Administration of medicines: Introduction

Last updated: Sunday, July 05, 2015

You can download a PDF of the text of this tutorial (it doesn't include the Learning Exercises).

This section covers concepts that you may not have come across if you have not worked in a hospital before. It describes common enquiry types and gives you practical troubleshooting tips for resolving administration problems, but it does not give an in-depth description of each method of giving medicines.

Most clinical enquiries tend to relate to administration of medicines by injection or via the gut ('enteral'), but remember that there are other routes which you should not overlook. For example, the transdermal route can be a useful alternative if you are running out of suitable methods to give a medicine (e.g. fentanyl patches for pain in a patient with dysphagia). Similarly, the inhaled route can be used to administer a variety of drugs other than bronchodilators and corticosteroids (e.g. morphine for dyspnoea, antibiotics for cystic fibrosis, pentamidine for Pneumocystis jirovecii pneumonia).

Applying a transdermal patch       © Crown copyright 2017

Note that many enquiries about administration of medicines involve unlicensed use. Although medicines cannot be promoted outside the limits of their marketing authorisation, the Human Medicines Regulations 2012 do not prohibit the use of unlicensed medicines. It is recognised that informed use of unlicensed medicines or of licensed medicines for unlicensed purposes (‘off-label’ use) is often necessary – particularly in paediatric patients. Crushing tablets and opening capsules for administration through enteral feeding tubes is unlicensed but common practice; investigate all the appropriate licensed options first (e.g. liquids). The MHRA has provided guidance on the use of unlicensed medicines.