Dwellness™ • Medication Administration Routines

Medication Administration Routines

Dwellness™ customization for:

Your Patient

Medications List
Capsule

Normal Administration

[NOTE: Read the current Medications List very carefully, and refer to it as you administer medications. Do this every time you administer medications.]
[NOTE: Pay close attention to which medications must be shaken before use.]

→ CAUTION: NEVER administer medications, nutrition, or hydration by mouth — always via g-tube. ←

Medications List

Click here — August 2021 — and review carefully for full information.

Morning Medications — Daily

[NOTE: During alternating months, a medication called Lansoprazole is administered just before the first syringe of food is given. This medicine helps control acid reflux. If this is a month for Lansoprazole, do not give the Famotidine listed below.]

Between 7:00 and 8:00 am
  • Lansoprazole

    • → CAUTION: Administer Lansoprazole just before giving the first syringe of food in the morning. Alternate every other month with Famotidine (see below). If you are giving Lansoprazole, DO NOT give Famotidine. ←


    1. Place the quick-dissolving Lansoprazole tablet in an empty, clean, dry 20mL syringe
    2. Draw up water into the syringe
    3. Lansoprazole dissolves very quickly, so administer as soon as it’s dissolved
    4. Give the first syringe of food right after administering Lansoprazole
    5. If it is a month for Lansoprazole, then give the rest of your patient's breakfast before administering the rest of the morning medications

  • Abilify 30mg tablet — ½ tab — the ½ tabs of Abilify are placed into a separate medication bottle the night before, when the Abilify tabs are split for the evening medications
    1. Place the ½ tab of Abilify into a clean, dry 20mL syringe
    2. Draw up water (at least 15mL) into the syringe
    3. Tilt the syringe with the tip up, and push out the air
    4. Set aside the syringe so the Abilify can dissolve

  • Cough medicine — Guaifenesin (Robitussin, Siltussin, etc.)
    1. Draw up the Guaifenesin into one clean, dry 20mL syringe
    2. Draw up the Guaifenesin into an additional 10mL syringe

  • Vimpat (Lacosamide)
    1. Draw up 20mL of the Vimpat into a clean, dry 20mL syringe
    2. Draw up 10mL additional Vimpat into a clean, dry 10mL syringe
      • Total Vimpat = 30mL

  • Banzel (Rufinamide)
    1. Shake the bottle well
    2. Draw up two 20mL syringes of the Banzel into two clean, dry 20mL syringes
    3. Draw up an additional 5mL of Banzel into a 5mL syringe
      • Total Banzel = 45mL

  • Loratadine (Claritin)
    1. Place one tablet (10mg) of Loratadine into an empty, clean, dry 20mL syringe
    2. Draw up water (at least 15mL) into syringe
    3. Tilt the syringe with the tip up, and push out the air
    4. Set aside the syringe so the Loratadine can dissolve

  • Vitamin D Liquid
    • Draw up 2½ mL into a clean, dry 5mL syringe

  • NovaFerrum (specially formulated iron supplement)
    1. Shake the bottle well
    2. Draw up 1 mL into a clean, dry 5mL syringe

  • Famotidine

    • → CAUTION: Alternate Famotidine every other month with Lansoprazole. Famotidine is administered after your patient's morning feeding, with the other medications. In contrast, note that Lansoprazole is administered just before the morning feeding. If it is a month to give Lansoprazole, DO NOT give Famotidine — see note above… ←

    [NOTE: Famotidine is in powder form when it comes from the pharmacy. Every time you open a fresh bottle, it must be reconstituted before dispensing. Use fresh, filtered water and a 20mL syringe that has not been used previously. Open the Famotidine bottle and put a total of 46mL of water into it. Close the cap and shake thoroughly. It is ready to use.]


    1. Shake the bottle well
    2. Draw up 5 mL into a clean, dry 5mL syringe

  • Fluticasone nasal spray
    1. Swirl, do not shake
    2. Tilt your patient's head forward so the spray bottle stays between 0° and 45° upright
    3. Give two sprays in each nostril
    4. Gently massage your patient's sinuses adjacent to your patient's nose, under your patient's eyes

  • Tobradex ophthalmic ointment
    1. Gently pull down just below your patient's left eye to expose the inside of your patient's eyelid
    2. Squeeze the tube so about ¼ inch of Tobradex ointment comes out on the inside skin of your patient's eyelid — not your patient's eyeball
    3. Allow the eyelid to close
    4. Dab excess off your patient's outside skin with a clean, dry washcloth

  • Clotrimazole (LOTRIMIN) 1% cream
    • For fungus on toes
    • Apply 1 application topically two times a day
Replace split gauze on G-tube stoma
  1. Tear the tape that secures the gauze and dispose of it
  2. Check to make sure the site is clean
    • If it needs cleaning, use only water on a clean washcloth
  3. Apply a clean split gauze
  4. Apply a short strip of paper medical tape across the split on the front of the gauze
  5. Fold half the tape over the split and press firmly on the back of the gauze

Evening Medications — Daily

Between 7:00 and 8:00 pm
  • Abilify 30mg tablet — ½ tab — the ½ tabs of Abilify are placed into a separate medication bottle the night before, when the Abilify tabs are split for the evening medications
    1. Place the ½ tab of Abilify into a clean, dry 20mL syringe
    2. Draw up water (at least 15mL) into the syringe
    3. Tilt the syringe with the tip up, and push out the air
    4. Set aside the syringe so the Abilify can dissolve

  • Melatonin

    • → CAUTION: Watch carefully the type of tablet you’re using. There are some that are 5mg tabs, where you’ll need two of them and you’ll need to crush them. The other type is 10mg, and is a quick-dissolving tablet. ←


    1. If you are using the 5mg Melatonin tabs, crush and place two of them in a clean, dry 20mL syringe
    2. Draw up water in the syringe and shake
    3. Tilt the syringe with the tip up, and push out the air
    4. Set aside to allow it to dissolve
    5. For the 10mg quick-dissolving tabs, place one Melatonin tab in a clean, dry 20mL syringe
    6. Draw up water and shake

  • Cough medicine — Guaifenesin (Robitussin, Siltussin, etc.)
    1. Draw up the Guaifenesin into one clean, dry 20mL syringe
    2. Draw up the Guaifenesin into an additional 10mL syringe

  • Vimpat (Lacosamide)
    1. Draw up 20mL of the Vimpat into a clean, dry 20mL syringe
    2. Draw up 10mL additional Vimpat into a clean, dry 10mL syringe
      • Total Vimpat = 30mL

  • Banzel (Rufinamide)
    1. Shake the bottle well
    2. Draw up two 20mL syringes of the Banzel into two clean, dry 20mL syringes
    3. Draw up an additional 5mL of Banzel into a 5mL syringe
      • Total Banzel = 45mL

  • Clonazepam compound suspension (keep refrigerated)
    1. Shake bottle well
    2. Draw up 6mL in the Clonazepam in a clean, dry 10mL syringe

  • Pregabalin
    1. Open one Pregabalin capsule and empty into a clean, dry 20mL syringe
    2. Draw up water in the syringe and shake
    3. Set aside to dissolve

  • Duloxetine (Cymbalta)

    • → CAUTION: It’s recommended that you give Duloxetine last, since it has to be administered immediately after it is dispensed. Do not let it sit. ←


    1. Draw up 10-15mL of applesauce in a clean, dry 20mL syringe
    2. Place the syringe on its side so the applesauce is lower than the syringe tip
    3. Pull out the plunger
    4. Open one capsule of Duloxetine and empty into the applesauce in the syringe
    5. Keeping the air still in the syringe, shake the syringe in all directions to evenly distribute the Duloxetine beads
    6. Tilt the syringe with the tip up, and push out the air
    7. Administer immediately – do not allow this mixture to sit
      • Push through the extension very slowly so it doesn’t clog
      • If it starts to clog, gently pull the plunger back a little, then slowly push again
    8. Flush with water or apple juice

    • Clotrimazole (LOTRIMIN) 1% cream
      • For fungus on toes
      • Apply 1 application topically two times a day
Replace split gauze on G-tube stoma
  1. Tear the tape that secures the gauze and dispose of it
  2. Check to make sure the site is clean
    • If it needs cleaning, use only water on a clean washcloth
  3. Apply a clean split gauze
  4. Apply a short strip of paper medical tape across the split on the front of the gauze
  5. Fold half the tape over the split and press firmly on the back of the gauze

Intervention Medications

  • Acetaminophen (Tylenol)
    1. Learn your patient's signals for pain, and respond with Acetaminophen when needed
    2. Allow at least four hours between doses
    3. Draw up 20mL of Acetaminophen in a clean, dry 20mL syringe

  • Oxycodone 5 mg/5 mL solution
    • Learn your patient's signals that show he has continuing pain, even after Acetaminophen (Tylenol) as a first step
    • 2.5-7.5 mL (2.5-7.5 mg total) by gastric tube route every eight hours as needed for pain not controlled by Acetaminophen (Tylenol)
    • Take 2.5 ml for pain rated 4-6
    • Take 5 ml for pain rated 7-10

  • Simethicone (Gas-X) 125mg tablets
    1. Learn to recognize your patient's signs of having pain from gas pressure
    2. Administer after giving food via G-tube
    3. Use 1-2 tablets, depending on your patient's level of discomfort
    4. Crumble the medicine thoroughly into a small spoon
    5. Transfer the crumbled medicine into a clean, dry 20mL syringe
    6. Draw water into the syringe and shake vigorously
    7. Shake as you inject gradually into the Y-port g-tube extension

  • Sumatriptan (IMITREX) 20 mg/actuation nasal spray
    • Learn your patient's signals that show your patient's early signs of a potential migraine
    • Administer 1 spray (20 mg total) into one nostril as needed for migraine
    • May repeat dose once in 2 hours if the migraine is unresolved
    • Do not exceed 40mg in 24 hours

  • Ondansetron (Zofran)
    1. Learn your patient's signals for nausea caused by difficulty processing your patient's own secretions
    2. Usually best if administered as soon as he has trouble swallowing or coughing up secretions
      • When this happens, your patient makes gagging sounds
    3. Draw up 5mL of Ondansetron in a clean, dry 5mL syringe

  • Clindamycin skin ointment
    1. When acne is observed, apply this ointment
    2. Alternate from day to day with the Adapalene, below

  • Adapalene skin ointment
    1. When acne is observed, apply this ointment
    2. Alternate from day to day with the Clindamycin, above

  • Glycerin suppository 2g
    • Insert 1 suppository (2g total) into the rectum daily
    • Follow instructions for having a BM on the toilet, explained in Toileting

  • Budesonide
    1. Administer Budesonide in a nebulizer at the first signs of lung congestion/wheezing
    2. Do not use for upper airway congestion
    3. Limit use to one day of early intervention, and switch to Levalbuterol if symptoms persist

  • Levalbuterol (Xopenex)

    • → CAUTION: Do NOT use Albuterol. Your patient is allergic to it. Levalbuterol is a different medication, and is safe to use. ←


    1. Administer Levalbuterol in a nebulizer if lung congestion/wheezing persist after the early intervention with Budesonide
    2. If symptoms persist or get worse after one day, consult Mayo Clinic pulmonology

  • Optional — Sodium Chloride Inhalation Solution, USP 0.9%
    • In cases of mild respiratory problems, or prophylactically
      • 1 vial exclusively in nebulizer for therapeutic effect
    • In cases of moderate to severe respiratory problems
      • Add Sodium Chloride to Levalbuterol in nebulizer treatment

  • Ciprodex ear drops
    1. Ciprodex ear drops are to be used only as ordered by a doctor, after careful examination of your patient's eardrums and ear canals by a trained professional — a doctor or nurse
    2. Ciprodex ear drops are kept in stock at home to ensure their availability in case a doctor or nurse orders them
    3. Carefully follow the directions on the label

  • Nayzilam (Midazolam) nasal spray

    • → CAUTION: Nayzilam is an emergency seizure medication, used only for seizure emergencies. Learn and practice its use. Do not use except in case of seizure emergency. ←




[NOTE: Regularly check the refill dates on all medications that are most often used. If the date is within one week, then call and refill the prescription. For more information, see the Care Contacts.]


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