Module 9: Medication administration Flashcards
What is the therapeutic objective of drug therapy?
“The objective of drug therapy is to provide maximum benefit with minimum harm”
What does the nurses role include in therapeutic objective of drug admin?
- acquiring and using a scientific knowledge base,
- a clear orientation toward safety,
- awareness of legislation and current medication administration standards,
- excellent assessment and monitoring competence.
What is pharmacology?
the study of the effect of drugs on living organisms.
What is pharmacy?
the art of preparing, compounding, and dispensing drugs.
what does a liscensed pharmacist do?
o prepares and dispenses drugs as ordered by the physician, dentist, nurse practitioner, and other health care professionals on the basis of provincial or territorial legislation.
what is a drug?
is any chemical that affects physiological processes.
What is a medication?
is a substance administered or the prevention, diagnosis, cure, treatment, or relief of a symptom or disease. In the health care context, the words medication and drug are used interchangeably.
Medications are a primary treatment that patients associate with restoration of health
What is involved in the “teaching” for client and drug admin?
- And their adverse drug events
- Promoting patient adherence to the medication regimen
- Evaluating the patients technique for all routes of medication delivery
What is a prescription?
The written direction for the preparation and administration of a drug
How many different names can one drug have?
- generic name,
- official name,
- chemical name,
- trademark or brand name.
What is a “generic” name and give examples
It is assigned before a drug becomes official. It is approved by Health Canada under the Food and Drug Regulations Act.
ex.
Acetominphen is the generic name for tylenol
Ibupropen is the generic name for advil
dimenhydrinate is the trade name for Gravol TM, Dramamine
Aspirin is the trade names for ASA , Entrophen
what is the “official” name?
- the name under which a drug is listed in one of the official publications.
what is the “chemical” name?
the name by which a chemist knows it; it describes the chemical constituents and molecular structure of the drug
what is a DIN and where is it found?
• Each drug is evaluated by Health Canada Therapeutic Products Directorate and approved for sale in Canada receives an eight-digit Drug Identification Name (DIN). This number is found on the label of all prescriptions and over the counter drugs (OTCS) as well as natural health products.
Why are drug standards developed?
to ensure uniform quality
What are official drugs?
those designated by the Canadian Federal Food, Drug, and Cosmetic Act
what is the nurses role in the legal aspects of drug admin?
a) know how nursing practice acts in their jurisdictions define and limit their fxns
b) Be able to recognize the limits of their own knowledge and skills
who is responsible for incorrectly administering a written incorrect dosage?
The nurse, and the prescribing health care provider
what is a high alert medication?
medications that carry a high risk of harming the patient when they are used in error), including controlled substances, which require the verification of two registered nurses
What is necessary for any portion or all of a controlled substance that is discarded?
must be witnessed and documented by both nurses
How are children’s medications computed?
Children’s medication doses are computed on the basis of body surface area and weight
What should each medication order include?
- patient’s name
- order date
- medication name
- dosage
- route
- time of administration and indication
- prescriber’s signature.
What are the 10 “rights” of medication administration?
- right medication,
- right dose
- right patient
- right route
- right time and frequency
- right documentation
- right reason
- right evaluation (or assessment)
- right patient education
- right to refuse.
who can administer medications?
The nurse should administer only the medications that they prepared; prepared medications must never be left unattended.
What is nurse responsible for?
- evaluating the effects of the medications
- teaching patients about their medications and possible adverse drug events
- promoting adherence
- and evaluating the patient’s technique for medication delivery.
What is clinical pharmacology?
Clinical Pharmacology: the study of drugs in humans.
Therapeutics or pharmacothera-peutics:
Therapeutics or pharmacothera-peutics: the use of drugs to diagnose, prevent or treat disease or to prevent pregnancy
What are the properties of an ideal drug?
Effectiveness
Safety
Selectivity
What are the factors that determine the intensity of drug responses for administered drug dosages?
Drug
Dosage
Route
Timing
What are the factors that affect how much of the drugs gets to its site of action? (Pharmacokinetics)
Drug absorption
Drug distribution
Drug metabolism
Drug excretion
What is pharmacokinetics?
The study of how medications 1) Enter the body 2) Are absorbed and distributed into cells, tissues, or organs 3) Alter physiological functions 4) Exit the body
What are the factors that affect absorption?
Route of administration Ability of the medication to dissolve Blood flow to site of administration Body surface area Lipid solubility of medication
What does distribution depend on?
Circulation
Membrane permeability
Protein binding
How are medications metabolized?
into a less potent or an inactive form
What is biotransformation and where does it occur?
Biotransformation occurs when enzymes detoxify, degrade, and remove active chemicals
Occurs in the liver
How are medications excreted?
Kidneys Liver Bowel Lungs Exocrine glands
What are the factors that determine the intensity of drug responses?
- pharmacodynamics
- Sources of inidividual variations
What are factors included in pharmacodynamics?
Binding of the drug to its receptor
Patient’s functional state
Placebo effects
What are the factors in individual variations?
Drug interactions
Physiologic variables – age, gender, weight
Pathologic variables – effectiveness of the liver and kidneys
Genetic variables
To safely and accurately administer medications, nurses need knowledge related to…?
Pharmacology Pharmacokinetics Growth and development Human anatomy Pathophysiology Psychology Nutrition Mathematics
How are medications classified?
- Effects on body system
- which symptoms relieved
- desired effect
What are the different types of medication forms?
Solid - Caplet, capsule, tablet, enteric-coated tablet, Pill
Liquid - Elixir, extract, aqueous solution, aqueous suspension, syrup, tincture
Other oral forms
Topical - Ointment, liniment, lotion, paste,
Parenteral - solution , powder
Instillation into body cavities - Solution, intraocular disc, suppository
What does parenteral mean?
administration of medication in any other non-oral form usually relating to injection
What is the difference between therapeutic classification of medication? give an example
Therapeutic classification: a way or organizing drugs based on their therapeutic usefulness in treating particular diseases;
e.g. Cardiac Care Drugs affect cardiovascular function
Pharmacological classification: addresses a drug’s mechanism of action, or how a drug produces its effect in the body.
e.g. Pharmacotherapy for hypertension
Some medications are part of more than one class of drugs;
e.g. aspirin is an analgesic, antipyretic and anti-inflammatory
What are considerations for medication actions?
- A patient does not always respond in the same way to each successive dose of a medication
- Sometimes the same medication causes very different responses in different patients
- Therefore, nurses need to understand all the effects that medications can have on patients.
what are the four different types of medication actions?
1) Therapeutic affects - Expected or predictable
2) Side affects - Unintended secondary effect
3) Adverse affects - Severe, negative response to medication
4) Toxic affects - Medication accumulation in the bloodstream
What is a idiosyncratic reaction?
Overreaction or underreaction to a medication
What is the difference between side affects and severe adverse affects of medication action?
Side effect - It is PREDICTABLE: Unintended, unavoidable secondary effects that a medication predictably will cause.
e.g. Narcotics may cause nausea or constipation
Severe adverse effect - UNPREDICTABLE and UNDESIRABLE: Severe adverse effects or adverse drug events (ADE) are unintended, undesirable and often unpredictable.
Can be intolerable, negative responses that justify immediately discontinuation of the medication
e.g. Kidney failure
What is a contraindiction?
Many medications should not be taken by some patients due to unwanted, dangerous reactions.
Prescribing aspirin to children and teenagers is contraindicated due to risk of Reye’s Syndrome
What is a medication “interaction”?
Interactions are events in which one medication modifies the action of another.
what is a “syngistic” effect?
A synergistic effect occurs when the combined effect of two medications is greater than the effect of the medications given separately
