Patient Counseling-Administering a medicine
Patient Counseling-Administering the medicine: Administering the medicine may be simple in the case of tablets and capsules. It can be difficult in the case of some newer formulations.Even in the case of tablets and capsules, we must give special instructions sometimes. For example, in the case of NSAIDS, we must tell that the patient must swallow the medicine, sitting upright, and with a full glass of water. This is because, NSAIDS, most of them being weak acids, may harm the oesophagus if they get lodged there. We see that many types of tablets are there and each type needs one way of administration. TABLETS: Type of tablet Instruction for administration ? Simple compressed tablet Place on tongue and swallow with water. ? Layered and delayed action tablets Warning : Do not chew ? Chewable tablets Chew and swallow ? Lozenges Let it dissolve in mouth, ? Sunlingual tablet Place under tongue and let dissolve. Do not swallow ? Buccal Place between gum and cheek (buccal) and let dissolve. Do not swallow. ?Dispersible tablet Disperse in water and swallow ? Tablets for external use Dissolve in water and use externally ?Vaginal or rectal tablets Moisten with water and insert vaginally or rectally ?Effervescent tablets dissolve in water and take while effervescing. Opthalmic Preparations: We must give special instructions for opthalmics. Otherwise patients do not use them properly and medicine is wasted. ? Put your finger below the eyelid and pull it down. ? This will form a pouch in the lower lid where the eyedrops are to be placed. ? Then close your eye and lightly put your finger on the eye for a minute so that the eye drops are retained in the eye. Inhalers: First exhale totally. Now open the cap, put the capsule containing the drug dose in the vaporizer against your mouth, press the inhaler, and go for deep inhalation. Hold your breath for several seconds to retain the medicine. Remove the inhaler and slowly exhale through pursed lips. Suppositories: ? If suppositories are stored in refrigerator, they must be made to come to room temperature before they are used. ? Cocoa butter suppositories: rub with fingers before use so that the surface melts and provides lubrication for insertion. ? Glycerinated gelatin or polyethylene glycol suppositories: moisten with water before use, as water provides lubrication. ? Vaginal inserts (compressed tablets) : moisten with water before use for good lubrication and disintegration. Transdermal Systems: Choose a clean, dry, hairfree area on the body like the abdomen and place the adhesive side of the transdermal patch on it. Fix the patch there. As soon as the patch is removed from its protective liner it must be pressed firmly in place. We must make sure that there is good contact, especially near the edges. There should be no oily nature or wound or inflammation or irritation on the area where a transdermal patch is applied. It is better not to apply a transdermal patch near the waistline, as in this area, tight clothing will be there. Rotate the place of application. Do not put it everyday on the same place. When you are placing a new patch, remove the old patch. Discard used patches carefully. Tear them into pieces and throw in dustbin. This is especially true for nitroglycerin. This is because, any kid may take a discarded patch, mistake it for a tattoo or plaything and apply it on himself/herself. The small remnant of nitroglycerin in it may cause him/her some harm. To explain the importance of instructions regarding method of administration, I will tell one or two cases that I heard. The following case was related to us by Dr. Ahikrishna, a famous eye specialist in Visakhapatnam, when he came to our college once for our NPW celebrations. One young mother took her infant to a pediatrician and he prescribed some enzyme drops to the baby. After going home, she opened the medicine bottle and found a dropper and bottle in it. In her experience, she always associated a dropper with eye drops. She took out the enzyme drops with the dropper and placed a few drops in each eye. The baby started crying at the top of its voice and the eyes got inflamed soon. Mother, baby and grandmother came running to his clinic and it took him a lot of difficulty to put down the inflammation of the eyes of the baby. Only last month we went to a medical camp and one pediatrician was telling me how one child was prescribed CALADRYL lotion and some other cough preparation for some allergy. The child swallowed the caladryl lotion, which is an external preparation and applied the cough preparation on the place where there was allergy. I am sure all of you will also have such stories in your memory. My point is this, there is a great need to tell patients about how to use the medicines, especially if the dosage form is something new. Reference: 1. USPDI Volume II, Advice for the patient, fifteenth edition, 1995. 2. Remington: The science and Practise of Pharmacy, Nineteenth edition. This blog does not contain any plagiarized material.