PHARMACOLOGY
Routes of Administration Ways used to get a drug into the tissue of the body.
Onset of Action The amount of time needed before a drug takes effect.
Two main Routes ORAL Parenteral
Oral Most common Anything swallowed (pills, capsules, liquid) What is the abbreviation for by Mouth? Absorption: small intestines On set of action: 30-60 min.
Parenteral Any other way to get medication into the body. Sublingual: under the tongue Absorbed immediately into the bloodstream Onset of action: 1 min.
Parenteral Cont. 2. Buccal: Between the cheek and gum Absorbed by mucus membrane On set of action: 2-3 min. 3. Inhalation: breathed in through the lungs On set of action: 1 min
Parenteral cont. 4. Topical On top of the skin Creams, lotions onset of action: 1hr Transdermal patch onset of action: 30-60 min Rectal, vaginal onset of action: 15-30 min
Parenteral cont. 5. Injections: directly into the tissue where it is absorbed into the bloodstream. Intradermal: several minutes Subcutaneous: several minutes Intramuscular: several minutes Intravenous: within a minute
Five Rights of Medication 1. Right Patient 2. Right Medication 3. Right Dose/amount 4. Right Route 5. Right Time ALWAYS CHECK EACH 3 TIMES!!!!!!!!!!!!!!
Injections: Safety Always wear gloves Never recap a dirty needle Always dispose of needles in a sharps container Clean skin with alcohol to prevent infection Use correct technique to prevent injury to nerves, blood vessels, and tissue.
Intradermal Injections For allergy and tuberculin testing Administered just under the surface of the skin Fine gauge needle 26 or 27G Length 3/8”-5/8”
Intradermal Injection Bevel is faced upward so the substance is expelled into the dermis. Makes a small wheal or bleb if done correctly. Angle of insertion 10-15 degrees Amount: .01-.05cc Injection sites: Anterior forearm, mid-back area
Intradermal
Intradermal
Subcutaneous Injection Immunizations, insulin Administered at a 45 degree angle Amount: no more than 2cc Needle length: ½ inch Gauge: 25-27 Sites: Deltoid (upper outer part of the arm), Abdomen, upper thigh Aspirate before injecting!
Subcutaneous Sites
Intramuscular Injection Needle length: 1-3” G: 23-18 (depends on the viscosity of the liquid) Angle: 90 degrees Max Amount: 3.0cc
Intramuscular Sites: Deltoid (upper outer portion of the arm) Gluteus medius (upper outer portion of the hip) Siatic nerve Ventrogluteal (lateral outside portion of the hip) Vastus Lateralis (mid-portion of the thigh) used on children under two
Deltoid, Ventrogluteal, Gluteus Medius
Z-Tract Method
Anaphylactic Shock Always watch for adverse reaction to any medication but especially if it is new to the patient. Check patient within 30 min. This can be life threatening!!
Anaphylactic Shock S/S Early: Anxiety Weakness Sweating SOB Rash/welts
Anaphylactic Shock S/S Late: Nausea/diarrhea Hypotension Shock Arrhythmia Respiratory congestion Laryngeal edema
Anaphylactic Shock TX: Epinephrine (adrenalin) given to counteract the reaction. Inject just above the initial site. Notify physician Monitor vital signs