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Medicationpart1 110202192115 Phpapp02 PDF
Medicationpart1 110202192115 Phpapp02 PDF
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
NURSING SKILLS
Medication
Liquid
Elixir medication in a clear liquid containing
water, alcohol, sweeteners & flavor.
Syrup medication combined in a water & sugar
solution.
Suspension finely divided, undissolved
particles in liquid medium that needs to be
shaken before use.
Solution a drug dissolved in another substance.
MEDICATION
FUNCTIONS OF THE NURSE
Semi-Solid
Ointment semi-solid preparation containing a
drug to be applied externally.
Liniment medication mixed with alcohol, oil
or soap, which is rubbed on skin.
Lotion drug particles in a solution for topical
use.
Suppository easily melted medication
preparation in a firm base such as gelatin that is
inserted in the body.
Drug Effects
Primary (Therapeutic)
Intended Effect of the drug.
FIVE RIGHTS
The Right Drug with
The Right Dose through
The Right Route at
The Right Time to
The Right Patient
Right Recording & Documentation
Right Approach
Right Frequency
Right to Refuse
Right Education
Right Assessment
Right Evaluation
The Right Drug
Name
Generic Name
Trade Name
Preparation
Solid
Capsule powder or gel form of an active drug
enclosed in a gelatinous container, may also be
called liquigel.
Pill Mixture of a powdered drug with a
cohesive material; may be round or oval.
Foundations of Nursing
Medication
Secondary (Side-Effect)
Not intended effect of the drug
Allergy
Rapidly-developing reaction.
Signs & Symptoms may appear on the skin,
respiratory system or the GIT.
Anaphylactic Reaction life-threatening
reaction that may result in respiratory distress,
severe bronchospasm, tachycardia, hypotension
& cardiovascular collapse. May be treated by
epinephrine, bronchodilators & antihistamines.
Symptoms & signs of allergy to drugs:
Fever
Diarrhea GIT
Urticaria Local Effect
Rash Local Effect
Nausea GIT
Vomiting GIT
Toxicity
Overdose taking in a lethal dose of medication.
Cumulative Effect
The body cannot metabolize one dose of the
drug before another dose is administered.
The drug is taken in more frequently than it
is excreted & each new dose increases the
total quantity in the body.
May cause permanent damage to the
kidneys or liver.
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
Iatrogenic Effect
The drug produces a disease condition.
Examples: Chloramphenicol, which is taken for
Typhoid Fever, may cause Depression of the Bone
Marrow functions, such as Anemia,
Thrombocytopenia, Neutropenia,
Idiosyncratic Effect
It is the unexpected peculiar response to drug,
either over response, under response, different
response than expected.
Unexplained response
Drug Interaction
Effects of one drug are modified by the prior on
concurrent administration of another drug. Thereby
increasing or decreasing the pharmacological effect.
Drug Antagonism
Conjoint effect of two drug is less than the effect of
drug acting separately
Drug Summation
The combined effect of two drugs produces a result
equals the sum of the individual effects of each agent.
Drug Synergism
The combined effects of drugs is greater than the sum
of each individual agent acting independently
Drug Potentiation
The concurrent administration of two drugs in which
one drug increases the effect of the other drug.
Drug Tolerance
A decreased physiologic response to the repeated
administration of a drug or chemically related
substance.
Excessive increase in the dosage is required in order
to maintain the desired therapeutic effect.
Drug Abuse
Inappropriate intake of a substance, either continually
or periodically.
Drug Dependence
It is persons reliance or a need to take a drug or
substance.
Intense physical or emotional disturbance is produced
if drug is withdrawn.
Drug Addiction
It is due to biochemical changes in the body tissues,
especially the nervous system. These tissues come to
require the substance from normal functioning.
DRUG PREPARATIONS
1. Oral (Capsule, Pills, Tablets, Extended Release, Elixir,
Suspension, Syrup. )
2. Topical. Drug is applied directly to the body site, usually, the
skin or mucous membranes. ( Liniment, Lotions, Ointment,
Suppository, Transdermal Patch.)
3. Injectable. Introduction of medication into the body by a
syringe. ( Vials, Ampules, Pre-Filled Syringes. )
DRUG CLASSIFICATIONS
1. Body Systems
- Drugs that affect the bodily systems, such as the
Digestive System, Cardiovascular System, etc.
2. Symptoms Relieved
- Ex: Fever, Colds, Cough, etc.
3. Clinical Indication of the Drug
- Ex: Analgesic, Anti-Pyretic, Anti-Hypertensive.
PHARMACOKINETICS
- Study of the movement of drug molecules in the body.
Absorption.
Route of Administration.
Injected medications are usually absorbed more
rapidly than oral medications
Drug Solubility.
Liquid medications are absorbed more rapidly than
solid preparations, as liquid medications do not have
to be dissolved by the gastric juices.
pH.
Acidic drugs are well absorbed in the stomach.
Basic drugs remain ionized or insoluble in an acid
environment.
They can only be dissolved in the Small Intestines.
Drug Dosage.
A higher dose than the normal is usually given when a
patient is in acute distress and the maximum
therapeutic effect is desired as quickly as possible.
A maintenance dose is a lower dosage that becomes
the usual or daily dosage
Blood Flow.
Rich blood supply enhances absorption.
Pain
Stress
Drug Habituation
It is the emotional reliance on a drug to maintain a
sense of well being, accompanied by feelings of need
or cravings for drug.
DRUG NOMENCLATURE
Foundations of Nursing
Medication
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
Metabolism
Also called Biotransformation.
The breakdown of the drug to an inactive form.
The liver is the primary site for drug metabolism.
Physiologic changes or presence of a Liver disease
may complicate the process.
Factors That Affect Drug Metabolism
Age
Nutrition
Liver enzymes involved in metabolism rely on
adequate amount of amino acids, lipids, vitamins and
carbohydrates.
Insufficient amount of major body hormones
Distribution
After a drug has been absorbed into the bloodstream, it
is distributed throughout the body.
Drug accumulates in specific tissues for its action to
take place.
Distribution depends on the rate of perfusion and
capillary permeability to the drug.
Excretion
Plasma-Protein Binding
Medications connect with plasma protein in the
vascular system.
Clients with reduced plasma protein such as kidney or
liver disease could receive a heightened drug effect.
Volume Distribution
Client with edema has an enlarged area in which a
drug can be distributed and may need an increased
dose.
Barriers to Drug Distribution
Blood Brain Barrier
Placental Barrier
Obesity
Receptor Combination
A receptor is an area on the cell wall ( protein or
nucleic acid ) where drug attaches and response takes
place.
Agonist, drug will connect itself to the receptor site
and cause pharmacological response.
Foundations of Nursing
Medication
Renal Excretion
Carried out by glomerular filtration and tubular
secretion, which increases quantity of drug excreted.
Drugs
Probenecid, prevent the excretion of penicillin.
Antacid, prevent elimination of ASA
Blood Concentration Level
Half-Life
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
2. Weight
Expected responses to drugs are based largely on those
reactions that occur when the drugs are given thealthy
adults (18-65 years old, 150 lb.)
Drug doses for children are calculated by weight or
Body Surface Area.
3. Sex
6. Pathology
The presence of a disease may affect the drug action.
Pathologic conditions that involve the Liver may slow
themetabolism & alter the dosage of the drug needed
to reach a therapeutic level.
7. Environment
Sensory deprivation and overload may affect drug
responses.
Nutritional state may also affect the bodys reaction to
certain drugs.
8. Timing of Administration
The presence of food in the stomach delays the
absorption of orally administered medications.
MEDICATION ORDERS
Foundations of Nursing
Medication
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
Foundations of Nursing
Medication
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
Advantages
Most convenient
Usually less expensive
Safe, does not break skin
barrier
Administration usually
does not cause stress
Disadvantages
Inappropriate for client
with N & V
Drugs may have
unpleasant taste and odor
Inappropriate when GIT
has reduced motility.
Inappropriate if client
cannot swallow.
Cannot used before
certain diagnostic test or
surgical procedure
May discolor teeth, harm
tooth enamel.
May irritate gastric
mucosa.
Can possible aspirated.
1.
2.
PROCEDURE
Check medicine cards with
physicians order sheet or clients
chart for written orders or any
changes in the order.
Arrange the medicine cards in the
medication tray according to the
following:
o Location of the client
o Time of administration
o Condition of client (more
Foundations of Nursing
Medication
RATIONALE
Counter checking
prevents error in
medication
3.
4.
5.
6.
medications.
Handwashing
removes
microorganisms that
can cause infection.
Mixing liquid
medicine can reduce
concentration and
strength of the drug.
7.
Prevents spread of
infection
Advantages
Sublingual / Buccal
Most convenient
Usually less expensive
Safe, does not break skin
barrier
Administration usually
does not cause stress
Can be administered for
local effect
Disadvantages
Sublingual / Buccal
Inappropriate for client
with N & V
Drugs may have
unpleasant taste and odor
If swallowed, drug may
be inactivated by gastric
juice.
Drug must remain under
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
6.
7.
8.
9.
b)
Objectives
To provide an eye medication the client requires to
treat an infection or other reason.
Considerations
The eye is the most sensitive organ to which the nurse
applies medications. Care must be taken to prevent
instilling medication directly into cornea.
Instilling wrong concentration may cause local
irritation of the eyes as well as systemic effects
Equipment
Medication bottle with eye dropper or ointment tube
Cotton ball or tissue
Eye patch or tape (optional)
3.
PROCEDURE
Check medicine cards with
physicians order sheet or clients
chart for written orders or any
changes in the order.
Arrange the medicine cards in the
medication tray according to the
following:
a. Location of the client
b. Time of administration
c. Condition of client (more
serious clients are scheduled
last)
Wash your hands
4.
5.
2.
Foundations of Nursing
Medication
RATIONALE
Counter checking
prevents error in
medication
Eye Drops
11. Squeeze prescribed dose in the
eyedropper
12. Place a tissue below the lower lid
1.
Ensure correct
dosage
Cotton or tissue
absorbs medication
that escapes eye
Helps prevent
accidental contact of
dropper with eye,
thus reducing risk of
injury and transfer
of infection.
Prevents pressure
and trauma to
eyeball and prevents
fingers from
touching eye.
Prevent damage
directly to the
cornea. Reduces
stimulation of blink
reflex
Prevents overflow of
medication into
nasal passage and
possible systemic
effect.
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
Eye Ointment
17. Separate clients eyelids and grasp
lower lid, exert downward pressure
over the cheek.
18. Instruct patient to look up
19. Apply ointment along insidebedge
of the lower eyelid from inner to
outer canthus.
20. Wipe excess medication
1.
2.
Distributes
medication without
traumatizing eye
Promtes comfort and
facilitate cleanliness
3.
4.
5.
21.
22.
23.
24.
6.
Eye Irrigation
c)
7.
PROCEDURE
Check medicine cards with
physicians order sheet or clients
chart for written orders or any
changes in the order.
Arrange the medicine cards in the
medication tray according to the
following:
a. Location of the client
b. Time of administration
c. Condition of client (more
serious clients are scheduled
last)
Wash your hands
RATIONALE
Counter checking
prevents error in
medication
8.
Straightening of ear
canal provides direct
access to deeper
external ear
structures.
Forceful instillation
of medicine into
occluded canal can
cause injury to
eardrum.
Allows complete
distribution of
medication. Pressure
and massage moves
medication inward.
Equipment
Medication bottle with dropper
Cotton tipped applicator
Cotton ball
Foundations of Nursing
Medication
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
A.
Nasal Sprays
B.
Nasal Inhalers
Nasal Drops
d)
Nasal Medication
Nasal instillation ( nose drops ) usually are
instilled for their astringent effect .
Equipment
Medication bottle with dropper or spray container
Facial tissue
Foundations of Nursing
Medication
Vaginal Medication
Abejo
Nursing Skills
Medication
Prepared by: Mark Fredderick R. Abejo R.N, M.A.N
10
f)
Rectal Medication
Drugs administered rectally exert either a local or
systemic effect on the gastrointestinal mucosa.
Considerations
Rectal medication is a convenient and safe method of
giving certain medications but not as reliable as oral or
parenteral routes in terms of drug absorption and
distribution.
Improper placement can result in expulsion of the
suppository before medication dissolves and is
absorbed into the mucosa.
Never force a suppository into a mass of fecal
material. It may be necessary to administer a small
cleansing enema before a suppository can be inserted.
Do not cut the suppository into sections to divide the
dosage, the active drug may not be distribute evenly
within the suppository.
Foundations of Nursing
Medication
E.
Abejo