23 Med Administration

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23 Med Administration
2012-02-06 01:35:10
med admin

Chapter 23
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  1. Pharmacokinetics
    • the characteristic interactions of a drug and the body in terms of its absorption, distribution, metabolism, and excretion
    • (what the body does to a drug)
  2. Pharmacodynmics
    • study of the biochemical and physiological effects of durgs: study of drug mechanism action.
    • (what the drug does to the body)
  3. Metabolite
    a product of metabolism; a substnace produced by metbolism, which results in the breakdown of the drug.
  4. Potentiation / Synergism
    When one drug increases the action or the effect of another drug.
  5. Agonist
    A drug that produces a predictable response at the intended site of action.
  6. Agonist
    A drug that binds to a receptor of a cell and triggers a response by the cell. An agonist often mimics the action of a naturally occurring substance.
  7. Antagonist
    A drug that will block the action of another drug. (used to counteract the effects of a previously given drug)
  8. Idiosyncratic drug reactions (IDR)
    • An individual's unique hypersensitivity to a particular drug.
    • Unpredictable adverse drug reactions that do not occur in most patients
  9. Adverse drug reaction
    a harmful, unintended reaction to a drug administered at a normal dosage.
  10. Contraindications
    Conditions in which the drug should not be used.
  11. 8 Factors affecting responce to medication.
    • 1. Age
    • 2. Weight
    • 3. Physical Health (poor health do not tolerate well)
    • 4. Phychological Status (Stress, anxiety, alter response to drugs)
    • 5. Environmental Temperature- Affects metabolism
    • 6. Sex
    • 7. Amount of food in stomach
    • 8. Dosage forms - influence onset, intensity, & duration of a drug.
  12. Unit-dose system
    a portable cart with drawers, containing a 24 hour supply of medications for each patient. Each medication individually wrapped in a unit dose.
  13. Computer - controlled dispensing systems
    A computerized screen is used to request a specific medication. A security code is used to access only those medications perscribed for a pt.
  14. Standing orders
    Orders that are already written by a physician for a patient. Can be carried out without having to call the physician.
  15. 6 Rights of medication administration
    • 1. right patient
    • 2. right dose
    • 3. right time
    • 4. right route
    • 5. right patient
    • 6. right documentation
    • * right to refuse
  16. Routes of Administration
    • Enteral - by GI tract
    • Percutaneous - through skin or mucous membranes
    • Parenteral - Though the blood stream; routes other than the alimentary (GI) or respiratory tract.
  17. Parenteral
    Taken into the body or administered in a manner other than through the digestive tract (usually needle routes)
  18. Ointment
    Oil based semi solid medication
  19. Cream
    Semisolid, nongreasy emulsion
  20. Lotions
    • Aqueous
    • Are not be be rubbed in (pat onto skin)
  21. Transdermal Patches (Topical Disk)
    • Adhesive-backed medication patch
    • Provide sustained continues medication.
    • Apply to dry, clean area free of hair
  22. Ear Drops
    • Room Temp
    • Children 3 and under pull ear downward and back
    • Adults pull ear up and upward and back
    • Instill without touching ear with dropper.
    • Keep patient in position for 5-10 min.
  23. Nose Drops
    • Have patient lie down and hyperextend the neck over edge of bed or a pillow under shoulders.
    • Have children / infant lie down with head back and down?
    • Have patient hold position for a few min. and refrain from blowing nose immediately after installation.
  24. Nasal Sprays
    • Shake bottle
    • Hold one nostril, inhale and squeezing bottle in other nostirl.
    • Refrain from blowing nose immediatly after installation.
  25. Eye Drops & Ointments
    • Wipe from inner canthus outwards (avoids introducing microorganisms into lacrimal ducts)
    • Administer to conjuntival sac (effect of drug is obtained only when drops enter sac)
    • For ointment have pt close eye and more eyes (Spread medication evenly)
  26. MDI (Metered dose inhaler)
    • Lips do not touch inhaler. Position 1/2 - 1 inch from mouth.
    • With spacer (Areo Chamber) have patient exhale then place device in mouth. (spacer allows medication to ride into airway)
    • press and inhale slowly hold breath for 10 seconds. Exhale through pursed lips
    • Wait 2-5 min between puffs (5-10 min if more than one med is perscribed)
  27. Sublingual / Buccal Medications
    • Place under tonge or between check and gums
    • Tablet needs to disolve. Do not chew and swallow.
    • Do not follow with water.
    • Dissolution allows rapid absorption into the blood stream
  28. 6 Reasons to use parental routes
    • 1. Medications are altered by GI secretions
    • 2. Patient is unable to take by mouth.
    • 3. Parenteral routes have a rapid onset than oral
    • 4. Duration of effects are shorter than oral
    • 5. Smaller doses are possible (drugs are not altered by GI and Liver)
    • 6. IV meds are possible to regulate closely. they enter directly into blood stream and onset of drug action is immediate.
  29. Gauge and needle used for IM injections
    • 21-23 gauge
    • 1 - 1 1/2 needle
  30. Gauge used for blood administration, emergency IV, and surgical cases.
  31. Gauge & needle for intradermal injections infants and children
    • 25-27
    • 3/8 - 5/8
  32. Gauge and needle used for Sub-Q
    • 25-27 Gauge
    • 5/8 - 1/2 Needle
  33. Gauge and Needle used for Insulin
    • 29-30 Gauge
    • 1/2 and 5/16 ?
  34. Components of a med order
    • 1.Patient
    • 2. DOB
    • 3. Date & time of order
    • 4. Drug
    • 5.Dosage (size & frequency)
    • 6. Physicians signature
    • 7. Special Instructions
  35. Location of Ventrogluteal site
    Palm on greater trochanter, fingers pointed toward the anterior iliac spine and iliac crest.
  36. Location of the deltoid site
    Between the acromion process and an imaginary line of the axillary fold.
  37. Maximun amount that can be injected in a IM injection to the deltoid.
    1 ml
  38. When is a ID injection used?
    • Vaccines
    • Skin tests
    • Local anesthetics
    • Small volumes