Med Admin Flashcards
Therapeutic effect
The expected or predicted physiological response that a medication causes
Six rights
The right patient The right medication The right dose The right time The right route The right documentation
Toxic effect
Develop after prolonged intake of a medication or when medication accumulates in the blood because of impaired metabolism or excretion
Idiosyncratic reaction
Unpredictable where a pt overreacts or under reacts to a medication, or has a reaction different from normal
Mild Allergic reaction (4)
Urticaria- raised irregularly shaped skin eruptions ( reddened margins and pale centers)
Rash
Pruritus– itching of the skin, that accompanies most rashes
Rhinitis- inflammation of mucous membranes lining nose; causes swelling and clear watery discharge
Terms associated with medication action
Onset– time it takes after medication is administered for it to produce a response
Peak– time for medication to reach its highest effective concentration
Trough–minimum blood serum concentration of medication reached just before the next scheduled dose
Duration– time during which the medication is present in concentration great enough to produce a response
Plateau– blood serum concentration of a medication reached and maintained after repeated fixed doses
Controlled Substances C-I C-II C-III C-IV C-V
C-I High abuse potential
No acceptable medical use
May lead to severe dependence
ex: Heroin, LSD, marijuana
C-II High abuse potential Accepted medical use May lead to severe dependence Mophine, methodone, Ritalin, secobarbitral, codeine
C-III Less abuse potential-potential high dependence
Preparations containing limited amount of above substances
34 day limited supply
RX expires 6 months
written oral script
C-IV Low abuse
Physical/psychological dependence
Valium
C-V
May not require script
Meds for cough, diarrhea
Process for medication reconciliation (4)
1) Verify–obtain a comprehensive and current list of the patients meds. Be sure to ask about vitamins, herbal and nutritional supplements, OTC, insulin pens, transdermal patches, inhalers, and other meds that people do not typically consider meds
2) Clarify– make sure that the list if meds, dosages, and frequencies are accurate; clarify the list with as many people as necessary
3) Reconcile– compare new medication orders with current list; investigate any discrepancies with the patients health care provider
4) Transmit– communicate the updated and verified list to caregivers and the patient as appropriate. Teach pt to carry list of current meds and share with all health care members
Factors that influence that rate of absorption (5)
The administration route ability to dissolve blood flow to the admin site body surface area lipid solubility of medication
most biotransformation occurs where?
In the “Liver”, although the lungs kidneys, blood and intestines also play a role
What is the main organ for excretion?
Kidneys
-if patients have reduced renal function they are at risk for toxicity
Therapeutic effect
the intended or desired effect
When you compare the label of meds to the MAR
1) before removing the container from the supply drawer
2) as the Amount of med ordered is removed from the container
3) at the patients bedside before administering the meds to the patient
classification of drug
Ways to categorize medications
May indicate:
1) Effect of a drug on a body system~(action)
2) Symptoms that the drug relieves~(ex; edema)
3) Desired effect of the drug~ (diuresis~lowers B/P)
Pharmacokinetics (4 step)
1) Absorption
2) Distribution
3) Metabolism~ most metab/ in LIVER
4) Excretion
Therapeutic effect
local~ ex) eye drops, cough drops, ointments
systemic~ ex) anaphylaxis (epinephrine)
Sometimes both systemic and local
ex) Aspirin~ prevent clotting
anti-inflammatory
Side effect
is one that is a normal expected side effect of a medication
Synergistic effect
2 drugs together have a greater therapeutic effect than if one was given alone
ex) Tylenol w/codeine
Antagonistic effect
2 drugs decreasing the effect of the other drug
ex) antacids and tetracycline
Synergistic and Antagonistic effect Can be positive or negative
Aspirin and Coumadin taken together
Routes of Administration(3)
1) Oral~ economical, slower, longer onset but
longer duration
2) Topical
3) Parental
Idiosyncratic Reaction
unpredictable effect in where a patient overreacts or underreacts to medication
Oral (3)
1) Swallowed
2) Sublingual~ under the tongue*DO NOT
SWALLOW Dissolved
3) Buccal~ along cheek (dissolves) & alternate sides ( local and systemic)
Topical (3)
can be instilled (suppository, drop, cream, patch)
1) Instillation (applied to body orifices and cavities, absorbed through mucous membranes)
2) Skin
3) Inhalation (rescue inhaler)
Parenteral (7)
administered other than GI
Sterile gloves with”IV” but, clean gloves with others
1) Intradermal ~ under dermis (slowest acting) TB
testing, allergy testing
2) Subcutaneous~ small doses into fat (between dermis and muscle)
3) Intramuscular~ great absorption within 1/2 hr
4) Intravenous~ Rapid onset~~Large doses
Potassium always IV
5) Intraarterial~ *central line
6) Intrathecal~ Spinal (aka Intraspinal)
7) Intraarticular~ Joint (steroids)
Essential Parts of a medication order (6)
1) Full name
2) date and time
3) Drug name
4) Dosage
5) Route and administration
6) Signature
Medication Administration Critical Elements
1) Wash hands
2) Patients ID bracelet is compared with the MAR to ensure the right patient
3) Head of the bed at 40 degrees or higher for oral meds
4) The correct meds are administered
5) the correct dose is administered
6) med is given a half hour before or a half hour behind scheduled time
7) given by the prescribed route
8) date, time, and initials are documented on the MAR
9) Principle of asepsis are observed
10) Principles of safety are observed
Contradictions to Oral Medication Administration
1) Impaired swallowing
2) Nausea and vomiting
3) NPO
4) Nasogastric suctioning
