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DRUG NAMES. ChemicalGeneric (Nonproprietary)Trade (Brand). DRUG CLASSIFICATION. Share similar characteristicsIndicates effect of medication on a body system. Drug Classification. Beta Blockers-olpropranolol (Inderal), metoprolol (Lopressor)ACE Inhibitors-prilenalapril (Vasotec
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1. MEDICATION ADMINISTRATION One of the greatest and most dangerous sources of errors
2. DRUG NAMES Chemical
Generic (Nonproprietary)
Trade (Brand)
3. DRUG CLASSIFICATION Share similar characteristics
Indicates effect of medication on a body system
4. Drug Classification Beta Blockers
-ol propranolol (Inderal), metoprolol (Lopressor)
ACE Inhibitors
-pril enalapril (Vasotec), lisinopril (Zesteril)
5. Drug Classifications Cephalosporins
cef- cefaclor (Ceclor), cefazolin (Ancef)
Aminoglycosides
-cin tobramycin, gentamicin
NOT azithromycin=macrolide
6. Pharmacokinetics How does the drug become therapeutically useful?
How does the drug
..
enter body; reach its site of action; become metabolized; and get eliminated from the body
7. PharmacokineticsABSORPTION
Passage of drug molecules into blood from site of administration
8. Absorption Route
Ability to dissolve
Blood flow
Body surface area
Lipid solubility
9. PharmacokineticsDISTRIBUTION
After absorption, distributed throughout the body to tissues/organs and ultimately to the site of action
10. DISTRIBUTION Blood flow
Membrane permeability
Protein binding
11. DISTIBUTIONProtein Binding
Degree to which the drug binds with protein affects its distribution
12. PharmacokineticsMETABOLISM Biotransformation occurs under influences of enzymes that detoxify, degrade, and remove biologically active chemicals
Why is this important?
13. PharmacokineticsEXCRETION
After the drug is metabolized, it leaves the body through:
kidneys, liver, bowel, or lungs
(May be found in other secretions
e.g., sweat and breast milk)
14. Medication Actions Therapeutic effect(s)
Side effect(s)
Adverse effect(s)
Toxic effects
Idiosyncratic reaction(s)
Allergic reaction(s)
Medication interaction (synergistic effect)
15. Medication Dose Responses
Serum Half-Life
Time it takes to lower medication concentration in serum by half
16. Nursing Responsibilities Who is responsible?
What do you need to know?
17. Medication Order Clients full name
Date/Time (med ordered)
Drug name
Dosage
Route of administration
Time and frequency of dose
Signature of prescriber (physician, surgeon, nurse practitioner, physician assistant)
18. Dosage Calculation Review conversions and drug calculations
Double-check Calculations
19. 8 Rights of Correct Medication Administration Patient
Drug
Dose
Route
Time
Documentation
Rationale
Pts right to refuse
(Traditionally 5 Rights of Medication Administration)
20. Preparing to Administer Medications Beginning of shift (right after report)
30 minute window (before & after scheduled time)
Take MAR to Pyxis or drawer
Sign bottom of MAR
Top to bottom, left to right
21. Preparing to Administer (cont.) Check med THREE TIMES
Dont open medication packet until at bedside
Go to room with meds and MAR
22. Proper Administration Identify client ***********
Against Wristband
Have patient state their name
PREPARE MEDS FOR ONE PATIENT AT A TIME
23. What do you need to know before administering meds? Assessment Findings
What is the expected effect and possible side effect?
WHY is patient receiving med?
Does patient still need the med?
(Re-assessment)
Evaluate patients response to med
24. Routes of Administration PARENTERAL vs. NONPARENTERAL
25. Routes of Administration Oral
Eye (ophthalmic)
Lungs (inhaler)
Skin
Injection
What are other routes?
26. Parenteral Administration Injection sterile/surgical asepsis
syringe
needle
Which size will you use?
27. Injection Preparation Ampule
Vial
28. Subcutaneous Injections Heparin
Lovenox
Insulin
29. Insulin Preparation Clear before cloudy
Why?
30. Intramuscular Injections Deltoid
Vastus Lateralis
Ventrogluteal
Dorsogluteal
31. Intramuscular Injections Technique
Z-track Method
32. IM Injections Z-track recommended for ALL IMs
Minimizes local skin irritation by sealing
medication in muscle tissue
Use large, deep muscle
Change needle before injection
33. Z-track Technique (cont.) Skin taut and laterally ~ 2.5-3.5cm (1-1.5) Insert like dart (90 degree angle)
ASPIRATE 5-10 seconds
Inject slowly wait 10 seconds
Withdraw and release skin
Apply pressure
Sharps container
34. Injection Skill Practice in lab.
Practice manipulating and reading syringes.
Practice drug calculations.
Practice site identification.