[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Medications and dose calculation](https://durgical.com/en/nursing/areas/medication/) › Other routes: inhaled, topical, eye, ear, rectal and vaginal # Other routes: inhaled, topical, eye, ear, rectal and vaginal - Procedure Each route has its own technique: where the drop goes, how to breathe with an inhaler, or how the patient should lie afterwards. Updated Nov 5, 2026 ## Key points - Eye drops: into the lower conjunctival sac without touching the eye; then gentle pressure on the inner corner of the eye; the patient does not rub the eye. - Ear drops: adult, pinna up and back; child, straight back; under 3 years, down and back; the patient lies with the ear up for 5 minutes. - Metered-dose inhaler: shake, breathe out, press as a slow breath in begins and hold the breath 5–10 seconds; a spacer helps. - After an inhaled corticosteroid: rinse the mouth and spit, to prevent oral thrush. - Rectal suppository: left Sims position, insert past the sphincter towards the navel. - Vaginal route: patient lying on the back with knees bent; she stays lying down 5–10 minutes. ## What it is Besides the oral and parenteral routes, many drugs are given into the eyes, ears, nose, lungs, skin, rectum or vagina. Some aim at a local effect; others, such as the rectal route or patches, at a systemic effect that bypasses the gut. The rights apply exactly as for any other route. What changes is the technique: where the drug is placed, the patient's position and how long they should stay that way. ## Indications - A local effect in the eye, ear, nose, skin, airway, rectum or vagina. - A systemic effect when the oral route is not possible (rectal, transdermal patch). - Inhaled treatment in asthma and obstructive lung disease. ## Contraindications and precautions - Rectal: assess for diarrhoea or active rectal bleeding; the route may not suit some heart conditions (vagal stimulation). - Eye and ear: do not touch the eye or ear with the dropper tip. - Ear: a ruptured eardrum generally rules out drops unless sterile technique is ordered. - Patches: remove the old one, do not apply to broken or irritated skin, rotate sites and never apply heat over certain patches. ## Equipment - The drug in its form (drops, ointment, inhaler, suppository, pessary, cream or patch) and the medical order. - Clean gloves. - Gauze or tissues; water-soluble lubricant for the rectal and vaginal routes. - A spacer if the patient uses one. - Vaginal applicator. ## Step by step (and why) - Apply the rights and identify the patient — «minor» routes have errors too. - Explain the procedure and protect privacy — helps cooperation, especially for rectal and vaginal routes. - Eye: pull down the lower lid, instil into the sac and press the inner corner — reduces systemic absorption. - Ear: pull the pinna up and back in adults (down and back under 3 years) — straightens the canal. - Inhaler: shake, have the patient breathe out and press as a slow breath in starts; hold the breath — the drug reaches the airways. - Rectal: left Sims position, lubricate and insert past the sphincter — so it is not expelled. - Vaginal: on the back with knees bent; applicator its full length, or suppository along the back wall — helps retention. - Keep the position a few minutes, remove gloves and document — ensures absorption and traceability. ## Complications - Systemic effects of eye drops if the inner corner of the eye is not pressed. - Dizziness or nausea after ear drops. - Oral thrush with inhaled corticosteroids if the mouth is not rinsed. - Vasovagal reaction during rectal insertion: dizziness, sweating, slow pulse or low blood pressure. ## Next step: when to call for help - Breathlessness that worsens after the inhaler: report at once. - Severe eye pain, loss of vision or increasing redness: report. - Dizziness, pallor or a slow pulse during rectal insertion: stop, lay the patient flat and report. - If the patient cannot master the inhaler technique, report so a spacer or another device can be considered. ## Test yourself Think of the answer, then tap the question to see it. ## Where is an eye drop instilled? Into the lower conjunctival sac, without touching the eye with the bottle. ## Which way is the pinna pulled to instil ear drops in an adult? Up and back; in a child under 3, down and back. ## Why is the mouth rinsed after an inhaled corticosteroid? To remove drug left in the mouth and prevent oral thrush. ## In what position is a rectal suppository given? In the left Sims position, with the upper leg bent. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/other-routes-inhaled-topical-eye-ear-rectal-and-vaginal/) ## Connections ## Related 2 - [The rights of medication administration](https://durgical.com/en/nursing/the-rights-of-medication-administration/) - [Giving oral medications (and through a feeding tube)](https://durgical.com/en/nursing/giving-oral-medications/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Nursing Skills (Open RN), 16.2 Basic Concepts (Administration of Medications Via Other Routes)](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Skills_(OpenRN)/16%3A_Administration_of_Medications_Via_Other_Routes/16.02%3A_Basic_Concepts) (Open RN, Chippewa Valley Technical College (LibreTexts), 2022); [Nursing Skills (Open RN), 16.3 Checklist for Transdermal, Eye, Ear, Inhalation, and Vaginal Routes Medication Administration](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Skills_(OpenRN)/16%3A_Administration_of_Medications_Via_Other_Routes/16.03%3A_Checklist_for_Transdermal_Eye_Ear_Inhalation_and_Vaginal_Routes_Medication_Administration) (Open RN, Chippewa Valley Technical College (LibreTexts), 2022); [Nursing Skills (Open RN), 15.2 Basic Concepts of Administering Medications](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Skills_(OpenRN)/15%3A_Administration_of_Enteral_Medications/15.02%3A_Basic_Concepts_of_Administering_Medications) (Open RN, Chippewa Valley Technical College (LibreTexts), 2022); [Nursing Skills (Open RN), 15.5 Checklist for Rectal Medication Administration](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Skills_(OpenRN)/15%3A_Administration_of_Enteral_Medications/15.05%3A_Checklist_for_Rectal_Medication_Administration) (Open RN, Chippewa Valley Technical College (LibreTexts), 2022). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/other-routes-inhaled-topical-eye-ear-rectal-and-vaginal/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/other-routes-inhaled-topical-eye-ear-rectal-and-vaginal/