Oral Medications¶
Overview¶
Oral medications are the most common route of administration in nursing. They come in solid forms — tablets, capsules, and caplets — and require accurate calculation to ensure the correct dose is given.
Reading the Medication Order¶
Every medication order contains:
| Component | Example |
|---|---|
| Patient name | John Smith |
| Medication name | metoprolol |
| Dose | 25 mg |
| Route | orally (PO) |
| Frequency | twice daily (BID) |
| Prescriber signature | Dr. Jones |
Reading the Stock Label¶
The stock label tells you what is available:
| Component | Example |
|---|---|
| Medication name | metoprolol tartrate |
| Strength | 25 mg per tablet |
| Form | tablet |
| Total quantity | 100 tablets |
The Calculation¶
Once you have the order and stock, set up the unit cancellation chain:
Tablets and Capsules¶
Example 1 — Straightforward: Order: metoprolol 50 mg orally Stock: 25 mg per tablet
Example 2 — Half tablet: Order: lisinopril 5 mg orally Stock: 10 mg per tablet
Scored vs Unscored Tablets
- Scored tablets have a line across the middle and are designed to be split — 0.5 tablet is acceptable
- Unscored tablets should never be split
- Enteric coated tablets should never be split or crushed
- Capsules should never be split unless specifically formulated as sprinkle capsules
Example 3 — Unit conversion required: Order: levothyroxine 0.1 mg orally Stock: 50 mcg per tablet
Example 4 — Higher stock strength: Order: atorvastatin 20 mg orally Stock: 40 mg per tablet
Daily and Multi-Dose Calculations¶
Example 5: Order: metformin 500 mg orally three times daily for 7 days Stock: 500 mg per tablet How many tablets for the full course?
Step 1 — tablets per dose: [\frac{500 \cancel{\text{ mg}}}{1} \times \frac{1 \text{ tablet}}{500 \cancel{\text{ mg}}} = 1 \text{ tablet per dose}]
Step 2 — total tablets: [1 \text{ tablet} \times 3 \text{ doses/day} \times 7 \text{ days} = 21 \text{ tablets}]
Reasonableness Check¶
Tablet Safety Guidelines
- Giving more than 3 tablets per dose is unusual — recheck
- Giving less than 0.5 tablet is unusual — recheck
- If the answer is not a multiple of 0.5, recheck your work
- Never crush or split medications without verifying it is safe
Practice Problems¶
Problem 1
Order: atenolol 100 mg orally Stock: 50 mg per tablet How many tablets?
Answer
Problem 2
Order: warfarin 2.5 mg orally Stock: 5 mg per tablet How many tablets?
Answer
Verify tablet is scored before splitting.
Problem 3
Order: levothyroxine 0.075 mg orally Stock: 25 mcg per tablet How many tablets?
Answer
Problem 4
Order: prednisone 40 mg orally Stock: 20 mg per tablet How many tablets?
Answer
Problem 5
Order: amoxicillin 500 mg orally three times daily for 10 days Stock: 250 mg per capsule How many capsules for the full course?
Answer
Step 1 — capsules per dose: [\frac{500 \cancel{\text{ mg}}}{1} \times \frac{1 \text{ capsule}}{250 \cancel{\text{ mg}}} = 2 \text{ capsules per dose}]
Step 2 — total capsules: [2 \times 3 \times 10 = 60 \text{ capsules}]
Problem 6 — Flag This Answer
Order: digoxin 0.5 mg orally Stock: 62.5 mcg per tablet How many tablets?
Answer
Flag This
8 tablets is far outside the reasonable range. Before proceeding, verify the order, recheck the stock concentration, and consult the prescriber or pharmacist. Do not administer without clarification.
Clinical Tip
Always read the medication label three times:
- When retrieving the medication from storage
- When preparing the dose
- Before administering to the patient
This is not a suggestion — it is a professional standard.