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Basic Pharmacology

Welcome to NUR 106 Basic Pharmacology For Nurses

Instructor: M Kroning, RN MSN

Basic Pharmacology For Nurses


Welcome to NUR 106 Instructor: Maureen Kroning, RN MSN Office: Ext: 4707 Office location: Academic II Rm: 2305 Office hours: Wed 1-6pm

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Slide 2

Basic Pharmacology For Nurses


Text book: Authors : Clayton, Stock and
Harroun 14th Edition

Chapters:
1,2,3,7,8,9,10,11,12,14,16,20,23,25,27,29,30, 33,34,35, 36, 42,46,48

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Slide 3

NUR 106: Course Schedule



1/24: 1/31: 2/7: 2/14: 2/21: 2/28: 3/7: 3/14: Ch: 1,2 Ch: 3,7,8 Ch: 9, 10 Exam 1 Ch: 11,12, 14 Ch: 16,20,23 Ch: 25,29 Exam 2

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Slide 4

NUR 106: Course Schedule Contd


3/21: 3/28: 4/4: 4/11: 4/18: 4/25: 5/2: 5/9:
Ch: 30,33 Ch: 34,35 No Classes 27,36 Exam 3 Ch: 42, 46 Ch: 48 Last Day of Class- Exam 4

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Slide 5

Chapter 1
Definitions, Names, Standards, and Informational Sources Foundations of Pharmacology

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Slide 6

Types of Drug Names:


Chemical Generic Official Trademark (brand) Proprietary

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Slide 7

CHEMICAL NAME

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Slide 8

Sources of Drug Information



American Drug Index American Hospital Formulary Service Drug Interaction Facts Drug Facts and Comparisons Handbook on Injectable Drugs Handbook of Nonprescription Drugs MartindaleThe Complete Drug Reference Package inserts Natural Medicines Comprehensive Database Physicians Desk Reference (PDR) Nursing journals
Slide 9

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Sources of Patient Information

United States Pharmacopeia Dispensing


Information (USPDI)

Therapeutic Choices

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Slide 10

U.S. Drug Legislation

Federal Food, Drug, and Cosmetic Act (1938,


1952, 1962)

Controlled Substances Act (1970)

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Slide 11

Foundations of Pharmacology
Drug review process

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Slide 12

Chapter 2
Principles of Drug Action and Drug Interactions

Mosby items and derived items 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 1

Basic principles
A strong understanding of the human bodys processes are important to grasp drug actions and drug interactions in the body

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Slide 14

Examples:
Antagonistbeta blockers

Agonistepinephrine

Partial agonistpentazocine

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Slide 15

Drug Stages After Administration


Absorption Distribution Metabolism Excretion

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Slide 16

Categories of Drug Administration


Enteral route: PO, Rectal, NG Parenteral route: subQ, IM, IV Percutaneous route: inhalation, sublingual,
topical

HalfHalf-life of Drugs

Factors modifying the


quantity of drug reaching a site of action after a single oral dose

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Slide 18

Terms used in relationship to medications


Desired action Side effects/ Adverse effects Allergic reactions: i.e. hives, urticaria Idiosyncratic reactions Carcinogenicity Teratogen
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Slide 19

Principles of Drug Action and Drug Interactions


Desired effect: when a drug enters a patient,
is absorbed and distributed, and produces the expected response

Adverse effect: Any noxious, unintended and


undesired effect of a drug, which occurs at d i d ff t f d hi h t doses used in humans for prophylaxis, diagnosis or therapy (World Health Organization)

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Slide 20

Principles of Drug Action and Drug Interactions (contd)


Drug interaction
Drug interactions represent 3% to 6% of preventable in-hospital adverse drug reaction cases Drug interactions are a major component of the number of hospital emergency department visits and admissions

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Slide 21

Factors Influencing Drug Action



Age Body weight Metabolic rate Illness Psycological aspects Tolerance Drug dependence Cumulative effect

Chapter 3
Drug Action Across the Life Span

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Slide 23

Drug Action Across the Life Span


Age and gender affect drug therapy Gender-specific medicine
A developing science th t studies th d l i i that t di the differences in the normal function of men and women and how people of each sex perceive and experience disease

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Slide 24

Across The Life Span



Age <38 weeks 0-1 month 1-24 months 1-5 years 6-12 years 13-18 years 19-54 years 55-64 years 65-74 years 75-84 years 85+ years

Title of Stage Premature Newborn, neonate Infant, baby Young child Older child Adolescent Adult Older adult Elderly The aged The very old

Drug Action Across the Life Span


In nearly every body system, men and women function differently Men and women perceive and experience disease differently Fundamental questions remain about how humans function and the effect of disease on function Pharmacogenetics Polymorphisms
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Slide 26

Drug Absorption: Age Considerations


Special considerations for pediatric and older
adult patients
Differences in muscle mass, blood flow, and inactivity affect medicines given intramuscularly Topical and transdermal administration differs in the very young and the very old

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Slide 27

Drug Absorption: Age Considerations


Topical administration in infants is effective
because:
Outer layer of skin (stratum corneum) not fully developed de eloped Skin more fully hydrated; plastic diaper increases skin hydration Inflammation (diaper rash) increases absorption
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Slide 28

Drug Absorption: Age Considerations


Difficult to predict in geriatric patients
Dermal thickness decreases with age and may enhance absorption Drying, wrinkling, and decreased hair follicles decrease absorption Decreased cardiac output and diminishing tissue perfusion also affect absorption

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Slide 29

Drug Absorption: Age Considerations


Gastrointestinal absorption influenced by:
Gastric pH Gastric emptying time Enzymatic activity Blood flow of mucous lining and intestines

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Drug Absorption: Gender Considerations


Increased potential for toxicity and slower
absorption times in women
Empty solids more slowly Have greater gastric acidity Have lower gastric levels of alcohol dehydrogenase needed to metabolize alcohols

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Slide 31

Drug Distribution
Depends on pH, body water concentrations,
presence and quantity of fat tissue, protein binding, cardiac output, and regional blood flow

I f t have larger volume of water content Infants h l l f t t t


and require higher dose

With age, total body water decreases and fat


increases

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Slide 32

Drug Distribution
Highly fat-soluble drugs take longer to act
and accumulate in fat tissues, increasing potential for toxicity

P Protein bi di i binding
Drugs that are relatively insoluble are transported in circulation by binding to plasma proteins

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Drug Distribution
Age considerations Some drugs have lower protein binding in
neonates and require larger loading dose

Albumin levels decrease with age


Gender considerations Some differences between men and
women in globulin proteins

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Slide 34

Drug Metabolism
Drug metabolism
Process by which the body inactivates medicine Affected by genes, diet, age & maturity of enzyme systems Liver weight and hepatic blood flow decrease with age

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Slide 35

Routes of Medication Excretion


Primary Routes

Renal tubules: into the urine GI tract: through feces


Minor Routes

Evaporation: through skin Exhalation: from the lungs Secretion: in saliva & breast milk

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Drug Excretion
Metabolites of drugs (and sometimes the
drug itself) eventually excreted

Preterm infant has 15% of adult renal


capacity; fully functional by 9 to 12 months

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Slide 37

Drug Excretion (contd)


Decreased renal function with age No prediction of renal function can be based
y g solely on age because of wide individual variation in changes

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Slide 38

Percentages of Body Water

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13

Therapeutic Drug Monitoring


Entails measurement of a drugs
concentration in biologic fluids to correlate the dosage administered and the level of medicine in the body with the pharmacologic response

Timing of drugs administration and collection


of specimen are crucial to accurate interpretation

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Slide 40

Use of Monitoring Parameters


Before administering medicine, assess
expected therapeutic actions, side effects, reportable adverse effects, probable drug interactions

Monitoring parameters related to patients


age

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Slide 41

Monitoring Parameters: Pediatric Patients


Infants and young children more susceptible
to dehydration

Weight variation affects dosage g g Aspirin never to be administered to children Allergic reactions occur rapidly in children,
most commonly to antibiotics
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Monitoring Parameters: Older Adult Patients

Factors that place older patient at risk:


Reduced renal and hepatic function Chronic illness Polypharmacymultiple-drug therapy required by chronic illness A greater likelihood of malnourishment due to polypharmacy
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Slide 43

Monitoring Parameters: Older Adult Patients

Drug therapy
Take thorough drug history and nutritional assessment Determine whether new symptoms have y p been induced by existing medicines Gradually taper dosage when discontinuing drug Start at one third to one half normal dosage when initiating therapy; gradually increase Review regimen periodically
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Slide 44

Potentially Inappropriate Medications for Older Adult Patients

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Use of Monitoring Parameters: Pregnant Women


Avoid drugs if at all possible When taking womans history, be alert to
possibility of pregnancy

I Instruct patient to avoid d i id drugs, alcohol, l h l


tobacco

Try nonpharmacologic treatments before


using medicines

Avoid herbal medicines


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Slide 46

Drugs Known to Be Teratogenic

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Slide 47

Use of Monitoring Parameters: BreastBreast-Feeding Patients


Some drugs are known to enter breast milk
and harm nursing infant

Discuss all medications with physician Take medicine immediately after breastfeeding or just before infants longest sleeping period

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16

Chapter 7
Principles of Medication Administration

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Slide 49

Legal and Ethical Considerations


Standards of care: developed by the states
nurse practice act, state and federal law, JCAHO, professional organizations Before administering medication, nurse must have:
Current license t practice C t li to ti Clear policy statement authorizing the act Signed medication order Understanding of rationale for drug use Understanding of drug action, dosing, dilution, route and rate of administration, side effects, adverse effects to report, contraindications
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Slide 50

Contents of Patient Charts



Summary sheet Consent forms Physicians order form History and physical exam form Progress notes P t Critical pathways Nurses notes Laboratory tests record

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Contents of Patient Charts



Graphic record Flow sheets Consultation reports Other diagnostic reports Medication administration record (MAR) or medication profile PRN or unscheduled medication record Case management Patient education record

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Slide 52

Legal and Ethical Considerations


Standards of care: developed by the states
nurse practice act, state and federal law, JCAHO, professional organizations Before administering medication, nurse must have:
Current license t practice C t li to ti Clear policy statement authorizing the act Signed medication order Understanding of rationale for drug use Understanding of drug action, dosing, dilution, route and rate of administration, side effects, adverse effects to report, contraindications
Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 53

Contents of Patient Charts



Summary sheet Consent forms Physicians order form History and physical exam form Progress notes Critical pathways Nurses notes Laboratory tests record

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Contents of Patient Charts (contd)



Graphic record Flow sheets Consultation reports Other diagnostic reports Medication administration record (MAR) or medication profile PRN or unscheduled medication record Case management Patient education record

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Slide 55

The Kardex

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Slide 56

Drug Distribution Systems


Floor or ward stock system Individual prescription order system C Computer-controlled di t t ll d dispensing system i t Unit dose system Long-term care unit dose system
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Narcotic Control Systems

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Slide 58

The Drug Order Stat order


Standing order Renewal order PRN order Verbal orders Electronic transmission of patient orders
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Slide 59

Medication Errors
Prescribing errors Transcription errors Dispensing errors Administration errors Monitoring errors

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Nurse Responsibilities
Verification
Nurse makes professional judgment regarding acceptability and safety of the drug order, including type of drug, dose and dose preparation, therapeutic intent, route, potential allergic reactions, or contraindications

Transcription
Nurse is responsible for verification of orders transcribed by others

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Slide 61

The Six Rights


1. Right drug
Compare exact spelling and concentration of drug with medication card and drug container; drug label should be read three times

2. Right time g
Standard abbreviations Standardized administration times Maintenance of consistent blood levels Maximum drug absorption Diagnostic testing PRN medications
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Slide 62

The Six Rights (contd)


3. Right dose
Abnormal hepatic or renal function Nausea and vomiting Accurate dose forms Accurate calculations Correct measuring devices

4. Right patient
Bracelet checking Pediatric and older adult patients

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Slide 63

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The Six Rights 5. Right route


IV route Intramuscular route Intravenous route Subcutaneous route Oral route

6. Right documentation
Safety/ethical considerations Legal considerations Always include date/time, drug name, dose, route, site of administration
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Slide 64

Special Documentation Circumstances


Patient refuses medication
Thoroughly record incident and reason for refusal in nurses notes Notify physician

Medication error occurs


Notify physician Complete incident report

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Slide 65

Chapter 8
Percutaneous Administration

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Percutaneous Administration Application of medications to the skin or


mucous membranes for absorption

Includes:
Topical application of ointments, creams, lotions, lotions or powders to the skin Inhalation of aerosolized liquids or gases Installation of solutions into the mucous membranes of the mouth, eye, ear, nose, or vagina

Always follow the six rights of drug


administration
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Slide 67

Percutaneous Administration
Premedication assessment and explanation Patient teaching
Hygiene requirements Proper application techniques and timing Cautions particular to drug or drug administration Side effects When to contact physician

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Slide 68

Percutaneous Administration
Documentation
Date, time, drug, dosage, route Record ongoing assessment data, including signs of adverse drug effects

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Creams, Lotions, Ointments Wash hands, put on gloves, position patient


Clean area Wear gloves Shake lotion bottle; use tongue blade to
remove desired amount of ointment or cream from container

Use dressings according to orders


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Slide 70

Patch Testing Method to identify sensitivity to contact


materials (soaps, pollen, dyes)

Allergens on patch placed in contact with


back, arms, or thighs

Patch left in place for 48 hours Site aired for 15 minutes, then read Emergency equipment must be available in
case of anaphylactic response
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Slide 71

Patch Testing
Wash hands, put on gloves,position patient Clean the area Wear gloves g Apply dose-measuring applicator paper Do not rub in ointment Cover area with plastic wrap
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Transdermal Drug Delivery Disk or patch providing controlled release of


medication

Wash hands,put on gloves,position patient Apply topical disk or patch Application frequency depends on drug Wash hands after application Label disk with time, date, nurse initials
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Slide 73

Topical Powders
Particles of medication in a talc base Wash hands, put on gloves Position the patient Wash and thoroughly dry area Apply powder, smooth over area for even
coverage
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Slide 74

Sublingual and Buccal Tablets


Sublingual tablets: placed under the tongue Buccal tablets: held in the buccal cavity Advantage: rapid absorption and onset of
action

Action is usually systemic, rather than


localized to the mouth

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Eye Drops, Ointments, and Disks


OD (right eye), OS (left eye), OU (both eyes) Wash hands, put on gloves,position patient Inspect affected eye Expose lower conjunctival sac Approach eye from below Never touch eye with dropper, tube
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Slide 76

Ear Drops Ensure ear is clear of wax


Warm medication to room temperature Younger than age 3: pull earlobe downward
and back

Older than age 3 and adults: pull earlobe


upward and back

Patient should remain on side for a few


minutes
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Slide 77

Nose Drops, Nasal Spray


Patient should blow nose gently Nose drops
Position patient lying down with head hanging back

Nose spray
Patient is upright Block one nostril Shake bottle and insert tip into nostril Spray while patient inhales

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Nebulizers and Inhalers


Nebulizers
Prepare medication and fill nebulizer Patient exhales Put nebulizer in mouth; do not seal completely Patient inhales

Metered-dose inhalers
Follow instructions on inhaler

Dry powder inhalers


Follow instructions on inhaler

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Slide 79

Vaginal Medications
Wash hands, put on gloves Fill applicator Place patient in lithotomy position, elevate
hips with pillow

Spread labia and insert applicator or p pp


suppository

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Slide 80

Chapter 9
Enteral Administration

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Administration of Oral Medications


Enteral is direct administration to the GI tract Most drugs are available in oral dose forms:
Capsulessmall, cylindrical gelatin containers used to administer unpleasant tasting medications; timed-release capsules (provides a gradual and continuous release of the drug); lozenges or trochesflat disks in a flavored base Tablets (powdered drugs that have been compressed) Elixirsdrugs dissolved in water and alcohol Emulsions of water-in-oil or oil-in-water Liquid suspensions and syrups
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Slide 82

Administration of Oral Medications


Common methods used to administer oral
medications
Unit dose packaging providing a single dose Souffl cups Medicine cups Medicine droppers Teaspoons Oral syringes: plastic syringes calibrated and used to measure liquid medications Nipples with additional holes, used for infants

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Slide 83

Administration of Solid-Form SolidOral Medications


Two techniques for administering medications:
the medication card and unit dose distribution

Perform premedication assessment in all cases All techniques follow FIVE RIGHTS procedure:
RIGHT patient RIGHT drug RIGHT route of administration RIGHT dose RIGHT time of administration

ALWAYS check or recheck the FIVE RIGHTS


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Slide 84

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Administration of Solid-Form SolidOral Medications


General principles apply to all distribution systems
Give the most important medications first Do not touch the medication with your hands Encourage liquid intake to ensure swallowing Remain with patient while medication is taken; DO NOT leave the medication at bedside unless an order to do so exists Discard the medication container

Provide complete documentation of administration


and responses to therapy
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Slide 85

Administration of Solid-Form SolidOral Medications


Documentation of medication administration and
responses to drug therapy is called the Sixth Right

General principles apply to all medication


administration
Chart date, time, drug name, dosage, and route of administration d i i t ti Regularly record patient assessments to evaluate therapeutic effectiveness Chart and report any sign of adverse drug effects

Perform and validate essential education about drug


therapy and other aspects of intervention for the individual
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Slide 86

Administration of Liquid-Form LiquidOral Medications


General procedures are the same as with
solid-form oral medications

Perform premedication assessment in all


cases

All techniques follow the FIVE RIGHTS


procedure

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Administration of Liquid-Form LiquidOral Medications (contd)


General principles for infants, children, and
adults
Give adults and children the most important medications first NEVER dilute medications without specific orders. DO NOT leave a medication at the bedside without an order to do so Check an infants ID and be certain the infant is alert

Provide complete documentation of


administration and responses to therapy
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Slide 88

Administration of Liquid-Form LiquidOral Medications


Measuring techniques vary according to
receptacle used

With a measuring cup:


Cover label to prevent smearing; place fingernail at exact level on measuring cup; read the volume at the level of meniscussee Figure 9-13. Recheck FIVE RIGHTS.

With an oral syringe:


Select syringe of appropriate size. Draw up prescribed volume of medication from bottle or medicine cup
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Slide 89

Administration of Medications by Nasogastric Tube


Drugs are administered via NG tube for
specific patients, using a liquid form whenever possible. Remember:
Always flush the tube before and after administration Perform premedication assessment p Assemble equipment before administration

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Administration of Medications by Nasogastric Tube (contd)


Prepare doses as for administration of solidform or liquid-liquid form oral medications

Three methods for checking NG tube location Follow procedure for administering
medication di i

DO NOT attach suction for 30+ minutes Provide complete documentation of


administration and responses to therapy

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Slide 91

Administration of Enteral Feedings via Gastrostomy of Jejunostomy Tube


Enteral formulas are in several mixtures to
meet individual needs

Assemble equipment beforehand Prescribed enteral formula should be


checked

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Slide 92

Administration of Enteral Feedings Via Gastrostomy or Jejunostomy Tube (contd)

Formula should be fully labeled Discard unused formula every 24 hours Follow the guidelines specific for patients
receiving general nutrition via intermittent or continuous feedings Follow FIVE RIGHTS
RIGHT patient, RIGHT drug (formula), RIGHT route of administration, RIGHT dose (amount, dilution, strength), RIGHT time

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Administration of Enteral Feedings via Gastrostomy or Jejunostomy Tube (contd)

Verify tube placement and initiate feeding Flush, then clamp tube Proceed with tube feeding technique
Intermittent: use Toomey syringe y y g Continuous: use disposable feeding container and enough formula for a 4-hour period

Provide complete documentation of


administration and responses to therapy

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Slide 94

Administration of Rectal Suppositories


Suppositories are solid medication designed
to dissolve inside a body orifice

Equipment is simple:
Finger cot or disposable glove Water-soluble lubricant Prescribed suppository P ib d it

Perform standard premedication assessment

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Slide 95

Administration of Rectal Suppositories (contd)


Technique begins with FIVE RIGHTS
Explain procedure and check pertinent parameters Patient bends uppermost leg Apply lubricant t ti of suppository. Pl A l l bi t to tip f it Place suppository about 1 inch beyond orifice, past internal sphincter

Provide complete documentation of


administration and responses to therapy

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Administration of a Disposable Enema


The dose form will be a prepackaged,
disposable-type enema solution

Equipment is simple Perform standard premedication assessment

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Slide 97

Administration of a Disposable Enema (contd)


Technique begins with FIVE RIGHTS
Explain procedure and check pertinent parameters Time of last defecation Patient b d P ti t bends uppermost leg tl Apply lubricant to rectal tube Insert lubricated tube and insert solution

Provide complete documentation of


administration and responses to therapy

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Slide 98

Parenteral Administration
Parenteral means drug administration by any
route other than the gastrointestinal tract

Parenteral route
Intradermal Subcutaneous Intramuscular (IM) Intravenous (IV)

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Chapter 10
Parenteral Administration: Safe Preparation of Parenteral Medications

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Slide 100

Equipment Used in Parenteral Administration


The syringe has three parts: barrel, plunger,
and tip

Syringes are calibrated in minims, milliliters,


or cubic centimeters

Tuberculin syringes are used to measure


small volumes of medication accurately ll l f di ti t l

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Slide 101

Equipment Used in Parenteral Administration (contd)


The insulin syringe has a special scale for
measuring insulin

In the United States, insulin is manufactured


in U-100 concentration
The U-100 syringe holds 100 units of insulin per milliliter Low-dose insulin syringes are used for patients receiving 50 units or less of U-100 insulin

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Equipment Used in Parenteral Administration (contd)


Prefilled syringes are disposable and have a
premeasured amount of medication
Advantages: time saved in preparation, less chance of contamination h f t i ti Disadvantages: additional expense, different holders for different cartridges, volume of second medication limited

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Slide 103

Equipment Used in Parenteral Administration (contd)


The needle has three parts:
Hub Shaft Beveled tip

The needle gauge is the diameter of the hole


through the needle

Needle selection depends on age of patient,


and site (subcutaneous, IM, or IV)see Table 10-1
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Slide 104

Equipment Used in Parenteral Administration (contd)


Major safety development: needleless
systems
Provide an alternative to needles for routine procedures, reducing the risk of needlesticks with contaminated sharps

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Equipment Used in Parenteral Administration (contd)


Other safety devices have been developed
BD Safety-Lok Syringe BD SafetyGlide Shielding Hypodermic Needle BD SafetyGlide Syringe Tiny Needle Technology BD Integra Syringe

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Slide 106

Parenteral Dose Forms


Ampules
Glass containers usually containing a single dose

Vials
Glass containers that contain one or more doses

Mix-O-Vials
Glass containers with one dose, two compartments
Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 107

Preparation of Parenteral Medication


Equipment needed for preparation of
parenteral medications
Drug in sterile, sealed container Syringe of the correct volume Needles of the correct gauge and length Needleless access device Antiseptic swab MAR or medication profile

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 108

36

Preparation of Parenteral Medication


Techniques for preparing all parenteral
medications
Use the five RIGHTS: Right Patient, Right Drug, Ri ht R t of Ad i i t ti D Right Route f Administration, Ri ht Right Dose (Amount and Concentration), Right Time of Administration Check the drug dose form ordered against the source you are holding

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 109

Preparing a Medication from an Ampule


Move solution to the bottom of the ampule Cover the ampule neck with a sterile gauze
pledget or antiseptic swab while breaking off top

Using an aspiration needle, withdraw


medication from ampule

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 110

Preparing a Medication from an Ampule


Remove the needle from the ampule and
point the needle vertically

Pull back the plunger. Replace the aspiration


needle with a new sterile needle

Push plunger until medication is at tip of


needle

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

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37

Preparing a Medication from a Vial


Cleanse the top of the vial of diluent Pull plunger of syringe to fill with an amount
of air equal to the volume of the solution to be withdrawn

Insert the needle or needleless access device


through the diaphragm, inject air

Withdraw the measured volume of diluent


required to reconstitute the powdered drug
Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 112

Preparing a Medication from a Vial


Tap the vial of powdered drug to break up
caked powder; cleanse the rubber diaphragm with swab

Insert the needle or needleless access device


in the diaphragm and i j t th dil i th di h d inject the diluent i th t in the powder

Mix thoroughly to dissolve powder Change needle to correct gauge and length
to administer the medication to the patient
Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 113

Preparing a Medication from a MixMix-O-Vial


Tap the container a few times to break up the
caked powder

Remove the plastic lid protector Push firmly on the diaphragm-plunger Mix thoroughly Cleanse the rubber diaphragm and remove
drug using syringe to administer to patient
Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 114

38

Special Preparations
Occasionally two medications may be drawn
into the same syringe for a single injection

M di ti Medications need t b prepared f use i d to be d for in


the sterile field during a surgical procedure

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Slide 115

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