MEDICATION

King Saud University

College of Nursing
NUR 122
 Drug administration
Medication: substance administered for the
diagnosis, cure, treatment, or relief of a
symptom or for prevention of a disease.

 Medication or drugs are given to exert

specific physiologic effects on the body.

 They play an important role in preventing,

treating, and curing illness, their
administration has become one of the most
important, complex and risk-laden aspects
of nursing care.
 Routes of drug administration
 Oral: Per mouth
 Sublingual: under the tongue
 Buccal: against the cheek
 Pareneteral: IV, IM, SC, intradermal, intracardiac,
intrathecal,intrapleural, intraosseous
 Topical: skin, eyes, ear, nose, rectum or vagina.

 Effects: local, systematic.

 Medication are prescribe by physician.
 Medication order includes the name of the drug, the dose,
the route, frequency, date and time.
 Effects of Drugs
 Therapeutic effect = desired effect
– Reason drug is prescribed
 Side effect = secondary effect
– Unintended, usually predictable
– May be harmless or harmful
 Drug toxicity
– Result from overdose, ingestion of external use
drug
– Buildup of drug in blood
 Drug allergy
– Immunologic reaction to drug
– Mild to severe reactions (anaphylaxis)
 Drug tolerance
– Need increasing doses to maintain therapeutic
effect
 Drug interaction
– One drug affecting effect of another
 Actions of Drug on the body
 Pharmacodynamics:
– Process by which drug changes the body
(mechanism of action).

 Pharmacokinetics:
– Study of absorption, distribution,
biotransformation, and excretion of drugs
 Pharmacokinetics
 Absorption: movement from the
administration site into the bloodstream.
 Distribution: transportation of the drug from
its site to the site of action.
 Metabolism: the drug is converted by
enzymes into a less active form that can be
excreted, (most drugs are metabolized in the
liver).
 Excretion: elimination from the body. The
kidneys are the most important route.
 Drug Nomenclature
 Chemical name — describes the chemical
constituents of the drug
 Generic name — assigned by the
manufacturer that first develops the drug
 Trade name — brand name given by the
company that sells the drug
 Drug Preparations
 Oral:
– Capsule, pill, tablet, suspension, syrup
 Topical:
– lotion, ointment, suppository, transdermal patch
 Injectable:
- Vial, Ampoule
 Mechanisms of Drug Actions
 Drug-receptor interaction — drug interacts
with one of more cellular structures to alter
cell function
 Drug-enzyme interaction — combines with
enzymes to achieve desired effect
 Acting on cell membrane or altering the
cellular environment
 Factors Affecting Drug
Absorption
 Route of administration
 Drug solubility
 pH
 Local conditions at site of administration
 Drug dosage
 Serum drug levels
 Adverse Effect of Medications
 Iatrogenic disease: disease caused
unintentionally by medical therapy.
 Allergic effects: immunologic reaction to the
drug.
 Toxic effects
 Drug interactions
 Signs and Symptoms of Drug
Allergy
 Rash
 Urticaria
 Fever
 Diarrhea
 Nausea
 Vomiting
 Anaphylactic reaction
 Factors affecting
Medication action
 Developmental considerations
 Weight
 Gender
 Diet
 Genetic and cultural factors
 Psychological factors
 Illness & disease
 Environment, timing of administration
 Types of Medication Orders

 Standing order — carried out until cancelled

by another order
 Prn order — as needed
 Stat order — carried out immediately & once
 Parts of the Medication Order
 Patient’s name
 Date and time order is written
 Name of drug to be administered
 Dosage of drug
 Route by which drug is to be administered
 Frequency of administration of the drug
 Signature of person writing the order
Medication Prescription
 The 7 rights
1. Right Medication
2. Right Dose
3. Right Rout
4. Right Time (b.i.d, t.i.d, q.i.d. q8h)
5. Right Client
6. Right information
7. Right Documentation
 Controlled Substances
Required Information
 Name of patient receiving narcotic
 Amount of narcotic used
 The hour narcotic was given
 The name of physician prescribing narcotic
 Name of the nurse administering narcotic
 Oral Medications
 Solid form — tablets, capsules, pills
 Liquid form — suspensions, syrups
– Oral Route — having patient swallow the drug.
– Enteral route — administering drug through an
enteral tube
– Sublingual administration — placing drug under
tongue
– Buccal administration — placing drug between
tongue and cheek
 Administration of Parenteral
Medications
 Subcutaneous injection — subcutaneous tissue
(0.5-1 ml)
 Intramuscular injection - muscle tissue (1-3ml)
 Intradermal injection — corium (under
epidermis) (0.1 ml)
 Intravenous injection — into a vein
 Intracardial injection — heart tissue
 Intraperitoneal injection — peritoneal cavity
 Intraspinal injection — spinal canal
 Intraosseous injection — bone
Sites for Intramuscular Injections
 Ventrogluteal site
 Vastus lateralis site
 Deltoid muscle site
 Dorsogluteal site
Ventrogluteal site
Vastus Lateralis site
 Deltoid Site

Copyright 2008 by
Pearson Education, Inc.
 Dorsogluteal Site

Copyright 2008 by
Pearson Education, Inc.
Criteria for Choosing Equipment
for Injections
 Route of administration
 Viscosity of the solution
 Quantity to be administered
 Body size
 Type of medication
 Topical Administration of
Medications
 Eye: eye drops, ointments
 Ears: ear drops
 Nose: nasal drops
 Rectal: suppositories
 Skin applications: ointment, cream lotion
 Medical Record Documentation
 Document & sign each dose of medication,
as soon as it is given, and the patient
response.
 Intentional or inadvertent omitted drugs.
 Refused drugs.
 Medication errors.
 Type of Medication Errors
 Inappropriate prescribing of the drug
 Extra, omitted, or wrong doses
 Administration of drug to wrong patient
 Administration of drug by wrong route or rate
 Failure to give medication within prescribed
time
 Incorrect preparation of a drug
 Improper technique when administering drug
 Giving a drug that has deteriorated
 Medication Errors
 Check patient’s condition immediately;
observe for adverse effects.
 Notify nurse manager and physician.
 Write description of error on medical record
and remedial steps taken.
 Complete special form for reporting errors.
 Patient Teaching
1. Review techniques of medication
administration.
2. Remind patient to take the medication as
prescribed for as long as prescribed.
3. Instruct patient not to alter dosages without
consulting physician.
4. Caution patient not to share medications with
others even if they have the same disease.