An introduction to medication administration in english

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2. Medications are substances prescribed by the client’s prescribing practitioner to help in the treatment, relief , or cure of the cause of the client’s health alterations or in the prevention of such alterations . Nurses play an essential role in the administration of, education about, and evaluation of the effectiveness of prescribed medications . Introduction

3. Medication administration requires specialized knowledge, judgment , and nursing skill based on the principles of pharmacology . The focus of this lecture is to assist the nursing student in applying principles of pharmacology and in acquiring skills in the safe administration of medications. Medication administration

4. Pharmacokinetics refers to the study of the absorption, distribution , metabolism, and excretion of drugs to determine the relationship between the dose of a drug and the drug’s concentration in blood and biological fluids. Pharmacokinetics

5. The degree and rate of absorption, or passage of a drug from the site of administration into the bloodstream, depend on several factors such as the drug’s physicochemical effects, its dosage form , its route of administration, its interactions with other substances in the digestive system and patient's various characteristics such as age and weight Absorption of a drug

6. Oral preparations, such as tablets and capsules, must first disintegrate into smaller particles for gastric juices to dissolve and prepare the drug for absorption in the small intestines . Drugs administered intramuscularly are absorbed through the muscle into the bloodstream Absorption of a drug

7. Suppositories are absorbed through the mucous membranes into the blood . Intravenous drugs are immediately bioavailable because of their direct injection into the blood to produce a drug effect Sublingual medications are absorbed more quickly than are subcutaneous injections. Absorption of a drug

8. Distribution refers to the movement of drugs from the blood into various body fluids and tissues. The rate at which the drug reaches the specific site of action is affected by blood flow, cell membrane permeability, and the protein binding capacity of the medication. Distribution of the drug

9. The process of metabolism ( also known as biotransformation) refers to the physical and chemical processing of the drug. In metabolism, the drug is inactivated and changed into a water-soluble compound that can be excreted by the body. The liver is the primary source of biotransformation. Metabolism of the drug

10. Excretion is the process in which drugs are eliminated from the body. Factors that affect the kidneys’ ability to excrete drugs include maturity of the kidneys, circulation, and disease. As kidney function decreases, there can be an accumulation of drugs , which can result in toxicity Excretion of the drug

11. Drugs are available in many forms for administration by a specific route such as oral route or parenteral route. The nurse should be aware of the various drug forms and how they are administered. Certain drug preparations require special consideration regarding administration. Preparation and route of drugs

12. Drugs prepared for administration by one route should not be substituted by other drug forms. For example, when a client has difficulty swallowing a large tablet or capsule, the nurse should not administer an oral solution or elixir of the same drug without first consulting the prescribing practitioner because a liquid may be more easily and completely absorbed, producing a higher blood level than a tablet. Preparation and route of drugs

13. ORAL ROUTE - Most drugs are administered by the oral route because it is the safest, most convenient, and least expensive method . The disadvantage of the oral route is that it is slower acting than the other routes. Oral route drug forms includes- • Tablets: compressed or molded substances to be swallowed whole, chewed before swallowing, or placed in the buccal pocket or under the tongue (sublingual ) • Preparation and route of drugs

14. Capsules : substances encased in either a hard or a soft soluble container or gelatin shell that dissolves in the stomach. Caplets : gelatin-coated tablets that dissolve in the stomach Powder and granules : finely ground substances. Troches , lozenges, and pastilles : similar preparations of drugs designed to dissolve in the mouth Preparation and route of drugs

15. Enteric-coated tablets : coated tablets that dissolve in the intestines. Time-release capsules : encased substances that are further enclosed in smaller casings that deliver a drug dose over an extended period of time Sustained-release : compounded substances designed to release a drug slowly to maintain a steady blood medication level Preparation and route of drugs

16. Syrup: it is make to change the taste of medicines. it is a thick sweet liquid, often made by adding boiling sugar and water or fruit juice. Elixirs:  are sweetened hydro-alcoholic (water and alcohol) liquids for oral use. Typically, alcohol and water are used as solvents when the drug will not dissolve in water alone. Preparation and route of drugs

17. PARENTERAL ROUTE - parenteral means introduction of a medication by any route other than the oral-gastrointestinal route. However, medical usage of this term refers to injecting medication into body tissue. It includes – Intradermal, subcutaneous, intramuscular, intravenous, intrathecal or intraspinal , intracardiac , intrapleural , intra-arterial , and intra-articular injections. Preparation includes ampules, single dose vials and multi-dose vials Preparation and route of drugs

18. TROPICAL ROUTE - Most topical drugs are given to deliver a drug at, or immediately beneath, the point of application. Although a large number of topical drugs are applied to the skin , other topical drugs include eye, nose and throat, ear, rectal , and vaginal preparations. Tropical drug form includes- Liniments: substances mixed with an alcohol, oil, or soapy emollient that are applied to the skin Preparation and route of drugs

19. Ointments : semisolid substances for topical use. Pastes : semisolid substances, thicker than an ointment, that are absorbed slowly through the skin Transdermal patches : contain medication that is absorbed through the skin over an extended period of time Preparation and route of drugs

20. Suppositories : gelatin substances designed to dissolve when inserted in the rectum, urethra, or vagina. Inhalations : drugs or dilution of drugs administered by the nasal or oral respiratory route for a local or systemic effect Drops : Optic (eye) and otic (ear ) and nasal solutions that are instilled as drops. Preparation and route of drugs

21. The prescribing practitioner determines the therapeutic drug plan and conveys the plan to others by initiating orders or a prescription . Safe practice dictates that a nurse follows only a written or typed order, or an order entered into a computer system because these types of orders are less likely to result in error or misunderstanding. Under certain circumstances, such as in an emergency, a verbal order from the physician may be given to a registered nurse. Which should be written soon after the emergency normalizes. Medication orders

22. ABBREVIATION MEANING a.c . before meals p.c. after meals ad lib freely , as desired b.i.d . or b.d . two times a day cap capsule elix elixir Abbreviations used in Medication orders

23. ABBREVIATION MEANING h hour hrly hourly ID intradermal IM intramuscular IV intravenous IVPB intravenous piggyback Abbreviations used in Medication orders

24. ABBREVIATION MEANING per by PO by mouth prn as needed q every q2h every 2 hours q.i.d . four times a day Abbreviations used in Medication orders

25. ABBREVIATION MEANING stat immediately supp suppository susp suspension tab tablet t.i.d . three times a day Tr or tinct tincture Abbreviations used in Medication orders

26. ABBREVIATION MEANING U Units HS half strength/sleeping time TIW Thrice a week EOD Every other day aq. bull. Boiling water bol large single dose Abbreviations used in Medication orders

27. 5 mL - 1 teaspoonful 10 mL - 1 dessertspoonful 15 mL - 1 tablespoonful 30 mL - 1 ounce 60 mL - 1 wineglassful 120 - 1 teacupful Measurement system of drugs

28. 1 mg = 1/60 grain 4 mg = 1/15 grain 10 mg = 1/6 grain 15 mg = 1/4 grain 30 mg = 1/2 grain 60 mg = 1 grain 1000 g (1 kg) = 2.2 pounds ( lbs ) Measurement system of drugs

29. Several rules have been devised to calculate infants’ and children’s dosages (e.g., Young’s rule, Clark’s rule etc.) but these rules give only approximate dosages . Regardless of the method used in calculating pediatric drug dosages, the nurse should realize that dosages are approximate and often need adjustment based on the child’s response Pediatric doses

30. Young’s rule- If adult dose is 500 mg than a dose for 8 year old child is Pediatric doses

31. clarks’s rule- If adult dose is 500 mg than a dose for a child having 60 lbs weight Pediatric doses

32. By – SURESH KUMAR ( Nursing Tutor )