Unit 4 Oral Medication Flashcards
Cardinal Rules of Medication Administration
Always –>Ten-rights; 3 checks
NEVER–> admin a med you did not prepare
YOU are legally liable if you cause harm to a pt from medication you administer
Characteristics
Absorbed mainly in the small intestine
Slower onset
Prescription in higher doses than parental route
NEVER direcly touch oral meds
Advantages/ Benefits of Oral Medication
Most Common, Least Expensive, Most Convient
Decreased risk for infection (does not break skin barrier)
Disadvantages
Unpleasant taste
Irritation of gastric mucosa
Irregular/ slow absorption
Stains teeth
Contraindicated (inappropriate) for
Oral Medications
N/V NPO Can't Swallow/ Dysphagia Unconscious Potential for aspiration
Alterations in Absorption (po)
food in stomach
Rate of Gastric Emptying
slow gastric empty –> prolongs absorption
increase gastric empt –>decrease absorption
Gastric Suctioning
- med withheld/ give by alt. route
- may (w/ order) give this route and hold suction for (20-30 MINS)
Changes in the Elderly that affect response
Decreased LIVER & KIDNEY function Decreased gastric mobility, acid production, blood flow to GI -->impaired absorption Decreased Protein Binding Sites Multiple drugs Increased Adipose Tissue
The decreased number of Protein Binding Sites
Alters the blood-brain barrier–> Fat soluble drugs reach brain –> dizziness and confusion
Increased body fat–> decreased total body fluid =
drug toxicity (more easily)
Solid Froms of Oral Medications
Tablets
Capsules
Lozenges
Powders
Tablets
Powered medications &/or other substances compressed into hard disks
May be scored,crushed –> easier swallowing
Coated Tablets
NEVER broken, crushed, chewed
Protects against environment/ Conceals bitter taste
Delays absorption until intestines (Enteric Coated)
Prevents damage to gastric mucosa
Chewable Tablets
Contains flavoring, sweeteners
ALWAYS follow with H20 –> dissolve & absorb
Good for pt who can’t swallow intact dose
Effervescent Tablets
disintegration in solution
Rapid onset action
Ex: antacids & analgesics
Time Released
Released & absorbed gradually (in stages)
Pt take fewer pills per day
Do NOT crush, chew, or break open
Capsules
solid dose form of powder, liquid or oil
1+ meds &/or inert substances incased in small shell
Gelatinous material that dissolves in GI tract
Colored to aid in identification
Gelatinous Material that dissolves in GI Tract
Capsules
Soft Capsules
CAN be opened and mixed with soft foods
Make sure pt gets COMPLETE Dose
Hard Capsules
Contain Drugs that irritate mouth & esophagus
NEVER break/ open
Sustained Release
SR in name
NEVER break/ open
Gradual release of drug over time
Lozenges or Troche:
Designed to be placed in mouth
Flat, round dosage from containing drug
Flavored sugar and mucilage
Powders
Mixed in Liquids
Come in large quantities/dispensed per dose ordered
Mix in 15ml to aid absorption
Types of Liquids
Syrups Solution Suspensions Elixirs Tinctures
Syrups
Sugar, water, + flavor NOT FOR DIABETICS 1* children and adults with dysphagia Soothes irritated mucus membrane Usually ordered by the teaspoon (1tsp=5ml)
Solutions
Given orally, parentally, or externally
Must Be STERILE if given parentally
Suspensions
liquid and solid mixture in which solid particles are not dissolved; particles will settle out
Types of Suspensions
Magmas
Gels
Emulsions
Magmas
Thick, milky
Type of Suspension
Gels
Small suspended particles
Type of Suspension
Emulsions
mixture of oil & water with agents that keep droplets suspended
SPECIAL CARE TO PREVENT ASPIRATION
Type of Suspensions
Elixirs
Med dissolved in ALCOHOL and WATER, &/or sweetener
CAUTION: NOT FOR Alcoholic
May dilute with small amount of H20
Tinctures
More potent Elixir
Oral or Topical
Sublingual Oral Medication
Under Tongue
Dissolved/ ABSORBED via MUCOUS MEMBRANE
IMMEDIATE absorption by surrounding blood supply
NOT CHEWED OR SWALLOWED
Buccal Medication
Between cheek & gum or under upper lip Dissolved/ absorb. via MUCOUS MEMBRANE IMMEDIATE absorption by surrounding bld supply Local/ systemic action Not often used
Purpose of Administering Oral Medication
Provide Medicine that has systemic/ local effect on G.I. TRACT
Assessments for Administering Oral Medication
- Allergies
- Ability to Swallow
- Vomiting & Diarrhea
- Specific Drug Actions ( Side effects, interactions, adverse reactions)
- Pt’s Knowledge
- Lab values, vital signs specific to medication
3 checks
- when removed from drawer
- pouring into med cup
- at bedside
LOCK MED CART– DO NOT LEAVE UNLOCKED
Administering Tablets
Place into Med Cup
DO NOT remove from wrapper until at bedside
If stock med, place correct dose in cup
**Keep Narcotics, meds that require v/s separate
If difficulty swallowing, crush/ mix pill with soft food
Preparing Liquids
Mix Med Lay Cap up to prevent contamination Measure prescribed dose Pour from UNLABELED SIDE of bottle At EYE LEVEL-- BOTTOM of Meniscus Rx Syringe Set on flat surface to check accuracy --> pour excess out --NOT BACK INTO BOTTLE DO NOT leave pour med unattended NEVER USE DROPER FROM ANOTHER MED
