1. King Saud University College of Nursing NUR 122
MEDICATION
King Saud University
College of Nursing
NUR 122

2. Drug administration
Medication: substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of a disease.
Medication or drugs are given to exert specific physiologic effects on the body.
They play an important role in preventing, treating, and curing illness, their administration has become one of the most important, complex and risk-laden aspects of nursing care.

3. Routes of drug administration
Oral: Per mouth
Sublingual: under the tongue
Buccal: against the cheek
Pareneteral: IV, IM, SC, intradermal, intracardiac, intrathecal,intrapleural, intraosseous
Topical: skin, eyes, ear, nose, rectum or vagina.
Effects: local, systematic.
Medication are prescribe by physician.
Medication order includes the name of the drug, the dose, the route, frequency, date and time.

4. Effects of Drugs Therapeutic effect = desired effect
Reason drug is prescribed
Side effect = secondary effect
Unintended, usually predictable
May be harmless or harmful
Drug toxicity
Result from overdose, ingestion of external use drug
Buildup of drug in blood

5. Drug allergy Drug tolerance Drug interaction
Immunologic reaction to drug
Mild to severe reactions (anaphylaxis)
Drug tolerance
Need increasing doses to maintain therapeutic effect
Drug interaction
One drug affecting effect of another

6. Actions of Drug on the body
Pharmacodynamics:
Process by which drug changes the body (mechanism of action).
Pharmacokinetics:
Study of absorption, distribution, biotransformation, and excretion of drugs

7. Pharmacokinetics
Absorption: movement from the administration site into the bloodstream.
Distribution: transportation of the drug from its site to the site of action.
Metabolism: the drug is converted by enzymes into a less active form that can be excreted, (most drugs are metabolized in the liver).
Excretion: elimination from the body. The kidneys are the most important route.

8. Drug Nomenclature
Chemical name — describes the chemical constituents of the drug
Generic name — assigned by the manufacturer that first develops the drug
Trade name — brand name given by the company that sells the drug

9. Drug Preparations Oral: Topical: Injectable: - Vial, Ampoule
Capsule, pill, tablet, suspension, syrup
Topical:
lotion, ointment, suppository, transdermal patch
Injectable:
- Vial, Ampoule

10. Mechanisms of Drug Actions
Drug-receptor interaction — drug interacts with one of more cellular structures to alter cell function
Drug-enzyme interaction — combines with enzymes to achieve desired effect
Acting on cell membrane or altering the cellular environment

11. Factors Affecting Drug Absorption
Route of administration
Drug solubility pH
Local conditions at site of administration
Drug dosage
Serum drug levels

12. Adverse Effect of Medications
Iatrogenic disease: disease caused unintentionally by medical therapy.
Allergic effects: immunologic reaction to the drug.
Toxic effects
Drug interactions

13. Signs and Symptoms of Drug Allergy
Rash
Urticaria
Fever
Diarrhea
Nausea
Vomiting
Anaphylactic reaction

14. Factors affecting Medication action
Developmental considerations
Weight
Gender
Diet
Genetic and cultural factors
Psychological factors
Illness & disease
Environment, timing of administration

15. Types of Medication Orders
Standing order — carried out until cancelled by another order
Prn order — as needed
Stat order — carried out immediately & once

16. Parts of the Medication Order
Patient’s name
Date and time order is written
Name of drug to be administered
Dosage of drug
Route by which drug is to be administered
Frequency of administration of the drug
Signature of person writing the order

17. Medication Prescription

18. The 7 rights Right Medication Right Dose Right Rout
Right Time (b.i.d, t.i.d, q.i.d. q8h)
Right Client
Right information
Right Documentation

19. Controlled Substances Required Information
Name of patient receiving narcotic
Amount of narcotic used
The hour narcotic was given
The name of physician prescribing narcotic
Name of the nurse administering narcotic

20. Oral Medications Solid form — tablets, capsules, pills
Liquid form — suspensions, syrups
Oral Route — having patient swallow the drug.
Enteral route — administering drug through an enteral tube
Sublingual administration — placing drug under tongue
Buccal administration — placing drug between tongue and cheek

21. Administration of Parenteral Medications
Subcutaneous injection — subcutaneous tissue (0.5-1 ml)
Intramuscular injection - muscle tissue (1-3ml)
Intradermal injection — corium (under epidermis) (0.1 ml)
Intravenous injection — into a vein
Intracardial injection — heart tissue
Intraperitoneal injection — peritoneal cavity
Intraspinal injection — spinal canal
Intraosseous injection — bone

22. Sites for Intramuscular Injections
Ventrogluteal site
Vastus lateralis site
Deltoid muscle site
Dorsogluteal site

23. Ventrogluteal site

24. Vastus Lateralis site

25. Deltoid Site Copyright 2008 by Pearson Education, Inc.
Figure Landmarks for the deltoid muscle of the upper arm, used for intramuscular injections.
Figure Administering an intramuscular injection into the deltoid site.
Copyright 2008 by Pearson Education, Inc.

26. Dorsogluteal Site Copyright 2008 by Pearson Education, Inc.
Figure Landmarks for the dorsogluteal site for an intramuscular injection.
Copyright 2008 by Pearson Education, Inc.

27. Criteria for Choosing Equipment for Injections
Route of administration
Viscosity of the solution
Quantity to be administered
Body size
Type of medication

28. Topical Administration of Medications
Eye: eye drops, ointments
Ears: ear drops
Nose: nasal drops
Rectal: suppositories
Skin applications: ointment, cream lotion

29. Medical Record Documentation
Document & sign each dose of medication, as soon as it is given, and the patient response.
Intentional or inadvertent omitted drugs.
Refused drugs.
Medication errors.

30. Type of Medication Errors
Inappropriate prescribing of the drug
Extra, omitted, or wrong doses
Administration of drug to wrong patient
Administration of drug by wrong route or rate
Failure to give medication within prescribed time
Incorrect preparation of a drug
Improper technique when administering drug
Giving a drug that has deteriorated

31. Medication Errors
Check patient’s condition immediately; observe for adverse effects.
Notify nurse manager and physician.
Write description of error on medical record and remedial steps taken.
Complete special form for reporting errors.

32. Patient Teaching Review techniques of medication administration.
Remind patient to take the medication as prescribed for as long as prescribed.
Instruct patient not to alter dosages without consulting physician.
Caution patient not to share medications with others even if they have the same disease.