Unit 15.Drugs

8/2/2019 Unit 15.Drugs

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Unit 15. Administration of medicine

Drugs :

A substance used to promote health, to

prevent, to diagnose and to cure disease.

Are chemical substances derived from

different sources which are used to alter or

change the function of cells, organs for

organism by reacting with them.


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Abbreviations used when

administering drugs

AC: before meal

PC: after meal

AM: in the morning

PM: afternoon/ evening

OD: once a day

HS: at bed time

OM: each morning

ON: each night

P.R.N: when required


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SOS: if necessary

BID/BD: twice a day

TDS/TID: three times a day, 8 hourly QID: four times a day, 6 hourly

Stat: immediately (at once)

H:hourly


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Abbreviations regarding route

PO: per oral

IM: intra muscular

IV: intravenous ID: intradermal

SC: subcutaneous

PV: per vagina PR: per rectum


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Abbreviations regarding preparation of

the drugs

Mist: mixture

Tr./tinct: tincture

Syp: syrup

Sp: spirit

Lot: lotion

Liq: liquid

Inf: Infusion

Fl: fluid


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Abbreviation regarding the amounts

Grg: gargle

Kg: kilogram

O: pint

Mg: miligram

O: ounce

Gm: gram

Ml: mililitre

Tab: tablet Cap: capsule

Tsp: Tea spoon


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Types of medicaton action

Therapeutic effect: medications desired andintentional effects

Adverse effects: effects other than therapeuticeffect. These are generally considered severeresponses to medication. E.g client may becomecomatose when a drug is ingested.

Side effect: minor adverse effects. Are theunintended secondary effects of medications

predictably will cause. Many side effects areharmless and can be ignored. Some are harmfuland undesirable.


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Toxic effect: medication toxicity results from

overdose or abnormal accumulation of drug in the

blood because of impaired metabolism or

excretion. Toxicity can permanently damage organ

function e.g liver and kidney. Hyper sensitivity reaction: it occurs when a client

is unusually sensitive to a medication therapeutic

effect or secondary effect. An estimatedtherapeutics dosage of medication may be too

large for the client and may result in degree of

action greater than desired.


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Tolerance : it occurs when a client develops a

decreased response to it, requiring an

increased dose to achieve the therapeutic

effects.

Idiosyncratic reaction: this occurs when a

patient over reacts or under reacts to a rug or

has a reaction different from the normal.


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Mode of action of drugs


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Purposes of medication

To diagnose disease

To treat disease

To promote health condition To prevent health alterations

To relieve pain


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Six rights of administering drugs

Ensures safety in giving drugs

For safe administration of drugs, give the right doseof the right drugs to the right route at right time.

Six rights are:Right dose

Right drugs

Right patientRight time

Right route

Right documentation


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Right dose

Read the physicians orders to know the

correct dose.

Check age and weight of the patient

Calculate doses correctly

Ensure accuracy in measuring

Use dry medicine glasses for pouring liquidmedicines.

Hold the ounce glass at the eye level, keep the

thumb at the desired level and pour the


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Know abbreviation and symbols of amounts

Help the patient to take all the medicines.

Formula ,Dose ordered quantity in hand = volume to be givenDose available


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Right drugs

Read the physicians order. If the order is not clear,

consult the physician or other seniors.

When the drugs are first ordered, the nurse compares

the prepared medicine card with the physicians written

order.

Select the right drugs from the cupboard.

When administering drug, the nurse should compare

the label of the drug three times:

Before taking from shelf

Before measuring

When returning to shelf before removing hand from

container.


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Look for the colour, odour and consistency of the

drug.

Administer medicine only from a clearly labeled

container.

Avoid conversation or any thing that distracts mind.

Know abbreviations of drugs

Be familiar with the trade name of the drugs

Do not accept verbal orders

Correctly identify the patient before administration Be sure about the changing of orders.


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Right patient

Check the medication card/ record against the

patients name, bed and other patients

identification

Ask the patient to tell you his/her name.

For unconscious patient or children use an

identification tag.


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Right time

Many drugs are ordered for certain times of

day.

Insulin e.g in normally given before meals.

Antibiotics are usually ordered every 6,8 or 12

hours throughout the day and night.

Diuretics are usually given in the morning

rather than the evening

Read physicians order.


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Know the hospital routines for intervals.

Give near the time ordered , fifteen minutes

before or after the designated time.

Know abbreviations for time as AC, PC and BD.


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Right route

Read the physicians order carefully to ensure

the route of administration.

Know abbreviation for methods e.g I/V, I/M,

P/O

If any error occurs, it should be immediately

reported to the ward sister and the physician.


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Routes of administration of drug

Oral administration

Oral route : given by mouth is designed to be

swallowed which is absorbed in stomach and

intestine

Sublingual : drug is placed under the tongue and

letting slowly dissolve e.g nitroglycerine

Buccal: hold inside of mouth until they dissolve

e.g Lozenges

Adminstration through tubes: through

naso rastric tubes.


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Parenteral administration

Means giving of therapeutic agents outside the

alimentary tract

Intra dermal: into the dermis

Intra muscular: into the muscle

Intra venous: into the vein

Intra arterial: into the arteryIntra thecal: into the spinal cavity

Intra peritoneal : into the peritoneal cavity


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Intra osseous: into the bone marrow

Subcutaneous: into the subcutaneous tissue.


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Topical application

Dermalatogic preparation: applied to the skin

Instillation and irrigation: is putting drug in

liquid form into the body cavity e.g eye, ear

nasal instillation

Insertion: introduction of solid forms of drugs

into body orifices e.g rectal and vaginal

suppositories

Inhalations : drugs introduced into the body in

the from of vapour e.g oxygen inhalation,

stem inhalation


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Oral Medication

The administration of medication by mouthand ensuring that the patient swallows the

medicine.

Purposes of medication:To prevent the disease

To cure the disease

To promote the health

To give palliative treatment

To give as a symptomatic treatment.


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Advantages

This method is safe and convenient

It is effective method

There is no pain while giving drugs Few and mild allergic reaction

No need of trained person

Cheap

Easy to administer


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contraindication

Alteration in gastrointestinal tract like vomiting

Surgical resection of a portion of gastrointestinal

tract.

Patients with gastric suction/ aspiration

Prior to certain tets/ surgeries

Patients on NPO status Patients with poor gag reflex

Unconscious/ confused patient


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Patients who are unable to swallow e.g

patient with neuromuscular disorder

When drugs are destroyed in the stomach by

the action of digestive juice e.g insulin


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Disadvantages

Sometimes the patients may not swallow the

medicine

The drug may only be partially absorbed

It may irritate the gastric mucosa and can cause

vomiting or diarrhoea and the effect are lost

Unpleasant taste

Drug may absorb slowly


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Forms of oral medication

Solid forms of medication: it includes tablets,

capsules and powders

Tablets

Interic coated tablet: medication with hard surface

that impads absorption until the medication

reaches the small intestine

Sustained release tablet: especially formulated for

gradual absorption

Lozenge : tablets that dissolve in mouth.


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Capsules: capsules are oral preparation in

which one or medicinal substance, powder or

liquid are placed inside shell.

Powder: dry particles, reduced to dust or a

mass of very small fine dry pieces.

Li id f f di i


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Liquid form of medication

It includes syrup, suspension and elixir, emulsion

Syrup : medication dissolved in concentrated sugar

solution may contain flavoring to make medication

more testable.

Suspension: finely divided drug particles dispersed

in liquid medium. It must be shaken before

administration

Elixir: liquid preparation of medication with alcohol

base e.g cough syrup

Emulsion : suspension within an oily base


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Articles required

Medication card/ patients file

Medication tray

Medicine

Measuring cup/dropper/plastic cup; spoon, medicine cup

Kidney tray/paper bag

Glass of water

Mortar and pestle

Scissors

Towel or sponge cloth, cotton to dry the measuring

cup,glass or spoon

Jug of water


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Procedure

Identify the patients name and verify

medication order

Assess for any contraindication

Prepare needed articles

Check medication card/ form with the

physicians written order for accuracy,

completeness etc. check the patients name,

name of drug, dose, route and time of

administration.

Explain the purpose of medication to the

patient.


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Wash hands

Take appropriate medication from stock ortray and compare the label of medication with

cardex , check expiry date, dose, route,

indication and contraindication, calculateddose if needed.

For tablets/capsules, pour required number

from bottle into bottle cap and transfer tomedication cup. Do not touch with fingers.


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To prepare unit-dose tablets or capsules place tablets

or capsules directly into medication cup withoutremoving wrapper.

Medicines that need pre-administration assessment

should be placed separately.

To prepare liquids, shake the bottle.

Hold the bottle with the label against the palm of hand

when pouring.

Hold the medication cup to eye level and fill it todesired level.

Discard if there is excess liquid in the cup into sink,

wipe the mouth of bottle with paper towel.


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Return the drug container back to the cupboard

after checking the label.

Identify the patient by comparing name on card

with the name the patient gives when asked.

Perform necessary pre-administration assessment

for specific medication

Explain to the patient the medication to be given

and allow the patient to clarify doubts.

Assist patient to sitting or side lying position


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Administer drug properly

Ask if the patient wishes to hold medication incup/hand before placing in mouth.

Administer only one drug at time

Offer a glass of water with the drug to be

administered . First give little water to moisten

the mouth and then give medicine one at

time.Place medication under tongue and allow it

dissolve completely in case of sublingually

administered medication.


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Instruct the patient to place the medication inmouth against cheeks until it dissolves

completely in case of buccal administration.

If the patient is unable to hold, medication in

hand place cup to the lip and introduce each

drug into mouth one at a time using a spoon.

If the tablet/capsule falls to the floor, discard it

and repeat tablet preparation.

Stay with the patient until each tablet is

swallowed. (make sure medicine are

swallowed


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Assist the patient to a comfortable position

Dispose off soiled supplied and wash hands.

Replace articles

Clean work area

Record the medication administration with date,

time and signature.

Record and report any reaction observed after the

administration of the drug to the ward sister and

doctor.


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Unit 15.Drugs

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