This document discusses medication administration including definitions of key terms, purposes of medication, legislation around drug standards, routes of drug delivery, factors influencing drug action, and the importance of proper documentation and monitoring. It provides an overview of medication management from prescribing and storage to administration including assessing patients, following safety procedures like the five rights, and monitoring for side effects.

2. Medication administration
Rita Pokharel

3. Medications
definition
• Medications are substances prescribed by the
client’s health care practitioner to help in the
treatment, relief, or cure of the cause of the
client’s health alteration or in the prevention
of an alteration.

4. Purposes of medication
• To treat and cure illnesses.
• To prevent from illnesses.

5. Medication Management
• Requires the collaborative efforts of many
health care providers.
• Medication administration requires
specialized knowledge, judgment, and skills.

6. Drug Standards and Legislation
• A drug is a chemical substance intended to
elicit a specific effect.
• Standards are set to ensure drug uniformity
in:
– Strength.
– Purity.
– Efficacy.
– Safety.
– Bioavailability (readiness to produce a drug effect).

7. Standards
• The United States Pharmacopeia and the
National Formulary (USP and NF) are books of
drug standards for use in the United States.
• National formulary
• Department of drug administration
• Narcotics law of Nepal

8. Legislation: The FDA
• The Food and Drug Administration (FDA) tests
all drugs for toxicity before granting a
company the right to market a drug.

9. Drug Nomenclature
• Drugs are usually referred to by their generic
name (not capitalized) or by their trade name
(always capitalized).

10. Drug Action
• A drug’s ability to combine with a cellular drug
receptor.
• Depending on the location of the cellular
receptor, the drug can have a local effect, a
systemic effect, or both.

11. Pharmacology
• The study of the effects of drugs on living
organisms.

12. Medication Management
• Its purpose is to produce the desired drug
action by maintaining a constant drug level.
• Drug action is based on the drug’s half-life
(the time it takes the body to eliminate half of
the blood concentration level of the original
drug dose).

13. Routes of Drug Absorption
• Oral.
• Topical.
• Inhalants.
• Parenteral (injectable).
– Intradermal (into the dermis).
– Subcutaneous (into the subcutaneous tissue).
– Intramuscular (into the muscle).
– Intravenous (into a vein).

14. Pharmacokinetics
• 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
biological fluids.

15. The 4 Properties of Drug Action
• Absorption (passage of a drug from the site of
administration into the bloodstream).
• Distribution (the movement of drugs from the blood
into body fluids and tissues).
• Metabolism (the physical and chemical processing of
a drug by the body).
• Excretion (the elimination of drugs from the body.

16. Drug Interaction
• The effect one drug can have on another drug.

17. Side Effects and Adverse Reactions
• Drug Allergy.
• Drug Tolerance.
• Toxic Effect.
• Idiosyncratic Reaction.

18. Food and Drug Interactions
• Certain drugs may interfere with the
absorption, excretion, or use in the body of
one or more nutrients.
• Certain foods may increase or decrease the
absorption of a drug into the body.
• Other foods may alter the chemical actions of
drugs, preventing their therapeutic effect on
the body.

19. Factors Influencing Drug Action
• Genetic factors.
• Age.
• Height.
• Weight.
• Physical conditions.
• Mental conditions.

20. Medication Orders
• All medication orders should contain:
– Client’s name
– Date & Time
– Name of Drug to be administered
– Doasage
– Route of administration
– Time & frequency
– signature of person ordering

21. Types of Orders
• Stat (those that should be administered
immediately).
• Single-Dose (one-time medications).
• Scheduled (administered routinely until order
is canceled by another order).
• PRN (on as-needed basis).

22. Five “Rights” of
Safe Drug Administration
• Right drug.
• Right dose.
• Right client.
• Right route.
• Right time.

23. Additional rights
• Right of the patient
• Right reason
• Right history assessment
• Right evaluation of interaction
• Right documentation
• Right education and information

24. Documentation of Drug
Administration
• A critical element of drug administration is
documentation.
• The standard is “if it was not documented it
was not done.”
• The nurse should document that a drug has
been given after the client has received the
drug.

25. Drug Supply and Storage
• Scheduled drugs for each client are usually
dispensed in a unit dose form.
• Certain drugs may be stock supplied
(dispensed and labeled in large quantities)
and stored in the medication room.
• Narcotics and controlled substances must be
administered in accordance with regulations
of the country and state.

26. Assessment before medication
• Drug History (Allergies, Prescription Drugs
taken, Over-the-Counter Drugs used).
• Medical History (Biographical data, Lifestyle
and beliefs, Sensory and cognitive status).
• Physical Examination.
• Diagnostic and Laboratory Data.

27. Oral Drugs
• Oral medications should be poured and
measured at eye level to ensure accuracy.

28. Parenteral Drugs
• Although the physician will determine the
dose and route of a parenteral drug, the nurse
is responsible for choosing the correct gauge
and length of the needle to be used.

29. Equipment to Administer Parenteral
Drugs
• Syringes.
• Needles.
• Ampules (glass containers of single-dose
drugs).
• Vials (glass, single- or multiple-dose rubber-
capped drug containers).

31. Intradermal Injection
• Injections typically used to diagnose
tuberculosis, identify allergens, and
administer local anesthetics.

32. Subcutaneous Injection
• Injections into the subcutaneous tissue,
between the dermis and the muscle.
• Commonly used in the administration of
medications such as insulin and heparin.

33. Intramuscular Injection
• Used to promote rapid drug absorption and to
provide an alternate route when the drug is
irritating the subcutaneous tissue.

34. Intravenous Therapy
• Requires parenteral fluids (hypotonic fluid,
isotonic fluid, hypertonic fluid)
• Special equipment needed:
– Administration set.
– IV pole.
– Filter.
– Regulators to control IV flow rate.
– Established venous route.

35. Blood Transfusion
• To replace blood loss (deficit) with whole
blood or blood components.
• Special equipment needed:
–Administration set.
–IV pole.
–Filter.
–Regulators to control IV flow rate.
–Established venous route.

36. • Other parenteral routes, such as intrathecal or
• intraspinal, intracardiac, intrapleural, intra-
arterial, and intra-articular, are used by
physicians
and in some cases
• by advanced practice registered nurses for
medication administration.

37. The Importance of Monitoring
• always carefully monitor client reactions to
medications and ensure that clients are
appropriately educated as to the actions, side
effects, and contraindications of all
medications they are receiving.
• Clients receiving IV therapy or blood
transfusions require constant monitoring for
complications.

38. Topical Medications
• Eye medications.
• Ear medications.
• Nasal instillations.
• Respiratory
inhalants.
• Rectal instillations.
• Vaginal instillations.