MEDICINE.ppt for nurses and lhvs ppt for bsn

MEDICINE.ppt for nurses and lhvs ppt for bsn

1. MedicationMedication

ByBy

Prem ChandPrem Chand

Nursing Lecturer Nursing Lecturer
BCNAHSBCNAHS
11

2. MEDICATIONMEDICATION

Medication is a Medication is a
substance administered substance administered
for the diagnosis cure, for the diagnosis cure,
treatment, or relief of treatment, or relief of
symptom or for symptom or for
prevention of disease. prevention of disease.

In the health care In the health care
context, the word context, the word
medication & drug are medication & drug are
generally used generally used
interchangeably. interchangeably.
22

3. Cont…..Cont…..

The term “Drug” also has the The term “Drug” also has the
connotation of an illicitly obtained connotation of an illicitly obtained
substance such as heroin, cocaine or substance such as heroin, cocaine or
amphetamines. amphetamines.

In the United States and Canada, In the United States and Canada,
medications are usually dispensed on medications are usually dispensed on
the order of physicians & dentists. the order of physicians & dentists.
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4. 
One drug can have four kinds of name One drug can have four kinds of name
is below. is below.

Generic name Generic name 2. Official name. 2. Official name.

Chemical name Chemical name 4. Trademark or 4. Trademark or
brand name. brand name.

Generic name is given before a drug Generic name is given before a drug
before a drug becomes officially are before a drug becomes officially are
approved medication. approved medication.
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5. Cont…..Cont…..

The official name is the name under which it The official name is the name under which it
is listed in one of the official publications (e.g, is listed in one of the official publications (e.g,
the United States Pharmacopeia). the United States Pharmacopeia).

The chemical name is the name which a The chemical name is the name which a
chemist knows it. This name describes the chemist knows it. This name describes the
constituents of the drug precisely. constituents of the drug precisely.

A drug’s trade name is the name given by the A drug’s trade name is the name given by the
drug manufacturer. drug manufacturer.

The trade name is sometime called the brand The trade name is sometime called the brand
name. name.
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6. 
Pharmacology:Pharmacology: The study of the effect The study of the effect
of drugs on living organisms. of drugs on living organisms.

Pharmacy:Pharmacy: Pharmacy is the art of Pharmacy is the art of
preparing, compounding and preparing, compounding and
dispensing drugs. dispensing drugs.

A Pharmacy technician is a member of A Pharmacy technician is a member of
the health team who is some states the health team who is some states
administers drugs to clients. administers drugs to clients.
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7. 
Drug Standards: Drug Standards:

Drugs may have natural (e.g, plant, mineral and Drugs may have natural (e.g, plant, mineral and
animal) sources or they may be synthesized in the animal) sources or they may be synthesized in the
laboratory. laboratory.

Example: Example:

Digitals & opium are plant derived. Digitals & opium are plant derived.

Iron is sodium chloride is minerals. Iron is sodium chloride is minerals.

Insulin & vaccines have animal or human sources. Insulin & vaccines have animal or human sources.

Sulfonamides & proponyphene hydrochloride (The Sulfonamides & proponyphene hydrochloride (The
analgesic Dragon) are the product of laboratory analgesic Dragon) are the product of laboratory
synthesis. synthesis.
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8. 
Pharmacopoeia:Pharmacopoeia: Pharmacopoeia is a Pharmacopoeia is a
book containing a list of products used in book containing a list of products used in
medicine with description of the product, medicine with description of the product,
chemicals tests for determining identity chemicals tests for determining identity
& purity and formulas & prescriptions. & purity and formulas & prescriptions.

Pharmacopoeia & formularies are Pharmacopoeia & formularies are
invaluable reference sources for nurses invaluable reference sources for nurses
& nursing students. & nursing students.
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9. LEGAL ASPECTS OF DRUG LEGAL ASPECTS OF DRUG
ADMINISTRATIONADMINISTRATION

The administration of drugs in both the The administration of drugs in both the
United States & Canada is controlled by United States & Canada is controlled by
law. law.

Nurses need to know how nursing Nurses need to know how nursing
practice acts in their areas define & practice acts in their areas define &
limits their functions. limits their functions.

Be able to recognize the limits of their Be able to recognize the limits of their
own knowledge and skill. own knowledge and skill.
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10. 
By the law, nurses are responsible for By the law, nurses are responsible for
their own action regardless of while they their own action regardless of while they
there is a written order (EO) If a there is a written order (EO) If a
physician writers an incorrect order (C.O) physician writers an incorrect order (C.O)
(Demerol 500 mg instead of Demerol 50 (Demerol 500 mg instead of Demerol 50
mg) A nurse who administers the written mg) A nurse who administers the written
incorrect dosage is responsible for the incorrect dosage is responsible for the
error as well as the physician. error as well as the physician.
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11. EFFECTS OF DRUGSEFFECTS OF DRUGS

The Therapeutic Effect of a The Therapeutic Effect of a
drug also referred to as the drug also referred to as the
desired effect, is the primary desired effect, is the primary
effect. effect.

Example of Therapeutic Example of Therapeutic
effect of morphine sulfate is effect of morphine sulfate is
analgesia, and the analgesia, and the
therapeutic effect of therapeutic effect of
diazepam is relief of anxiety. diazepam is relief of anxiety.

Side effect or 2nd day effect Side effect or 2nd day effect
of drugs. of drugs.

Side effect of including Side effect of including
Nausea, and vomiting. Nausea, and vomiting.
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12. Cont…..Cont…..

Some side effects are tolerated for the drugs Some side effects are tolerated for the drugs
therapeutic effect more severe side effects therapeutic effect more severe side effects
also called adverse effects or reactions. also called adverse effects or reactions.

Drug Toxicity: Deleterious effects of a drug on Drug Toxicity: Deleterious effects of a drug on
an organism or tissue result from over an organism or tissue result from over
dosage ingestion of drug intended for dosage ingestion of drug intended for
external use, & buildup of the drug in the external use, & buildup of the drug in the
blood b/c of impaired metabolism or exertion blood b/c of impaired metabolism or exertion
(cumulative effect). (cumulative effect).
1212

13. cont…..cont…..

Example of a toxic effect is respiratory Example of a toxic effect is respiratory
depression due to the cumulative effect of depression due to the cumulative effect of
morphine sulfate in the body. morphine sulfate in the body.

Drug Allergy: Drug allergy is an immunologic Drug Allergy: Drug allergy is an immunologic
reaction to a drug. reaction to a drug.

Allergic reactions can be either mild or severe. Allergic reactions can be either mild or severe.

Severe allergic reaction usually occurs Severe allergic reaction usually occurs
immediately after the administration of drugs immediately after the administration of drugs
is called an “Anaphylactic Reaction. is called an “Anaphylactic Reaction.
1313

14. Cont…..Cont…..

Drug Tolerance “Drug tolerance exists is a Drug Tolerance “Drug tolerance exists is a
person who has usually low physiologic person who has usually low physiologic
response to a drug and who requires increases response to a drug and who requires increases
in the dosage to maintain a given therapeutic in the dosage to maintain a given therapeutic
effect. effect.

Drug tolerance produce are opiates Drug tolerance produce are opiates
barbiturates, ethyl alcohol & tobacco. barbiturates, ethyl alcohol & tobacco.

Idiosyncratic drug an abnormal susceptibility Idiosyncratic drug an abnormal susceptibility
to an agent (e.g.) drugs. to an agent (e.g.) drugs.

Synergistic: effect of another force or Synergistic: effect of another force or
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15. Action of Drugs on the bodyAction of Drugs on the body

Onset of action: The time after administration Onset of action: The time after administration
when the body initially responds to the drug. when the body initially responds to the drug.

Peak Plasma Level: The highest plasma level Peak Plasma Level: The highest plasma level
achieved by a single does when the elimination achieved by a single does when the elimination
rate of a drug equals the absorption rate. rate of a drug equals the absorption rate.

Drug Hale Life (elimination half life) the time Drug Hale Life (elimination half life) the time
required for the elimination process to reduce required for the elimination process to reduce
the concentration of the drug to one half what it the concentration of the drug to one half what it
was at initial administration. was at initial administration.

Plateau: A maintained concentration of a drug in Plateau: A maintained concentration of a drug in
the plasma during a series of scheduled doses. the plasma during a series of scheduled doses.
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16. PharmacodynamicsPharmacodynamics

The study of the biochemical & The study of the biochemical &
physiological effects of drugs & the physiological effects of drugs & the
mechanisms of their reactions, mechanisms of their reactions,
including the correlation of their actions including the correlation of their actions
& effects with their chemical structure. & effects with their chemical structure.
1616

17. 
Pharmakinetics:Pharmakinetics: The study of the absorption, The study of the absorption,
distribution, biotransformation & excretion of distribution, biotransformation & excretion of
drugs. drugs.

Absorption:Absorption: The process by which a drug The process by which a drug
passes into the bloodstream. passes into the bloodstream.

Distribution: the transportation of a drug Distribution: the transportation of a drug
from its site of absorption to its site of action. from its site of absorption to its site of action.

When a drug enters the blood stream it is When a drug enters the blood stream it is
carried to most vascular organism that is carried to most vascular organism that is
livers kidney and brain. livers kidney and brain.
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18. 
Bio-Transformation:Bio-Transformation: Biotransformation also called Biotransformation also called
detoxification or metabolisms are a process by which detoxification or metabolisms are a process by which
drug is converted to a le native form.drug is converted to a le native form.

Most biotransformation takes place in liver. Most biotransformation takes place in liver.

Excretion:Excretion: Process by which metabolites & drugs are Process by which metabolites & drugs are
eliminated from the body. eliminated from the body.

Most Metabolites are eliminated by the Kidneys in the Most Metabolites are eliminated by the Kidneys in the
urine. urine.

Some are excreted in the feces, the breath, Some are excreted in the feces, the breath,
perspiration, Saliva and breast milk. perspiration, Saliva and breast milk.
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19. 
FACTORS AFFECTING MEDICATION ACTION: FACTORS AFFECTING MEDICATION ACTION:

A number of factors other than the drug itself A number of factors other than the drug itself
can effect its action. can effect its action.

DEVELOPMENTAL FACTORS: DEVELOPMENTAL FACTORS:

During pregnancy women must be very During pregnancy women must be very
careful about taking medication. Drugs taken careful about taking medication. Drugs taken
during pregnancy pose a risk throughout during pregnancy pose a risk throughout
pregnancy, but pose the highest risk during pregnancy, but pose the highest risk during
the first trimester, due to the formation of the first trimester, due to the formation of
vital organs & functions of the fetus during vital organs & functions of the fetus during
the time. the time.
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20. 
Most drugs are contraindicated because of Most drugs are contraindicated because of
the possible adverse effects on the fetus. the possible adverse effects on the fetus.

CULTURAL ETHNIC AND GENETIC FACTORCULTURAL ETHNIC AND GENETIC FACTOR

A client’s response to a drug is influenced A client’s response to a drug is influenced
by genetic variations such as gender, size & by genetic variations such as gender, size &
body composition. This variation in body composition. This variation in
response is called pharmacokinetics.response is called pharmacokinetics.
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21. 
ETHNOPHARMACOLOGY:ETHNOPHARMACOLOGY: The The
systematic study of the use of medicinal systematic study of the use of medicinal
plants by specific cultural groups. plants by specific cultural groups.

DIET:DIET: Nutrients can effect the action of Nutrients can effect the action of
a medication (e.g.) vitamin “K” found in a medication (e.g.) vitamin “K” found in
green leafy vegetables can counteract green leafy vegetables can counteract
the effect of an anticoagulant such as the effect of an anticoagulant such as
warfare (drug). warfare (drug).
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22. 
Environment: Environment:

The client’s environment can effect the action The client’s environment can effect the action
of drugs, particularly those used to alter of drugs, particularly those used to alter
behavior and mood. behavior and mood.

Environmental temperature may also drug Environmental temperature may also drug
activity. activity.

PSYCHOLOGIC FACTOR:PSYCHOLOGIC FACTOR: The sciences dealing The sciences dealing
with the minds and mental processes, with the minds and mental processes,
especially in relationship to human & animal especially in relationship to human & animal
behavior. behavior.
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23. 
ILLNESS AND DISEASE: ILLNESS AND DISEASE:

Illness & disease can also effect the action of Illness & disease can also effect the action of
drugs. drugs.

ORAL:ORAL: Oral administration is the most Oral administration is the most
common, less expensive and most convenient common, less expensive and most convenient
route for most clients. route for most clients.

In oral administration the drug is swallowed In oral administration the drug is swallowed
b/c skin is not broken as it is for an injunction, b/c skin is not broken as it is for an injunction,
oral administration is also a safe method. oral administration is also a safe method.
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24. 
SUBLINGUAL: SUBLINGUAL:

In sublingual administration a drug is placed In sublingual administration a drug is placed
under the tongue, which it dissolves I a under the tongue, which it dissolves I a
relatively short time, the drug is largely relatively short time, the drug is largely
absorbed into the blood venal on the under absorbed into the blood venal on the under
side of the tongue. The medication should not side of the tongue. The medication should not
be swallowed. be swallowed.

Nitroglycerin is one example of a drug Nitroglycerin is one example of a drug
commonly given in this manner. commonly given in this manner.
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25. 
BUCCAL: BUCCAL:

Buckle MEANS “Pertaining to the check”. Buckle MEANS “Pertaining to the check”.

In buckle administration an accreditation (e.g. In buckle administration an accreditation (e.g.
tables) is held in mouth against the mucous tables) is held in mouth against the mucous
membranes of the check until the drug membranes of the check until the drug
dissolve. dissolve.

The drug may act locally on the mucous The drug may act locally on the mucous
membrane of the mouth or systemically when membrane of the mouth or systemically when
it is swallowed in the Saliva. it is swallowed in the Saliva.
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26. ROUTE OF ADMINISTRATIONROUTE OF ADMINISTRATION

OralOral

I/MI/M

I/VI/V
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27. ROUTE OF ADMINISTRATIONROUTE OF ADMINISTRATION

Oral Oral

AdvantagesAdvantages

Most convenient usually least expensive safe, Most convenient usually least expensive safe,
does not break skin barrier. does not break skin barrier.

Administration usually does not cause stern Administration usually does not cause stern
some new oral medications are designed to some new oral medications are designed to
rapidly dissolve on the tongue, allowing for rapidly dissolve on the tongue, allowing for
faster absorption & action. faster absorption & action.
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28. 
Disadvantage: Disadvantage:

Drug may discolor teeth, harm tooth enamel. Drug may discolor teeth, harm tooth enamel.

Drug may irritate gastric mucosa. Drug may irritate gastric mucosa.

Drug can be aspirated by seriously ill clients. Drug can be aspirated by seriously ill clients.

Sublingual Sublingual

AdvantagesAdvantages

Drug can be administered for local effect. Drug can be administered for local effect.

More potent than oral route between drug More potent than oral route between drug
directly enters the blood & bypasses the liver. directly enters the blood & bypasses the liver.
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29. 
Disadvantages Disadvantages

If swallowed, drug may be inactivated by If swallowed, drug may be inactivated by
gastric juices. gastric juices.

Drug is rapidly absorbed into the blood stream. Drug is rapidly absorbed into the blood stream.

BUCCAL RETALBUCCAL RETAL

AdvantagesAdvantages

Can be used when drug has objectionable taste Can be used when drug has objectionable taste
or order. or order.

Drug released at low, steady rate. Drug released at low, steady rate.

Provides a local therapeutic effect. Provides a local therapeutic effect.
2929

30. 
The effect only the area. The effect only the area.

Topical application includes the following. Topical application includes the following.

Dermatologic preparations – applied to Dermatologic preparations – applied to
skin. skin.

Instillations and irrigations – applied into Instillations and irrigations – applied into
the body cavities or caprices, such as the body cavities or caprices, such as
urinary bladder, eyes, ears nose, rectum urinary bladder, eyes, ears nose, rectum
or various. or various.
3030

31. 
Inhalations – administered into the Inhalations – administered into the
respiratory tract by a equalizer or respiratory tract by a equalizer or
pressure breathing apparatus. Air pressure breathing apparatus. Air
oxygen & vapor are generally used to oxygen & vapor are generally used to
carry the drug into the lungs. carry the drug into the lungs.
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32. ROUTE OF DRUG ROUTE OF DRUG
ADMINISTRATIONADMINISTRATION

RIGHT ROUTERIGHT ROUTE

RIGHT TIMERIGHT TIME

RIGHT CLIENTRIGHT CLIENT

RIGHT CLEINT EDUCATION RIGHT CLEINT EDUCATION

RIGHT DOCRIGHT DOC

RIGHT TO REFUSERIGHT TO REFUSE

RIGHT ASSESSMENTRIGHT ASSESSMENT

RIGHT EVALUATIONRIGHT EVALUATION
3232

33. ROUTE OF DRUG ADMIN:ROUTE OF DRUG ADMIN:

RIGHT MEDICATIONRIGHT MEDICATION

RIGHT DOSERIGHT DOSE
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34. REFERENCE REFERENCE

KOZIER & ERB.KOZIER & ERB.

WWW.GOOOOOGLE .COMWWW.GOOOOOGLE .COM
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