Chapter 4 - Medication Preparation And Supplies Flashcards
Terminology
Before administering injections or giving any medications, what are the six rights of Proper Drug Administration?
- right drug
- right dose
- right route
- right time
- right patient
- right documentation
The injection site should be free of:
- lesions
- bruises
- inflammation
- edema
- masses
- tenderness
- sites of previous injections
What are the three injection routes?
- Intradermal (ID)
- Subcutaneous (SC)
- Intramuscular (IM)
Capsule
P. 44
Drug contained within a gelatin-type container.
- easier to swallow than non coated tablets.
- double chamber may be pulled apart to add drug powder to soft foods or beverages for patients who have difficulty swallowing (unless specifically contraindicated for absorption).
Drug form
P. 42
Refers to the type of preparation in which the drug is supplied.
Elixir
P. 45; 587
Usually sweetened, aromatic liquid used in the compounding of oral medicines.
-Or fluid extract. Liquid drug forms with alcohol base.
- should be tightly capped to prevent alcohol evaporation.
- should not be available to alcoholics.
- caution use in small children.
Enema
P. 45; 587
The introduction of a solution into the rectum and colon to stimulate bowel activity and cause emptying of the lower intestine.
• drug may be either a suspension (needs to be shaken before administration) or a solution to be administered as an enema.
Emulsion
P. 45
Liquid drug preparation that contains oils and fats in water.
Enteric-coated tablet
P. 44
Tablet with a special coating that resists disintegration by gastric juices. The coating dissolves further down the GI tract in the enteric, or intestinal, region.
Inhalation drug forms
P. 52; 590
Forms of a drug to be inhaled by the respiratory system usually through a specialized device such as a metered-dose inhaler (MDI).
- Spray
- Mist
Injectable drug forms
P. 45-49
Forms of drugs manufactured to be given via injection such as intravenous (IV) or intramuscular (IM).
- liquid: drug suspended (suspension) or dissolved (solution) in a sterile vehicle.
- powder: dry particles of drugs. The powder itself cannot be injected. It must be mixed with a sterile diluting solution (sterile water or saline solution) to render an injectable solution.
Oral drug forms
P. 44; 591
Drugs manufactured to be given via the oral route such as pills, solutions, and capsules.
- tablet
- enteric-coated
- capsule
- lozenge
- suspension
Lozenge (troche)
P. 44
Tablet containing a palatable flavoring, indicated for a local (often soothing) effect on the throat or mouth.
Parenteral
P. 43
Refers to any route not involving the GI tract, including injection, topical (skin or mucosal), transdermal and the inhalation route.
Reconstitution
P. 46; 593
The return of a substance previously altered for preservation and storage to its original state, as is done with dried blood plasma and powdered medications.
Rectal drug forms
P. 45; 593
Drugs manufactured to be administered via the rectal route, such as suppositories.
- suppository
- enema
Route of delivery
P. 42; 593
The way that drugs are taken into the body.
- intramuscular
- intravenous
- topical
- oral
- rectal
- subcutaneous
Solution
P. 45
Liquid drug form in which the drug is totally and evenly dissolved.
• Appearance is clear rather than cloudy or settled (as with a suspension).
Suppository
P. 45
Drug suspended in a substance, such as cocoa butter, that melts at body temperature.
Used:
• rectal
• vagial
• urethral
Suspension
P. 44
Liquid form of medication that must be shaken well before administration because the drug particles settle at the bottom of the bottle. The drug is not evenly dissolved in the liquid until properly shaking the mixture.
Sustained-release capsule or tablet
P. 44
Capsule or tablet containing drug particles that have various coatings (often of different colors) that differ in the amount of time required before the coatings dissolve. This form of drug preparation is designed to deliver a dose of drug over an extended period of time.
Sustained-release capsule or tablet
P. 44
Capsule or tablet containing drug particles that have various coatings (often of different colors) that differ in the amount of time required before the coatings dissolve. This form of drug preparation is designed to deliver a dose of drug over an extended period of time.
Syrup
P. 45; 594
A concentrated solution of sugar in water to which specific medicinal substances are usually added.
• Sweetened, flavored liquid drug form. Cherry syrup drug preparations are common for children
Tablet
P. 44
Disk of compressed drug.
Topical drug forms
P. 49
Drugs for dermal application and drugs for mucosal application.
-Those for dermal application include the following:
- cream or ointment
- lotion
- liniment
- transdermal patch
Those for mucosal application include the following: • eye, ear, and nose drops • eye ointment • vaginal creams • rectal and vaginal suppositories • douche solution • Buccal tablet • sublingual tablet • sandwiching the drug between very thin plastic membranes and then placing it under the patient's eyelid.
Intramuscular injection
P. 46
Injected into the muscle by positioning the needle and syringe at a 90 degree angle from the skin.
•Absorption is fairly rapid due to the vascularity (presence of many blood vessels) in the muscle
Subcutaneous injection
P. 46
Injected into the fatty layer of tissue below the skin by positioning the needle and syringe at a 45 degree angle from the skin.
• this may be the route of choice for drugs that should not be absorbed as rapidly as through the IV or IM routes.
Intradermal injections
P. 46
Injected just beneath the skin by positioning the needle bevel up and the syringe at a 15 degree angle from the skin.
- This route is used primarily for allergy skin testing.
- because of the lack of vascularity in the dermis, absorption is slow.
Intravenous injections
P. 46
Injected directly into a vein. Immediate absorption and availability to major organs renders this route a dangerous one.
• IV drugs are usually administered by physicians, paramedics, or registered nurses.
- Types of IV Injections:
* IV Push
* IV Infusion
* IV piggyback (IVPB)
Epidural injection
P. 48
Injected into a catheter that has been placed by an anesthesiologist in the epidural space of the spinal canal.
• Medications for pain can be administered into the catheter by bolus a (measured amount of solution) in a syringe or by continuous infusion through the tubing attached to a bag of solution.
Less common parenteral routes
P. 48-49
- Intraosseous - injected directly into the marrow of the long bones. This route may be used to administer medications during a cardiac arrest or other emergency situations when traditional IV access is not available.
- intraventricular - drug injected directly into the brain via a catheter (called a ventriculostomy) to be placed in a brain ventricle. In critical care, antibiotics can be given via ventriculostomy tube.
- intraspinal - injected into the subarachnoid space, which contains cerebrospinal fluid that surrounds the spinal cord. Drugs injected by this route are frequently anesthetics, which render a lack of sensation to those regions of the body distal to the intraspinal injection.
- intracapsular (intra-articular) - injected into the capsule of a joint, usually to reduce inflammation, as in bursitis. Arthritic or bursitic joints often injected with anti-inflammatory drugs include shoulders, elbows, wrists, ankles, knees, and hips.
Various supplies used for administering all different drug forms
(P. 52-56)
- medicine cup
- individual pill crusher and pill cutter
- ampule
- vial
- needles
- syringes
- oral syringes
Occupational Safety and Health Administration (OSHA)
P. 56
Have mandated that every effort be made to reduce the risk of needle-stick injuries that could lead to exposure to blood-borne pathogens, such as the human Immunodeficiency virus (HIV), Hepatitis B virus (HBV) or hepatitis C virus (HCV).
