MEDICATION ADMINSTRATION IN ENGLISH
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TITLE OF THE PROCEDURE-
MEDICATION
ADMINISTRATION-AN INTRODUCTION
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Medications
are substances prescribed by the client’s prescribing practitioner to help in
the treatment, relief, or cure of the cause of the client’s health alterations
or in the prevention of such alterations. Nurses play an essential role in the
administration of, education about, and evaluation of the effectiveness of
prescribed medications.
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Medication
administration requires specialized knowledge, judgment, and nursing skill
based on the principles of pharmacology. The focus of this lecture is to assist
the nursing student in applying principles of pharmacology and in acquiring
skills in the safe administration of medications.
PHARMACOKINETICS-
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Pharmacokinetics
refers to the study of the absorption, distribution, metabolism, and excretion
of drugs to determine the relationship between the dose of a drug and the
drug’s concentration in blood and biological fluids.
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ABSORPTION-
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The degree
and rate of absorption, or passage of a drug from the site of administration
into the bloodstream, depend on several factors such as the drug’s
physicochemical effects, its dosage form, its route of administration, its
interactions with other substances in the digestive system, and patient's
various characteristics such as age and weight
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Oral
preparations, such as tablets and capsules, must first disintegrate into
smaller particles for gastric juices to dissolve and prepare the drug for
absorption in the small intestines.
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Drugs
administered intramuscularly are absorbed through the muscle into the
bloodstream
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Suppositories
are absorbed through the mucous membranes into the blood.
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Intravenous drugs are immediately bioavailable
because of their direct injection into the blood to produce a drug effect
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Sublingual medications are absorbed more quickly than
are subcutaneous injections.
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DISTRIBUTION-
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Distribution
refers to the movement of drugs from the blood into various body fluids and
tissues. The rate at which the drug reaches the specific site of action is
affected by blood flow, cell membrane permeability, and the protein binding
capacity of the medication.
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METABOLISM-
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The process
of metabolism (also known as biotransformation) refers to the physical and
chemical processing of the drug. In metabolism, the drug is inactivated and
changed into a water-soluble compound that can be excreted by the body. The
liver is the primary source of biotransformation.
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EXCRETION-
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Excretion is
the process in which drugs are eliminated from the body. Factors that affect
the kidneys’ ability to excrete drugs include maturity of the kidneys,
circulation, and disease. As kidney function decreases, there can be an
accumulation of drugs, which can result in toxicity
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DRUG FORMS- Drugs
are available in many forms for administration by a specific route such as oral
route or parenteral route. The nurse should be aware of the various drug forms
and how they are administered. Certain drug preparations require special
consideration regarding administration.
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Drugs
prepared for administration by one route should not be substituted by other
drug forms. For example, when a client has difficulty swallowing a large tablet
or capsule, the nurse should not administer an oral solution or elixir of the
same drug without first consulting the prescribing practitioner because a
liquid may be more easily and completely absorbed, producing a higher blood
level than a tablet.
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ORAL ROUTE -
Most drugs are administered by the oral route because it is the safest, most
convenient, and least expensive method. The disadvantage of the oral route is
that it is slower acting than the other routes. Oral route drug forms includes-
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• Tablets:
compressed or molded substances to be swallowed whole, chewed before
swallowing, or placed in the buccal pocket or under the tongue (sublingual)
} •
Capsules: substances encased in either a hard or a soft soluble container or
gelatin shell that dissolves in the stomach.
} Caplets: gelatin-coated
tablets that dissolve in the stomach
} Powder and granules:
finely ground substances.
} Troches, lozenges, and
pastilles: similar preparations of drugs designed to dissolve in the mouth
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Enteric-coated
tablets : coated tablets that dissolve in the intestines.
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Time-release
capsules: encased substances that are further enclosed in smaller casings that
deliver a drug dose over an extended period of time
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Sustained-release:
compounded substances designed to release a drug slowly to maintain a steady
blood medication level
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Syrup: it is
make to change the taste of medicines. it is a thick sweet liquid, often made
by adding boiling sugar and water or fruit juice.
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Elixirs: are
sweetened hydro-alcoholic (water and alcohol) liquids for oral use. Typically,
alcohol and water are used as solvents when the drug will not dissolve in water
alone.
PARENTERAL ROUTE - parenteral means introduction of a medication by any
route other than the oral-gastrointestinal route. However, medical usage of
this term refers to injecting medication into body tissue. It includes – Intradermal,
subcutaneous, intramuscular, intravenous, intrathecal or intraspinal,
intracardiac, intrapleural, intra-arterial, and intra-articular
injections. Preparation includes
ampules, single dose vials and multi-dose vials
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TROPICAL
ROUTE - Most topical drugs are given to deliver a drug at, or immediately
beneath, the point of application. Although a large number of topical drugs are
applied to the skin, other topical drugs include eye, nose and throat, ear,
rectal, and vaginal preparations. Tropical drug form includes-
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Liniments:
substances mixed with an alcohol, oil, or soapy emollient that are applied to
the skin
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Ointments:
semisolid substances for topical use.
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Pastes:
semisolid substances, thicker than an ointment, that are absorbed slowly through
the skin
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Transdermal
patches: contain medication that is absorbed through the skin over an extended
period of time
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Suppositories:
gelatin substances designed to dissolve when inserted in the rectum, urethra,
or vagina.
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Inhalations:
drugs or dilution of drugs administered by the nasal or oral respiratory route
for a local or systemic effect
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Drops: Optic
(eye) and otic (ear) and nasal solutions that are instilled as drops.
MEDICATION ORDER-
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The
prescribing practitioner determines the therapeutic drug plan and conveys the
plan to others by initiating orders or a prescription. Safe practice dictates
that a nurse follows only a written or typed order, or an order entered into a
computer system because these types of
orders are less likely to result in error or misunderstanding. Under certain
circumstances, such as in an emergency, a verbal order from the physician may
be given to a registered nurse. Which should be written soon after the emergency normalizes.
ABREVIATIONS AND THEIR MEANING-
|
ABBREVIATION |
MEANING |
|
a.c. |
before meals |
|
p.c. |
after meals |
|
ad lib |
freely, as
desired |
|
b.i.d. or b.d. |
two times a day |
|
cap |
Capsule |
|
elix |
elixir |
|
h |
hour |
|
hrly |
hourly |
|
ID |
intradermal |
|
IM |
intramuscular |
|
IV |
Intravenous |
|
IVPB |
intravenous
piggyback |
|
per |
by |
|
PO |
by mouth |
|
prn |
as needed |
|
q |
every |
|
q2h |
every 2 hours |
|
q.i.d. |
four times a day |
|
stat |
immediately |
|
supp |
suppository |
|
susp |
suspension |
|
tab |
tablet |
|
t.i.d. |
three times a day |
|
Tr or tinct |
tincture |
|
U |
Units |
|
HS |
half strength/sleeping time |
|
TIW |
Thrice a week |
|
EOD |
Every other day |
|
aq. bull. |
Boiling water |
|
bol |
large single dose |
|
5 ML |
1 teaspoonful |
|
10 ML |
1 dessertspoonful |
|
15 ML |
1 tablespoonful |
|
30 ML |
1 ounce |
|
60 mL |
1 wineglassful |
|
120 ML |
1 teacupful |
|
1 mg |
1/60 grain |
|
4 mg |
1/15 grain |
|
10 mg |
1/6 grain |
|
15 mg |
1/4 grain |
|
30 mg |
1/2 grain |
|
60 mg |
1 grain |
|
1000 g |
1 kg or 2.2 pounds (lbs) |
PEDIATRIC DOSES
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Several rules
have been devised to calculate infants’ and children’s dosages (e.g., Young’s
rule, Clark’s rule etc.) but these rules give only approximate dosages.
Regardless of the method used in calculating pediatric drug dosages, the nurse
should realize that dosages are approximate and often need adjustment based on
the child’s response
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