4. Med Admin Flashcards
Enteral & Sustained-release tablets: (Oral route)
Enteral:
Enteric-coated tablets are supposed to pass through the stomach intact, disintegrate, and release the drug content for absorption in the intestines.
Sustained-release tablets:
- SR- sustained release
- ER/XR/XL - extendedrelease
- CR- controlled release
Advantages:
- protect the stomach from drug
- protect the drug from stomach acids
- release drug in the intestines after the stomach
Disadvantages:
- first pass effect: concentration of drug will be reduced once it gets to its destination so the effect will be reduced as well
- slower release (3-40 min)
- pt must be able to swallow
Other oral routes
Sublingual: under tongue. No swallowing, no water
Buccal: cheek
Elixir: water and alcohol solution
Syrup: sugary sticky solution
Suspension: finely dispersed drug particles in liquid. Must shake.
Route: nasogastric & gastrostomy
Nasogastric tube: passed thru nose, down back of throat, thru esophagus and into stomach
Gastrostomy tube: feeding tube inserted endoscopically or surgically thru the abd wall and into the stomach. (surgery is difficult because there is a chance of inserting into lungs instead of esophagus
- choose liquids over solids
- crush/dissolve pills
- stop feed, flush with 30 cc sterile water, give med, flush, restart feed
- to admin on empty stomach, stop feed 30 min before and after admin
- monitor pt for signs of complications
Enteral Route: Topical
creams, gels, lotions, paste, ointment, powsers, transdermal patches, inhaler
-low side effects because absorbed very slowly and amounts reaching general circulation are minimal
Parental Route
Any other route other than oral or topical
SC
IM
IV
Medication Errors
- preventable
- common cause of adverse health care outcomes
- can be no effects or directly causing death or disability
Med error actions
- recognize error
- assess pt for VS
- inform instructor immediately
- med error report
- supervisory nurse informed (with instructor)
- doctor/prescriber informed
- ongoing assessment of pt
General Principles of Drug Therapy
The goal of drug choice and dosing levels: maximize beneficial effects and minimize adverse effects
Individualize drug and titrate as often as needed
Drug titration is ongoing and often required lab work as well as assessment (hx and exam)
Consider special populations (infants, preg, older adults, liver or kidney dysfunction)
Consider drug effects on QOL
Drug Therapy Therapeutic goals
Medical:
- cure/slow pathology
- minimize disease sequela and suffering
- return pt to function in community asap
Nursing:
- empower pt /fam/communities to move toward relational and self-care (independent wellness)
- includes interventions, education, follow up, collaborative care, motivational communication
Drug Therapeutics
With increased knowledge of pharmacology and increased skills of motivational communication/education, you will have the tools to:
- alleviate pain
- fight infection
- improve cardiac and resp. function
- promote self care and informed choice
- prevent epidemics
- cure disease
- promote wound healing
- calm anxiety
What to teach pts about a drug:
- side effects
- how often
- taken with or without meals
- what it is for
- if it interacts with anything
- how to self monitor
