Medication Administration PDF

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Summary

Medication administration and pharmacokinetics....

Description

Medication Administration Objectives (pg. 609) 1. Discuss nursing roles & responsibilities in medication administration - Preparing, administering, and evaluation of the effects of medications (how they affect the patient's health status) - Knowing pharmacokinetics to time med administration, route of administration, & evaluating patient response - Teaching patients about side effects - Encouraging them to follow the medication regimen - Evaluating the family/caregiver's ability to administer medications if needed 2. Describe the physiology mechanisms of medication action 3. Forms of medications Form

Description

Oral Route: Solid forms ●

Caplet

Solid, shaped like a capsule & coated for easy swallowing

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Capsule

Encased in a gelatin shell

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Tablet

Compressed powder; as binders (adhesive for the powder to stick together), disintegrators (helps tablet dissolve), lubricants, and fillers

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Enteric-coated tablets

Dissolves & absorbs in intestines, NOT stomach

Oral Route: Liquid forms ●

Elixir

Clear fluid with water/alcohol; sweetened

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Extract

Concentrated, made from removing the active med from its other components

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Aqueous solution

Substance dissolved in water/syrups

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Aqueous suspension

Finely dissolved drug particles in liquid medium (settle on bottom when sets)

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Syrup

Meds dissolved in a concentrated sugar solution

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Troche (lozenge)

Flat/round tablet that dissolves in mouth

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Aerosol

Sprayed/absorbed in mouth & upper airway

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Sustained release

Tablet/capsule with small coated particles of a med that need a varying amount of time to dissolve

Topical Route ●

Ointment

Usually has 1 or more meds

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Liniment

Has alcohol, oil, or soapy emollient applied to skin

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Lotion

Protects, coats or cleanses skin

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Paste

Absorbed more slowly than ointment; used for skin protection

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Transdermal disk/patch

Absorbed slowly over a long period of time

Parenteral Route ●

Solution

Water with 1 or more dissolved components

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Powder

Dissolved in a sterile liquid (water, normal saline) before administration

Body Cavities ●

Intraocular disk

Small, flexible oval with 2 soft outer layers & a middle layer with medication (slowly releases meds when moistened by ocular fluid)

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Suppository

Solid dosage mixed with gelatin & shaped in pellet form for insertion (melts when reaches body temp., releasing med for absorption)

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Differentiate among different types of medication actions Therapeutic effects Adverse effects Discuss developmental factors that influence pharmacokinetics Discuss factors that influence medication actions How a medication is absorbed - Route of administration: - Skin = slow absorption - Orally = slow due to passing through GI tract - Mucous membranes/airways = quick; tissues have more blood vessels - IV injection = quickest, immediate response due to entering systemic circulation - Ability of a med to dissolve: - Solutions/suspensions already in liquids absorb faster than tablets/capsules - Acidic meds go through GI tract quickly - Basic meds are not absorbed before getting to small intestine - Blood flow to the site of administration: - Greater the blood supply, the faster the med is absorbed (med is absorbed once blood reaches administration site) - Body surface area (BSA): - Meds absorbed faster when in contact with a larger surface area - Lipid solubility: - Lipid-soluble meds cross cell membrane quicker - Food in the stomach affects absorption - ALWAYS check with pharmacology books, package inserts/pharmacy BEFORE giving a patient a med to see what the medication-medication or medication-food interactions exist How a medication is distributed - Circulation: - Vascularity of a patient's tissues/organs determines how fast a med is distributed - Low vascularity = slow distribution - Membrane permeability: - Medication's ability to pass through tissues/membranes of target cells - Protein binding: - How meds bind to serum proteins affects distribution (most partially bind, reducing its effect) How a medication is metabolised - Patients with liver disease can have toxic reactions to drugs because more of them accumulate in the body due to liver's decreased ability to break down harmful substances before distributed to tissues

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How a medication is excreted - Adequate fluid intake helps proper elimination of meds for adults (50 mL/kg/hr) - Impaired renal function limits the kidney's ability to properly excrete meds → increasing risk for medication toxicity 7. Discuss methods used to educate patients about prescribed medications 8. Compare and contrast the roles of the health care provider, pharmacist, and nurse in medication administration 9. Implement nursing actions to prevent medication errors 10. Describe factors to consider when choosing routes of medication administration - The form and composition of the medication (determines route of administration, absorption & metabolism) 11. Calculate prescribed medication does correctly 12. Discuss factors to include in assessing a patient's needs for and response to medication therapy 13. Identify the 6 rights of medication administration and apply them in clinical settings 14. Correctly and safely prepare and administer medications 1. Pharmacokinetics - Absorption: the passage of medication into the blood from its site of administration - Oral drugs have a slow absorption - IV drugs have the most rapid absorption - Liquids absorb faster than tablets - Food may interfere with absorption - Some meds interfere with absorption of other meds - Distribution: medications are distributed into the body - Circulation - Membrane permeability - Protein binding - Metabolism: - Most of the drug is metabolized in the liver...but also in the lungs, kidneys, intestines, and blood - Excretion: after medications are metabolized, they exit the body through the kidneys, liver, bowel, exocrine glands, and lungs...