• Communicating effectively with the patient on the proper

use of certain prescribed medications such as metered

dose inhaler (MDI), spacer, nebulizer, insulin self
administration, eye drops, ear and nose drops,
application of ointments and creams etc., and also the
use of transdermal patch is extremely important as only if
properly administered, the treatment will prove beneficial.
 TRANSDERMAL PATCH

1. See instructions for patch site mentioned with the drug.

2. Do not apply over damaged skin, skin folds and under
tight clothing.
3. Do not touch the 'drug' side while removing patch from
package. Put it on skin, press firmly and rub the edges to
seal it.
4. Change the application site regularly.
5. Area of application should be kept clean and dry.
6. Remove and replace as per the instructions.
 FOR INSTILLATION OF EYE DROPS AND
OINTMENTS
Eye drops
• Use the drug formulation meant for ophthalmic use.
• Wash the hands, do not touch opening of dropper.
• Look upward and make a 'gutter' by pulling the lower
eyelid down.
• Keep the dropper as close to gutter as possible without
touching to eye and instil the amount of drug (usually 1
drop) prescribed in the gutter.
• Close the eyes for two minutes but not too tight.
• Remove excess fluid with tissue.
• If more than one kind of eye-drop is used keep a gap of at
least five minutes before applying the next drops.
Administration of eye-drops to children:
1.Let the child lie back in a head-lowered position head
straight.
2. Eyes of the child should be closed.
3. Gently retract lower lid; and instil the drug into corner of
conjunctival sac.
4. Keep the head straight.
5. Remove excess fluid with tissue.
Eye ointment
• Wash the hands.
• Do not touch tip of ointment tube.
• Tilt head a little backwards.
• Take the tube in one hand.
• Make a gutter by pulling down lower eyelid with other
hand.
• Bring the tip of the tube close to 'gutter' and apply the
ointment as prescribed. Close the eye for two minutes and
remove excess ointment with clean tissue.
 FOR INSTILLATION OF NOSE DROPS AND
NASAL SPRAYS
Nasal drops
• Blow the nose, lie down with a pillow under the
shoulders keeping the head straight or sit down and tilt
head backward.
• Insert the dropper into the nostril about one centimetre.
• Instil the drops as prescribed.
• Tilt head forward (head between knees) immediately
after instillation of drops.
• Sit up after a few seconds.
• Same procedure is repeated for other nostril, if required.
• Rinse the dropper with warm water.
 Nasal spray

1. Blow the nose.

2. Sit and slightly tilt the head forward.
3. Shake the spray and insert the tip in one nostril.
4. Close the mouth and other nostril.
5. Squeeze the vial (container) to spray the drug and sniff
slowly.
6. After spray remove the tip from the nose and bend the
head forward (head between the knees).
7. Sit up after a few seconds and breathe through mouth.
8. Same procedure is repeated for other nostril, if required.
9. Rinse the tip with warm water.
 FOR INSTILLATION OF EAR DROPS

• Open the ear canal by pulling the ear up and back for
adults. Open the ear canal by pulling the ear down and
back for children.
• Instil the drug on the side of the canal.
 FOR RECTAL SUPPOSITORIES

• Wash the hands.

• Lubricate the end with a water-soluble lubricant.
• Put on gloves.
• Insert the suppository into the rectum up to the length of
finger. Keep suppository next to the mucosal wall.
• Wash the hands.
• Note: If the patient prefers and capable of self
administration, then provide the suppository and give
instructions for self-administration.
 FOR VAGINAL MEDICATIONS (TABLET,
CREAM, OINTMENT, GEL)

Vaginal tablet with applicator

• Wash the hands. Place the tablet into the open end of
applicator.
• Gently insert the applicator with the tablet into the vagina
without force and as far as possible.
• Release the tablet by depressing the plunger and then
withdraw applicator.
• Discard the applicator, if disposable or clean applicator
thoroughly with soap and warm water after each use, if not
disposable.
• Wash the hands.

Vaginal tablet without applicator.

• Wash the hands.
• Moisten the tablet by dipping in warm water.
• Gently insert tablet into the vagina without force and as far as
possible.
• Wash the hands.
VAGINAL CREAMS, OINTMENTS AND GELS
(APPLICATOR)

• Wash the hands. Apply small amount of cream into the

open end of applicator.
• Gently insert the applicator into the vagina without force
and as far as possible.
• Release the medication (creams/ointment/gel) by
depressing the plunger and then withdraw applicator.
• Discard the applicator, if disposable or clean applicator
thoroughly with soap and warm water after each use, if not
disposable. Wash the hands.
Note: If the patient prefers and capable of self
administration, then provide the vaginal medication and
give instructions for self-administration.
ORAL REHYDRATION SOLUTION AND ITS
USE
PREPARATION OF ORAL
REHYDRATIONSOLUTION FROM ORS PACKET
1. Boil and cool one litre of water.
2. Open ORS sachet and add whole content in one litre
water and shake well for few minutes to dissolve it
completely.
3. ORS is ready for use and it should be used within 24
hours.
 HOW TO USE (INSTRUCTION TO CHILD’S
PARENTS OR ATTENDANTS)

1. It is used to prevent or overcome dehydration due to

fluid loss as a result of diarrhoea.
2. It should be prepared fresh for a day.
3. Give small amount of ORS after every episode of
diarrhoea or vomiting as follows:
Children < 2 years - 50-100 mL of ORS
Children 2-10 years - 100-200 mL of ORS
Children > 10 years and adults - 200-250 mL of ORS
4. Amount should be repeated to administer as much as
possible.
5. Discard the remaining amount at the end of day.
6. If child or adult has vomiting or can not take orally or
frequent diarrhoea then consult the doctor immediately for
further treatment (suitable i.v. fluid).
 INHALATIONS

• Inhalations have advantages that they are more effective

with less systemic effect.
• Specific dose is inhaled with each inhalation.
• For asthma, usually oral inhalation is used while for nasal
allergies/rhinitis nasal route is preferred.
• Oral inhalations are used mainly for asthma; nasal sprays
for nasal allergies (allergic rhinitis).
• Several drugs are available in solutions for nasal or
oral inhalation; they are usually self-administered as a
spray into the nose or mouth. Thus, patient should be
trained to properly use the MDI correctly. Therefore, it
is very important that health care provider must know
correct use and should be able to train the patient.
• Inhalations (aerosols) are stable suspensions of extremely
small liquid or solid particles (0.5 to 5 microns) in a
medium such as air or oxygen. They are administered by
nebulisers.
• This results in delivering the drug to the bronchi or even
the alveoli.
• Nasal Spray: The nasal mucous membrane is highly
vascular and based on this property (high vascularity) some
of the drugs are used by nasal route to produce the systemic
effect and this is highly convenient to the patient.
 AEROSOL-MDI
• Cough up sputum before drug use as much as possible.
• Shake the medication/aerosol before use.
• Hold the aerosol upside down or as per instructions by
manufacturer.
• Empty the lungs of air as much as possible by slowly
breathing out. Tight the lips around mouthpiece and
slightly tilt the head backwards.
• Breathe deeply, activate the aerosol while keeping the
tongue down.
• Hold breath for 10-15 seconds and breathe out through
nose.
• Rinse the mouth by using warm water.
 INHALER WITH CAPSULES

• Cough up sputum before drug use as much as possible.

• Hold the aerosol upside down or as per instructions by
manufacturer.
• Cough up as much sputum as possible.
• Keep the capsule in the inhaler as per instructions by
manufacturer.
• Empty the lungs of air as much as possible by slowly
breathing out.
• Tight the lips around mouthpiece and slightly tilt the head
backwards.
• Breathe deeply, through inhaler and hold the breath for
10-15 seconds.
• Breathe out through the nose and Rinse the mouth by
using warm water.
 HOW TO INJECT INSULIN
USING A SYRINGE

• Where to inject insulin?

• You can inject insulin into your abdomen, upper arm,
buttocks, hip, and the front or side of the thigh. Insulin
works fastest when it is injected into the abdomen
• Use a different area within the site each time you inject
insulin. For example, inject insulin into different areas in
your abdomen. Insulin injected into the same area can
cause lumps, swelling, or thickened skin.
• Wash your hands with soap and water. This will help
prevent an infection. Dry your hands with a clean towel or
paper towel.
• Clean the skin where you will inject the insulin. You can
use an alcohol pad or a cotton swab dipped in alcohol.
• Grab a fold of your skin. Gently pinch the skin and fat
between your thumb and first finger.
• Insert the needle straight into your skin. Do not hold the
syringe at an angle. Make sure the needle is all the way
into the skin. Let go of the pinched tissue.
• Push down on the plunger to inject the insulin. Press on
the plunger until the insulin is gone. Keep the needle in
place for 5 seconds after you inject the insulin.
• Pull out the needle. Press on your injection site for 5 to
10 seconds. Do not rub. This will keep insulin from
leaking out.
• Throw away your used insulin syringe as directed. Do
not recap the syringe before you throw it away.
THANK YOU