Medication technicians are healthcare professionals trained and certified to administer medications to patients under the supervision of a licensed nurse. They work in various settings, such as assisted living facilities, nursing homes, hospitals, and home health care agencies. Medication technicians are vital in ensuring the safety and well-being of the patients they serve and reducing the workload and stress of the nurses they assist.

In Pennsylvania, medication technicians must complete an approved medication administration training program that consists of at least 100 hours of instruction, including 40 hours of classroom theory, 20 hours of skills laboratory, and 40 hours of clinical practice. The program covers topics such as medication administration principles, techniques, routes, forms, and documentation; medication safety, storage, and disposal; medication orders, labels, and packaging; medication calculations and conversions; common medications, their uses, effects, and side effects; and medication errors and adverse reactions. Upon completion of the program, medication technicians must pass a written and practical examination to obtain their certification. They must also renew their certification every two years by completing 16 hours of continuing education.

This article aims to overview Pennsylvania medication technicians’ training and certification process and discuss specific skills and knowledge needed to perform their duties effectively and safely. The article will cover the following topics:

• The Patient’s Five Rights
• Obtaining blood sugar readings
• Insulin injections
• Trulicity Injections
• Subcutaneous injections
• Eye drops
• Nasal Sprays
• Inhalers and nebulizers
• Suppositories
• Sublingual, buccal, and translingual medications
• Feeding tubes
• Topical treatments
• Rectal diazepam
• Epinephrine auto-injectors

By the end of this article, you will better understand the role and responsibilities of Pennsylvania medication technicians and the training and certification requirements they must meet. You will also learn some best practices and tips for administering medications to patients via different routes and forms and how to prevent and manage potential complications and adverse reactions. This article is intended for anyone interested in becoming a medication technician in Pennsylvania or wanting to learn more about this rewarding and challenging career.

Patient Five Rights of Medication Administration

As a medication technician, you are responsible for administering medications to patients safely and effectively. One of the ways to ensure this is to follow the patient’s five rights, a set of principles that guide the medication administration process. The patient five rights are:

• The right patient: You should always check the patient’s identity before giving any medication. To confirm that you have the right patient, you can use two identifiers: the patient’s name, date of birth, medical record number, or wristband. If possible, you should also ask the patient to state their name and date of birth. To identify them, it would be best never to rely on the patient’s room number, bed number, or appearance alone.
• The right drug: You should always check the medication label and order before giving any medication. It would be best to compare the name, strength, and dosage of the medication on the label with the name, strength, and dosage of the medication on the order. You should also check the expiration date and the appearance of the medication. You should never use any expired, damaged, or unclear medication. You should also be aware of the indications, contraindications, interactions, and side effects of the medication you are giving.
• The right dose: Before giving any medication, you should always check the amount you need to give the patient. You should use the appropriate measuring device, such as a syringe, a dropper, or a cup, to measure the exact dose of the medication. It would be best to never use any household utensils, such as a teaspoon or a tablespoon, to measure the medication. You should also double-check your calculations and conversions, if needed, to ensure that you are giving the correct dose of the medication.
• The right time: You should always check when the medication needs to be given to the patient before giving any medication. You should follow the schedule on the order as to when to administer the medication, such as once a day, twice a day, or every four hours. You should also consider the factors that may affect the timing of the medication, such as the patient’s condition, the food intake, the other medications, or the laboratory tests. You should never give any medication too early or later than prescribed or recommended unless instructed by the doctor or the nurse.
• The right route: You should always check how the medication needs to be given to the patient before giving any medication. You should follow the instructions on the label and the order on administering the medication, such as by mouth, injection, inhalation, or topical application. You should also use the appropriate device, technique, and site to deliver the medication, such as a pill, a needle, an inhaler, or a patch. You should never give any medication by a route different from what is prescribed or recommended unless instructed by the doctor or the nurse.

By following the patient’s five rights, you can reduce the risk of medication errors and ensure patient safety and quality of care. You should also document the medication administration, monitor the patient’s response, and report any adverse reactions or incidents to the nurse or the doctor. You should also educate the patient and the family about the medication, its purpose, benefits, risks, and instructions. You should also respect the patient’s rights, such as the right to information, the right to consent, the right to refuse, and the right to privacy and confidentiality.

Obtaining Blood Sugar Readings

Blood sugar readings are measurements of the amount of glucose, or sugar, in the blood. Glucose is the body’s main energy source, and it comes from our food. The level of glucose in the blood changes throughout the day, depending on what and when we eat, how much we exercise, and other factors. Monitoring blood sugar readings is important for people who have diabetes, a condition that affects how the body uses glucose. People with diabetes need to keep their blood sugar levels within a target range to prevent or delay complications, such as nerve damage, kidney damage, eye problems, and heart disease.

To obtain blood sugar readings, medication technicians need to use a device called a blood glucose meter and a small strip of paper called a test strip. A blood glucose meter is a small electronic device that can measure the amount of glucose in a drop of blood. A test strip is a disposable paper with a chemical coating that reacts with glucose. The test strip is inserted into the blood glucose meter, and then a drop of blood is applied to the end of the test strip. The blood glucose meter reads the test strip and displays the blood sugar reading on a screen. There are several types and models of blood glucose meters and test strips, and they may have different features and functions. Medication technicians should follow the manufacturer’s and nurse’s instructions when using blood glucose meters and test strips.

The procedure for obtaining blood sugar readings is as follows:

• Wash your hands with soap and water and put on gloves.
• Check the expiration date, the code number of the test strip, and the blood glucose meter. Make sure they match and are not expired.
• Turn on the blood glucose meter and insert the test strip into the slot. Wait for the meter to show a symbol or a message that indicates it is ready for testing.
• Use a lancet, a small needle-like device, to prick the side of the patient’s fingertip. Squeeze the finger gently to get a drop of blood. Do not use the same lancet more than once.
• Touch the end of the test strip to the drop of blood and wait for the meter to beep or flash. Do not smear or wipe the blood on the test strip.
• Read and record the blood sugar reading on the meter’s screen. Dispose of the used test strip and lancet in a sharps container.
• Apply pressure to the puncture site with a cotton ball or gauze pad until the bleeding stops. If needed, apply a bandage.
• Remove your gloves and wash your hands with soap and water.
• Report the blood sugar reading to the nurse and follow the nurse’s instructions for further actions.

Some precautions for obtaining blood sugar readings are:

• Do not use alcohol wipes or hand sanitizer to clean the patient’s finger before pricking. Alcohol can interfere with the accuracy of the test result.
• Do not squeeze the finger too hard or too long to get a drop of blood. This can cause the blood to mix with tissue fluid, which can also affect the accuracy of the test result.
• Do not reuse test strips or lancets. They are for single use only and can become contaminated or damaged if used more than once.
• Do not store test strips in extreme temperatures or humidity. They can lose their effectiveness and give false readings.
• Do not share blood glucose meters, test strips, or lancets with other patients. They can transmit infections or diseases.

Medication technicians need to know the normal and abnormal ranges of blood sugar levels and the signs and symptoms of high and low blood sugar to interpret and document the blood sugar readings. The normal range of blood sugar levels for most people is between 70 and 130 milligrams per deciliter (mg/dL) before meals and less than 180 mg/dL two hours after meals. However, the target range may vary depending on the patient’s age, health condition, and treatment plan. The nurse will provide the medication technician with the patient’s target range and the actions to take if the blood sugar reading is above or below the target range.

High blood sugar, or hyperglycemia, occurs when the blood sugar level is above the target range. High blood sugar can be caused by eating too much, exercising too little, taking too little insulin or other diabetes medications, being sick or stressed, or having an infection or injury. Some signs and symptoms of high blood sugar are:

• Increased thirst and urination
• Dry mouth and skin
• Blurred vision
• Headache
• Fatigue
• Nausea and vomiting
• Fruity breath odor

Low blood sugar, or hypoglycemia, occurs when the blood sugar level is below the target range. Low blood sugar can be caused by skipping or delaying meals, exercising too much, taking too much insulin or other diabetes medications, drinking alcohol, or having a hormonal imbalance. Some signs and symptoms of low blood sugar are:

• Shaking and sweating
• Hunger and nausea
• Dizziness and lightheadedness
• Confusion and irritability
• Weakness and fatigue
• Headache and blurred vision
• Seizures and loss of consciousness

Medication technicians should document the blood sugar readings in the patient’s chart or electronic record, along with the date, time, and any relevant information, such as the patient’s food intake, activity level, medication dosage, and signs and symptoms of high or low blood sugar. Medication technicians should also report abnormal blood sugar readings or changes in patient condition to the nurse as soon as possible.

Insulin Injections

Insulin is a hormone that helps the body use glucose (sugar) from food for energy or store it for future use. People with diabetes, a condition in which the body either does not make enough insulin or cannot use it properly, need to take insulin injections to lower their blood glucose levels and prevent or delay diabetes complications.

As a medication technician, you may be responsible for administering insulin injections to patients with diabetes under the supervision of a licensed nurse. To do this, you need to know the following:

• The types and actions of insulin and the devices used for insulin delivery
• The sites and techniques for insulin injections
• How to prepare and administer insulin injections
• The potential complications and adverse reactions of insulin injections and how to manage them

Different types of insulin are available and vary in how quickly they start to work, how long they last, and when they peak. Some examples are:

• Rapid-acting insulin, such as lispro (Humalog), aspart (Novolog), or glulisine (Apidra), starts working in 15 minutes, peaks in 1 hour, and lasts for 2 to 4 hours.
• Short-acting insulin, such as regular human insulin (Humulin R, Novolin R), starts to work in 30 minutes, peaks in 2 to 3 hours, and lasts 3 to 6 hours.
• Intermediate-acting insulin, such as NPH human insulin (Humulin N, Novolin N), starts to work in 2 to 4 hours, peaks in 4 to 12 hours, and lasts for 12 to 18 hours.
• Long-acting insulin, such as glargine (Lantus, Basaglar), detemir (Levemir), or degludec (Tresiba), which starts to work in 2 to 6 hours, does not have a peak and lasts for up to 24 or 36 hours.
• Premixed insulin combines two types of insulin in one vial or pen, such as 70/30 (NPH/regular), 75/25 (lispro protamine/lispro), or 50/50 (aspart protamine/aspart).

Insulin Type	Starts Within	Peak Time	Lasts For
Rapid-acting	15 minutes	1 hour	2 to 4 hours
Short-acting	30 minutes	2 to 3 hours	3 to 6 hours
Intermediate-acting	2 to 4 hours	4 to 12 hours	12 to 18 hours
Long-acting	2 to 6 hours	None	Up to 24 or 36 hours
Premixed	Varies	Varies	Varies

The doctor will prescribe the best type of insulin for each patient based on their blood glucose levels, lifestyle, and preferences. The patient may need to take more than one type of insulin to manage their diabetes throughout the day and night. You should follow the nurse’s orders and the manufacturer’s instructions on how to store, mix, and use each type of insulin.

Different devices, such as syringes, pens, pumps, or jet injectors, can deliver insulin. Syringes and pens are the most common and affordable devices. Syringes are plastic tubes with a plunger and a needle at the end. Pens look like pens but have a cartridge filled with insulin and a disposable needle. Pumps are small machines that deliver insulin through a tube and a needle inserted under the skin. Jet injectors use high pressure to spray insulin through the skin without a needle.

The device you use may depend on the patient’s personal preference, insurance coverage, and doctor’s recommendation. You should follow the manufacturer’s instructions and the nurse’s orders on using, storing, and disposing of your device and insulin. You should also check your insulin’s expiration date and appearance before using it. Do not use insulin that is cloudy, discolored, or has particles in it.

You can inject insulin into different parts of the patient’s body, such as the abdomen, upper arm, thigh, buttock, or hip. The best place to inject insulin is when enough fat tissue is under the skin and can be absorbed quickly and consistently. The abdomen is preferred for most patients because it is easy to reach and has the fastest absorption rate. However, you should not inject insulin within 2 inches of the patient’s belly button, into scars, moles, or bruises, or into areas where the skin is inflamed, infected, or injured.

You should also rotate your injection sites to prevent lipodystrophy, a condition where the fat tissue under the skin becomes lumpy or dented and affects insulin absorption. You can rotate within the same area, such as different spots on the patient’s abdomen, or switch to a different area, such as their arm or leg. You should keep track of your injection sites and use a different spot each time.

The technique for injecting insulin may vary depending on the device, type, and injection site. However, the general steps are:

• Wash your hands with soap and water and dry them well.
• Prepare your device and insulin according to the instructions. If you use a syringe or a pen, you may need to mix, prime, or dial the insulin dose. Make sure the device is free of air bubbles.
• Choose an injection site and clean it with an alcohol swab or a cotton ball dipped in alcohol. Let it dry completely.
• Pinch a fold of skin and fat tissue between your thumb and index finger. Hold the device at a 90-degree angle and insert the needle into the skin. If you use a syringe or a pen, push the plunger or the button to inject the insulin. If you use a pump or a jet injector, follow the device instructions to deliver the insulin.
• Keep the needle in the skin for a few seconds to ensure all the insulin is injected. Then, pull the needle out and gently press the injection site with a cotton ball or gauze pad. Do not rub or massage the area.
• Dispose of the used needle, syringe, or cartridge in a puncture-proof container. Do not reuse or share them with anyone else.
• Record your insulin’s date, time, dose, and injection site.

Insulin injections can cause some side effects, such as:

• Hypoglycemia, or low blood glucose, can happen if the patient takes too much insulin, skips or delays a meal, exercises more than usual, or drinks alcohol. Symptoms of hypoglycemia include shakiness, sweating, hunger, headache, dizziness, confusion, irritability, or fainting. Give the patient 15 grams of fast-acting carbohydrates to treat hypoglycemia, such as glucose tablets, fruit juice, regular soda, or hard candy. Then, check the patient’s blood glucose after 15 minutes and repeat the treatment if it is still low. You should also report the hypoglycemia episode to the nurse and follow the nurse’s instructions for any further actions.
• Hyperglycemia, or high blood glucose, can happen if the patient takes too little insulin, eats more than usual, has an infection, illness, or stress, or takes certain medications. Symptoms of hyperglycemia include thirst, dry mouth, frequent urination, blurred vision, fatigue, or nausea. To prevent hyperglycemia, you should check the patient’s blood glucose regularly and adjust the insulin dose, diet, and exercise according to the nurse’s advice. You should also encourage the patient to drink plenty of water and seek medical attention if they have signs of diabetic ketoacidosis, such as fruity breath, abdominal pain, vomiting, or difficulty breathing.
• Injection site reactions include pain, redness, swelling, itching, or bruising. These can happen if you inject insulin into the same spot repeatedly, use a bent or dull needle, or do not rotate your injection sites. To avoid injection site reactions, you should change your needle after each use, inject it into a different spot each time, and apply a cold compress or an over-the-counter cream to the affected area. You should also contact the nurse if the patient has signs of infection, such as pus, warmth, or fever.
• Allergic reactions, such as rash, hives, itching, swelling, or difficulty breathing, can happen if the patient is allergic to insulin or any ingredients in the device. To prevent allergic reactions, you should check the label of the patient’s insulin and device and avoid anything the patient is allergic to. You should also carry an epinephrine auto-injector (EpiPen) and seek emergency medical help if the patient has a severe allergic reaction.
• Weight gain can happen because insulin helps the body store glucose as fat. To prevent weight gain, follow the nurse’s instructions on the patient’s diet, exercise, blood glucose, and insulin monitoring. You should also talk to the nurse if the patient has trouble managing their weight or if they have other risk factors for heart disease, such as high blood pressure or high cholesterol.

Insulin injections are an effective way to lower blood glucose levels and prevent or delay diabetes complications. However, they also require careful monitoring, adjustment, and education. You should work with the nurse, the patient, and the patient’s family or caregivers to learn how to administer insulin safely and correctly. You should also follow the patient’s diabetes care plan, which includes checking their blood glucose, giving them their medications, helping them with their diet and exercise, and reporting any changes in their condition. By doing so, you can improve the patient’s diabetes control and their quality of life.

Trulicity Injections

As a medication technician, you may need to administer Trulicity injections to patients with type 2 diabetes. Trulicity medication helps lower blood sugar levels and reduce the risk of heart problems. Trulicity mimics a natural hormone that stimulates insulin production and lowers glucose production.

Trulicity is given as a subcutaneous injection once a week. The injection device is a Trulicity pen, a prefilled, single-use pen containing the medication. The Trulicity pen is easy to use and does not require mixing or measuring. It has a hidden needle and a button that automatically injects the medication when pressed.

To administer Trulicity injections correctly and safely, you should follow these steps:

• Wash your hands and put on gloves. Check the patient’s name, date of birth, and medication order. Verify the patient’s identity and explain the procedure to them. Obtain their consent and cooperation.
• Check the expiration date and the appearance of the Trulicity pen. The liquid inside the pen should be clear and colorless. Do not use the pen if it is expired, damaged, or cloudy.
• Remove the base cap from the pen by pulling it straight off. Do not twist or bend the cap. Throw away the cap in the trash. Do not put the cap back on the pen.
• Hold the pen with the gray end pointing up and tap the pen gently to move any air bubbles to the top. Press and hold the green button until a drop of liquid appears at the needle tip. This is called priming the pen and ensures that you deliver the right dose of medicine.
• Choose a clean, dry injection site on the patient’s stomach, thigh, or upper arm. Avoid areas that are bruised, swollen, or scarred. Pinch a fold of skin at the injection site and insert the needle at a 90-degree angle. Press the green button firmly and hold it for 10 seconds. You will hear a click when the injection starts and another click when it is done. The dose counter will show zero when the injection is complete.
• Pull the needle out of the skin and release the skin fold. Do not rub or massage the injection site. The needle will automatically retract into the gray end of the pen and lock in place. You will see a yellow band on the pen’s gray end. This means the pen has been used and cannot be used again.
• Dispose of the used pen and needle in a puncture-resistant container. Do not reuse or share the pen or needle with anyone else. Follow your local laws and regulations when properly disposing of the container.
• Remove your gloves and wash your hands. Document the medication administration, including the date, time, dose, site, and adverse reactions. Monitor the patient’s vital signs and blood sugar levels. Report any abnormal findings to the nurse or the doctor.

The dosage of Trulicity is usually 0.75 mg once a week, but it may vary depending on the patient’s condition and response. It would be best to administer Trulicity on the same day each week, at any time, with or without food. If you miss a dose, you can administer it as soon as you remember, as long as it is within three days of the scheduled dose. If it is more than three days, skip the missed dose and administer the next dose on the regular day. Do not administer two doses in the same week.

The best injection sites for Trulicity are areas with a layer of fat under the skin, such as the stomach, thigh, or upper arm. You should rotate the injection sites each week to avoid irritation and lumps. Do not administer Trulicity into a muscle or a vein.

Trulicity may cause some side effects, such as:

• nausea, vomiting, diarrhea, or constipation
• belly pain, indigestion, or burping
• loss of appetite or weight loss
• fatigue or headache
• injection-site reactions, such as rash, bruising, or pain

Most of these side effects are mild and go away over time. However, some side effects may be serious and require medical attention, such as:

• signs of an allergic reaction, such as rash, itching, swelling, or trouble breathing
• signs of pancreatitis, such as severe and persistent belly pain, nausea, vomiting, or fever
• signs of thyroid cancer, such as swelling or a lump in the neck, trouble swallowing, a hoarse voice, or shortness of breath
• signs of low blood sugar, such as sweating, shakiness, hunger, dizziness, or confusion

To prevent or manage the side effects of Trulicity, you should:

• Encourage the patient to drink plenty of fluids and eat small, frequent meals to avoid dehydration and nausea.
• Check the patient’s blood sugar levels regularly and follow the nurse’s or the doctor’s instructions on adjusting the dose of Trulicity or other diabetes medications.
• Ask the patient if they have any history of pancreatitis, thyroid, kidney, or stomach problems.
• Ask the patient if they are pregnant, breastfeeding, or planning to become pregnant.
• Ask the patient about all the medications, supplements, and herbal products they are taking, especially insulin, sulfonylureas, or warfarin.
• Seek emergency medical help if the patient has any signs of a serious side effect or an overdose.

Trulicity is a safe and effective medication that can help patients with type 2 diabetes control their blood sugar levels and lower their risk of heart problems. However, it is not a substitute for a healthy lifestyle. You should also educate the patient about the importance of following a balanced diet, exercising regularly, and quitting smoking to improve their health and well-being.

Subcutaneous Injections

Subcutaneous injections deliver medications into the fatty layer of tissue under the skin. This method allows the medication to be absorbed slowly and steadily into the bloodstream, which can benefit some drugs that need to maintain a constant level in the body. Subcutaneous injections are also less painful and easier to perform than intramuscular or intravenous injections, which require deeper and larger needles.

Some examples of medications that are given by subcutaneous injection are:

• Insulin helps lower blood sugar levels in people with diabetes.
• Heparin, which prevents blood clots in people with certain conditions.
• Allergy shots help reduce allergic reactions in people with allergies.
• Growth hormone, which stimulates growth and development in children with growth disorders.
• Some vaccines, such as hepatitis B, influenza, and rabies

As a medication technician, you may be responsible for administering subcutaneous injections to patients under the supervision of a licensed nurse. To do this, you need to know the following:

• The sites and techniques for subcutaneous injections
• How to prepare and administer subcutaneous injections
• The potential complications and adverse reactions of subcutaneous injections and how to manage them

The sites for subcutaneous injections are the areas of the body with enough fat tissue under the skin and where the medication can be absorbed quickly and consistently. The most common sites are:

• The abdomen at least 2 inches away from the belly button.
• The back or side of the upper arm.
• The front of the thigh.
• The upper outer area of the buttock

You should avoid injecting it into scarred, bruised, inflamed, infected, or injured areas. You should also rotate your injection sites to prevent lipodystrophy, where the fat tissue under the skin becomes lumpy or dented and affects the medication’s absorption. You can rotate within the same area, such as different spots on the abdomen, or switch to a different area, such as the arm or leg. You should keep track of your injection sites and use a different spot each time.

The technique for subcutaneous injections may vary depending on the device, the medication, and the patient’s preference. However, the general steps are:

• Wash your hands with soap and water and dry them well.
• Gather your supplies, such as the medication, the syringe or pen, the needle, the alcohol swab, the cotton ball or gauze pad, and the sharps container.
• Check the label and the medication’s expiration date and ensure it is the patient’s right type, dose, and time. If the medication is in a vial, you may need to mix it or roll it gently between your palms to dissolve any crystals. If the medication is in a pen, you may need to prime it or dial the dose. Follow the manufacturer’s instructions and the nurse’s orders on how to prepare the medication. Do not use the medication if it is cloudy, discolored, or has particles.
• Choose an injection site and clean it with an alcohol swab or a cotton ball dipped in alcohol. Let it dry completely.
• Pinch a fold of skin and fat tissue between your thumb and index finger. Hold the syringe or pen at a 90-degree angle and insert the needle into the skin. Push the plunger or the button to inject the medication. Keep the needle in the skin for a few seconds to make sure all the medication is injected. Then, pull the needle out and gently press the injection site with a cotton ball or gauze pad. Do not rub or massage the area.
• Dispose of the used needle, syringe, or cartridge in a puncture-proof container. Do not reuse or share them with anyone else.
• Record the medication’s date, time, dose, and injection site. Report any abnormal findings or problems to the nurse.

Subcutaneous injections can cause some side effects, such as:

• Pain, redness, swelling, itching, or bruising at the injection site. These are usually mild and temporary and can be reduced by changing the needle after each use, rotating the injection sites, and applying a cold compress or an over-the-counter cream to the affected area. You should contact the nurse if the patient has signs of infection, such as pus, warmth, or fever.
• Allergic reactions include rash, hives, itching, swelling, or difficulty breathing. These are rare but serious and can be life-threatening. You should check the patient’s medical history and allergies before giving any medication and avoid anything they are allergic to. You should also carry an epinephrine auto-injector (EpiPen) and seek emergency medical help if the patient has a severe allergic reaction.
• Medication-specific reactions include low blood sugar (hypoglycemia) for insulin, bleeding or bruising for heparin, and flu-like symptoms for some vaccines. These depend on the type and dose of the medication and the patient’s condition and response. You should follow the nurse’s instructions on monitoring, preventing, and treating these reactions. You should also educate the patient and their family or caregivers on the signs and symptoms of these reactions and when to seek medical attention.

Subcutaneous injections are a safe and effective way to deliver medications to patients who need them. However, they also require careful preparation, administration, and education. You should work with the nurse, the patient, and the patient’s family or caregivers to learn how to give subcutaneous injections correctly and safely. You should also follow the patient’s care plan, which includes checking their vital signs, giving them their medications, helping them with their daily activities, and reporting any changes in their condition. By doing so, you can improve the patient’s health and well-being.

Giving Patients Eye Drops

As a medication technician, you may need to administer eye drops to patients with various eye conditions, such as glaucoma, dry eyes, and infections. Eye drops are liquid medications applied directly to the eye’s surface, usually in small amounts, such as a single drop or a few drops. Eye drops can have different functions, such as:

• Lubricating the eye and relieving dryness, irritation, or discomfort
• Reducing inflammation, itching, or allergy symptoms
• Lowering the pressure inside the eye and preventing or treating glaucoma
• Fighting bacteria, viruses, or fungi and treating infections
• Dilating the pupil and preparing the eye for an exam or surgery
• Constricting the blood vessels and reducing redness

Eye drops are usually administered using a dropper bottle or a single-use vial. A dropper bottle is a small plastic bottle with a rubber bulb and a nozzle that delivers the drops. A single-use vial is a small plastic container with a twist-off cap and a narrow opening that releases the drops. Both devices are designed to prevent contamination and ensure accurate dosing.

To administer eye drops correctly and safely, you should follow these steps:

• Wash your hands and put on gloves. Check the patient’s name, date of birth, and medication order. Verify the patient’s identity and explain the procedure to them. Obtain their consent and cooperation.
• Check the expiration date and the appearance of the eye drops. They should be clear and colorless unless they are meant to be a specific color. Do not use the eye drops if they are expired, cloudy, discolored, or have particles.
• Shake the dropper bottle gently if the eye drops need to be mixed. Do not shake the single-use vial. Remove the cap or twist off the top of the device, and avoid touching the tip with your fingers or any surface.
• Tilt the patient’s head back slightly and ask them to look up. Use your thumb and index finger to gently pull down the lower eyelid and create a small pocket. Hold the device above the eye, about an inch away, and squeeze or tap it gently to release one drop into the pocket. Do not touch the eye or the eyelid with the device.
• Ask the patient to close their eye gently and move it around to spread the drop. Use a sterile gauze pad or a tissue to blot any excess liquid from the corner of the eye. Do not rub the eye or apply pressure to it.
• If you need to administer more than one drop or more than one type of eye drop, wait at least five minutes between each drop to prevent washing out the previous one. If you use an ointment or gel, apply it last, as it can temporarily blur the vision.
• Replace the cap or discard the device after use. Do not reuse or share the device with anyone else. Remove your gloves and wash your hands. Document the medication administration, including the date, time, dose, eye, and adverse reactions. Monitor the patient’s vital signs and eye condition. Report any abnormal findings to the nurse or the doctor.

The dosage, timing, and frequency of eye drops depend on the type and purpose of the eye drops, as well as the patient’s condition and response. You should follow the doctor’s prescription or the manufacturer’s instructions carefully. Some general guidelines are:

• Use the exact number of drops prescribed or recommended. Using too many or too few drops can affect the effectiveness or safety of the eye drops.
• Use the eye drops at regular intervals, as directed. Do not skip or double up on doses. If you miss a dose, administer it as soon as you remember unless it is almost time for the next dose. In that case, skip the missed dose and resume the normal schedule. Do not administer two doses at once.
• Use the eye drops for the duration prescribed or recommended. Do not stop using them without consulting the doctor, even if the symptoms improve. Stopping them too soon can cause the condition to worsen or recur.
• Store the eye drops in a cool, dry, and dark place, away from heat, light, and moisture. Do not refrigerate or freeze the eye drops unless instructed to do so. Keep the eye drops out of the reach of children and pets.

Eye drops are generally well tolerated, but they may cause some side effects, such as:

• Burning, stinging, or itching sensation in the eye.
• Blurred or changed vision.
• Increased sensitivity to light.
• Eye irritation, redness, or swelling.
• Eye discharge, crust, or infection.
• Headache or dizziness.
• Allergic reactions such as rash, hives, or difficulty breathing.

To prevent or manage the side effects of eye drops, you should:

• Inform the patient about the possible side effects and how to cope with them,
• Ask the patient if they have any history of eye problems, allergies, or reactions to eye drops,
• Ask the patient if they wear contact lenses, as some eye drops may not be compatible with them,
• Ask the patient about all the medications, supplements, and herbal products they are taking, especially those that may affect the eye pressure, pupil size, or vision,
• Seek emergency medical help if the patient has any signs of a serious side effect or an overdose.

Eye drops are a safe and effective treatment for various eye conditions. However, they are not substitutes for regular eye exams and proper eye care. You should also educate the patient about the importance of following a healthy lifestyle, protecting their eyes from sun damage, and avoiding eye strain to improve their overall eye health.

Administering Nasal Sprays

As a medication technician, you may need to administer nasal sprays to patients with various conditions that affect the nose, sinuses, or respiratory system. Nasal sprays are medications that you spray directly into your nostrils. They deliver a fine mist of medication into the nasal cavities, where it can act locally or be absorbed into the bloodstream.

There are different types and functions of nasal sprays, depending on the active ingredients and the purpose of the treatment. Some of the common types of nasal sprays are:

• Steroid nasal sprays contain corticosteroids, anti-inflammatory drugs that can reduce swelling, irritation, and mucus production in the nose and sinuses. They treat allergic rhinitis, nasal polyps, and chronic sinusitis.
• Antihistamine nasal sprays: These sprays contain antihistamines, drugs that block the effects of histamine, a chemical that causes allergic reactions. They can relieve sneezing, itching, runny nose, and congestion caused by allergies.
• Decongestant nasal sprays contain decongestants, drugs that shrink the blood vessels in the nose and sinuses. They can reduce congestion and improve breathing by opening up the nasal passages. They are used to treat colds, flu, and sinus infections.
• Saline nasal sprays contain salt water, which can moisten and cleanse the nose and sinuses. They can also help loosen and thin the mucus, flush out allergens and irritants, and prevent dryness and crusting. Saline nasal sprays treat dryness, irritation, or congestion caused by various factors, such as low humidity, allergies, or medications.

To administer nasal sprays correctly and safely, you should follow these steps:

• Wash your hands and put on gloves. Check the patient’s name, date of birth, and medication order. Verify the patient’s identity and explain the procedure to them. Obtain their consent and cooperation.
• Check the expiration date and the appearance of the nasal spray. It should be clear and free of particles. Do not use it if it is expired, cloudy, discolored, or has lumps.
• Shake the nasal spray gently if it needs to be mixed. Remove the cap and avoid touching the nozzle with your fingers or surfaces.
• Ask the patient to blow their nose gently to clear any mucus or debris. Tilt the patient’s head slightly forward and ask them to breathe through their mouth.
• Hold the nasal spray in one hand and use the other hand to gently close one nostril. Insert the nozzle into the other nostril and aim it slightly away from the center of the nose. Press the pump or squeeze the bottle to release one spray into the nostril. Ask the patient to breathe gently through their nose and out through their mouth. Repeat the same steps for the other nostril if needed.
• Wipe the nozzle with a clean tissue and replace the cap. Do not rinse the nozzle with water or any other liquid. Dispose of the tissue and any leftover medication in a proper way. Do not reuse or share the nasal spray with anyone else. Remove your gloves and wash your hands. Document the medication administration, including the date, time, dose, route, and adverse reactions. Monitor the patient’s vital signs and condition. Report any abnormal findings to the nurse or the doctor.

The dosage, timing, and frequency of nasal sprays depend on the type and purpose of the nasal sprays and the patient’s condition and response. You should follow the doctor’s prescription or the manufacturer’s instructions carefully. Some general guidelines are:

• Use the exact number of sprays prescribed or recommended. Using too many or too few sprays can affect the effectiveness or safety of the nasal spray.
• Use the nasal spray at regular intervals, as directed. Do not skip or double up on doses. If you miss a dose, administer it as soon as you remember unless it is almost time for the next dose. In that case, skip the missed dose and resume the normal schedule. Do not administer two doses at once.
• Use the nasal spray for the duration prescribed or recommended. Do not stop using it without consulting the doctor, even if the symptoms improve. Stopping the nasal spray too soon can cause the condition to worsen or recur.
• Store the nasal spray in a cool, dry, and dark place, away from heat, light, and moisture. Do not refrigerate or freeze it unless instructed to do so. Keep it out of the reach of children and pets.

Nasal sprays are generally well tolerated, but they may cause some side effects, such as:

• Burning, stinging, or itching sensation in the nose.
• Dripping or runny nose.
• Dryness or irritation of the nose or throat.
• Sneezing or coughing.
• Headache or dizziness.
• Nosebleeds or nasal ulcers.
• Allergic reactions such as rash, hives, or difficulty breathing.

To prevent or manage the side effects of nasal sprays, you should:

• Inform the patient about the possible side effects and how to cope with them.
• Ask the patient if they have any history of nose problems, allergies, or reactions to nasal sprays.
• Ask the patient about all their medications, supplements, and herbal products, especially those that may interact with the nasal sprays.
• Seek emergency medical help if the patient has any signs of a serious side effect or an overdose.

Nasal sprays are a safe and effective way to treat conditions affecting the nose, sinuses, or respiratory system. However, they are not a substitute for regular medical care and monitoring. You should also educate the patient about the importance of following a healthy lifestyle, avoiding allergens and irritants, and practicing good nasal hygiene to improve their overall health and well-being.

Inhalers and Nebulizers

Inhalers and nebulizers deliver medications into the lungs. They treat lung conditions such as asthma and chronic obstructive pulmonary disease (COPD). These devices help improve breathing and prevent or reduce symptoms such as wheezing, coughing, and shortness of breath.

Different types and functions of inhalers, nebulizers, and medications can be used with them. Some examples are:

• Metered-dose inhaler (MDI): This handheld device releases a measured amount of medication as a spray or aerosol. The medication is in a pressurized canister attached to a mouthpiece or a spacer. A spacer is a tube or a chamber holding the medication until inhaled. Spacers can help deliver the medication more effectively and reduce the side effects in the mouth and throat. MDIs can be used with various medications, such as bronchodilators, corticosteroids, or combination drugs. Bronchodilators relax the muscles around the airways and make them wider. Corticosteroids reduce inflammation and swelling in the airways. Combination drugs contain both a bronchodilator and a corticosteroid.
• Dry powder inhaler (DPI): This handheld device delivers medication as a fine powder. The medication is in a capsule, blister, or reservoir loaded into the device. The device is activated by breathing in through the mouthpiece. Unlike MDIs, DPIs do not use a propellant or a spacer. DPIs can be used with various medications, such as bronchodilators, corticosteroids, or combination drugs.
• Nebulizer: This machine converts liquid medication into a mist or vapor. The medication is in a cup or a chamber attached to a mouthpiece, a mask, or a tube. The machine uses compressed air, oxygen, or ultrasonic waves to create the mist. The mist is then inhaled through the mouthpiece or the mask. Nebulizers can be used with various medications, such as bronchodilators, corticosteroids, or antibiotics. Nebulizers are often used by people who have difficulty using inhalers, such as young children, elderly people, or people with severe symptoms.

The procedure and precautions for inhalers and nebulizers may vary depending on the device, the medication, and the patient’s condition. However, some general steps and tips are:

• Wash your hands with soap and water and dry them well.
• Check the label and the medication’s expiration date and ensure it is the patient’s right type, dose, and time. Follow the manufacturer’s instructions and the nurse’s orders on preparing, storing, and disposing of the medication and the device. Do not use the medication if it is cloudy, discolored, or has particles.
• Choose a comfortable and quiet place to use the device. Sit up straight or stand up. If you are using an inhaler, shake it well before each use. If you use a nebulizer, plug it in and turn it on.
• Breathe out slowly and completely. If you use an inhaler, place the mouthpiece between your teeth and close your lips around it. If you are using a spacer, place the inhaler’s mouthpiece into the spacer, place the mouthpiece between your teeth, and close your lips around it. If you are using a nebulizer, place the mouthpiece in your mouth or the mask over your nose and mouth.
• Breathe in slowly and deeply through your mouth. If you use an inhaler, press down on the canister once as you breathe in. If you use a nebulizer, breathe normally and occasionally take a deep breath. Hold your breath for about 10 seconds or as long as you can. Then, breathe out slowly.
• Repeat the steps until you have taken the prescribed number of puffs or until the medication in the nebulizer is gone. Wait about 1 minute between each puff if you use an inhaler. Rinse your mouth with water and spit it out after using the device. This can help prevent oral thrush, a fungal infection in the mouth, especially if you use a corticosteroid medication.
• Clean and store the device according to the instructions. If using an inhaler, remove the canister and rinse the mouthpiece and the spacer with warm water. Let them air dry completely before putting them back together. If you use a nebulizer, wash the cup, mouthpiece, or mask with warm water and mild soap. Rinse them well and let them air dry completely. Replace the filter and the tubing as needed.
• Record the date, time, dose, and device of the medication. Report any abnormal findings or problems to the nurse.

Some precautions for using inhalers and nebulizers are:

• Do not use someone else’s device or medication. They can transmit infections or diseases.
• Do not use more or less medication than prescribed. This can cause unwanted side effects or reduce the effectiveness of the treatment.
• Do not stop using the device or the medication without consulting the nurse. This can worsen the symptoms or cause withdrawal effects.
• Do not mix different medications in the same device unless instructed by the nurse. This can cause interactions or incompatibilities.
• Do not expose the device or the medication to extreme temperatures, humidity, or sunlight. This can damage them or affect their quality.

Follow the manufacturer’s and nurse’s instructions to use inhalers and nebulizers correctly. You should also demonstrate the device to the nurse and ask for feedback. You should also educate the patient and their family or caregivers on how to use the device, when, and how to clean and store it. You should also encourage the patient to use the device as prescribed and to report any problems or concerns to the nurse.

Inhalers and nebulizers can cause some complications and adverse reactions, such as:

• Bronchospasm, or tightening of the airways, can cause wheezing, coughing, chest tightness, or difficulty breathing. This can happen if the medication is too cold, too strong, or not well tolerated by the patient. To prevent bronchospasm, you should warm up the medication by holding it in your hands before using it, use a spacer with the inhaler, or pre-treat the patient with a bronchodilator medication. To treat bronchospasm, you should stop using the device and give the patient a rescue inhaler, such as albuterol (ProAir, Ventolin), which can quickly relax the airways. You should also report the bronchospasm to the nurse and follow the nurse’s instructions for further action.
• Infection can cause fever, chills, cough, sputum, or pain. This can happen if the device or the medication is contaminated with bacteria, viruses, or fungi. To prevent infection, you should wash your hands before and after using the device, clean and store the device properly, and use sterile water or saline for the nebulizer. To treat infection, you should stop using the device and give the patient antibiotics or antifungals as prescribed by the doctor. You should also report the infection to the nurse and follow the nurse’s instructions for any further actions.
• Medication-specific reactions include increased heart rate, tremors, nervousness, or insomnia for bronchodilators and oral thrush, hoarseness, or sore throat for corticosteroids. These depend on the type and dose of the medication and the patient’s condition and response. To prevent medication-specific reactions, you should follow the nurse’s instructions on monitoring, preventing, and treating them. You should also educate the patient and their family or caregivers on the signs and symptoms of these reactions and when to seek medical attention.

Inhalers and nebulizers are useful devices that deliver medications into the lungs. However, they also require careful preparation, administration, and education. You should work with the nurse, the patient, and family or caregivers to learn how to use inhalers and nebulizers correctly and safely. You should also follow the patient’s care plan, which includes checking their vital signs, giving them their medications, helping them with their daily activities, and reporting any changes in their condition. Doing so can improve the patient’s lung function and quality of life.

Suppositories

Suppositories are solid medications that enter the body through the rectum, vagina, or urethra. They are used to deliver medications that cannot be taken by mouth or need to act locally in the area where they are inserted. Suppositories melt or dissolve inside the body and release the medication. Suppositories can treat various conditions, such as constipation, hemorrhoids, infections, pain, and nausea.

Different types and functions of suppositories and medications can be used with them. Some examples are:

• Rectal suppositories: These are inserted into the anus and reach the lower part of the large intestine. They are usually shaped like a bullet or a cone and are about an inch long. They can treat constipation, hemorrhoids, fever, nausea, or pain. Some common medications that are given by rectal suppositories are glycerin, bisacodyl, acetaminophen, promethazine, and morphine.
• Vaginal suppositories: These are inserted into the vagina and reach the cervix and the uterus. They are usually shaped like an egg or a capsule and are about half an inch long. They can be used to treat vaginal infections, dryness, or irritation. They can also be used for birth control or hormone replacement therapy. Some common medications that are given by vaginal suppositories are miconazole, clotrimazole, metronidazole, progesterone, and estrogen.

The procedure and precautions for administering suppositories may vary depending on the type, the medication, and the patient’s condition. However, some general steps and tips are:

• Wash your hands with soap and water and dry them well.
• Check the label and the medication’s expiration date to ensure it is the patient’s right type, dose, and time. Follow the manufacturer’s instructions and the nurse’s orders on preparing, storing, and disposing of the medication and the suppository. Do not use the suppository if broken, cracked, or discolored.
• If the suppository is too soft, you can harden it by putting it in the refrigerator or holding it under cold water for a few minutes. Do not freeze the suppository or expose it to heat or sunlight.
• If the suppository is wrapped, remove the wrapper and moisten the suppository with water or a water-based lubricant. Do not use oil-based lubricants, such as petroleum jelly, as they can damage the suppository or interfere with its absorption.
• Choose a comfortable position to insert the suppository. For rectal suppositories, you can lie on your side with your knees bent or stand with one leg raised on a chair. For vaginal suppositories, you can lie on your back with your knees bent or stand with your feet apart. For urethral suppositories, you can sit or stand with your penis upright.
• Gently insert the suppository into the appropriate body opening using your finger or an applicator if provided. For rectal suppositories, push the suppository about an inch into the anus, past the sphincter muscle. For vaginal suppositories, push the suppository as far as you can into the vagina, toward the cervix. Do not force the suppository or cause any pain or discomfort to the patient.
• Hold the suppository for a few seconds to prevent it from slipping out. Then, remove your finger or the applicator and wash your hands with soap and water.
• Ask the patient to remain still for about 15 to 20 minutes to allow the suppository to dissolve and absorb. Do not let the patient use the bathroom or have sex until the suppository has taken effect unless instructed otherwise by the nurse.
• Record the date, time, dose, and type of the suppository. Report any abnormal findings or problems to the nurse.

Some precautions for administering suppositories are:

• Do not use suppositories if the patient has allergies or sensitivities to the medication or the suppository base. Before giving any supplements, check the patient’s medical history and allergies, and avoid anything they are allergic to.
• Do not use suppositories if the patient has wounds, infections, or inflammation in the area where the suppository is inserted. This can cause irritation, pain, or bleeding. Contact the nurse if the patient has any signs of infection, such as pus, redness, swelling, or fever.
• Do not use suppositories if the patient has any bowel or bladder problems, such as diarrhea, constipation, or urinary retention. This can affect the medication’s absorption or elimination. Contact the nurse if the patient has any changes in their bowel or bladder habits or any difficulty or pain in passing stool or urine.
• Do not use more or less suppositories than prescribed. This can cause unwanted side effects or reduce the effectiveness of the treatment. Follow the nurse’s instructions on how often and how long to use the suppositories, and do not stop or change the dose without consulting the nurse.
• Do not mix different medications in the same suppository unless instructed by the nurse. This can cause interactions or incompatibilities that can affect the safety or efficacy of the treatment. Use only the medication and the suppository prescribed for the patient, and do not substitute or combine them with other products.

To administer suppositories correctly, follow the manufacturer’s and nurse’s instructions. You should also demonstrate how to insert the suppository to the nurse and ask for feedback. You should also educate the patient and their family or caregivers on the purpose, the benefits, and the risks of the suppository and how to use it properly. You should also encourage the patient to use the suppository as prescribed and to report any problems or concerns to the nurse.

Suppositories can cause some complications and adverse reactions, such as:

• Pain, burning, itching, or irritation at the site of insertion. These are usually mild and temporary and can be relieved by applying a cold compress or an over-the-counter cream to the area. You should contact the nurse if the patient has severe or persistent pain or irritation or develops a rash, hives, or swelling.
• Bleeding or discharge from the rectum, vagina, or urethra. These can happen if the suppository damages the tissue or causes an infection. You should contact the nurse if the patient has any unusual bleeding or discharge in color, amount, or odor or if the patient has any signs of infection, such as fever, chills, or pain.
• Medication-specific reactions include nausea, vomiting, diarrhea, headache, dizziness, or allergies. These depend on the type and dose of the medication and the patient’s condition and response. You should follow the nurse’s instructions on monitoring, preventing, and treating these reactions. You should also educate the patient and their family or caregivers on the signs and symptoms of these reactions and when to seek medical attention.

Suppositories are a convenient and effective way to deliver medications to the body. However, they also require careful preparation, administration, and education. You should work with the nurse, the patient, and family or caregivers to learn how to use suppositories safely and correctly. You should also follow the patient’s care plan, which includes checking their vital signs, giving them their medications, helping them with their daily activities, and reporting any changes in their condition. By doing so, you can improve the patient’s health and well-being.

Sublingual, Buccal, and Translingual Medications

Sublingual, buccal, and translingual medications are oral medications that are not swallowed but absorbed through the mouth’s mucous membranes. These medications can deliver drugs that act locally in the mouth or throat, enter the bloodstream, and act throughout the body. Sublingual, buccal, and translingual medications can have advantages over traditional oral medications, such as faster onset, higher bioavailability, and lower risk of side effects. However, they also have some disadvantages, such as limited drug choices, potential irritation, and difficulty in administration.

The differences and similarities between sublingual, buccal, and translingual medications are:

• Sublingual medications are placed under the tongue, where they dissolve and are absorbed by the sublingual glands. Examples of sublingual medications are nitroglycerin (Nitrostat) tablets for chest pain, buprenorphine (Subutex) tablets for opioid dependence, and zolpidem (Edluar) tablets for insomnia.
• Buccal medications are placed between the cheek and the gum, where they dissolve and are absorbed by the buccal glands. Examples of buccal medications are buprenorphine/naloxone (Zubsolv) tablets for opioid dependence, asenapine (Saphris) tablets for bipolar disorder and schizophrenia, and miconazole (Oravig) tablets for oral thrush.
• Translingual medications are sprayed or applied onto the tongue, where they dissolve and are absorbed by the lingual glands. Examples of translingual medications are nitroglycerin (Nitrolingual) spray for chest pain, apomorphine (Kynmobi) film for Parkinson’s disease, and fentanyl (Subsys) spray for cancer pain.

The advantages and disadvantages of each route are:

• Sublingual medications can be absorbed quickly and directly into the bloodstream, bypassing the stomach and the liver. This can result in faster onset, higher bioavailability, and lower risk of side effects. Sublingual medications also have the advantage of being easy to use and discreet. However, sublingual medications have the disadvantage of being limited by the size and solubility of the drug, as well as the saliva production and pH of the mouth. Sublingual medications also have the disadvantage of requiring the patient to keep the medication under the tongue until it dissolves, which can be uncomfortable or inconvenient.
• Buccal medications have the advantage of being absorbed slowly and steadily into the bloodstream, providing a sustained effect. Buccal medications also have the advantage of being less affected by saliva production and pH than sublingual medications. However, buccal medications have the disadvantage of being limited by the size and solubility of the drug, as well as the blood flow and permeability of the cheek. Buccal medications also have the disadvantage of requiring the patient to keep the medication between the cheek and the gum until it dissolves, which can cause irritation or difficulty speaking or eating.
• Translingual medications can be absorbed rapidly and directly into the bloodstream, bypassing the stomach and the liver. This can result in faster onset, higher bioavailability, and lower risk of side effects. Translingual medications are also convenient and easy to use, as they do not require the patient to hold them in the mouth. However, translingual medications have the disadvantage of being limited by the size and solubility of the drug, as well as the saliva production and pH of the mouth. Translingual medications also have the disadvantage of being more expensive and less available than other routes.

The procedure and precautions for administering sublingual, buccal, and translingual medications are:

• Wash your hands with soap and water and dry them well.
• Check the label and the medication’s expiration date and ensure it is the patient’s right type, dose, and time. Follow the manufacturer’s instructions and the nurse’s orders on preparing, storing, and disposing of the medication and the device. Do not use the medication if it is broken, cracked, or discolored.
• If the medication is wrapped, remove the wrapper and moisten the medication with water or saliva if needed. Do not break, crush, or chew the medication.
• Choose a comfortable position for the patient and yourself. If the patient is conscious and cooperative, ask them to open their mouth, lift their tongue, or move their cheek. If the patient is unconscious or uncooperative, gently open their mouth, lift their tongue, or move their cheek with your fingers.
• Gently insert the medication into the appropriate mouth area using your finger or an applicator, if provided. Place the medication under the tongue, as far back as possible, for sublingual medications. Place the medication between the cheek and the gum, preferably on the lower jaw for buccal medications. For translingual medications, spray or apply the medication onto the tongue, as directed by the device. Do not force the medication or cause any pain or discomfort to the patient.
• Ask the patient to keep the medication in place until it dissolves, which may take several minutes. Do not let the patient swallow, spit, drink, eat, or smoke until the medication has taken effect unless instructed otherwise by the nurse.
• Record the date, time, dose, and route of the medication. Report any abnormal findings or problems to the nurse.

Some precautions for administering sublingual, buccal, and translingual medications are:

• Do not use sublingual, buccal, or translingual medications if the patient has allergies or sensitivities to the medication or the device. Check the patient’s medical history and allergies before giving any medication, and avoid anything the patient is allergic to.
• Do not use sublingual, buccal, or translingual medications if the patient has wounds, infections, or inflammation in the mouth or throat. This can cause irritation, pain, or bleeding. Contact the nurse if the patient has any signs of infection, such as pus, redness, swelling, or fever.
• Do not use more or less sublingual, buccal, or translingual medications than prescribed. This can cause unwanted side effects or reduce the effectiveness of the treatment. Follow the nurse’s instructions on how often and how long to use the medications, and do not stop or change the dose without consulting the nurse.
• Do not mix different medications in the same device or mouth area unless instructed by the nurse. This can cause interactions or incompatibilities that can affect the safety or efficacy of the treatment. Use only the medication and device prescribed for the patient, and do not substitute or combine them with other products.

Follow the manufacturer’s and nurse’s instructions to correctly administer sublingual, buccal, and translingual medications. You should also demonstrate the device to the nurse and ask for feedback. You should also educate the patient and their family or caregivers on the medication’s purpose, benefits, and risks and how to use it properly. You should also encourage the patient to use the medication as prescribed and to report any problems or concerns to the nurse.

Sublingual, buccal, and translingual medications can cause some complications and adverse reactions, such as:

• Pain, burning, itching, or irritation at the site of administration. These are usually mild and temporary and can be relieved by rinsing the mouth with water or applying a cold compress or an over-the-counter cream to the area. You should contact the nurse if the patient has severe or persistent pain or irritation or develops a rash, hives, or swelling.
• Nausea, vomiting, diarrhea, headache, dizziness, or allergic reactions. These depend on the type and dose of the medication and the patient’s condition and response. You should follow the nurse’s instructions on monitoring, preventing, and treating these reactions. You should also educate the patient and their family or caregivers on the signs and symptoms of these reactions and when to seek medical attention.

Sublingual, buccal, and translingual medications are useful ways to deliver medications to the body. However, they also require careful preparation, administration, and education. You should work with the nurse, the patient, and the patient’s family or caregivers to learn how to use sublingual, buccal, and translingual medications safely and correctly. You should also follow the patient’s care plan, which includes checking their vital signs, giving them their medications, helping them with their daily activities, and reporting any changes in their condition. By doing so, you can improve the patient’s health and well-being.

Giving Medications via Various Types of Feeding Tubes

As a medication technician, you may need to administer medications via feeding tubes to patients who cannot swallow or eat normally. Feeding tubes are medical devices that deliver liquid nutrition and fluids directly into the stomach or the small intestine. Feeding tubes can also be used to give medications that are available in liquid form or can be crushed and dissolved in water.

Different feeding tube types depend on where they are inserted and how long they are used. Some of the common types of feeding tubes are:

• Nasogastric (NG) tube: This is a thin, flexible tube inserted through the nose and down the throat into the stomach. It is usually used for short-term feeding, such as a few days or weeks. It can be easily removed when it is no longer needed.
• Gastrostomy (G) tube: This is a thicker, more durable tube inserted through a small incision in the abdomen into the stomach. It is usually used for long-term feeding, such as months or years. A doctor can replace or remove it when it is no longer needed.
• Jejunostomy (J) tube: This tube is similar to the G tube but is inserted through the abdomen into the jejunum, the middle part of the small intestine. It is usually used for long-term feeding patients with stomach problems, such as gastric reflux or delayed emptying. A doctor can also replace or remove it when it is no longer needed.

To administer medications via feeding tubes, you will need a device that can deliver the liquid medication into the tube. Some of the common devices are:

• Syringe: This plastic device has a plunger and nozzle that fit into the end of the feeding tube. You can use a syringe to push the liquid medication into the tube by hand and flush the tube with water before and after giving the medication to prevent clogging.
• Gravity bag: This plastic bag has a tube and a clamp attached. You can fill the bag with the liquid medication and hang it above the patient’s head. You can use the clamp to control the flow of the medication into the feeding tube by gravity. You can also use a gravity bag to flush the tube with water before and after giving the medication to prevent clogging.
• Pump: This electronic device has a tube and a clamp attached. You can connect the pump to the feeding tube and set the desired medication delivery rate and volume. The pump will automatically and steadily deliver the medication into the feeding tube. You can also use a pump to flush the tube with water before and after giving the medication to prevent clogging.

To prepare and administer medications via feeding tubes correctly and safely, you should follow these steps:

• Wash your hands and put on gloves. Check the patient’s name, date of birth, and medication order. Verify the patient’s identity and explain the procedure to them. Obtain their consent and cooperation.
• Check the expiration date and the appearance of the liquid medication. It should be clear and free of particles. Do not use the medication if it is expired, cloudy, discolored, or has lumps.
• If the medication is not liquid, you can crush the tablet, open the capsule, and dissolve the powder in water. Use a mortar and pestle or a pill crusher to crush the medication finely. Use a small amount of water, such as 15 to 30 milliliters, to dissolve the medication completely. Do not crush or dissolve any medication that is enteric-coated, extended-release, or sublingual, as this can affect the effectiveness or safety of the medication.
• If the patient receives continuous feeding, you must stop and clamp the tube before giving the medication. You can resume the feeding after giving the medication and flushing the tube unless instructed otherwise by the doctor or the nurse.
• If the patient is receiving intermittent or bolus feeding, you must give the medication between the feeding sessions unless instructed otherwise by the doctor or the nurse.
• Choose the device you will use to give the medication, such as a syringe, a gravity bag, or a pump. Fill the device with the liquid medication and attach it to the end of the feeding tube. Make sure there are no air bubbles in the device or the tube.
• Elevate the patient’s head to at least 30 degrees and check the position of the feeding tube. After injecting a small amount of air into the tube, use a stethoscope to listen for a whooshing sound over the stomach or intestine. You can also check the pH of the fluid aspirated from the tube, which should be acidic for the stomach or neutral for the intestine.
• Flush the feeding tube with water before giving the medication to clear any residual food or fluid. Depending on the size of the tube, use at least 15 to 30 milliliters of water. You can use the same device you used for the medication or a separate syringe to flush the tube.
• Administer the medication into the feeding tube using the device you choose. If you are using a syringe, push the plunger slowly and steadily. If using a gravity bag, adjust the clamp to control the flow. If you use a pump, set the rate and volume and start the pump. Do not mix different medications in the same device or give them simultaneously. Give each medication separately and flush the tube with water between each medication.
• Flush the feeding tube with water after giving the medication to prevent clogging and ensure complete delivery. Depending on the size of the tube, use at least 15 to 30 milliliters of water. You can use the same device you used for the medication or a separate syringe to flush the tube.
• Disconnect the device from the feeding tube and clamp the tube if needed. Dispose of the device and any leftover medication properly. Do not reuse or share the device with anyone else. Remove your gloves and wash your hands. Document the medication administration, including the date, time, dose, route, and adverse reactions. Monitor the patient’s vital signs and condition. Report any abnormal findings to the nurse or the doctor.

The dosage, timing, and frequency of medications via feeding tubes depend on the type and purpose of the medications and the patient’s condition and response. You should follow the doctor’s prescription or the manufacturer’s instructions carefully. Some general guidelines are:

• Use the exact amount of liquid medication or water that is prescribed or recommended. Too much or too little can affect the medication’s effectiveness or safety.
• Use the medication at regular intervals, as directed. Do not skip or double up on doses. If you miss a dose, administer it as soon as you remember unless it is almost time for the next dose. In that case, skip the missed dose and resume the normal schedule. Do not administer two doses at once.
• Use the medication for the duration prescribed or recommended. Do not stop using the medication without consulting the doctor, even if the symptoms improve. Stopping the medication too soon can cause the condition to worsen or recur.
• Store the liquid medication in a cool, dry, and dark place, away from heat, light, and moisture. Do not refrigerate or freeze it unless instructed to do so. Keep the liquid medication out of the reach of children and pets.

Medications via feeding tubes are generally well tolerated, but they may cause some side effects, such as:

• Nausea, vomiting, diarrhea, or constipation
• Abdominal pain, bloating, or cramping
• Heartburn, reflux, or aspiration
• Changes in appetite or weight
• Headache or dizziness
• Allergic reactions such as rash, hives, or difficulty breathing

To prevent or manage the side effects of medications via feeding tubes, you should:

• Inform the patient about the possible side effects and how to cope with them
• Ask the patient if they have any history of allergies or reactions to medications
• Ask the patient about all the medications, supplements, and herbal products they take, especially those that may interact with the medications via feeding tubes.
• Seek emergency medical help if the patient has any signs of a serious side effect or an overdose.

Medications via feeding tubes are a safe and effective way to treat various conditions that affect the patient’s ability to swallow or eat normally. However, they are not a substitute for regular medical care and monitoring. You should also educate the patient about the importance of following a healthy lifestyle, maintaining good oral hygiene, and preventing infections to improve their health and well-being.

Topical Treatments

Topical treatments are medications applied to the skin or mucous membranes to treat various conditions, such as infections, inflammation, pain, or skin disorders. Topical treatments can deliver drugs that act locally in the area where they are applied or that enter the bloodstream and act throughout the body. Topical treatments can have advantages over oral or injectable medications, such as faster onset, lower dosage, and fewer systemic side effects. However, they also have disadvantages, such as potential irritation, allergy, or infection at the application site.

Different types and functions of topical treatments and medications can be used with them. Some examples are:

• Creams are semi-solid emulsions of oil and water that are easy to spread and absorb. They can treat dry, scaly, or inflamed skin conditions like eczema, psoriasis, or dermatitis. Some common medications given by creams are corticosteroids, antifungals, antibiotics, or antihistamines.
• Gels are transparent or translucent liquids containing a thickening agent, such as carbomer or cellulose. They can treat oily, acne-prone, or infected skin conditions like acne, rosacea, or impetigo. Some common medications gels give are benzoyl peroxide, clindamycin, metronidazole, or adapalene.
• Ointments are greasy or oily preparations containing a high oil and low water concentration. They can treat dry, cracked, or irritated skin conditions such as burns, wounds, or ulcers. Some common medications used in ointments are petrolatum, lanolin, zinc oxide, or bacitracin.
• Powders: These are dry powders such as baby powder or anti-fungal powder.
• Lotions are liquid preparations containing low oil and high water. They can treat large or hairy areas of the skin that need cooling or soothing, such as sunburn, insect bites, or rashes. Some common medications lotions give are calamine, camphor, menthol, or pramoxine.
• Sprays are pressurized liquids delivered as a fine mist or jet. They can be used to treat hard-to-reach or painful areas of the skin that need rapid or uniform coverage, such as the scalp, nails, or mucous membranes. Some common medications sprays give are lidocaine, minoxidil, clotrimazole, or nystatin.
• Patches are adhesive or non-adhesive dressings containing a reservoir of medication released slowly and steadily into the skin. They can be used to treat chronic or systemic conditions that need continuous or controlled delivery, such as pain, angina, or nicotine addiction. Some common medications that are given by patches are fentanyl, nitroglycerin, or nicotine.

The procedure and precautions for applying topical treatments may vary depending on the type, the medication, and the patient’s condition. However, some general steps and tips are:

• Wash your hands with soap and water and dry them well.
• Check the label and the medication’s expiration date and ensure it is the patient’s right type, dose, and time. Follow the manufacturer’s instructions and the nurse’s orders on preparing, storing, and disposing of the medication and the device. Do not use the medication if it is discolored, separated, or has particles.
• Clean and dry the affected skin or mucous membrane area with a mild soap, water, or antiseptic solution. Do not apply the medication to broken, infected, or inflamed skin or mucous membranes unless instructed by the nurse.
• Depending on the type of medication, apply a thin layer of the medication to the affected area using your finger, a cotton swab, a spatula, or an applicator. Do not rub or massage the area unless instructed by the nurse. Do not apply more or less medication than prescribed, as this can cause unwanted side effects or reduce the effectiveness of the treatment.
• If needed or instructed by the nurse, cover the area with a bandage, dressing, or plastic wrap. This can help protect the area, prevent evaporation, or enhance the medication’s absorption. Do not cover the area too tightly, which can cause irritation or infection. Change the bandage, dressing, or plastic wrap as often as the nurse instructs.
• Wash your hands again with soap and water after applying the medication. Do not touch your eyes, nose, mouth, or genitals with the medication on your hands, as this can cause irritation or infection. If the medication gets into these areas, rinse them well with water and contact the nurse.
• Record the date, time, dose, and type of the medication. Report any abnormal findings or problems to the nurse.

Some precautions for applying topical treatments are:

• Do not use topical treatments if the patient has allergies or sensitivities to the medication or the device. Before applying any medication, check the patient’s medical history and allergies and avoid anything the patient is allergic to.
• Do not use topical treatments if the patient has any wounds, infections, or inflammation in the area where the medication is applied. This can cause irritation, pain, or bleeding. Contact the nurse if the patient has any signs of infection, such as pus, redness, swelling, or fever.
• Do not use more or less topical treatments than prescribed. This can cause unwanted side effects or reduce the effectiveness of the treatment. Follow the nurse’s instructions on how often and how long to use the topical treatments, and do not stop or change the dose without consulting the nurse.
• Do not mix different medications in the same device or area of the skin or mucous membrane unless instructed by the nurse. This can cause interactions or incompatibilities that can affect the safety or efficacy of the treatment. Use only the medication and device prescribed for the patient, and do not substitute or combine them with other products.
• Do not expose the area where the medication is applied to heat, sunlight, or water unless instructed by the nurse. This can affect the medication’s absorption or elimination. Protect the area with clothing, sunscreen, or a waterproof bandage.

Follow the manufacturer’s and nurse’s instructions to apply topical treatments correctly. You should also demonstrate how to apply the medication to the nurse and ask for feedback. You should also educate the patient and their family or caregivers on the medication’s purpose, benefits, and risks and how to use it properly. You should also encourage the patient to use the medication as prescribed and to report any problems or concerns to the nurse.

Topical treatments can cause some complications and adverse reactions, such as:

• Pain, burning, itching, or irritation at the site of application. These are usually mild and temporary and can be relieved by stopping the medication, washing the area with water, and applying a cold compress or an over-the-counter cream. You should contact the nurse if the patient has severe or persistent pain or irritation or develops a rash, hives, or swelling.
• Allergic reactions include rash, hives, itching, swelling, or difficulty breathing. These are rare but serious and can be life-threatening. You should check the patient’s medical history and allergies before applying any medication and avoid anything they are allergic to. You should also carry an epinephrine auto-injector (EpiPen) and seek emergency medical help if the patient has a severe allergic reaction.
• Medication-specific reactions include nausea, vomiting, diarrhea, headache, dizziness, and insomnia. These reactions depend on the type and dose of the medication and the patient’s condition and response. You should follow the nurse’s instructions on monitoring, preventing, and treating these reactions. You should also educate the patient and their family or caregivers on the signs and symptoms of these reactions and when to seek medical attention.

Rectal Diazepam

Rectal diazepam is a medication that is inserted into the rectum to stop or prevent seizures. It belongs to a class of drugs called benzodiazepines, which work by calming abnormal activity in the brain. Rectal diazepam is used as a rescue medication for people who have epilepsy and experience cluster seizures, which are episodes of increased or prolonged seizure activity that do not stop on their own. Rectal diazepam is not for daily use to prevent seizures.

The indications and contraindications for rectal diazepam are:

• Indications: Rectal diazepam is indicated for the management of selected, refractory patients with epilepsy on stable regimens of antiepileptic drugs (AEDs) who require intermittent use of diazepam to control bouts of increased seizure activity. Rectal diazepam is intended for rectal administration only.
• Contraindications: Rectal diazepam is contraindicated in patients with a known hypersensitivity to diazepam or any of its ingredients or to other benzodiazepines. Rectal diazepam is also contraindicated in patients with acute narrow-angle glaucoma, untreated open-angle glaucoma, or myasthenia gravis. Rectal diazepam should not be used in patients with respiratory depression, severe hepatic impairment, or sleep apnea syndrome. Rectal diazepam should not be administered to children under two years of age.

The procedure and precautions for administering rectal diazepam are:

• Procedure: Rectal diazepam comes in a prefilled syringe with a flexible plastic tip. The syringe is available in two forms: Diastat® and Diastat® AcuDial™. Diastat® has a fixed dose of diazepam, while Diastat® AcuDial™ can be adjusted to deliver a customized dose of diazepam. The dose of rectal diazepam depends on the patient’s weight, age, and seizure history. The dose should be prescribed by a doctor and confirmed by a pharmacist. The syringe should be stored at room temperature and protected from light. The syringe should be used within 4 hours of opening the protective packaging. The syringe should not be reused or shared with anyone else.

To administer rectal diazepam, follow these steps:

• Wash your hands with soap and water and dry them well.
• Put on disposable gloves if available.
• Check the label and the syringe’s expiration date and ensure it is the right type, dose, and time for the patient. If you are using Diastat® AcuDial™, ensure the dose display window shows the correct dose and the green “ready” band is visible. If the dose is incorrect or the green band is not visible, do not use the syringe and immediately contact the doctor or pharmacist.
• Remove the protective cap from the syringe tip. Do not touch the syringe tip or let it touch anything else. If the syringe tip is damaged or contaminated, do not use the syringe and contact the doctor or pharmacist immediately.
• Lubricate the syringe tip with the lubricating jelly or water that came with the syringe. Do not use any other lubricant, such as petroleum jelly, as it may affect the medication’s absorption.
• Position the patient on their side or stomach with their upper leg bent forward. Gently separate the buttocks and expose the rectum. If the patient wears a diaper, fold it or remove it.
• Gently insert the syringe tip into the rectum, about half an inch for a child or one inch for an adult. Do not force the syringe or cause the patient any pain or discomfort. Hold the syringe in place and slowly push the plunger until it stops. The plunger will lock in place, and the syringe will be empty.
• Keep the syringe in the rectum for at least 3 seconds. Then, gently pull the syringe out and dispose of it in a puncture-proof container. Do not reuse or share the syringe with anyone else.
• Keep the patient on their side and observe them for at least 10 minutes. The medication should start working within 5 to 15 minutes and last for up to 12 hours. Do not give the patient anything to eat or drink until they are fully awake and alert. Do not give the patient another dose of rectal diazepam for at least 4 hours unless instructed by the doctor.
• Record the date, time, dose, and response of the patient. Report any abnormal findings or problems to the doctor.
• Precautions: Some precautions for administering rectal diazepam are:
  • Do not use rectal diazepam if the patient has any allergies or sensitivities to diazepam or any of its ingredients or to other benzodiazepines. Check the patient’s medical history and allergies before giving any medication, and avoid anything the patient is allergic to.
  • Do not use rectal diazepam if the patient has any of the contraindications mentioned above. Contact the doctor if the patient has any of these conditions or if you are unsure if they have them.
  • Do not use more or less rectal diazepam than prescribed. This can cause unwanted side effects or reduce the effectiveness of the treatment. Follow the doctor’s instructions on how often and how long to use rectal diazepam, and do not stop or change the dose without consulting the doctor.
  • Do not use rectal diazepam with other medications that can affect the central nervous system, such as opioids, alcohol, antihistamines, or antidepressants. This can cause serious interactions affecting the patient’s breathing, blood pressure, or heart rate. Tell the doctor about all the medications that the patient is taking or has recently taken, including prescription, over-the-counter, herbal, or recreational drugs.
  • Do not use rectal diazepam with grapefruit or grapefruit juice. This can increase the amount of diazepam in the blood and cause serious side effects. Avoid grapefruit and grapefruit juice while using rectal diazepam and for at least three days after the last dose.
  • Do not drive, operate machinery, or perform any activities that require alertness or coordination while using rectal diazepam or for at least 24 hours after the last dose. Rectal diazepam can cause drowsiness, dizziness, or impaired judgment, affecting the ability to perform these tasks safely.

The potential complications and adverse reactions of rectal diazepam and how to manage them are:

• Complications: Some possible complications of rectal diazepam are:
  • Rectal irritation, bleeding, or infection. This can happen if the syringe tip damages the tissue or introduces bacteria into the rectum. To prevent this, lubricate the syringe tip, insert it gently, and keep it clean and sterile. To treat this, stop using rectal diazepam, wash the area with water, and apply a cold compress or an over-the-counter cream. Contact the doctor if the patient has severe or persistent pain, bleeding, or signs of infection, such as pus, redness, swelling, or fever.
  • Withdrawal symptoms. This can happen if rectal diazepam is used for a long time or in high doses and then stopped suddenly. Withdrawal symptoms can include anxiety, agitation, insomnia, tremors, seizures, or hallucinations. To prevent this, do not use rectal diazepam more often or longer than prescribed, and do not stop using it without consulting the doctor. To treat this, contact the doctor and follow their instructions on how to taper off rectal diazepam gradually and safely.
  • Dependence or addiction. This can happen if rectal diazepam is used for a long time or in high doses and causes a physical or psychological need for the medication. Dependence or addiction can lead to misuse, abuse, or overdose of rectal diazepam. To prevent this, do not use rectal diazepam more often or longer than prescribed, and do not increase the dose without consulting the doctor. To treat this, contact the doctor and seek professional help for substance use disorder.
• Adverse reactions: Some possible adverse reactions of rectal diazepam are:
  • Drowsiness, dizziness, headache, fatigue, or confusion. These are common and usually, mild side effects that can affect the mental or physical abilities of the patient. To prevent this, use the lowest effective dose of rectal diazepam and avoid using other medications that can cause drowsiness or dizziness. To treat this, monitor the patient’s vital signs, keep them comfortable and safe, and report any severe or persistent symptoms to the doctor.
  • Nausea, vomiting, diarrhea, constipation, or abdominal pain are common and usually mild side effects that can affect the patient’s digestive system. To prevent this, use the lowest effective dose of rectal diazepam and avoid using other medications that can cause gastrointestinal upset. To treat this, give the patient plenty of fluids, bland foods, and over-the-counter medications for nausea or diarrhea. Report any severe or persistent symptoms to the doctor.
  • Respiratory depression, hypotension, or bradycardia. These are rare but severe side effects that can affect the patient’s breathing, blood pressure, or heart rate. To prevent this, use the lowest effective dose of rectal diazepam and avoid using other medications that can affect the central nervous system, such as opioids, alcohol, antihistamines, or antidepressants. To treat this, stop using rectal diazepam, give the patient oxygen, and call 911 or seek emergency medical help. Report any severe or life-threatening symptoms to the doctor.

These are some of the possible adverse reactions of rectal diazepam. However, this is not a complete list, and other side effects may not be mentioned here. If you notice any other unusual or bothersome symptoms in the patient, you should contact the doctor immediately. You should also follow the doctor’s instructions on monitoring, preventing, and treating these reactions. You should also educate the patient and their family or caregivers on the signs and symptoms of these reactions and when to seek medical attention. By doing so, you can ensure the safety and well-being of the patient.

Epinephrine Auto-Injectors and EpiPens

Epinephrine auto-injectors contain a pre-filled syringe of epinephrine, a medication that can save lives in case of a severe allergic reaction (anaphylaxis). Various allergens, such as foods, insect stings, medications, or latex, can trigger anaphylaxis. Anaphylaxis can cause symptoms such as hives, swelling, difficulty breathing, low blood pressure, or shock. If not treated quickly, anaphylaxis can be fatal.

An Epi-Pen and an Epi Autoinjector are both devices that deliver epinephrine, a medication that can reverse the symptoms of a severe allergic reaction or anaphylaxis. However, they have some appearance, usage, and availability differences. Here are some of the main differences between them:

• Appearance: An Epi-Pen has a blue safety cap and an orange tip containing the needle. An Epi Autoinjector has a gray end and a yellow band indicating the needle. Both devices have a dose counter that shows zero when the injection is complete.
• Usage: To use an Epi-Pen, remove the blue safety cap, hold the pen with the orange tip pointing downward, and press the orange tip firmly against the thigh until you hear a click. To use an Epi Autoinjector, remove the base cap, hold the device with the gray end pointing up, and press the green button until a drop of liquid appears at the needle tip. Then, you need to hold the device with the gray end pointing down and jab it into the thigh until you hear a click.

The indications and contraindications for epinephrine auto-injectors are:

• Indications: Epinephrine auto-injectors are indicated for the emergency treatment of anaphylaxis in people who are at risk of or have a history of severe allergic reactions. Epinephrine auto-injectors can be used by the person experiencing anaphylaxis or by a caregiver or bystander trained to use them. Epinephrine auto-injectors can be used in any setting where anaphylaxis may occur, such as at home, school, work, or travel.
• Contraindications: Epinephrine auto-injectors are contraindicated in people allergic to epinephrine or any ingredient in the device. They should also be used with caution in people who have certain medical conditions, such as heart disease, high blood pressure, diabetes, thyroid problems, or glaucoma. Epinephrine auto-injectors should not be used in place of proper allergy management or medical care. They should not be used more than once per episode of anaphylaxis unless instructed by a doctor.

The procedure and precautions for using epinephrine auto-injectors are:

• Procedure: Epinephrine auto-injectors come in different brands, such as EpiPen®, Auvi-Q®, or Symjepi®. Each brand has its instructions for use, which should be followed carefully. The general steps for using an epinephrine auto-injector are:
  • Remove the device from its protective case and check the expiration date and the color of the solution. Do not use the device if it is expired, discolored, or cloudy.
  • Hold the device firmly in your hand, with the tip pointing downward. Do not touch the tip of the needle, as this may activate the device or cause injury.
  • Remove the safety cap or guard from the device. Do not put it back on, as this may prevent the device from working.
  • Inject the device into the outer thigh, through clothing if needed. Press the device firmly against the thigh until you hear a click or a hiss, indicating that the injection has started. Hold the device in place for 3 to 10 seconds, depending on the brand, to ensure the full epinephrine dose is delivered.
  • Remove the device from the thigh and massage the injection site for 10 seconds. The device may have a needle cover or a window that shows the needle after the injection. Dispose of the device in a puncture-proof container. Do not reuse or share the device with anyone else.
• Precautions: Some precautions for using epinephrine auto-injectors are:
  • Always carry two epinephrine auto-injectors if one dose is insufficient or malfunctions. Store the devices at room temperature, away from heat, light, and moisture. Do not expose the devices to extreme temperatures, such as in a car or a freezer.
  • Learn how to use the epinephrine auto-injector before you need it. Read the instructions carefully and practice with a trainer device if available. If you cannot do it yourself, ask your doctor, pharmacist, or nurse to show you how to use the device correctly. Teach your family, friends, or coworkers how to use it.
  • Use the epinephrine auto-injector when you notice signs of anaphylaxis, such as hives, swelling, difficulty breathing, or low blood pressure. Do not wait for the symptoms to worsen or for someone else to help you. Do not hesitate to use the device, even if you are unsure if it is anaphylaxis. It is better to use the device than to risk a life-threatening reaction.
  • Call 911 or seek emergency medical help immediately after using the epinephrine auto-injector. Tell the emergency responders you have used the device and give them the device if possible. You may need additional treatment, such as oxygen, fluids, or antihistamines. You may also need to be observed for several hours, as the symptoms of anaphylaxis may return after the effects of epinephrine wear off.
  • Tell your doctor about any medical conditions or medications you have before using the epinephrine auto-injector. Some conditions or medications may affect how epinephrine works or cause side effects. Tell your doctor if you are pregnant, breastfeeding, or planning to become pregnant. Epinephrine may harm an unborn baby or pass into breast milk, but it may be necessary to use it in a life-threatening situation.

The potential complications and adverse reactions of epinephrine auto-injectors and how to manage them are:

• Complications: Some possible complications of epinephrine auto-injectors are:
  • Injection site reactions include pain, redness, swelling, and bruising. These reactions are usually mild and temporary and can be treated by applying a cold compress or an over-the-counter pain reliever to the area. Contact your doctor if the injection site becomes infected, inflamed, or necrotic (dead tissue).
  • Needle stick injuries, such as bleeding, infection, or nerve damage. These can happen if the needle accidentally punctures the skin or a blood vessel. To prevent this, do not touch the needle or the tip of the device, and dispose of the device in a puncture-proof container. To treat this, apply pressure to the wound, clean it with soap and water, and apply a bandage. Contact your doctor if the wound becomes infected, swollen, or painful.
  • Overdose or misuse, such as increased heart rate, high blood pressure, tremors, anxiety, or seizures. These can happen if the device is used more than once per episode of anaphylaxis or if the device is used for other purposes, such as to treat asthma or to enhance performance. To prevent this, use the device only as prescribed and directed, and do not share the device with anyone else. To treat this, stop using the device, seek emergency medical help, and report the incident to your doctor.
• Adverse reactions: Some possible adverse reactions of epinephrine auto-injectors are:
  • Palpitations, chest pain, irregular heartbeat, or cardiac arrest. These are rare but severe side effects that can affect the heart and blood vessels. They are more likely to occur in people who have heart disease, high blood pressure, or other cardiovascular risk factors. To prevent this, tell your doctor about your medical history and medications before using the device, and use the lowest effective dose of epinephrine. To treat this, seek emergency medical help and report the symptoms to your doctor.
  • Nervousness, restlessness, headache, dizziness, or insomnia. These are common and usually mild side effects affecting the nervous system. They are caused by the stimulating effects of epinephrine on the brain and body. To prevent this, use the device only when needed and avoid using other stimulants, such as caffeine, nicotine, or cocaine. Relax, drink water, and take over-the-counter pain relievers to treat this. Report any severe or persistent symptoms to your doctor.
  • Nausea, vomiting, diarrhea, or abdominal cramps. These are common and usually mild side effects affecting the digestive system. They are caused by the effects of epinephrine on the stomach and intestines. To prevent this, use the device only when needed and avoid eating or drinking anything that may upset your stomach, such as spicy, fatty, or acidic foods or beverages. To treat this, drink fluids, eat bland foods, and take over-the-counter medications for nausea or diarrhea. Report any severe or persistent symptoms to your doctor.

These are some of the possible complications and adverse reactions of epinephrine auto-injectors. However, this is not a complete list, and other side effects may not be mentioned here. You should immediately contact your doctor if you notice any other unusual or bothersome symptoms after using the device. You should also follow your doctor’s instructions on monitoring, preventing, and treating these complications and adverse reactions. You should also educate yourself and your family or caregivers on the signs and symptoms of these complications and adverse reactions and when to seek medical attention. Doing so can ensure your safety and well-being and that of others.

Conclusion

In this article, we have learned about the roles and responsibilities of medication technicians in Pennsylvania. We have also learned about the different types of medications and routes of administration that medication technicians may encounter in their work. We have discussed the indications, contraindications, procedures, precautions, complications, and adverse reactions of some common medications, such as suppositories, sublingual, buccal, and translingual medications, topical treatments, rectal diazepam, and epinephrine auto-injectors. We have also demonstrated how to use these medications correctly and safely.

Training and certifying medication technicians in Pennsylvania is essential and beneficial for several reasons. First, it ensures that medication technicians have the knowledge and skills to perform their duties competently and confidently. Second, it improves the quality and safety of care for patients who need medication assistance. Third, it enhances the professional development and career opportunities for medication technicians. Fourth, it supports the collaboration and communication between medication technicians and other healthcare providers.

If you are interested in becoming a medication technician in Pennsylvania, or if you want to improve your skills and knowledge as a medication technician, we recommend that you take advantage of the following resources and opportunities:

• The Pennsylvania Department of Health (DOH) website provides information on the regulations, standards, and guidelines for medication technicians in Pennsylvania. The website can be found at https://www.health.pa.gov/.
• The Pennsylvania Department of Education (PDE) website provides information on the approved training programs and certification exams for medication technicians in Pennsylvania. The website can be found at https://www.education.pa.gov/.
• The Pennsylvania Association of Medication Technicians website provides information on membership, benefits, and events for medication technicians in Pennsylvania.

We hope that this article has been helpful and informative for you. We encourage you to continue learning and practicing as a medication technician in Pennsylvania. We wish you all the best in your journey and career as a medication technician. Thank you for reading.

Resources

Pennsylvania Medication Administration Training Program

Pennsylvania Department of Public Welfare (DPW), Office of Developmental Programs (ODP) Medication Administration Course for life sharers Lesson 9

For those that use the pre-filled Trulicity Pens that do not have to be primed (PDF)

How to Use Trulicity

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