2. 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.
Drug administration
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
– 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. 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.
Pharmacokinetics
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
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
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
18. The 7 rights
1. Right Medication
2. Right Dose
3. Right Rout
4. Right Time (b.i.d, t.i.d, q.i.d. q8h)
5. Right Client
6. Right information
7. 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
27. Route of administration
Viscosity of the solution
Quantity to be administered
Body size
Type of medication
Criteria for Choosing Equipment
for Injections
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
1. Review techniques of medication
administration.
2. Remind patient to take the medication as
prescribed for as long as prescribed.
3. Instruct patient not to alter dosages without
consulting physician.
4. Caution patient not to share medications
with others even if they have the same
disease.