Administration of Medication, Unit - 12 FON

ADMINISTRATION OF MEDICATION Presented By- Atul Yadav (RN,RM) UNIT 12

INTRODUCTION Client with acute or chronic alteration in their health may to use a variety of medication. The role of nurse in the administration of has becomes increasingly complex and diversified. Administration of correct medication and dosage by the specified route, using proper technique and taking appropriate precaution were once all that was expected of a nurse.

CONT… Administration of medication is a basic nursing function that involves knowledge and skill . The safe and accurate administration of medication is one of the most important responsibilities of a nurse. Improper administration of medication can cause harmful effects. The nurse administering medication should have the basic knowledge regarding drugs which include the following -

CONT…. Name of the drug. Classification. Route and time of administration. Principles of drug action. Dosage. Medication standards. Types and forms of drugs. Source of information about medication. System of medication distribution.

CONT… Medication order. Prescription and non-prescription medication. Weights and measures used. Preparations of solution and calculation of fractional doses. Storing of medication. Factors affecting safety in the administration of medication.

CONT…. Abbreviations and symbols used. Rules for administration of medicine. Legal aspects of medication administration. Nurse practice acts. Institutional medication policies. Client's rights. Substance abuse. Nurse’s role in administration of medication.

DRUG A drug is a substance that alters physiological function, with the potential for affecting health. A drug is a chemical substance that modifies body function when taken into the living organism, which may or may not be a therapeutic effects.

MEDICATION Medication may be defined as a substance used to promote health, to prevent illness, to diagnose, to alleviate or cure disease. A medication is a drug administered for its therapeutic effects. All medications are drugs, but not all drugs are medication.

1. NAME OF DRUGES OR Nomenclature Drugs may be known by several names:- (a) Chemical name is the name by which a drug is known to the chemists. For example the chemical name of the anti-inflammatory agent ibuprofen is 2-4 ( iso butyl phenyl) propionic acid.

CONT… (b). Generic name or non-proprietary name is the name assigned by the manufacturer who first developed the drug and is assigned by the United States Adopted Name Council . (c). Official name is the name by which the drug is identified in the official publication. For example BP (British Pharmacopoeia)

CONT… (d). Trade name or brand name or proprietary name is the registered name assigned by the manufacturer and is copyright. For Example Paracetamol (chemical name) have different trade names, such as Crocin , Calpol , Metacin etc.

CLASSIFICATION OF DRUGS Drugs may be classified in several ways: according to their:- a. C hemical composition, b. C linical actions , c. T herapeutic effect on body systems , e. T heir purpose and uses, f. T he symptoms relieved by the drug etc.

CLASSIFICATION OF DRUGS ACCORDING TO THEIR ACTION TERMINOLOGIES :- Analgesics : Drug used to relieve pain. Anaesthetics : Drugs which cause loss of sensation. Anthelmintics and vermifuges : Drugs which destroy and expel worms. Antipyretics : Drugs which reduce fever. Antidotes : Substances used to counteract the effects of poison.

CONT… Antiinfectives : Act either to inhibit, kill or retard the growth of micro-organisms. Antiinflammatory : Those help to reduce the inflammation. Anticoagulants : Substance which inhibit or decrease the blood-clotting process, either by inhibiting the formation of the formation of the clotting substances.

CONT… Anticonvulsants : Those used to prevent or treat convulsions therefore it is used in epilepsy. Antacids : Substance that react with hydrochloride acid to decrease the activity of the gastric secretion. Antiseptic : A substance that inhibits the growth of bacteria.

CONT… Antibiotics : Products of living micro-organism that have the ability to destroy or inhibit the growth of the organism. Antitussives : Drugs that inhibit the cough reflex, act primarily upon the cough centre in the C.N.S. Antidiarrheatics : Agent that are used to treat diarrhoea either by detoxicating the noxious substances or by killing the infectious gastrointestinal microorganism .

CONT….. Antiasthmatics : Drugs which provides symptomatic relief of asthmatic attacks by relaxing the smooth muscles of the bronchioles. Antipruritics : A drug that relives itching. Antispasmodics : An agent that relieves the spasmodic pains or spasm of the muscles.

CONT.. Antiemetics : Drug relliving or preventing nausea and vomiting. Antitubercular : The specific drugs used in the treatment of tuberculosis. Diuretics : Which increase the flow of urine. Digestants : An agent that promote digestion. Emetics : An agent that produce vomiting.

CONT… Galactagogue : Substance that increase the flow of milk. Hypnotics : Drugs that produce sleep. Haemostatics : An agent that stop hemorrhage. Hypotensive : Any substance that capable for lowering the blood pressure.

CONT…. Hormones : They are the substitutes for body hormones. Inotropes : They are the drugs that strengthen cardiac contraction. Mydriatics : Dilate the pupil of the eye. Myotics : Contract the pupil of the eye. Muscle relaxants : Agent used for diminution of tension or functional activity of muscles.

CONT…. Narcotics : A drug that produces stupor or complete insensibility. Sedatives : Substances which lessen the body activity. Stimulants : Increase the functional activity of an organ or system.

CONT….. Vasodilators : Drugs which dilate the blood vessels and consequently lower the blood pressure. Vasoconstrictors : Drug or agent that cause constriction of the blood vessels with the effect of raising the blood pressure .

ROUTES OF DRUGS ADMINISTRATION 1. Oral route: The most common route of drug administration. Drug are given by mouth more frequently than by other route. Advantages : (a) It is safe, convenient and economical. (b) Self medication is possible (c) Complication of parenteral therapy are avoided .

CONT…. Disadvantages : (a) Onset of drug action is slower than parenteral route. (b) Drug which are bitter in taste cannot be administer. (c) Drugs producing nausea/vomiting cannot be administer. (d) This route is not possible in an unconscious patient.

CONT… 2. Sublingual route :- The drug is placed under the tongue. It is allowed to dissolve in the mouth. Advantages : A. Onset of action is quick. B. Inactivation of drug in the stomach is avoided. C. The drug enters directly into systematic circulation without inactive in the liver.

CONT… 3. Rectal route:- The drug is placed inside rectum as suppositories, or enema. Advantages : A. This route is frequently used when nausea/vomiting are present. B. Irritation of gastric mucosa is avoided. C. It is suitable for those drugs which are destroyed by gastric acidity.

CONT… 4. Inhalation route:- The drugs are inhaled in the form of vapors and absorption of drugs occur through respiration tract mucosa. 5. Cutaneous or Topical route:- The application of suitable drugs dosage from to the skin for either local or systemic effects is known as topical route.

CONT… 7. Parental route:- Route of administration of drug other than alimentary tract are called parental. The drugs is injected with the help of an injection directly into the blood or some particular part of the body. Injections may be given :-

Intravenous The drugs are injected in one of superficial vein. A large volume of drugs can be administer easily through this route. Advantages :- A. It produce rapid action B. Dose is easy to monitor C. Large quantities of fluid can be given by this route.

CONT…. D. Drug is not destroyed either by liver or intestine. Disadvantages :- A. It is highly unsafe route B. Drug given can not be withdraw C. Trained personal is required to give this injection D. Venous irritation can be lead to thrombosis.

INTRAMUSCULAR The drugs is injected directly in the muscles .Gluteus and deltoid muscles are the most common sites use in adult . Advantages :- A. Fat soluble drugs can be given only by this route. B. onset of action is rapid. C. absorption is good

CONT…. Disadvantages :- A. Injection produce local pain B. Maximum of 5 ml can be given by this route.

INTRADERMAL (INTRACUTANEOUS) The drug is injected into the skin. This route is mainly for sensitivity test(for allergens) and immunization. The forearm and upper back are the chosen sites.

SUBCUTANEOUS The drug is injected directly in the subcutaneous tissue, fatty layer only small amount(0.5-1 ml) of drug can be given by this route.

PURPOSES OF MEDICATIONS Diagnose disease Prevent disease Treat disease/ decrease symptoms Restore normal function Maintain normal function

PRINCIPLES OF MEDICATION (SAFETY) Always use 7R’s:- Right patient Right route Right time Right medication/drug Right dose Right method Right documentation

MEDICATION ERRORS It is the administration of drug: 1. Which is not given according to the order. 2. Inappropriate for the client. 3.Medication was given but not charted. 4. Administration of medication at the wrong rate. 5. Administration of medication at wrong route.

CONT…. Administration of medication at wrong time. Administration of medication at wrong dose. Administration of wrong medication. Administration of medication to wrong client. NOTE:- When medication error occur note/document that as it occur.

DRUG FORM Medication are manufacture in a of forms or preparation to make them more useful or easy to administer. Many medication are made in several forms. The form of drug guides the route of administration. The nurse should be quit sure to use the proper form while administering medication.

CONT… Form/preparation Aqueous solution Capsule description One or more drugs dissolved in water. Powder or gel form of drug encased in a hard or soft outer casing that dissolves in stomach, liquids

CONT…. Form/preparation Lotion Ointment description Drugs in liquid suspension intended for external use. Semisolid preparation of a drug or drug in Vaseline that is applied to and absorbed by the skin

CONT…. Form/preparation Pill Powder description Drug in powder form mixed in a cohesive material such as liquids. A finely ground form of a drug or drugs. Some are used internally and some are used externally

STORAGE AND MAINTENANCE OF DRUGS To stock the medicine, each ward should be provided with a medicine cabinet/room. It should be large enough to hold all medication stocked in a ward. As far as a possible the medicine room should be kept separate and near to nursing room. A washing sink with running water should be there for hand washing.

CONT… Adequate light should be there for reading label of medicine. There should be a separate compartment for different kind of drugs to protect them from mixing . Drugs use for external use place separate from internal use medicine.

CONT…. The container should be place or arrange in alphabetically, so that it is easy to find them. Poisonous drugs should be kept in a separate cupboard which must be have separate lock and key. A senior nurse have the responsibility for poisonous drugs.

CONT… A register should be maintained to kept the account of the poisonous drugs. A daily inventory should be taken to prevent theft of narcotics. All the poisonous drugs should be marked “poison” in red ink. No drug should be stored without labels, even for a day.

CONT… All medication container should be kept closed always. The drug that are unusual in colour, odour and consistency should be returned to the pharmacy and replaced with fresh ones. Check the expiry dates of every drug before use.

EFFECTS OF DRUGS ON THE BODY Therapeutic Effect :- It is effect which is desired or the reason a drug is prescribed. Therapeutic effects are the medication’s desired and intentional effects. Local and systemic effects:- Local effects of a drug are expected when they are applied topically to the skin or mucus membrane.

CONT… A drug used for systemic effect must be absorbed into the blood stream to systemic effect in the various systems and parts of the body. Adverse Effects :- Adverse effect is any effect other than the therapeutic effect. Side Effect :- Side effects are the minor adverse effects. Side effects can be harmful or harmless.

CONT… Toxic effect:- The effects of drug after prolonged use of drug or due to overdose of drugs. Intolerance:- When a patient is more sensitive to effects of drugs, a drug produce toxic effects even at therapeutic doses.

CONT… Allergic reaction or hypersensitivity :- These reaction to drugs are the result of body’s immunological response to a drug. In this reaction drug act as a allergen. Idiosyncrasy:- These are defined as genetically determined unexpected response to drug, e.g., primaquine produce haemolysis in Negroes.

CONT… Photosensitivity :- Some drugs cause sensitization of skin to ultraviolet radiation. Drug Dependence :-It is a state of person in which the person has a compulsion to continue taking the drug in order to experience pleasurable psychic effects.

CONT… Withdrawal reaction:- Sudden discontinuation of some drugs result in adverse consequences. Teratogenicity:- some drugs produce fetal abnormalities if used in pregnancy, such drug are known as teratogenic. Carcinogenicity:- some drugs after prolonged administration may induce cancer.

FACTORS AFFECTION DRUG RESPONSE Age :- Infants, children and elderly requires smaller amount of dose as compared to adults. Sex :- Male required large dose as compared to produce same response. Race :- There may be racial different of drug response due to genetic differences or difference in life style etc.

CONT… Weight :- More weight patient needs higher doses. Route of administration :- The routes are also affects the drug response, i.e., parental route produce rapid action then other routes. Health and illness :- Many drugs are metabolised in liver and excreted through kidney.

CONT… Effects of other drugs :- When two or more drugs administer simultaneously. They may modify the response of each other. Tolerance :- Prolonged use of some drugs required high dosages for producing some response, e.g., opiates.

FACTORS AFFECTS DRUG ABSORPTION Physical state :- Form of drug either it is liquid, solid, or gaseous. Particle size :- Size of drug also affect the absorption. Solubility :- Easily solution drugs is quicker absorbed. Area of absorption surface :- Large area of absorption surface, quicker absorption of drug.

CONT… Route of administration :- Where it is IV,IM,SC,ID.

SYSTEMS OF DRUG MEASUREMENT

CONT…

CONVERTING MEASUREMENTS UNITS

CONT…

ABBREVIATIONS USED ad - up to a.c . - before meals b.i.d - twice daily conc. - concentrated C. - with dil - diluted div. - divide et. - and gutt . or gtt .- a drop h.s . - at bed time

Cont… i.c . - between meals m - mix (thou ) mist. - a mixture noct . or n . - at night o.h . - every hour p.c. - after meals p.prand - after dinner p.r.n . - as need arises q.i.d - four times a day q.s . - as much as may be required

Cont… q.h . - every hour q.q.hor . - every four hours S. - without stat. - immediately s .o.s - when required spt. - spirit syr. - syrup t.i.d - thrice daily t.d.s . - to be taken three times a day tinc . or tr . - a tincture

ORAL DRUG ADMINISTRATION EQUIPMENT ARTICLE REQUIRED A trolley A bowel of clean water. Ounce glass, minim glass, teaspoon, dropper etc. purpose To take different medications and articles to the bedside. To wash the medicine glass. To measure the medication.

CONT… ARTICLE REQUIRED Drinking water in a glass or feeding cup. Mortar and pestle. Medicine slab and spatula. Duster or towel Kidney tray & paper bag Plastic measuring cups and soufflé cups. Medicine cards. purpose To offer to the client after the medicine is given to him. To crush the medication. To divide the medicine. To wipe out the bottle. To discard the waste. To take the medication to the individual client. To write mediation order.

ORAL ADMINISTRATION PROCEDURE Wash hands. Read the physician order. After reading the medication card take the appropriate medicine from the shelf. Measure the medication, calculate dose if necessary. Take the medication as needed or ordered. Return the container back into the shelf.

CONT… Place the medication card with the medication on the tray. Prepare each medication into separate containers. Lock the medication cabinet and take the medication to the bed side. Identify the client with the medicine card. Administer medication as prescribe.

CONT… Provide water to drink after the medicines are administer. Place the ounce glass in the bowel of water.

Parental

CONT…

CANNULA

CONT…

NEEDLE STICK INJURIES

CONT…

THANKYOU

Administration of Medication, Unit - 12 FON

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Administration of Medication, Unit - 12 FON

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