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How to give medicines

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HealthWiki > A Book for Midwives > Medicines: uses, dosage, and precautions for the medicines referred to in this book > How to give medicines


Contents

Medicine names

a bottle labeled with the words Flagyl and metronidazole.
brand name
generic name

Medicines usually have 2 names. The generic (or scientific) name is the same everywhere in the world. Some companies that make medicines give each medicine they make a brand name. The same medicine made by 2 different companies will have 2 different brand names. In this book, we use generic names. If you need a certain medicine, any brand will do. Some brands cost much less than others.

a pharmacy worker speaking to a woman as he shows her a box of medicine.
We don't sell that brand. This one is just as good.
You may substitute one medicine for another if the generic names are the same.

Forms of medicines

Medicines come in different forms:

  • Tablets, pills, capsules, and liquids are usually taken by mouth. Sometimes they may need to be inserted in the vagina or rectum.
  • Inserts (suppositories, pessaries) are put into the vagina or the rectum.
  • Injections are given with a needle — into a large muscle (IM), under the skin (intradermal or subcutaneous injection), or into the blood (IV).
  • Liquids and syrups that are taken by mouth.
  • Creams, ointments, or salves that contain medicine are applied directly to the skin or in the vagina.


In this book, we use pictures to show how a medicine should be given.

a hand holding a syringe.
2 pills in the palm of a hand.
a tube with ointment being squeezed from it.
a medicine dropper.
a spoon with liquid in it.
Inject
medicines
when we show
this picture.
Give tablets, pills,
capsules, or inserts
when we show
this picture.
Use ointment
or cream when
we show this
picture.
Give drops
when we
show this
picture.
Give syrup
when we
show this
picture.


Often, the same medicine can be given in different forms. For example, many medicines can be given by mouth or given by an injection. Usually, it is best to give medicines by mouth, because injecting can have risks. But in an emergency, injecting the medicine may be better, because it will usually work more quickly. In this book, we recommend the most effective ways to give each medicine, but you may be able to give a medicine in another form. We do not explain how to give medicines by IV (in the vein), because this method has more risk.

How much medicine to give

Pills, tablets, and capsules come in different weights and sizes. To be sure you are giving the right amount, check how many grams (g), milligrams (mg), micrograms (mcg), or Units (U) each pill or capsule contains.

For tablets, capsules, inserts, and injectable medicines

Most tablets, capsules, inserts, and injectable medicines are measured in grams (g) and milligrams (mg):

1000 mg = 1 g
(one thousand milligrams is the same as one gram)
1 mg = 0.001 g
(one milligram is one one-thousandth part of a gram)
For example: One aspirin tablet has 325 milligrams of aspirin.
You could say
that one aspirin
tablet has:
.325 g
0.325 g
325 mg
All of these are
different ways to say
325 milligrams.


Some medicines, such as birth control pills, are weighed in micrograms (mcg or µcg):

1 µcg = 1 mcg = 1/1000 mg = 0.001 mg
This means there are 1000 micrograms in a milligram.

Injectable medicines may be measured in Units (U) or International Units (IU).

For liquid medicines

Syrups, suspensions, and other liquid medicines are usually given in milliliters (ml) or cubic centimeters (cc). A milliliter is the same as a cubic centimeter.

1 ml = 1 cc
1000 ml = 1 liter
Sometimes liquids are given in teaspoons (tsp) or tablespoons (Tbs).
1 tsp = 5 ml
1 Tbs = 15 ml
1 Tbs = 3 tsp
1 tablespoon equals 3 teaspoons.
tablespoon
teaspoons
5 ml

To be sure you are taking the right amount of a liquid medicine, be sure that your teaspoon is 5 ml, or measure the medicine in a syringe.

If your pharmacy does not have the correct weight or size of a medicine

You may have to give part of a pill, or more than one to get the right dose.

For example, if you only have 250 mg tablets of amoxicillin and you are supposed to give 500 mg each time, you must give 2 pills each time.
250 mg + 250 mg = 500 mg
Or, if you only have 500 mg tablets of amoxicillin and you need to give 250 mg each time, you must cut each pill in half.

Dosing by weight

For most medicines in this book, we suggest doses that any adult woman can use. But for some medicines, especially ones that can be dangerous, it is better to figure out the dosage according to a person's weight (if you have a scale).

For example, if you need to give gentamicin, and the dosage says 5 mg/kg/day, this means that each day you would give 5 milligrams (mg) of the medicine for each kilogram (kg) the person weighs.


So a 50 kg woman would receive 250 mg of gentamicin during 24 hours.


This amount should be divided up into separate doses. Dosage
instructions will say how many times the medicine should be
given each day.

Gentamicin should be given 3 times a day so you would give 80 mg in each dose.

When to take medicines

Some medicines should be taken once a day. Most must be taken more often. You do not need a clock. If the directions say:

"1 tablet every 8 hours" or "3 tablets a day" take 1 at sunrise, 1 in the afternoon, and 1 at night.
"1 tablet every 6 hours" or "4 tablets a day" take 1 in the morning, 1 at midday, 1 in the late afternoon, and 1 at night.
"1 tablet every 4 hours" take 6 pills a day, allowing the same amount of time between each pill.


This is because a medicine only works while it is in the body. After a certain length of time, it passes out of the body. The person must take it regularly throughout the day to keep enough medicine in her body. And taking too much at once can cause poisoning.

a row of four blank spaces under drawings of the sun rising, the sun fully risen, the sun setting, and the moon.

To remind someone who cannot read how often to take their medicine, you can draw them a picture like this:

In the blanks at the bottom, draw the amount of medicine to take and carefully explain what it means. For example:

1 pill in each of the 4 spaces.
1 half pill in each of the 4 spaces.
2 teaspoons in both the first space and the third space.
This means they should take 1 tablet 4 times a day: 1 at sunrise, 1 at midday, 1 in the late afternoon, and 1 at night. This means ½ tablet 4 times a day. This means 2 spoons of syrup 2 times a day.


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