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Medication

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  • 1. PDR & Medication Administration MED PREPJANET J. NELSON RN,CMA
  • 2. “A Little White Pill”  Your patient brings in this tablet but has forgotten the name. What is it?
  • 3. PDR Physician Desk Reference Old vs. New  Online with fee  App with fee  Brand and generic are combined  Additional pages for US Food and Drug contacts;poison control info. and herb and drug interactions
  • 4. VARIOUS TYPES OF PDRs Herbal Dental Diagnostic Oncology Ophthalmology
  • 5. PDR SECTIONS WHITE-Manufactures Index PINK-Brand and generic Index BLUE/GRAY-Product Category Color Photos-Product Identification Category WHITE-Product Information
  • 6. PRODUCT INFORMATION CATEGORY Black Boxes Description Clinical Pharmacology Indications & Usage Administration Contraindications Warnings Precautions Dosage and Administration Overdose Adverse Reaction How Supplied Reference
  • 7. Agencies/standardsFDA:DEA:Pure Food & Drug Act:Drug Standards:OHIO laws allow for medication to beadministered by: RN Dentist LPN Podiatrist CMA Physcian Assistant Physician (DO or MD)
  • 8. Doctor’s Order Include:*name of patient*date and time the order is written*name of medication*dosage to administer*route of administration*time & frequency of administration*signature of doctorVO or PO must be signed within 24 hours
  • 9. Medication FormsLIQUIDS: SEMI SOLIDS:Aqueous OintmentSuspension PasteSyrup SuppositoryTincture CreamElixirSOLIDS: CapsulePillTabletTrocheEnteric Coated
  • 10. Routes Of Administration Oral: Topical: Transdermal Parenteral: Vaginal IM Rectal ID Sublingual SQ Buccal IV Innunction Instillation Inhalation: Irrigation Doctors can administer medication by other routes
  • 11. Categories of Drugs•There are hundreds of drug categories.•Note the blue pages of the PDR, entitled“Drug Classification or Category Index”
  • 12. Categories of DrugsAnalgesic AntihelminthicAnesthesia AntineoplasticAntiacid AntiemeticAnti-arthritic Antiparasitic(NSAIDS) AntiparkinsonismAntibiotic AntipyreticAntifungal Psychiatric-antidepressantsAntiviral antipsychoticAnticholinergicAnticoagulant tranquilizerAnticonvulsant hypnoticAntidiarrheal Cerebral SimulantsAntidiabetic Corticosteroids (SAIDS)Antihistamine Contraceptive
  • 13. Categories of Drugs, Cont.AntitussiveEmeticLaxativeMuscle RelaxantVitaminsPlaceboSynergist
  • 14. Immunizationas recommended by CDC and AAPhttp://www.cdc.gov/nip/recs/child-schedule-color-press.pdf
  • 15. DosageABBREVIATIONS m = minim gr = grain Gm, gm or G = gram mL = milliliter (new approved) gtt = drop tbsp = tablespoon tsp = teaspoon mg = milligram = dram = ounce
  • 16. EquivalentsWeight: 60 mg = 1 gr 60 gr = 1 dram 8 drams = 1 ounceVolume 15 gtts = 1 mL (cc) 5 mL(cc) = 1 tsp 4 mL(cc) = 1 dram 30 mL (cc) = 1 ounce 24OmL (cc) = 1 cup 500 mL (cc) = 1 pint 1000 mL (cc) = 1 quart
  • 17. ROMAN NUMERALS ARABIC ROMAN1                                                             I2                                                             II3                                                             III4                                                            IV5                                                            V6                                                            VI7                                                            VII8                                                            VIII9                                                            IX10                                                         X20                                                          XX30                                                         XXX40                                                         XL50                                                         L100                                                      C500                                                      D1000                                                   M
  • 18. SIX RIGHTSRight MedicationRight Dose or amountRight patientRight timeRight method or route of administrationRight documentationRight of rational patient to refuseFollow other safety rules:
  • 19. Topical ApplicationTopical: Innunction Orally: TransdermalEye Instillation: Inhalation:Ear Instillation:Nose Instillation: Parenteral:Vaginal Application:Rectal:
  • 20. Parts of a Syringe The parts of a syringe that must remain sterile are: Inside of barrel Plunger Needle
  • 21. Injection Technique
  • 22. IM Injection Sites
  • 23. IM Injection Sites
  • 24. IM/SQ Injection Site
  • 25. Intramuscular TechniqueNever inject more than 5 cc/injectionSites: Dorsogluteal Ventrogluteal Deltoid Vastus LateralisSyringe: 3-5 mL with 21-23 gauge needle Fill with “bubble”Skin: Held tautInject: 90o angle and Aspirate May massage after injection
  • 26. Subcutaneous TechniqueNever inject more than 2 cc/injectionSite: Deltoid Anterior thigh Abdominal tissue SubscapularSyringe: 3 cc syringe with 25-27 gauge needleSkin: “Pinch” up skinInjection: 45o angle with bevel upward Aspirate May massage
  • 27. Intradermal TechniqueNever inject more than 0.1-0.2 mL (cc)Skin: Hold tautSites: anterior forearmSyringe:1 mL (cc) with 25-27 guage needleInject: 15o angle (almost parallel with skin) Aspirate “Wheal” will develop Never massage
  • 28. Intradermal injection
  • 29. Additional Modes of InjectionInsulin Pump:Continuous Subcutaneous Insulin Infusion Sytem