it contains administration of medication, its classification only

1. V I J Y A L A X M I M A K W A N A
T U T O R D E M O N S T R A T O R
Administration of medications

2. INTRODUCTION
 The ancient GREEKS believed drugs to be both
poison and medicine.
 Drug is whatever is ingested to treat any medical or
psychological condition.

3. DEFINATION
 A drug is a therapeutic agent; any substance other
than food, used in the prevention , diagnosis,
alleviation, treatment or cure of disease in humans
or animals.
 It is a chemical substances used in the treatment ,
cure, prevention or diagnosis of disease or used to
otherwise enhance physical or mental well being.

4. SOURCES OF DRUGS
• A)Plant Sources: Plant source is the oldest source of
drugs. Most of the drugs in ancient times were derived from
plants. Almost all parts of the plants are used i.e. leaves,
stem, bark, fruits and roots.
• 1. Leaves: a. The leaves of Digitalis Purpurea are the
source of Digitoxin and Digoxin, which are cardiac
glycosides. Leaves of Eucalyptus give oil of Eucalyptus,
which is important component of cough syrup. Tobacco
leaves give nicotine. Atropa belladonna gives atropine.

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• 2.Flowers: a. Poppy papaver somniferum gives
morphine(opoid). Vinca rosea gives vincristine and
vinblastine. Rose gives rose water used as tonic.
• B)Fruits Senna pod gives anthracine, which is a
purgative(used in constipation).Calabar beans give
physostigmine, which ischolinomimetic agent.
• C)Seeds:a Seeds of Nux Vomica give strychnine,
which is a CNS stimulant. Castor oil seeds give
castor oil. Calabar beans give Physostigmine,
which is acholinomimetic drug.

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Roots: a. Ipecacuanha root gives Emetine, used to induce
vomiting as in accidental poisoning. It also has
amoebicidal properties.
b. Rauwolfia serpentina gives reserpine, a hypotensive
agent .Reserpine was used for hypertension treatment
Cinchona bark gives quinine and quinidine, which are
anti malarial drugs.
Bark:
a Quinidine also has anti arrhythmic properties.
b. Atropa belladonna gives atropine, which anti
cholinergic.
c. Hyoscyamus Niger gives Hyoscine, which is a anti
cholinergic.

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 Stem: Chondrodendron tomentosum gives tubocurarine, which is
skeletal muscle relaxant, used in general a nest
 Animal Sources:
1.Pancreas is a source of Insulin, used in treatment of Diabetes.
2. Urine of pregnant women gives human chorionicgonadotropin
(hCG) used for the treatment of infertility
3. Sheep thyroid is a source of thyroxine, used in hypertension.
4.Cod liver is used as a source of vitamin A and D.
5. Anterior pituitary is a source of pituitary gornardotropins, used in
treatment of infer
6. Blood of animals is used in preparation ofvaccines.
7. Stomach tissue contains pepsin and trypsin, which are digestive
juices used in treatment of peptic diseases in the past. Nowadays
better drugs have

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 Synthetic/ Semi synthetic Sources Synthetic
Sources: When the nucleus of the drug from
natural source as well as its chemical structure is
altered, we call it synthetic. Examples include
Emetine Bismuth iodide
 Semi Synthetic Source: When the nucleus of drug
obtained from natural source is retained but the
chemical structure is altered, we call it semi-
synthetic. Examples include Apomorphine, Diacetyl
morphine, Ethinyl Estradiol, Homatropine,
Ampicillin and Methyltestosterone.

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 Microbiological Sources:1. Penicillium notatum is a fungus
which gives penicillin
2. Actinobacteria give Streptomycin
3. Aminoglycosides such as gentamicin and to bramycin are obtained
from streptomycin and micromonospora.
4 Recombinant DNA technology. Recombinant DNA technology
involves cleavage of DNA by enzyme restriction endonucleases. The
desired gene is coupled to rapidly replicating DNA (viral, bacterial
or plasmid). The new genetic combination is inserted into the
bacterial cultures which allow production of vast amount of genetic
material
Advantages: Huge amounts of drugs can be produced. Drug can be
obtained in pure form, is less antigenic.
Disadvantages: Well equipped lab is required. Highly trained staff is
required and is complex and complicated technique.

10. Rauwolfia serpentina

11. Poppy papaver somniferum

12. Vinca rosea

13. Senna pod

14. Calabar beans

15. Castor oil seeds

16. Types and forms of drug
 1. LIQUID: the active part of the medicine is combined
with a liquid to make it easier to or better absorbed. A
liquid may also called ‘mixture’, ‘solution’ or ‘syrup’.
 2.TABLET: These are round or oval solid shape. These are
present in the form of soluble or dispersible form which can
easily dissolve in water.
 3.CAPSULE: the active part of the medicine is contained
inside a plastic shell that dissolve slowly in the stomach.
 4.TOPICAL MEDICATION: these are the creams,
lotions or ointments that are applied directly onto the skin.
The active part of the medicine is mixed with another
substance that make it easy to apply to the skin.

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 5.SUPPOSITORIES: the active part of the medication is
combined with another substance and pressed into a ‘bullet
shape’ so it can easily inserted into rectum. It can’t be
swallowed.
 6.DROPS: these are often used where the active part of the
medicine works best if it reaches to the affected area
directly.
 7.INHALERS: the active part of the medicine is released
under pressure directly into the lungs.
 8.INJECTIONS: these are differing in how and where it
can be injected. Types- subcutaneous, intramuscular,
intratheacal, intravenous.

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 9.IMPLANTS OR PATCHES
 10.BUCCAL OR SUBLINGUAL TABLETS OR
LIQUIDS: these look similar to normal tablets or
liquids but they are not swallowed. Buccal drugs are
placed under cheeks so mouth lining will absorbs.
Sublingual tablets are placed under the tongue.
These tends only to be given in very specific
circumstances.
 11.CERATES: consistency of ointment and plaster.
They are soft enough to spread easily, but not liquefy
when heated to body heat. Eg- wax

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Collodions: Fluid solutions of gun cotton in a
mixture of alcohol and ether.
Decoctions: Are prepared by boiling the drug in
water. Take coarsely ground or bruised drug or
drugs1 part, cold water 20 parts and boil for 15 to
20minutes, then cool and strain. Powerful drugs
should only be used in smaller quantities, as much
less of them is required. As decoctions ferment in a
short time they should be renewed often. They
should never be made in tin dishes.

28. Decoctions

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 Dilutions, Homeopathic: In the low potencies the
writer makes his own dilutions, say up to the 2nd
or3rd. By taking 10 drops of homeopathic mother
tincture or of Lloyd's specific medicines to 90 drops
of 95% alcohol, and, shaking the mixture a few
hundred times, we have our first dilution. Of the first
dilution 10 drops to 90 drops of 95% alcohol, will
give us the 2nd dilution. Larger quantities maybe
used in the same proportion. The higher dilutions
the writer prefers to buy readymade.

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 Emulsions: By emulsions we understand a mixture of
oils with water in a mechanical way, not distributing it
chemically. Substances used for this purpose are acacia,
gum resins, yolks of eggs. etc.
 Extracts: Are prepared by evaporating alcoholic or
other vegetable medicinal solutions.
 Fluid Extracts: Alcoholic fluid preparations of
vegetable drugs, prepared by percolation and subsequent
concentration of a portion of the percolate by
evaporation. In some cases water or glycerin may be used
as a menstruum. However inmost cases, alcohol is the
menstruum needed. Fluidextracts are so constructed as
to represent one grain of the crude drug in each minim of
fluid extract.

31. gum resins

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 Glycerites: Mixtures or solutions of medicine in
glycerin
 Infusions: Are solutions of soluble constituents of
vegetable drugs, prepared by pouring hot water on same,
and allowing them to macerate and cool Coarsely ground
or bruised bark, herbs, flowers, seeds or roots 1 part to
boiling water 20 parts; cover tightly and let stand in a
warm place for 20 minutes to 1/2hour and then strain. Of
powerful drugs much less must be used, and then great
care exercised. Infusions should never be made in tin
dishes. As the infusion soon ferment they should be
renewed often. In most cases, if procurable, the green
drugs are preferable

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• Liniments: Are fluid or semi-fluid preparations nearly
of oils, although alcohol, etc., may be employed. Olive oil
or cottonseed oil are often used as a base.
• Medicated Waters: Are solutions of volatile
substances. May be prepared by direct solution in hot or
cold water, or by filtering water through some inert
powder, or cotton impregnated with volatile body. These
waters are chiefly employed as vehicles.
• Medicated Wines: Are fluid preparations in which
soluble medical principles are dissolved in wines.
• Oleoresins: Consists generally of fixed or essential oils,
associated with resins, and extracted from the crude drug
with ether, the latter evaporating later..

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 Ointments: Fatty preparations about the consistency of
lard or petrolatum, which usually constitute their bulk.
When applied to the skin they become fluid by the heat of
the body.
 Pills: Composed of a medicine or medicines. combined
with substances which cause them to retain their shape
and firmness. They may be sugar, chocolate or gelatin
coated as desired.
 Plasters: Usually applied to the body on a fine piece of
fabric. They require heat to spread them. When applied
to the body they adhere; but do not become soft. They are
chiefly composed of some resinous body. May be
medicated or not.

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 Poultices: Substances that are tenacious when wet and
accommodate themselves to the parts. They are applied
to relaxed tissue and also to exclude air. Maybe
medicated or not.
 Powders: These are medicines reduced to various
degrees of fineness. The degree is usually designated by
number; the numbers having reference to the number of
meshes to the linear inch in the sieve through which the
powder has been passed.
 Resins: Are the solid resinous constituents of vegetable
substances generally prepared by precipitation of an
alcoholic solution of the drug in acidulated or simple
water.

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• Spirits: Solutions of essential oils and other volatile
substances in alcohol.
 Suppositories: Pressed, rolled or moulded solid
bodies, generally prepared from cocoa butter and the
desired medical agent. Used in pelvic orifices.
Sometimes wax is added to prevent their melting too
easily.
 Syrups: Concentrated aqueous solutions of sugar or
thick solutions of sugar in medicated
aqueoussolutions.3. Tablets: Are medicated candies
either molded or compressed. They are usually
prepared from Triturations with the addition of some
harmless ingredient.

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• Tinctures: Are practically identical with extracts,
but much lower in strength. Prepare percolation,
maceration, generally the former be prepared from
fresh or bruised herbs. The average diluted alcohol
proportion being 2 ounces of the drug to 1 pint of
diluted alcohol.

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• Triturations: Are made by triturating (rubbing) a
medical substance with sugar of milk, the latter serving
simply as a diluents; they generally being made of a
certain drug and sugar of milk. There are two methods in
use, one in which one part of the drug is triturated with
nine parts of sugar of milk. This is known as the decimal
system. The other method is to triturate 1 part of the
drug with 99 parts of sugar of milk, this being known as
the centesimal system.
• Vinegars: Solutions of active constituents of a drug or
drugs in vinegar or diluted acetic acid.

44. TERMINOLOGIES
 1. Pharmaco therapeutics: It deals with the relative
effects of drugs in human systems for various
disorders.
 2. Pharmaco dynamics: It deals with experimental
science pertaining to theories of drug action.
 3.Pharmokynetics: It is the study of how drugs enter
the body, reach their site of action, are metabolized
and eliminated from the body.

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 4. Absorption: It is the passage of drug molecules
into the blood. To exert therapeutic effect the drugs
mist depend on the physical properties of the drug,
route of administration, presence or absence of food
in the stomach and interaction with the drugs.
 5. Metabolism: After a drug reaches its site of
action, is metabolized into an inactive form,
detoxify !degraded chiefly by liver. Also the lungs,
kidneys blood and intestines metabolize drugs

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 6. Excretion / Elimination: When drugs are
metabolized they exit the body through the kidneys
liver, bowels and exocrine glands.
 7. Side-effects: Unintended but anticipated
secondary effects, which may be harmless or
injurious.
 8. Adverse reaction: It is the secondary effect
which reflects the drug's action on other areas of
the body
 9. Toxic effects: Usually develop after a prolonged
intake of high doses of medication due to
accumulation of drug in the blood because of
impaired metabolism or excretion.

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10.Allergic reaction: It is an unpredictable immunological
response after exposure to an initial dose of medication.
A drug allergy may be mild or severe (Anaphylactic
reaction). Common allergy symptoms are urticaria,
eczema, pruritis and rhinitis
 11. Drug abuse: It is inappropriate intake of a substance
either continuously or periodically. It has two maifacets:
drug dependence and drug habituation.
 12. Drug habituation: It denotes a mild form of
psychological dependence. The habituated individual
develops the habit of taking the substance and feels
better after taking it

48. ROUTES OF DRUG ADMINISTRATIOR

49. ENTERAL
 the route of a drug depends on its properties desired
effect, patient's physical and mental condition
 Oral administration: It is the most common route
and the most convenient route for most patients.
 Sublingual: The drug is placed under the tongue
and letting it slowly dissolve, e.g. nitroglycerine.
 Insertions: Means introducing solid forms of drugs
in to the body artifices, e.g. suppositories are
introduced into the rectum and vagina.

50. PARENTERAL
 Parenteral administration: Parenteral means giving
of therapeutic agents outside the alimentary tract. It is
the type if administration accomplished by a needle.
a) Intramuscular-into the muscle.
b) Subcutaneous-in to the subcutaneous tissue
c) Intra dermal-into the dermis.
d) Intravenous-into the vein.
e) Intra-arterial-into the artery.
f) Intra-cardiac-into the cardiac muscles.
g) Intrathecal -into the spinal cavity.
h) Intra-osseous-into the bone marrow.
i) Intra peritoneal-into the peritoneal cavity

51. Intra-osseous

52. Intra-cardiac

53. Intra peritoneal

54. INHALATIONS
 Inhalations: The patient inhales the fumes in the
lung to have a local and systemic effect, e.g. nitrous
oxide (anesthetic effect).

55. TOPICAL APPLICATION
 Inunctions (topical application): It is the
application of the drug to the skin usually by a
friction , e.g. ointment.
 Implantation: Means planting or putting in of
solid drugs into the body tissues.
 Instillation: It is putting a drug in liquid form in to
the body cavity such a urinary bladder or into body
orifices such as ears eyes and nose.
 Insufflations:(Latin: insufflare, lit. 'to blow into') is
the act of blowing something (such as a gas, powder,
or vapor) into a body cavity

56. PRINCIPLES OF MEDICATION
ADMINISTRATION
 Nurse are responsible for administering medications
within their scopes of practices.
 Nurses are knowledgeable about the effects, side
effects, and interaction of medication and take action
as necessary.
 Nurses adheres to “rights of the patients”
 Nurses determines all orders for an individual are
clear, complete, current, legible, and appropriate for
the client before administering any medication.

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 If there is no alternative, nurses can administer a
medication using the pharmacy dispensing label as
an order after confirming it is still appropriate.
 Nurses act upon pre-printed orders when the
authorized health professionals has made those
orders client-specify by reviewing them, adding the
client’s name, customizing them by sign, and date.
 Nurses act upon verbal and telephone orders only
when circumstances require doing so and if there are
no other reasonable options.

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 Nurses administer only medications they themselves or a
pharmacist have prepared, except in an emergency.
 Nurses educate clients about all the client’s medications.
 Nurses understands the human and system factors that
increase medication errors and near misses and take a
step to prevent them.
 Nurses verify that medication orders, pharmacy labels
and/or medication administration records are completed
and include the name of the clients , the name of the
medication, the medication strength and dosage, route
and frequency and with which the medication is to be
administered.

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 When a medication error or near miss occurs at any
point in the process of prescribing, compounding,
dispensing or administering a medication, nurses
take appropriate steps to resolves and report it in a
timely manner.

60. CARE OF MEDICINE AND MEDICINE
CUPBOARD
 1.To stock the medicines, each ward should be provided
with a medicine cabinet.
 2. it should be large enough to accommodate all drugs to
be stocked in ward.
 3. As far as possible, the medicine cabinet should be kept
in% solute separate room adjacent to the nurse's room.
The nurse
 4. A washing sink with running water should be provided
in that room for hand washing facilities.
 5. Adequate lighting should be provided within the
cabinet to read the labels clearly.
 6. there should be separate compartments for different
allegories of drugs - for mixtures, tablets, powders etc.

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 6. there should be separate compartments for
different allegories of drugs - for mixtures, tablets,
powders etc.
 7.Drugs used for external use should be kept
separate from the drugs used for internal use.
 8. The containers should be arranged alphabetically,
so that it is easy to find them. 9.poisonous drugs
should be kept in a separate cupboard which must
have separate lock and key.
 10. A senior nurse should be responsible for the
poisonous tort medicines in the cupboard. age!

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 11. A register should be maintained to keep the
account of the poisonous drugs.
 12. A daily inventory should be taken to prevent theft
of narcotics.
 13.All the poisonous drugs should be marked
"poison" in red ink.
 14. No drug should be stored without labels, even for
a day. All containers should have labels written
neatly and legibly. The labels should contain the
name of the drug. the ingredients, the strength, the
dose etc.

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 15. All medicine containers should be kept closed
always. The containers keeping the capsules,
alcoholic preparations ,volatile drugs etc., should
have airtight caps. The tablets and pills tend to
disintegrate if exposed to air.
 16.The drugs that are unusual in color, odor and
consistency should be returned to the pharmacy and
replaced with fresh ones

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 17 Check the expiry date of every drug and make use of
before its expiry date is over or send it to the dispensary
and get it replaced
 18. The drugs which are the room temperature such as
vaccines, sera, antibiotics etc., should be kept in the
refrigerators
 19. Emergency drugs should be kept in place where they
are readily obtainable for emergency use.
 20. When indenting for drugs, indent only the required
quantity: the request for new supply of medicines should
be signed by the ward sister. All medicines should be
checked and signed as they are received from the
dispensary.

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 21. The medicine cabinet should always be kept neat
and clean and all equipments should kept clean and
dry after their use.
 22. The medicine cabinet should always be kept
locked and the key should be kept where only
doctors and nurses have access to it.
 23. The oily medicines should be kept in a separate
tray of a place of waterproof paper to prevent solling
the Special all cups or spoons are used which are
helpful in keeping the oily odors away from medicine
glasses

66. DRUG CLASSIFICATIONS
Pharmaceutical or a drug is classified on the basis of their origin.
1. Drug from natural origin: Herbal or plant or mineral origin, some
drug substances are of marine origin.
2. Drug from chemical as well as natural origin: Derived from partial
herbal and partial chemical synthesis chemical, example steroidal
drugs
3. Drug derived from chemical synthesis.
4. Drug derived from animal origin: For example, hormones, and
enzymes
5. Drug derived from microbial origin: Antibiotics
6. Drug derived by biotechnology genetic-engineering, hybridoma
technique for example
7. Drug derived from radioactive substances. Drug Categories:
Physicians have long recognized that different types of drugs
affect people differently None the less, drugs may be categorized
or classified according to certain shared symptomatologies or
effects. The DRE categorization process is premised on

67. these long-standing, medically accepted facts. DRE classify
drugs in one of seven categories: Central Nervous System
(CNS) Depressants, CNS Stimulants Hallucinogens,
Phencyclidine (PCP) and it’s a Narcotic Analgesics, Inhalants,
and Cannabis. Drugs from each of these categories can affect a
person to central nervous system can impair a person's
normal faculties, including a person's ability to safely operate
a motor vehicle
1. Central Nervous System (CNS) Depressants :CNS
Depressants slow down the operations of the brain and the
body. Examples of CNS Depressants include alcohol,
barbiturates, anti-anxiety tranquilizers(e.g., Valium, Librium,
Xanax, Prozac, and Thorazine), GHB (Gamma
Hydroxybutyrate),Rohypnol and many other anti-depressants
(e.g., as Zoloft, Paxil).

68.  2. CNS Stimulants: CNS Stimulants accelerate the
heart rate and elevate the blood pressure and "speedup"
or over-stimulate the body. Example Stimulants include
Cocaine, "Crack", Amphetamines and Methamphetamine
("Crank')
 3. Hallucinogens: Hallucinogens cause the user to
perceive things differently than they actual Examples
include LSD, Peyote, Psilocybin and MDMA (Ecstasy)
 4.Dissociative Anesthetics: One of the seven drug
categories. It includes drugs that inhibit pain cutting off
or dissociating the brain's perception of the pain. PCP
and it's analogs are examples of Dissociative Anesthetics.

69.  5. Narcotic Analgesics: A narcotic analgesic
relieves pain, induces euphoria and creates mood
changes in the user. Examples of narcotic analgesics
include Opium, Codeine, Heroin, Demerol, Darvon,
Morphine, Methadone, Vicodin and OxyContin.
 6. Inhalants: Inhalants include a wide variety of
breathable substances that produce mind-altering
results and effects. Examples of inhalants include
Toluene, plastic cement, paint, gasoline ,thinners,
hair sprays and various anesthetic gas

70.  7.Cannabis: Cannabis is the scientific name for marijuana. The
active ingredient in cannabis is deltatetrahydrocannabinol, or THC.
This category includes cannabinoids and synthetics like Dronabinol.
 Depressants: Drugs that decrease alertness by slowing down the
activity of the central nervous system (e.g. heroin, alcohol and
analgesics).
 Stimulants: Drugs that increase the body's state of arousal by
increasing the activity of the brain (e.g. caffeirnicotine and
amphetamines).
 Hallucinogenic: Drugs that alter perception and can cause
hallucinations, such as seeing or hearing somethig that is not there
(e.g. LSD and 'magic mushrooms').
 Other: Some drugs fall into the other category, as they may have
properties of more than one of the abc categories (e.g. cannabis has
depressive, hallucinogenic and some stimulant properties).

71. ELEMENTS OF MEDICATION USE
 [The Institute for Safe Medication Practices (ISMP)
has identified 10 key elements with the greatest
influence on medication use, noting that weaknesses
in these can lead to medication errors. They are:
patient information, drug information, adequate
communication, drug packaging, labeling, and
nomenclature, medication storage, stock
standardization, and distribution, drug device
acquisition, use, and monitoring, environmental
factors, staff education and competency, patient
education, quality processes and risk management.

72. PATIENT INFORMATION
 Accurate demographic information (the "right
patient") is the first of the five rights of medication
administration. Required patient information
includes name, age, birth date, weight, allergies,
diagnosis, current lab results, and vital signs

73. DRUG INFORMATION
 Accurate and current drug information must be
readily available to all caregivers. This information
can come from protocols, text references, order sets,
computerized drug information systems, medication
administration records, and patient profiles.

74. ADEQUATE COMMUNICATION
 Many medication errors stem from
miscommunication among physicians, pharmacists,
and nurses. Communication barriers should be
eliminated and drug information should always
verified. One way to promote effective
communication And team members is to use the
"SBAR" method (situation,background, assessment,
and recommendations).

75. DRUG PACKAGING,LABELING,AND
NOMENCLATURE
 Healthcare organizations should ensure that all
medication are provided in clearly labeled unit-dose
packages for institutional use. Packaging for many drugs
looks similar. A tragic case stemming from such
similarity occurred with heparin (one of the drugs on the
JC's "high-alert" list ,meaning it has a high potential for
causing patient harm). A few years ago, several pediatric
patients received massive heparin overdoses due to
misleading packaging and labeling Three infants died. As
a result, the Food and Drug Administration and Baxter
Healthcare (the heparin manufacturer) issued a letter via
the Med Watch program alerting clinicians to the danger
posed by similarly packaged drugs

76. MEDICATION STORAGE, STOCK,
ATANDARDIZATION AND DISTRIBUTION
 Many experienced nurses remember when critical
care units kept a medication "stash," which
frequently caused duplication errors. Potentially,
many errors could be prevented by decreasing
availability of floor-stock medications, restricting
access to high-alert drugs, and distributing new
medications from the pharmacy in a timely manner.

77. DRUG DEVICE ACQUISITION,USE,AND
MONITORING
 Improper acquisition, use, and monitoring of drug
delivery devices may lead to medication errors. Some
delivery system have inherent flaws that increase the
error risk. For example at one time, I.V. medication
tubing continued to flow or infuse when removed from
the pump. Thus, patients could receive boluses of
medications or I.V. solutions, which sometimes had
deleterious outcomes. During the admission process, for
instance, a patient receiving nitroprusside could receive a
large infusion of this drug when the I.V. tubing was
removed from the pump and the patient was transferred
from one bed to another. This design flaw has since been
resolved. In addition, syringes for administering oral
medications should not be compatible with I.V. tubing.

78. Environmental factors
 Environmental factors that can promote medication
errors Include inadequate lighting, cluttered work
environments, increased patient acuity, distractions
during drug preparation, administration, and
caregiver fatigue.

79. STAFF EDUCATION AND COMPETENCY
 Continuing education of the nursing staff can help reduce
medication errors. Medications that are new to the
should receive high teaching priority. Staff should
received updates on both internal and external
medication errors, as an error that has occurred at one
facility is likely to occur at another. (The heparin
overdoses described earlier happened at multiple
institutions.) As medication-related policies procedures,
and protocols are updated, this information should be
made readily available to staff members. Also,nurses can
attend pharmacy grand Some facilities now use nursing
grand rounds as a way to keep staff members competent.

80. Effects of Drugs on the Body

81. Therapeutic Effects
 Therapeutic Effects: It is the effect which is desired
or the reason a drug prescribed. Therapeutic effects
are the medication's desired and intentional effects.
These effects vary with the nature of medications,
the length of time the client has been receiving and
the client's physical condition. Interaction with other
drug also can affect a drug's therapeutic action.

82.  drugs are administered for the following purposes:
1. To promote health : drugs given to the individuals to increases
the resistance against diseases e.g., vitamins
2. To prevent diseases: e.g., vaccines and anti-toxins.
3. To alleviate diseases: Certain drugs are given for the palliative
effect or for the temporary relief of distressing Symptoms but
does not remove the cause or cure the diseases : analgesics
4. To diagnose disease: e.g., barium used in the X-ray studies,
5. By restoring normal functions e.g.. digoxin.
6. By supplying a substance that is deficient Insulin.
7. By destroying the causative organisms e.g.. Quinine in malaria.
8. By counteracting with a toxic substance circulating in the body
: e.g.. antidotes. By stimulating the functions of an organ or a
system e.g..stimulants
9. By depressing the functions of an organ or a system e.g.
sedatives

83. Local and systematic effect
 Local and Systemic Effects of a drug are expected
when they are applied specially to the skin or
mucous membrane.
 drug used for systemic effect must be absorbed into
the stream to produce the desired effect in the
various system and parts of the body.

84. Adverse Effect
 is any effect other than the therapeutic effect. Some
adverse effects are minor, whereas some other may
be very serious health problems. Adverse effects may
be more in a very seriously ill client or a client who
receive more medications.

85. Side Effects
 Side effects are the minor adverse effects. Side effects
can be harmful or harmless.

86. Allergic reaction
 Allergic reaction a client be react to a drug as a foreign body
and thus develops a symptoms of allergic reaction. This could
be severe or mild. A severe allergic reaction usually occurs
immediately and called anaphylactic reaction. A mild reaction
has a variety of symptoms from skin rashes to diarrhoea.
 Anaphylaxis: This is an immediate and severe reaction
marked by a decreased blood pressure, local oedema,
prickling feeling in the throat, oedema of the face and hands,
cyanosis, chocking cough, dyspnoea and wheezing due to
accumulated fluids and oedema in the respiratory tissues.
Unless acted quickly, death may follow within few minutes
Sera and penicillin etc., should be administered only after a
sensitivity test has been done to prevent such reactions.

87.  Skin rashes (Urticaria): Oedematous pinkish
elevations with itching may occur due to reaction of a
drug. Rash is usually generalized over the body
Pruritus: Itching of the skin with or without rash.
Angioedema: Oedema due to increased permeability
of the blood capillaries.

88.  Rhinitis: Excessive watery discharge from the nose
Lacrimal tearing: Excessive tears from the eyes.
 Nausea and vomiting: Due to stimulation of these centers
the brain.
 Diarrhea: Irritation of the mucosa of the intestines.
 Shortness of breath and wheezing due to laryngeal
oedema.Atropine-Like Side EffectsCertain drugs causes
dryness of the mouth and noseflushing and dryness of
the skin, tachycardia, urinarrelention and blurring of
vision. The client may need toreassured that the effects
will disappear when the drugwithdrawn. Clients, after
taking drugs, producing these sieffects should not
operate dangerous machinery.

89. Atropine-Like Side Effects
 Effects Certain drugs causes dryness of the mouth
and nose. flushing and dryness of the skin,
tachycardia, urinary retention and blurring of vision.
The client may need to reassured that the effects will
disappear when the drug withdrawn. Clients, after
taking drugs, producing these side effects should not
operate dangerous machinery.

90. Stimulations of the central nervous system: These are
characterized by anxiety, nervousness, insomnia
headache and double vision etc. Stimulation of the
nervous system may precipitate convulsions if the
client has the history of epilepsy.
Depression of the central nervous system: It is
characterized by dizziness, vertigo, drowsiness,
fatigue and ataxia. restriction of ambulation and use
of bed rails may be necessary The persons taking
such medications should not drive car or operate
machinery

91. Gastrointestinal System
 Irritation of the gastric mucosa: This is characterized
by nausea, vomiting, anorexia. This can be prevented
to some extent by not giving the drug in an empty
stomach. Give the drug with or after the meals or it
should be given along with one glass of milk or an
antacid.
 These drugs contraindicated if the client has a
history of peptic ulcer.
 Small bowel ulceration: It is characterized by
abdominal melaena, distension and diarrhoea.
Constipation

92. Hypersensitivity Reaction
 Hypersensitivity Reaction Drug This develops in a
client who is sensitive to a medical tie therapeutic
effects or secondary effects.

93. Toxicity
 Toxicity :High levels of the drug in the blood stream
produce toxic effects. Often the toxic effects of the drug
occurs due to cumulative effect of the drug or due to the
excess intake of the drug than what is needed for the
therapeutic effect
 Cumulative effect occurs when a person is unable to
metabolize the previous dose of the drug. Some of the
toxic effects are fatal for the client.
 Toxicity can affect and permanently damage organ
functions. Common drug toxicities include, nephro
toxicity (kidney)neurotoxicity (brain), hepato toxicity
(Liver), Immunotoxicity (immune system), ototoxicity
(hearing), cardio toxicity(heart)

94. INTERACTION
 Medication interaction occurs when a medication's
effects are altered by concurrent presence of other
medication or food. The interaction can result in the
following
 Synergistic effect occurs when a combination of
medications are given. In synergistic effect, the combined
effect of two or more drugs is different from the effect of
each drug when taken alone. The combined effect may be
less than what would be expected or greater than the
effect of each drug. Synergism may be a desired
therapeutic effect or an undesirable complication e.g.
alcohol and barbiturates are potentially lethal; Phenytoin
(Dilantin) has an inhibitory effect upon digitalis

95.  Antagonism: It result in decreased drug
effectiveness. Sometimes food influences a drug.
 DRUG INCOMPATIBILITY
Is a condition in which a drug is precipitates from
solution if mixed with other medication.

96. Tolerance
 Tolerance :It occurs when a client develops
decreased response to a drug, requiring increased
dose to achieve the therapeutic effects.