ch 31 medication administration Flashcards
Shaped like capsule and coated for ease of swallowing
Caplet (Solid Forms)
Medication encased in gelatin shell
Capsule(Solid Forms)
Powdered medication compressed into hard disk or cylinder; in addition to primary medication, contains binders (adhesive to allow powder to stick together), disintegrators (to promote tablet dissolution), lubricants (for ease of manufacturing), and fillers (for convenient tablet size)
tablet(Solid Forms)
Coated tablet that does not dissolve in stomach; coatings dissolve in intestine, where medication is absorbed
Enteric-coated tablet(Solid Forms)
Clear fluid containing water and/or alcohol; often sweetened
Elixir (Liquid Forms)
Syrup or dried form of pharmacologically active medication, usually made by evaporating solution
Extract(Liquid Forms)
Substance dissolved in water and syrups
Aqueous solution(Liquid Forms)
Finely dissolved medication particles dispersed in liquid medium; when suspension is left standing, particles settle to bottom of container
Aqueous suspension(Liquid Forms)
Medication dissolved in a concentrated sugar solution
Syrup(Liquid Forms)
Alcohol extract from plant or vegetable
Tincture(Liquid Forms)
Flat, round tablets that dissolve in mouth to release medication; not meant for ingestion
Troche (lozenge)
Oral Forms and Terms Associated with Oral Preparations
Aqueous medication sprayed and absorbed in mouth and upper airway; not meant for ingestion
Aerosol
Tablet or capsule that contains small particles of a medication coated with material that requires a varying amount of time to dissolve
Sustained release
Semisolid, externally applied preparation, usually containing one or more medications
Ointment (salve or cream)Topical Route
Usually contains alcohol, oil, or soapy emollient applied to skin
Liniment
medication pharmacokinetics, a patient’s health history, physical examination data, and knowledge gained through daily patient interactions
Safe medication administration requires
excrete lipid-soluble medications
exocrine glands
are the main organs for medication excretion
kidneys
is the expected or predicted physiological response caused by a medication
therapeutic effect
reduces cardiac workload and increases myocardial oxygen supply
nitroglycerin
, a steroid, decreases swelling, inhibits inflammation, reduces allergic responses, and prevents rejection of transplanted organs.
prednisone
very young and older adults, pregnant women, patients taking multiple medications, patients who are extremely underweight or overweight, and patients with renal or liver disease.
risk for adverse medication reactions
,an opioid antagonist, reverses the effects of opioid toxicity.
naloxone
not to chew or swallow the medication or to take any liquids with it. A buccal medication acts locally on the mucosa or systemically as it is swallowed in a person’s saliva
buccal route
Semiliquid suspension that usually protects, cools, or cleanses skin
Lotion (Topical Route)
Medication preparation that is thicker than ointment; absorbed through skin more slowly than ointment; often used for skin protection
Paste(Topical Route)
Medicated disk or patch absorbed through skin slowly over long period of time (e.g., 24 hours)
Transdermal disk or patch(Topical Route)
Sterile preparation that contains water with one or more dissolved compounds
Solution( Parenteral Route)
Sterile particles of medication that are dissolved in a sterile liquid (e.g., water, normal saline) before administration
Powder( Parenteral Route)
Small, flexible oval (similar to contact lens) consisting of two soft, outer layers and a middle layer containing medication; slowly releases medication when moistened by ocular fluid
Intraocular disk(Body Cavities)
Solid dosage form mixed with gelatin and shaped in form of pellet for insertion into body cavity (rectum or vagina); melts when it reaches body temperature, releasing medication for absorption
Suppository(Body Cavities)
Raised, irregularly shaped skin eruptions with varying sizes and shapes; eruptions have reddened margins and pale centers
Urticaria (hives) /Mild Allergic Reactions
Small, raised vesicles that are usually reddened; often distributed over entire body
Rash/Mild Allergic Reactions
Itching of skin; accompanies most rashes
Pruritus/Mild Allergic Reactions
Inflammation of mucous membranes lining nose; causes swelling and clear, watery discharge
Rhinitis/Mild Allergic Reactions
Period of time it takes after you administer a medication for it to produce a therapeutic effect
Onset of medication action:
Time it takes for a medication to reach its highest effective peak concentration
Peak action:
: Minimum blood serum concentration of medication reached just before the next scheduled dose
Trough
Length of time during which a medication is present in a concentration great enough to produce a therapeutic effect
Duration of action:
Blood serum concentration reached and maintained after repeated, fixed doses
Plateau:
AC, ac
Before meals
ad lib
As desired
BID, bid
Twice each day
PC, pc
After meals
prn
Whenever there is a need
q am
Every morning, every AM
qh
Every hour
Daily
Every day
q4h
Every 4 hours
QID, qid
4 times per day
STAT, stat
Give immediately
TID, tid
3 times per day
Convenient and comfortable Economical Easy to administer Often produce local or systemic effects Rarely cause anxiety for patient
Oral, Buccal, Sublingual Routes
Oral route is avoided when patient has alterations in gastrointestinal (GI) function (e.g., nausea, vomiting), reduced GI motility (after general anesthesia or bowel inflammation), and surgical resection of the GI tract.
Oral administration is contraindicated in patients unable to swallow (e.g., patients with neuromuscular disorders, esophageal strictures, mouth lesions).
Oral administration is contraindicated in patients who are unconscious, confused, or unable or unwilling to swallow or hold medication under tongue.
Oral medications cannot be administered when patients have gastric suction; are contraindicated before some tests or surgery.
Oral medications sometimes irritate lining of GI tract, discolor teeth, or have unpleasant taste.
Gastric secretions destroy some medications.
Oral, Buccal, Sublingual Routes/ disadvantage
when oral medications are contraindicated
More rapid absorption than with topical or oral routes
Intravenous (IV) infusion provides medication delivery when patient is critically ill or long-term therapy is necessary; if peripheral perfusion is poor, IV route preferred over injections
Parenteral Routes (Subcutaneous, Intramuscular, Intravenous, Intradermal)
There is risk of introducing infection.
Some medications are expensive.
Some patients experience pain from repeated needlesticks.
Subcutaneous, intramuscular (IM), and intradermal (ID) routes are avoided in patients with bleeding tendencies.
There is risk of tissue damage.
IM and IV routes have higher absorption rates, thus placing patient at higher risk for reactions.
They often cause considerable anxiety in many patients, especially children.
Parenteral Routes (Subcutaneous, Intramuscular, Intravenous, Intradermal) disadvantage
Primarily provides local effect
Painless
Limited side effects
Skin (Topical Routes)
Patients with skin abrasions are at risk for rapid medication absorption and systemic effects.
Medications are absorbed through skin slowly.
Skin (Topical Routes)
Prolonged systemic effects with limited side effects
Transdermal(Topical Routes)
Medication leaves oily or pasty substance on skin and sometimes soils clothing
Transdermal(Topical Routes) disadvantage
Therapeutic effects provided by local application to involved sites
Aqueous solutions readily absorbed and capable of causing systemic effects
Potential route of administration when oral medications are contraindicated
Mucous Membranes (Topical Routes)
Mucous membranes are highly sensitive to some medication concentrations.
Patients with ruptured eardrum cannot receive ear irrigations.
Insertion of rectal and vaginal medication often causes embarrassment.
Rectal suppositories contraindicated if patient has had rectal surgery or if active rectal bleeding is present
Mucous Membranes (Topical Routes) /disadvantage
Provides rapid relief for local respiratory problems
Used for introduction of general anesthetic gases
Inhalation(Topical Routes)
Some local agents cause serious systemic effects.
Inhalation(Topical Routes)/disadvantage
Route advantageous because it does not require frequent administration as eyedrops do
Intraocular Disk(Topical Routes)
Local reactions possible; expensive
Patients must be taught to insert and remove disk
Contraindicated in eye infections
Intraocular Disk(Topical Routes)/disadvantage
15 drops (gtt)
1 mL
1 teaspoon (tsp)
5 mL
1 pint (pt)
480 mL (approximately 500 mL)
1 quart (qt)
960 mL (approximately 1 L)
1 gallon (gal)
3785 mL (approximately 4 L)
do not use spacers.
BAIs and DPIs
patients use a spacer with the pMDI. A spacer is a tube that is 10.16 to 20.32 cm (4 to 8 inches) in length that attaches to the pMDI and allows the particles of medication to slow down and break into smaller pieces. This helps the medication get deeper into the lungs and enhances absorption.
spacer
release medication when a patient raises a lever and inhales. Release of the medication depends on the strength of the patient’s breath on inspiration, and a BAI is a good choice for patients who have difficulty in using pMDIs because it eliminates the need for hand-breath coordination
BAIs(breath-actuated metered-dose inhalers)
hold dry powder medication and create an aerosol when the patient inhales through a reservoir that contains a dose of the medication. The reservoir holds a dose of the medication. Compared with MDIs, DPIs deliver more medication to the lungs
DPIs (dry powder inhalers)
is indicated for a patient who has difficulty coordinating the steps, like patients with limited mobility/coordination
spacer
are the infections most commonly transmitted by contaminated needles
HBV and HCV
