Presented by Ganga Tiwari ( BSc. Nursing Fourth Year, Teaching Leanring) TU, IOM, MNC, Kathamandu Nepal

1. Mode of Action of Drugs and
Prevention of Medication Errors
Presented by Ganga Tiwari
BSc. Nursing Fourth Year, Teaching
Learning
TU, IOM, MNC, Kathmandu Nepal

2. MODE OF ACTION OF
DRUGS
 General anesthesia: Depresses
cerebral function, induce
unconsciousness and depress all
sensation. E.g. ketamine, propofol,
holothene, thiopentone sodium etc.
 Anesthetics: Drugs which causes loss
of sensation are anesthetics.
 Local anesthesia: Interfere with the
function of a nerve or nerve ending and
depress all sensation from a localized
area without interfering with the
consciousness e.g.procaine,

3. Contd..
 Analgesics: Drugs which relieves pain.
They are classified as narcotic and non-
narcotic.
 Narcotic analgesic drug: Relieves pain
probably by selectively acting on
receptors situated both in the higher
center brain and the spinal cord. e.g.
morphin,pethidine,fentanyl,tramadol are
narcotic analgesic .they binds with the
specific opioid receptors in the central
nervous system to reduce pain.

4. Contd..
 Non-narcotic analgesics: Relives
pain without producing hypnosis or
marked impairment or mental activity
by central as well as peripheral action.
e.g.NSAIDS(non- steroid anti-
inflammatory
drugs).aspirin,diclofenac,ketorolac,ibu
profen,nimesulide etc.

5. Contd..
 Diuretics: These are the drugs which
increases the flow of urine. e.g.
furosemide,chlorthiazide,amiloride,spir
onolactone etc.
 Antipyretics: These drugs reduces
body temperature by acting on
temperature regulating center on
hypothalamus when it is raised above
the body temperature. E.g.
paracetamol.

6. Contd..
 Emetics: Emetics are those drugs
which initiate vomiting by irritating
mucous membrane of stomach or by
stimulating the vomiting center of
medulla oblongata .e.g. apomorphine
,ipicacaunha used in non-corrosive
poisoning

7. Contd..
 Laxatives: laxatives are substances
that loosen stools and increases
bowel movements. they are used to
treat or prevent constipation. They can
be oral or suppository.eg. oral dietary
fibers,sorbitol,lactulose, senna
bisacodyl. (suppository-enema)

8. Contd..
 Anti-emetics: These drugs prevents
nausea and vomiting e.g.
ondansetron,
metoclopramide,promethazine,phenar
gan etc.
 Expectorants: Drugs which
increase the bronchial secretion and
help to cough of sputum are
expectorant e.g. sodium and
potassium iodide, ammonium chloride.

9. Contd..
 Carminatives: Causes expulsion of
gas from the stomach and intestine.
These drugs help to reduce flatulence.
It produces mild irritation to the
gastrointestinal tract leading to more
motility and causes relaxation of
sphincters e .g. sodium bicarbonate,
peppermint oil, tincture ginger.

10. Contd..
 Hypnotic: Those drugs which
induces sleep or maintain sleep
,similar to normal arousable sleep
e.g. thiopental
sodium,Lorazepam,midazolam.
 Sedatives/ tanquilizer: Those drugs
which depress central nervous system
and calm patient without inducing
sleep. e.g
phanobarbitol,conazepam,diazepam

11. Contd..
 Diphoretis:Those drugs which increases
action of sweat gland and induce
sweating.
E.g.tramadol,fentanyl,morphine.
 Tonic: Tonic produces and restores
normal tone of health. E.g. vitamin B
complex(fortiplex).
 Histamine: histamine is chemical
mediator of inflammation.it cause smooth
muscle contraction,including bronchiolar
and small vessel constriction ,increased
vascular permeability and secretion of
nasal and bronchial glands.

12. Contd..
 Anti - Anti- histamine: Drugs which destroys
and expel worms e.g.
albendazole,mebendazole.
 inflammatory: Helps to reduce inflammation.
E.g. ibuprofen,hydrocortisone,prednisolone.
 Antidote: Counteract the effects of poisoning
.e.g.
 Naloxone is antidote of morphine poisoning
 N- acetylcystein is an antidote of paracetamol
poisoning
 Atropine is antidote of organophospate
poisoning.
 Flumazenil is antidote of benzodiazepine
poisoning.

13. Contd..
 Myotics: Cotracts the pupil of eye.eg.
pilocarpine,physostigmine
 Mydriatrics: Dilates the pupil of eye.
E.g.
atropine,cyclopentolate,tropicamide.
 Stimulant: increases the functional
activity of organ. E.g. caffeine

14. Contd..
 Antacid: Neutralizes gastric acid
secretion. E.g. magnesium hydroxide,
sodium bicarbonate.
 Anti -coagulant: Inhibit or decrease
blood clotting process. E.g.
heparin,warfarin.etc
 Anti-mycotics: Prevents growth or
destroys fungus. Eg.
Ketoconazole,nystatin,benzoic acid.

15. PREVENTION OF
MEDICATION ERROR
THREE CHECKS:
1. Before pouring, mixing or drawing the medicine,
check its label against the entry on cardex. Be sure
that name, route, time, patient, dose match the
cardex entry.
2. At the bed side check the medicine once again
before administering it.
3. After administering the medication and before
returning the remaining medicine to the medication
cart or discarding .check label against cardex entry
again.

16. TEN RIGHTS:
1.RIGHT DRUG:
 A nurse must always administer a correct
medication.
 Always check the physicians order. if the
order is not clear consult the concerned
physician.
 Check the prepared medicine cardex
with physician’s order.
 Select ordered medicine from drug base.

17. Contd..
 Perform three checks
 Avoid selecting medicine based on size
and colour.be alert for similar looking
labels and similarly spelled names.
 Administer medicine from clearly labeled
container.
 Be familiar with abbreviation and trade
name of drugs.
 Be sure about changing orders.
 Do not accept verbal orders

18. 2.RIGHT DOSE
 Nurse should have knowledge
regarding dose of different drugs
administered.ci
 Check the physician order to know the
correct dose.
 Be sure that dose is within the
recommended range for patient’s age
and conditions.
 Ensure accuracy in measuring.

19. contd….
 Calculate the dose correctly, if the
available medication is different from the
dose recommended for E.g. if the
ordered dose is 500mg tablet and
available dose is 1000mg then break the
tablet into two equal parts using knife or
cutting device.*if the tablet breaks
unevenly discard it.
 When crushing a tablet clean the
crushing device before using it to remove
any pieces of previously crushed drug
and clean it after uses as well
 Help patient to take all medication.

20. Contd..
3.RIGHT TIME
 Medications are administered at a specific
time to maintain constant therapeutic level.
 Check the cardex for the time to give the
drug.
 Know the abbreviations as well.
 Know the right time to give a drug. E.g.
insulin is usually given half an hour before
meal. Lasix is normally given in morning and
afternoon only.
 Determine whether the patient is scheduled
for any diagnostic procedure ,surgery, blood
test that require patient to be in NPO

21. Contd..
4.RIGHT PATEINT
 Ask the patient to state his /her name.
 For unconscious patient, children,
mentally ill patient use the
identification tag. Or ask the patient’s
relatives.

22. Contd..
5.RIGHT ROUTE
 Check the cardex to ensure proper
form of the route ordered.
 Know the abbreviations for routes e.g.
IM, IV, SC etc.
 If any error occur immediately
inform to ward sister or physician
as it can be life threatening.

23. Contd..
6.RIGHT REASION
 Confirm the rationale for the ordered
medication .what is the patient’s
history? Why is he/ she taking this
medication?

24. Contd..
7. RIGHT DOCUMENTATION
 After administering a medication
document it on patient’s cardex . Be
sure to document the name of drug,
dose, route, exact time of drug
administration and signature of the
nurse providing the medication.

25. Contd..
8.RIGHT EVALUATION
 Make sure that the drug produced the
desired effect .if antihypertensive was
given .has his/her blood pressure
improved? if a patient is taking insulin
then his blood sugar is within normal
range or not.

26. Contd..
9.RIGHT TO REFUSE
 Give client enough autonomy to refuse
after properly explaining the side
effects.

27. Contd..
10.RIGHT EDUCATION
Client has right to be educated about
the drugs which he or she is prescribed.
education can be given on side effects
of drugs, precautions to be taken,
course of drug therapy dietary
consideration etc.

28. References
 Health learning material center. Institute of medicine of
medicine ,Tribhuwan University.Fundamentals of nursing (
second edition reprint ,2010). Kathmandu:Heidal Press
,Dillibazar.
 Basvanthappa,B.T.(2004). Fundamentals of Nursing. New
Delhi :Jaypee Brothers.
 Perry, A.G. and Potter, P.A. (2007).Basic Nursing Essentials
For Practice .(sixth edition): Mosby
 Giri, M. and Sharma,P. (2013). Essential Fundamental Of
Nursing.(first edition).Kathmandu: Medhavi Publication.
 Pathak ,S.and Devkota ,R.(2011).A Textbook Of
Fundamentals of Nursing.(second
edition).Kathmandu:Vidyarthi Prakashan.
 Taylor,C.R. and Lillis,C.(2008). Fundamental Of
Nursing.(Volume1):Lippincott William and Willikins
 Skidmere ,L . Nursing Drug Reference(2009): Mosby

29. THANK YOU!!!