Most medications you take by mouth are absorbed into your bloodstream through the walls of your intestine. The medication has to get to this area intact to work properly. You can help ensure this by taking the medication with plenty of water (at least half a glass) while standing or sitting upright. Stay in this upright position for a minute or two after taking the medication; this reduces the risk of a tablet, capsule, or other hard medication from getting stuck in the esophagus, the tube that connects your throat to your stomach. If a medication gets stuck it could damage the esophagus or the medication's actions could be delayed. Drinking plenty of water also aids absorption. If a pill does get stuck in your esophagus, eat a soft, bulky food such as a banana or a slice of bread and drink some water to help wash it down.
Always check with your primary care doctor, pharmacist, or a reliable reference book before manipulating crushing, opening, cutting, or chewing a medication in any way. Some tablets and capsules that seem too large to swallow may be crushed or mixed with a soft food such as applesauce. The same is true for liquids whose taste you dislike. If you mix a liquid medication with food, take the mixture immediately so that no one else takes it by accident. A number of medications are also available in a variety of forms, including easy-to-swallow liquids.
Long-acting or extended-release tablets or capsules should always be swallowed whole. Chewing or breaking open these types of pills will cause the medication to be released into your system rapidly, rather than gradually as intended. As a result, the medication may not work properly and may even cause harm.
Timing is often critical to the effectiveness of oral medications, yet the instructions that accompany many medications may seem unclear. A prescription that calls for you to take three doses a day, for example, may mean three doses during waking hours, or three doses spread out over a 24-hour period that is, every 8 hours. Ask your doctor or the pharmacist for more specific guidance if you are not clear on what you should do. In general, medications that you are taking regularly should be taken at the same time every day. A schedule that is consistent from day to day will not only help you remember to take the medication but will also ensure that your body is exposed to relatively constant levels of the active substance in the medication.
Food can alter the effectiveness of a medication, so carefully follow the medication's instructions as to whether or not the medication should be taken with food. Most medication works more quickly when taken on an empty stomach. Sometimes the presence of food reduces the amount of medication free to be absorbed into the body or it affects the speed at which the medication is absorbed into the body. However, in certain cases, some medication is better absorbed when taken with food. The type of food you eat makes a difference with medication. Certain medications, for example, bind to milk or milk products, thus hindering their absorption into the bloodstream. Some medications should be taken with food to minimize stomach irritation. As a general rule, avoid taking medications with hot drinks such as coffee or tea, because they can reduce or even erase the effectiveness of many medications.
If a prescription insert (or label in thecase of over-the-counter medications) instructs you to take the medication on an empty stomach and offers no specifics on how to do this, take it at least 1 hour before or 2 to 3 hours after eating.
The Many Forms of Tablets, Capsules and Liquids
Tablets, typically round in shape, contain the medication compressed into a solid form along with substances that bind the tablet together. Tablets come in many forms. Enteric-coated tablets are designed to dissolve in the small intestine rather than the stomach, which they pass through first. Chewable tablets, often tailored to appeal to children, should always be chewed thoroughly to avoid stomach irritation. Effervescent tablets are fashioned to dissolve completely in a liquid. Be sure to drink all the liquid. Sublingual tablets are placed under the tongue, and buccal tablets are tucked between the cheek and teeth. As these last two types of tablets dissolve, the medication quickly enters the bloodstream through the dense network of blood vessels lining the mouth. These types of tablets can prove quite valuable when fast action is needed; many people with angina (chest pain), for example, rely on sublingual nitroglycerin tablets when their condition flares. Never swallow a sublingual or buccal tablet. Caplets are tablets shaped into capsule form for easier swallowing. A lozenge is a tablet in which the medication has been incorporated into a sugar- or fruit-based paste; most lozenges are designed to be sucked on until they dissolve, much like a hard candy.
Capsules, typically cylindrical in shape, come in either soft gelatin form, with a liquid inside, or in hard gelatin form, with timed-release beads or powder inside. Sustained-release, slow-release, or timed-release pills (tablets or capsules) are designed to release medication slowly over time as they dissolve in the gastrointestinal tract.
Liquid medications come in several forms. Some are made into the following forms from granules, powders, effervescent tablets, or other dry substances:
 | A syrup consists of the active medicinal ingredients dissolved in a sugary
flavored solution. Syrups are usually quite thick.
| An elixir consists of the active medicinal ingredients mixed in a flavored
and sugary alcohol base.
| A suspension contains powdered or otherwise solid medication that has been
suspended rather than dissolved in a liquid. Because the medication often
settles down to the bottom, it is particularly important to shake a
suspension well before measuring out a dose. Some formulations require that
you mix the medication with a liquid (called a diluent) yourself.
| A solution consists of a clear liquid in which the medication has been
dissolved.
| A mixture contains one or more medications, dissolved to form a solution
or suspension.
| An emulsion is a medication contained in an oil-and-water base. | |
Medications that are applied to the skin and surface tissues of the body also called topical medications come in a wide array of forms, from creams and ointments to solutions, dusting powders, nasal drops, suppositories (rectal and vaginal), and ear and eye drops. Because topical medications deliver the medication directly to the problem site, topical medications generally do not cause the complications that systemic medications can. It is also much easier to control the impact of topical medications. Many infections and irritations of the skin, ears, and eyes are treated with topical medications.
As with other forms of medications, the belief that, with topical medications, more is better is not only misguided but potentially hazardous. Sometimes the risks of applying more medication than necessary can add up to more than mere skin irritation; topical steroids, for example, can cause body-wide side effects if taken in higher than recommended doses or repeatedly placed on large or damaged areas of skin. Avoid leaving any topical medication on for longer than is recommended.
Always wash your hands before and after applying a skin medication. Dab the prescribed amount onto the center of the affected area and spread the medication out from there in an even and thin layer. Unless otherwise directed, a spray should be held at least 6in. from the skin. Shake the container well before spraying.
Always wash your hands before applying eye medication and lie or sit down before applying the medication to make sure that you do not lose your balance and can focus on what you are doing. Eye medications typically come in ointment or drop form.
OintmentIf the ointment tube is cool, warm it up by rolling it between your hands. With a gauze, wipe away any crusting or secretions that have built up on the eye. Tilting your head back, gently pull down your lower eyelid by drawing down the skin below it, or pinching the skin directly under the lower eyelid to form a pocket between the eye and the lower eyelid. Look upward toward your forehead and squeeze a small amount (about a 1/2in.) of ointment onto the inside margin of the eyelid. Close the eye for 1 to 2 minutes to help the medication absorb into the eye. Try to avoid blinking because that will flush the medication out of the eye. Gently wipe away any excess medication on the eyelashes or cheeks with a clean tissue. Your vision may be blurry for a few moments after applying an ointment. To avoid contamination, never actually touch your eye, eyelid, cheek, or fingers with the medication tube opening. To help prevent contamination, end by squeezing a small amount of ointment onto a tissue and throw the tissue away.
DropsBring drops that are cool to room temperature by rolling the bottle between your hands. Shake the bottle. With a gauze, wipe away any crusting or secretions that have built up on the eye. Tilting your head back, gently pull down your lower eyelid by drawing down the skin below it, or pinching the skin directly under the lower eyelid to form a pocket between the eye and the lower eyelid. Squeeze the drops behind your lower eyelid. To help prevent contamination, carefully avoid touching the dropper to any part of the eye, including the eyelashes, skin around the eye, or fingers. Close your eye for 1 to 2 minutes to keep the medication in and to allow it to be absorbed. Gently wipe away any extra medication on the eyelashes or cheeks with a clean tissue.
Be gentle when administering ear medications; rough handling can damage the eardrum and ear canal. Never actually insert anything especially not a cotton swab past the outer ear. Avoid touching the ear canal with the dropper. To prevent spreading an infection, do not share ear medications. Most ear medications come in liquid form contained within a dropper.
DropsAlways wash your hands before and after administering an ear medication. Cool medication may make you feel dizzy or even nauseous, so warm it up, if needed, by rolling the bottle between your palms or running it under warm water for a few minutes. Also make sure the tip of the dropper is not cracked or chipped. Shake the bottle. Use gauze to gently clean away any ear drainage or crusting on the outer ear. Tilt your head sideways so that your ear faces the ceiling. To straighten the ear canal so that the medication can penetrate it well, draw your earlobe down and toward the back of your head. However, if you are administering drops to a child more than 3 years old, pull the side of the outer ear or the ear lobe up and back. Instill the prescribed number of drops. Hold your head in the same position for several minutes to allow the medication to absorb into the ear. Repeat these steps for the other ear if needed. Do not rinse the ear dropper; simply place it back into the bottle.
Nasal medications are available in several forms including drops, sprays, ointments, and aerosols. Gently blow your nose before administering a nasal medication and always wash your hands before and after applying it. To avoid passing infection from one person to another, never share nasal medications.
Nasal dropsIf the drops are cool, bring them to room temperature by rolling the container between your hands. Shake the container. Lie or sit down, and tilt your head back. Breathing through your mouth, slowly instill the prescribed number of drops into a nostril, carefully avoiding touching the sides of the nostrils with the dropper. After instilling the drops, keep your head tilted back for several seconds to allow the medication to absorb into the nasal cavity. Repeat this procedure for the other nostril if necessary. When finished, wash the dropper in hot, soapy water and dry it.
Nasal spraySit or stand with your head tilted back. Close off the opposite nostril by pressing against it with one finger, and with your other hand insert the tip of the sprayer (or pump bottle) about 1/2 in. into the nostril, with the tip of the container pointed toward the inner corner of the eye. Simultaneously squeeze the container and sniff in. Treat the other nostril the same way if needed. Avoid blowing your nose for 2 minutes or so if possible to allow the medication to do its work. Clean the sprayer tip with warm water and dry it well with a clean tissue. Always replace the cap.
There are several reasons for taking a medication rectally. Nausea or other complications may make it impractical to take the medication by mouth, for example. The stomach's digestive juices can destroy certain medications, or the rectum or anal area may need to be treated directly.
A few rectal medications mostly those for constipation or inflammatory bowel diseases are prescribed in enema form. Enemas are liquid medications inserted into the rectum with an applicator. But most medications designed for rectal administration come in the form of a suppository. These solid, bullet-shaped suppositories dissolve gradually, releasing the active ingredients that go on to affect the body as a whole. Some suppositories are solid when cold for example, when kept in the refrigerator but melt quickly at room temperature. These suppositories must be inserted quickly and efficiently.
Wash your hands before and after inserting a rectal suppository. Wear latex gloves or a finger cot, which covers one finger. The suppository should not be too soft; run the package under cool water for a few minutes to firm it up if necessary. Lie on your side, separate the cheeks of the buttocks, and gently insert the suppository high into the rectum, with the pointed end entering first. If the suppository slips out, simply reinsert it higher in the rectum. If you sense you need to lubricate the suppository, smear it with a small amount of water to make it slide in more easily. Holding the cheeks of the buttocks together for a few minutes may also encourage the suppository to stay in and will also give it time to dissolve.
Most vaginal medications are designed to treat conditions affecting the vagina alone, such as local yeast infections. Gels, foams, and creams are just a few of the forms of vaginal medications available.
Clean your hands before and after administering a vaginal medication. Empty your bladder. Spread the lips of the vagina and insert the medicine typically an applicator or suppository a few inches (or as directed) into the vagina. Do not use a tampon directly afterwards as it is likely to absorb the medicine. Wash reusable applicators with warm, soapy water and dry them well. A panty liner will protect underwear from medication that may leak out.
Inhalation Medications (Oral and Nasal)
Inhalation medications may affect the respiratory tract directly a benefit widely valued in asthma and emphysema medications or produce a general effect by entering the bloodstream through the lungs. Inhalation medications come in several forms, from metered dose inhalers, or MDIs, which often come with an attachment device called a spacer that makes them easier to use, to capsules delivered through an inhaler. Administering these types of medications correctly can prove challenging. Errors are common. So, in addition to getting a handout from your doctor that describes how to administer the medication these also can be found in virtually all inhalation medication packages you should periodically demonstrate your technique to your doctor or pharmacist.
There may be several reasons why you have been prescribed an injection medication. Speed is one of the most common; a medication that is injected into your body will circulate quickly through your system. Minutes and even seconds can be critical when attempting to treat a severe allergic reaction, for example. Sometimes an injection medication is prescribed because the stomach destroys the active substance when taken orally (insulin is an example of this) or the medication may fail to pass into the bloodstream because it cannot penetrate the walls of the intestine. Nausea or other adverse reactions to an oral medication may also justify the use of an injection medication.
Depending on the type of medication and the condition it is being used to treat, an injection will be administered one of three ways. Intramuscular injections are administered into a muscle, characteristically the buttock, thigh, or upper arm. Subcutaneous injections are delivered under the surface of the skin. Intravenous injections are administered directly into a vein.
Unless you have been carefully instructed on how to administer an injection medication a doctor or nurse should perform the procedure. If you have been shown how to administer an injection medication and have been prescribed needles to do so, make sure to dispose of them properly. This is important to avoid spreading infection as well as misuse of needles for illegal drug injection. Never use another person's needles because it can lead to the spread of hepatitis, bacterial infections, or infection with the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). Place used needles (and extra, unused needles) in a "sharps" container (sold in drugstores) and return them to your pharmacist.
One of the newest methods for administering medications is by transdermal patch, a medication-impregnated pad you place on the skin. These patches can offer steady and constant delivery of medication; the adhesive material releases a premeasured supply of medication gradually over a designated period of time. The patch also liberates the user from having to remember to take a medication every day. Medications that are commonly available in this form include estrogen, nitroglycerin (for angina), and nicotine (for smoking cessation), although there are many others. The packaging (or your prescription) should provide instructions on where to place the patch. To avoid excessive skin irritation, apply it to a relatively hair-free area of skin and remember to rotate the patch to a different spot every once in a while. Let your doctor know if the transdermal patch is irritating your skin; she may have strategies for relieving this reaction.