Week 2 - Medication Management via different routes Flashcards
Abbreviation: SR
Sustained/slow release
- veracaps SR verapamil
Abbreviation: MR
Modified release Diamicron MR (gliclazide)
Abbreviation: LA
Long acting. Ritalin LA methylphenidate
Abbreviation:XL
extended release. torpor XL metoprolol
Abbreviation:
Abbreviation: ER
extended release
Abbreviation: CR
controlled release
Abbreviation: CD
controlled delivery
Abbreviation:EC
What is medication?
- a substance administered for the diagnosis, cure, treatment or relief of a symptom or for prevention of disease
What is a prescription?
the written direction for the preparation and administration of a drug
3 names for a drug
- chemical name
- generic name
- trade/brand name
what is therapeutic effect?
the primary effect intended, the reason the drug is prescribed. e.g morphine sulphate for analgesia
What is a side effect?
the secondary effect is uninvited. side effects are predictable
What is an adverse effect
some side effects are tolerated for the drugs therapeutic effect, the more severe side effects are adverse effects
what are common medication errors
- Incorrect admission
documentation - Errors in prescription;
incorrect dose - One of the ‘rights’ is
wrong! - Administration of medication
when there is an allergy - Errors in
documentation
Colour Coding: Red
target issue and route of administration
- target: intra-arterial
- route: intra-arterial
Colour Coding: Blue
target issue and route of administration
- target : intravenous
- route: intravenous
Colour Coding: Yellow
target issue and route of administration
- target: neutral tissue
- route: epidural / intrathecal/regional
Colour Coding: Beige
target issue and route of administration
- target: subcutaneous tissue
- route: subcutaneous
Colour Coding: Pink target issue and route of administration
- target : miscellaneous
- route: any other not specified above
Pharmacokinetics what is Distribution
is the transportation of a drug from its site of
absorption to its site of action.
o blood circulation, protein binding, membrane permeability
Pharmacokinetics what is Metabolism
the process by which a drug is transformed
into a less active or inactive form.
o occurs in the liver, but also lungs, kidney, intestines
Pharmacokinetics what is Excretion
is the process by which metabolites and drugs are
eliminated from the body.
o mainly via the kidneys, but also intestines, lungs, skin, breastmilk
what to consider for the Cold Chain Management
System of transporting and storing vaccines within the
temperature range of +2C to +8C
* Ideal is + 5C
* Staff in hospitals/clinics responsible for:
– receiving
– stocking
– storing
– administering
* Must ensure cold chain is maintained at all stages
what to consider for the Storage of Schedule 8 and
Schedule 4 Appendix D
- Drugs of addiction
- Stock levels of S8 and S4D/R medications should be kept to
lowest level practicable - Must be stored in separate medication storage unit:
– Metal safe
– Securely attached to floor or wall
– Kept locked
– Lock should be five lever lock
– Close to CCTV monitoring
What to consider for medication storage
- All medications must
be stored in a locked
cupboard, room,
drawer or trolley
when not in
immediate use
2.Except for emergency
trolley medications
3.All medications must
be stored in same
container as received
from Pharmacy
4.Medications must be
stored in manner that
minimizes medication
error
5.Medication keys must
be kept separate from
other ward keys
What is the Medication calculation formulas Tablets and Capsules
Dose ordered/stock strength
What is the Medication calculation formulas Liquids
dose ordered/stock strength x volume (mM)/1
What is the Medication calculation formulas injection
dose ordered/stock strength x volume (mM)/1
What to consider about medication storage - patients own
- All patients advised to bring current medications with them to hospital
2.Once medication history documented – advise patient to send medications home
3.Patient’s own medications should not be used for inpatient use
expect:
1.not available from Pharmacy department
2. only used until stocked by pharmacy then
sent home
3. Patient is day-only admission
What to consider with vaccine storage
- Purpose built vaccine
fridges – glass door - Daily log of fridge
temperature - Do not open fridge until
you have located vaccine
you need - Document vaccines placed
in fridge - Place stock in labeled
containers
What top consider about your scope
- Under direct supervision for EVERY step of the procedure
- Must be supervised by a REGISTERED NURSE only
- Must have a valid written order
- Medication categories include Schedule 2, 3 and 4 …
NOT Schedule 4D/R or Schedule 8 - Routes of medication include ONLY those taught in the semester
and that appear in your Professional Practice Book
Geriatric Medication management lifespan considerations
Precautions associated
with comorbidities
* Polypharmacy –
prescription, over the
counter drugs, ‘sharing’
* Interactions between drugs
* Higher rate adverse effects
and mortality
* Increase risk falls, frailty
and disability
Paediatric Medication management lifespan considerations
- Variables impacting on the
calculation of a medication dose:
height/length, weight, age,
body surface area - Liquid forms
- Use disposable syringe to
prepare dose < 10 mL
What to consider Lifespan considerations
Medication doses for the very young and
older adult need to be adjusted due to
pharmacokinetic variations such as:
– immature or age affected organs – skin, intestine, liver & kidneys
– poor peripheral tissue perfusion
– higher (very young) or lower (older adult) water content
– composition of body fat
– lower plasma proteins (albumin)
– Weight
Pharmacokinetics what to consider Absorption
the process by which a medication passes
from the source of administration into the bloodstream.
It is influenced by factors such as
o body surface area, blood flow, presence of food, ability of
medication to dissolve, lipid solubility of medication
o the route of administration, such as:
oral, inhalation, topical, IM, IV
o medication form, such as:
liquid, capsule, tablet, enteric coated, sustained release,
suppository, transdermal patches
What to consider when Getting to know
medications
- Generic name & brand name(s),
& pharmaceutical company - Medication Schedule
- Therapeutic class
- Use
- Contraindications, precautions & interactions
- Adverse effects
- Medication forms (appearance,
description, stock strength available) - Recommended dose
- Directions for use
What to consider Non-Injectable Medicine
– INHalation
> Nebules are preferred
source of solutions for
inhalation
If nebuliser solutions must
be measured with a syringe
then label the syringe
- white
What to consider Non-Injectable Medicine
– Enteral Route
> Container and line labels
available
Syringes for non-injectable
solutions must not be
compatible with parenteral
entry portals
- green
