Master Routes of Administration Part One with Picmonic for Nursing RN

Medication taken by mouth (PO). This is the easiest and most economical way of administering medication. Do not give oral medications if the patient is lethargic, has decreased gastric function (nausea, vomiting), has NPO (nothing by mouth) orders, or is unable to swallow.

This medication is placed under the tongue to dissolve. The medication is absorbed through the mucosal membrane of the gums and should not be swallowed. Do not have the patient drink any water until the medication is fully dissolved.

Buccal Administration involves placing solid medication in the mouth and against the mucous membranes of the cheek until the medication dissolves. To avoid mucosal irritation, teach patients to alternate cheeks with each subsequent dose and advise patients not to chew or swallow the medication or take any liquids with it. Buccal medication acts locally on the mucosa or systemically when it is dissolved in the person's saliva

This is a potential route of administration when the patient is unable to take oral medications. It can be given as a suppository or enema. Rectal medications avoid about 2/3 of first-pass metabolism.

This can be in the form of a nasogastric tube, duodenal tube, or G-tube. Medications will need to be crushed. Important to note. You will need to confirm with the pharmacist to see if the medication can be safely crushed. Incorrect administration techniques could lead to poor patient outcomes such as enteral tube obstruction, reduced drug efficacy, and increased drug toxicity.
Always remember that oral medication crushed and administered via this method is bypassing several levels of the gastrointestinal tract, and therefore natural medication metabolism. How these medications will perform after avoiding this step cannot always be determined.

These are placed directly on the skin as a patch and left for an extended amount of time. Extended release medications are used for longer therapeutic effect.

These can be given via eyes, nose, or ears. Always confirm how many drops or sprays will be administered on both sides. Medication is easily absorbed through mucosal membranes and can cause systemic effects.

Always be sensitive to the patient if medication is being administered through this route. It may be embarrassing for the patient and can cause irritation of the mucosal membrane.

Inhaled medications are used for rapid relief of respiratory problems or for anesthesia. These medications can enter directly into the bloodstream and cause severe systemic side effects.