor.
Store medications out of reach of children.
If more than one type of eye drop medication is being used, wait at least 10 minutes before instilling the next eye drop medication.
If you wear soft contact lenses, remove them before administering the medication and wait at least 15 minutes after instilling eye drops before reinserting the lenses.

Inhalers

Steps by step instructions

Using an inhaler seems simple, but most patients do not use it the right way. When you use your inhaler the wrong way, less medicine gets to your lungs.

For the next 2 weeks, read these steps aloud as you do them or ask someone to read them to you. Ask your doctor, pharmacist or nurse to check how well you are using your inhaler.

Use your inhaler in one of the three ways pictured below (A or B are the best, but C can be used if you have trouble with A and B)

Steps for Using Your Inhaler

Getting Ready

Take off the cap and shake the inhaler
Breath out all the way
Hold you inhaler the way your doctor said (A, B, or C below).

Breathe in slowly

As you start breathing in slowly through your mouth, press down on the inhaler one time (If you use a holding chamber, first press down on the inhaler. Within 5 seconds, begin to breathe in slowly.
Keep breathing in slowly, as deeply as you can.

Hold your breath

Hold your breath as you count to 10 slowly, if you can.
Wait about 1 minute between puffs.

A. Hold inhaler 1 to 2 inches in front of your mouth
(about the width of two fingers)

B. Use a spacer/ holding chamber.
These come in many shapes and can be useful to any patient.

C. Put the inhaler in your mouth.
Do not use for steroids.

Clean Your Inhaler as Needed

Look at the hole where the medicine sprays out from your inhaler. If you see "powder" in or around the hole, clean the inhaler. Remove the metal canister from the L-shaped plastic mouthpiece. Rinse only the mouthpiece and cap in warm water. Let them dry overnight. In the morning, put the canister back inside. Put the cap on.

Additional Tips for Using Inhalers

There are three types of medication that can be delivered with a metered dose inhaler:
- Bronchodilators- medications that relax the muscles around the bronchial tubes and make breathing easier. These are used for immediate relief of symptoms.
- Corticosteroids- medications that decrease inflammation and swelling in the airways. They do not provide relief immediately but may help reduce the frequency and severity of acute attacks, if taken on a regular basis.
- Cromolyn- medication that reduces inflammation and reactions in the airways. It does not provide relief immediately but may help reduce the frequency and severity of acute attacks, if taken on a regular basis.
Rinse mouth with water or mouth wash after using corticosteroid medication to prevent hoarseness and fungal infections in the mouth and throat.
If you are taking more than one inhaled medication, it is important to take them in the correct order. Bronchodilating medications are usually taken first to open the airways and allow other types of medications to be more effectively inhaled into the lungs. Corticosteroids and cromolyn are inhaled after bronchodilating drugs.
Avoid the use of over-the-counter inhalers. Most of these contain epinephrine, which is effective for only a short time and may cause rebound bronchospasm (making it more difficult to breathe).
Take only the recommended number of puffs prescribed by your provider; over-use or incorrect use can be dangerous.
Notify your doctor if any of the following occur:
- You do not get relief from your metered dose inhaler
- You have increasing shortness of breath despite use of inhalers
- You are experiencing weakness, increased heart rate, shakiness, insomnia, nervousness, headaches, nausea or vomiting

Insulin - Injecting

Steps by step instructions

Select a site for insulin injection. Insulin may be injected into the fatty layer of tissue of the upper arm, the thighs, or the abdomen.
Clean the injection site with an alcohol pad and allow it to dry.
Pick up your prepared syringe and uncap it to expose the needle.
Pinch a fold of skin and quickly push the needle straight into the skin. Be sure that the needle is all the way in.
Quickly push the plunger all the way down to inject the entire insulin dose. Once the dose is injected, release the pinched skin and pull the needle straight out. Press on the injection site with an alcohol pad but do not rub the injection site.
Dispose of the syringe and needle properly after injection.

Additional Tips for Injecting Insulin

It is less painful and less damaging to the body's tissues if the insulin dose is brought to room temperature just prior to injecting.
Rotate your injection sites – give each insulin shot in a different spot.
Keep a record of your insulin injections in a log book – write down the time and the dose of each insulin injection. Show your log book to your doctor at each appointment.
Always check with your doctor or pharmacist if you have questions.

Insulin - Mixing

Steps by step instructions

Gather all necessary supplies: insulin vials, syringe, and alcohol pads.
Wash hands thoroughly with soap and water.
Check the insulin vials to be sure they are the correct insulin and strength. Also, check with your personal healthcare provider to make sure it is okay for you to mix your insulins in the same syringe. Some insulins such as Levemir, should not be mixed.
Clear insulin such as Regular, Novolog, Lispro, Lantus, and Apidra do not need to be agitated. All other types of insulin are cloudy and need to be agitated before a dose of insulin is drawn.
To agitate insulin, roll the insulin vial between the palms of your hands. Do not shake the insulin vial.
Inspect the insulin for any abnormalities in color, particulate matter, consistency, and thickness. If any abnormalities are seen, do not inject the insulin; throw it away and obtain a new vial.
If the vial is new, pop the colored cap off.
Clean the rubber stopper with an alcohol pad before each use.
Verify that you know the correct dose of each insulin to be mixed in the syringe.
You will be combing two types of insulin; clear which is short-acting, and cloudy which is longer-acting to make your total dosage.
Pick up the syringe and remove the needle and plunger caps. Pull back on the syringe plunger to draw air into the syringe. Draw in an amount of air equal to your dose of cloudy insulin. To measure the amount correctly, pull back on the plunger to the point where the top of the black rubber portion of the plunger meets the measurement line on the syringe.
Inject that air into the cloudy insulin vial. This is done to avoid creating a vacuum within the vial when you withdraw your insulin dose and will make it easier to withdraw the dose. DO NOT WITHDRAW THE INSULIN YET. Withdraw the empty syringe from the vial.
Repeat this process with the clear insulin. Pull back on the syringe plunger to draw air into the syringe. Draw in an amount of air equal to your dose of clear insulin. Inject that air into the clear insulin vial.
Invert the clear insulin vial and syringe and slowly withdraw the appropriate number of clear insulin units first. Remove any air bubbles in the syringe by gently tapping the syringe with your finger and carefully pushing any large air bubbles back into the vial.
Double check that you withdrew the proper dose of clear insulin and that no large air bubbles are present; then withdraw the syringe form the vial.
Insert the syringe needle into the rubber stopper of the cloudy insulin vial. Invert the vial and syringe and slowly and carefully withdraw the appropriate number of units of the cloudy insulin. Be sure to do this with accuracy since the insulin cannot be pushed back into the vial if too much is withdrawn or large air bubbles exist. Withdraw the syringe from the vial.
Double check that you withdrew the appropriate dose. Carefully cover the needle with its cap or lay the syringe down so that the needle does not touch anything. The dose of insulin is now ready to be injected.

Additional Tips for Mixing Insulin Doses

Always check your insulin vials to insure that you have the right type of insulin, that it is normal in appearance, and that it is not expired (expiration date is typically printed directly on the vial).
Know your correct insulin doses (of your short-acting and longer-acting insulin) before you get ready to draw them into the syringe.
Never change insulin brands, types, or concentrations (U-100 versus U-500) without first talking with your doctor.
Keep extra vials of insulin in your refrigerator. Make sure you don't run out!
Never let your insulins freeze.
Keep the vials of insulin that you are currently using in the refrigerator when possible. However, most insulins can be stored at room temperature for up to 30 days.
If insulin is not kept in the refrigerator, store it away from heat and light (below 860F).
Do not shake your insulin hard and do not let it get tossed around. Longer-acting insulins (typically cloudy in appearance) should be rolled between the palms of the hands to agitate. If insulin is handled roughly, it may be more likely to clump.
If you need to travel, protect insulin from getting too hot or cold. Do not leave it in a parked car, especially if it is very warm or very cold outside.
When drawing insulins into the syringe remember: CLEAR BEFORE CLOUDY.

Insulin - Preparing

Steps by step instructions

Gather all necessary supplies: the insulin vial, syringe and alcohol pads.
Wash hands thoroughly with soap and water.
Check the insulin vial to be sure it is the correct insulin and strength.
Clear insulin such as Regular, Novolog, Lispro and Lantus do not need to be agitated. All other types of insulin are cloudy and need to be agitated before a dose of insulin is drawn.
To agitate insulin, roll the insulin vial between the palms of your hands. Do not shake the insulin vial.
Inspect the insulin for any abnormalities in color, particulate matter, consistency, and thickness. If any abnormalities are seen, do not inject the insulin; throw it away and obtain a new vial.
If the vial is new, pop the colored cap off.
Clean the rubber stopper with an alcohol pad before each use.
Remove the needle and plunger caps and pull back on the syringe plunger to draw air into the syringe. Draw in an amount of air equal to your dose of insulin. To measure the amount correctly, pull back on the plunger to the point where the top of the black rubber portion of the plunger meets the measurement line on the syringe.
Insert the needle straight into the rubber stopper of the insulin vial and push the air into the vial. This is done to avoid creating a vacuum within the vial when you withdraw your insulin dose and will make it easier to withdraw the dose.
Invert the vial and syringe and slowly withdraw the appropriate number of insulin units from the vial.
Remove any air bubbles in the syringe by gently tapping the syringe with your finger and carefully pushing any large air bubbles back into the insulin vial.
Double check that you withdrew the proper dose from the insulin vial and that no large air bubbles are present; then withdraw the syringe form the vial.
Carefully cover the needle with its cap or lay the syringe down so that the needle does not touch anything. The dose of insulin is now ready to be injected.

Additional Tips for Preparing Insulin Doses

Always check your insulin vials to insure that you have the right type of insulin, that it is normal in appearance, and that it is not expired (expiration date is typically printed directly on the vial).
Know your correct insulin dose before you get ready to draw it into the syringe.
Never change insulin brands, types, or concentrations (U-100 versus U-500) without first talking with your doctor.
Keep extra vials of insulin in your refrigerator. Make sure you don't run out!
Never let your insulin freeze.
Keep the vial of insulin that you are currently using in the refrigerator when possible. However, most insulins can be stored at room temperature for up to 30 days.
If insulin is not kept in the refrigerator, store it away from heat and light (below 860F).
Do not shake your insulin hard and do not let it get tossed around. If insulin is handled roughly, it may be more likely to clump.
If you need to travel, protect insulin from getting too hot or cold. Do not leave it in a parked car, especially if it is very warm or very cold outside.

Nosedrops

Steps by step instructions

Blow your nose gently.
Wash your hands thoroughly with soap and water.
Check the dropper tip to make sure that it is not chipped or cracked.
Avoid touching the dropper tip against your nose or anything else - nose drops and the dropper must be kept clean.
Tilt your head as far back as possible, or lie down on your back on a flat surface (such as a bed) and hang your head over the edge.
Place the drops into your nose.
Bend your head forward, toward your knees and move it left and right.
Remain in this position for a few minutes.
Clean the dropper tip with warm water. Cap the bottle right away.
Wash your hands to remove any medication.

REMEMBER:

Follow directions carefully
Do not miss doses
Use nose drops only as long as directed
Store medications out of reach of children

Adapted from the Michigan Pharmacists Association's Patient Education Program.

Rectal Suppositories

Steps by step instructions

Wash your hands thoroughly with soap and water.
If the suppository is soft, hold it under cool water to harden it before removing the wrapper.
Remove the wrapper, if present.
If you were told to use half of the suppository, cut it lengthwise with a clean, single-edge razor blade.
Put on a finger cot or disposable glove, if desired (available at a pharmacy).
Lubricate the suppository tip with a water-soluble lubricant such as K-Y Jelly, not petroleum jelly (Vaseline). If you do not have this lubricant, moisten your rectal area with cool tap water.
Lie on your side with your lower leg straightened out and your upper leg bent forward toward your stomach.
Lift upper buttock to expose the rectal area.
Insert the suppository; pointed end first, with your finger until it passes the muscular sphincter of the rectum, about 1/2 to 1 inch in infants and 1 inch in adults. If not inserted past this sphincter, the suppository may pop out. (See below)
Hold buttocks together for a few seconds.
Remain lying down for about 15 minutes to avoid having the suppository come out.
Discard used materials and wash your hands thoroughly.

REMEMBER:

Follow directions carefully
Store suppositories in a cool place and avoid melting
Refrigerate them if so labeled
Do not miss doses
Store medications out of reach of children

Adapted from the Michigan Pharmacists Association's Patient Education Program

Wednesday, April 30, 2008

Types of Medical Drug Intake