MEDICATION ADMINISTRATION PRESENTATION ..

MEDICATION

1. MEDICATION ADMINISTRATION

2. INTRODUCTION Safe and accurate administration of medications is one of the nurses most important responsibilities. Medications are chemicals administered to clients to diagnose, treat and prevent diseases. Nurses need to know the actions and effects of the medication they give to the client.

3. DEFINITION OF MEDICATION Medication is a drug or a form of medicine that is used to treat or prevent disease. A medication is a substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease

4. Drug is any substance which alter the physiological and biological functions ,with the potential for affecting the individuals health . A medication is a drug, which is administered for its therapeutic effects on the body.

5. Pharmacology is the study of the effect of drugs on living organisms. The written direction for the preparation and administration of a drug is called a prescription .

6. ADMINISTRATION OF MEDICATION Administering medication involves providing the patient with a substance prescribed and intended for the diagnosis, treatment or prevention of a medical illness or condition.

7. While administering nurse should know the following principle: The nature of the drug Essential parts of medication order Abbreviations & symbols used in writing medications Weight & measurements used Preparation of solutions & dose calculation Storing of medicine Rules of medicine administration Ethical and legal aspects

8. DRUG NOMENCLATURE It’s the naming of drugs. This is the system that puts drugs into classification. One drug can have as much as 4 different names as follows: Chemical/ Molecular / Scientific name Nonproprietary / Generic name P roprietary/ Brand / Trade name

9. Chemical Name Any typical organic name; this precisely describes the constituents of the drug The name is given in accordance with the rules of chemical nomenclature, which are established by the International union of pure and applied chemistry ( IUPAC). E.g. N-(4-hydroxyphenyl) acetamide for paracetamol

10. Generic Name It is given by the manufacturer who first develops the drug; it is given before the drug becomes official. This name is usually agreed upon by the WHO. Often the generic name is derived from the chemical name. E.g. acetaminophen

11. Trade Name This name is given by the pharmaceutical firm, which sells the drug. Therefore ,a single drug can be sold under many of the proprietary name by different firms. These are written with the capital initial letters . Doctors usually prescribe the drugs with proprietary names of drugs. Example- calpol,Panadol

12. Examples CHEMICAL NAME L – thyroxine , T4 Acetyl Salicylic acid GENERIC NAME Levothyroxine Sodium Aspirin TRADE NAME Eltroxin , Synthyroid , Levothyroid Dispirin , Aspro , Wimprin etc.

13. PURPOSE OF MEDICATION Drugs can be administered for these purposes: Diagnostic purpose : to identify any disease Prophylaxis : to prevent the occurrence of disease. eg :-heparin to prevent thrombosis or antibiotics to prevent infection. Therapeutic purpose : to cure the disease.

14. To maintain & promote health. To restore physiologic process To aid in diagnosis To provide palliative effect To supply substances which is deficient ( eg : Insulin) To help in disease prevention To promote health eg : Vitamins To prevent disease eg : Vaccines To diagnose disease eg : Barium X ray To alleviate disease eg : Analgesics To treat or cure disease

15. Uses of Drugs Prevention - used as prophylaxis to prevent diseases e.g. vaccines; fluoride-prevents tooth decay . Diagnosis - establishing the patient’s disease or problem e.g. radio contrast dye; tuberculosis ( Mantoux ) testing . Suppression - suppresses the signs and symptoms and prevents the disease process from progressing e.g. anticancer, antiviral drugs.

16. Treatment - alleviate the symptoms for patients with chronic disease e.g. Anti-asthmatic drugs. Cure - complete eradication of diseases e.g. anti- biotics , anti- helmintics . Enhancement aspects of health - achieve the best state of health e.g. vitamins, minerals

17. Legal Aspects of Medication Preparation , dispensing and administration of medications are all covered by laws in every country. Dangerous Drug Act – 1930 and The Narcotic Drugs and Psychotropic Substances Act - 1985. It is an act that governs the procurement and use of some drugs especially the narcotics e.g. morphine, pethedine , cocaine etc. These drugs are prescription only drugs hence cannot be bought or administered without prescription.

18. Dangerous drugs are always kept under lock and key in the Dangerous Drug Cupboard under the care of trusted senior nurses. It is worth knowing that nurses are responsible for their own actions regardless of the presence of a written order. If a nurse gives an overdose of a drug because it is written by a doctor, the error is accounted to the nurse and not the doctor.

19. The nurse should bear in mind that ALL substances are poisons: there is none that is not a poison. The right dose differentiates a poison from a remedy.

20. EFFECT OF DRUGS ON BODY SYSTEM Therapeutic effect It’s the expected physiological response a medication causes. Each medication has a desired therapeutic effect for which its prescribed The nurse need to know about the therapeutic effect Eg: Theophylline as abronchodialator

21. Adverse effect Any undesirable or unintended consequences of drug administration. Eg: Allergies caused by drugs

22. Local & Systemic Effects When effect of drug is focused for small area is local effect. It is applied topically on skin or through mucus membrane. When the drug affects the whole body is systemic effect. It is achieved by absorption of drug in bloodstream.

23. Toxic effect The harm resulting from the adverse effect of drug It may develop after prolonged intake of high doses of a medication or medication accumulates in the blood because of impaired metabolism or excretion. Eg: Morphine relieves pain but high dose cause respiratory distress.

24. Side effect They are unintended secondary effects a medication will cause. It may be harmless If its severe the medication may be discontinued Eg: Theophylline may cause headache and dizziness

25. Synergistic effect Synergistic means combined. when drug is prescribed then its combination with another drug or food item can be enhancing or decreasing the effect of drug. It can be defined as the interaction between two or more drugs that causes the total effect of the drugs to be greater than the sum of individual effects of the each drug . A synergistic effect can be beneficial or harmful. Eg: when patient is prescribed barbiturates then alcohol ingestion can cause lethal synergistic effect.

26. Idiosyncratic reaction Medications may cause unpredictable effects in which a client overacts or under reacts to a medication or has a reaction that is not normal. Eg: Halothane, diclofenac , phenytoin

27. Allergic reaction Abnormal reaction of the immune system to a medication. It’s the unpredictable response to medication The drug act as antigen and stimulate antibody release Anaphylatic reactions include sudden constriction of bronchiolar muscles, edema of pharynx & larynx, severe wheezing etc.

28. Allergic reaction also include: Anaphylaxis Skin rashes ( urticaria ) Pruritis Angioedema Rhinitis Lacrimal tearing Nausea & Vomiting Diarrhea Shortness of breath & wheezing

29. Drug tolerance A persons diminished response to a drug. An increase in drug dosage may be needed to cause a therapeutic effect. Eg: Clients in pain medication may develop a tolerance over time & requires increasing dosage over time as in the case of morphine

30. Drug antagonism An interaction between two or more drugs that have the opposite effect on the body.

31. Effects of drugs on systems of body Gastro intestinal system Irritation of gastric mucosa Small bowel uceration Constipation Nervous system Abnormal involuntary movement eg : Tremor, chorea Stimulation of CNS Eg : Anxiety , Nervousness Depression in CNS Eg: Ataxia ,dizziness

32. Hemopoietic system Aplastic anemia Thrombocytopenia Granulocytosis Leukopenia Cardiovascular system Arrhythmias Hypotension hypertension

33. DRUG FORMS Medications are available in variety of forms. The form of the medication determines its route of administration.

34. Drug forms can be of three types; Solid form eg : caplet, capsule, pills, tablet,lozengers , suppository Semi solid form eg:ointment , paste, cream Liquid form eg : injections, drops, elixir,syrup , suspension, lotion, tincture, emulsion

35. Tablet : It is the powdered medication compressed into hard disk or cylinder. Capsule : Medication covered in gelatin shell. Gel or jelly : A clear or translucent semisolid that liquefies when applied to the skin.

36. Lozenge : A flat, round, or oval preparation that dissolves and releases a drug when held in the mouth. Lotion: Drug particles in a solution for topical use. Ointment : Semisolid preparation containing a drug to be applied externally.

37. Powder: Single or mixture of finely ground drugs. Solution: A drug dissolved in another substance. Suspension: Finely divided, undissolved particles in a liquid medium; should be shaken before use.

38. Syrup: Medication combined in a water and sugar solution. Suppository: An easily melted medication preparation in a firm base such as gelatin that is inserted into the body ( rectum, vagina , urethra)

39. Transdermal patch : Unit dose of medication applied directly to skin for diffusion through skin and absorption into the bloodstream.

40. Elixir: Clear fluid containing water or alcohol, usually has sweetener for easy swallowing. Emulsion: Mixture of two liquids uniformly dispersed throughout each other. Creams : A non greasy semi solid preparation used on to the skin

41. Liquid spray: It has a water and alcohol base. Some dispensed as foams or aerosol sprays. Tincture: An alcoholic solution is prepared from drugs derived from plants. Pellet / Bead: Drugs can be implanted into the body in the form of a pellet or bead that slowly releases medicine into tissues.

42. Pills: Tablets containing one or more drugs shaped into ovoid or oblong form. Injections : Liquid drugs in the ampoule or vial for IM, IV, SC , ID use. Drops : Liquid drugs for instillation in eyes, ears, nose. Paste : Thick & stiff preparation absorbed through skin more lowly than ointment

43. Pharmacokinetics Pharmaco means drugs & kinesis means movement. It is “what the body does to the drug ”. It includes absorption, distribution, metabolism and excretion. “ The process of movement of unchanged drug from the site of administration to systemic circulation is called as drug absorption”.

44. It is the movement of a drug from the site of administration into the blood stream. There are various factors influencing drug absorption. It includes:

45. Physiological properties of the drug.  eg ., lipid soluble form better absorbed than water soluble. Route of drug administration.   eg ., intravenous route directly enters the circulation   Food   eg ., milk and milk products decrease the absorption Presence of other drugs  eg ., ascorbic acid increases the absorption of oral iron. Gastrointestinal and other diseases  eg ., gastroenteritis decreases drug absorption.  

46. Pharmacodynamics Pharmacon means drug & dynamic means power It covers all the aspects relating to “what the drug does to the body”. It is the study of biochemical and physiological effects of drug and their mechanism of action at organ level as well as cellular level.

47. FACTORS AFFECTING MEDICATION ACTION Various factors affects the action of the medicine. Developmental Factors Pregnancy : Most drugs are contraindicated because of their possible adverse effects on the fetus. Infants usually require small dosages because of their body size and the immaturity of their organs.

48. In adolescence or adulthood , allergic reactions may occur. Old age have different responses to medications due to aging. Gender Different action can occur in men and women due to the distribution of body fat and fluid and hormonal differences.

49. Cultural, Ethnic, and Genetic Factors Genetic differences in the production of enzymes that affect drug metabolism. Cultural factors and practices (e.g., values and beliefs) can also affect a drug’s action. Diet Nutrients can affect the action of a medication. For example , vitamin K , found in green leafy vegetables, can counteract the effect of an anticoagulant such as warfarin

50. Environment Environmental temperature may also affect drug activity. When environmental temperature is high, the peripheral blood vessels dilate, thus increase the action of vasodilators . A client who takes a sedative or analgesic in a busy, noisy environment may not benefit as fully as if the environment were quiet and peaceful .

51. Psychological Factors A client’s expectations about what a drug can do can affect the response to the medication. Illness and Disease Drug action is altered in clients with circulatory , liver, or kidney dysfunction. Time of Administration The time of administration of oral medications affects the speed with which they act.

52. 9. Physiological variables Hormonal differences between men and women alter the metabolism of certain drugs. Age has a direct effect on drug action Drug metabolism depends on adequate nutrition for enzymes & protein. Most drugs bind with proteins before being distributed to their site of action.

53. Thank you…