Med Admin 2 Flashcards
(34 cards)
pharm concepts
medication names:
- chemical names (nurses rarely use)
- generic (use this)
- trade (brand name, can use w/generic)
classification:
- group of meds that work similarly
- have similar chemical makeup
- treat similar conditions
(ex: anti-pyretic, anti-inflammatory)
medication forms:
- pills
- injection
- liquid
- suppository
- topical
- orifice drops/sprays
- troches (lozenges?)
non-parenteral meds
introducing proper administration of:
- oral meds
- topical meds
- suppositories
- eye meds
- ear meds
- inhalant meds
adverse drug reactions (ADR)
unintended and undesired side effects at normal drug doses
side effects:
- predictable
- intensity is dose dependent
- development varies
- ex: drowsiness with antihistamines, gastric irritation with aspirin
(side effects that we tell patients)
adverse reactions
toxicity is severe ADR
- excessive drug dosing or therapeutic drug dosage
- ex: respiratory depression from morphine, hypoglycemia from overdose of insulin, neutropenia from anticancer drugs
adverse reactions
allergic reactions
- immune response
- intensity of reaction varies
- not based on dosage
- sensitivity of drug can change overtime
adverse reactions
- idiosyncratic effect: uncommon drug response bc of genetic disposition
- paradoxical effect: opposite effect drug was intended for
- iatrogenic effect: disease caused by drug (or treatment)
- teratogenic effect: causing birth defects
adverse reactions
physical dependence effect
- body has adapted to drug exposure
- opioids, barbiturates, amphetamines, psych meds, etc.
- abstinence syndrome
– warn patients of abrupt discontinuation
– harmful effects if continued abruptly
(ex: alcohol, suddenly stopping will need drugs to prevent abstinence syndrome)
adverse reactions
identification
adverse reactions
identification
- did symptoms occur shortly after drug use?
- did symptoms leave after drug discontinued?
- did symptoms reappear when drug was reinstitued?
adverse reactions
ways to minimize them
- education
- early identification
- monitoring
– lab values
– s/s
– individualized therapy: risks vs benefits
- black box warning
– strongest safety warning
– serious or life-threatening risk
– heavy black border around the text
medication guides
- description of drug and indications
- who should not take the drug
- how the drug should be taken (overdose? if dose is missed?)
- what should be avoided while taking the drug
- possible and reasonable side effects
oral meds
- tablets/caplets (tablets that look like capsules) /capsules (filled like gel)
- modified release
– delayed release: enteric coated
– extended release: controlled release, sustained release and long-acting
– oral disintegrating: disintegrates in mouth - syrups
- suspensions
administering oral meds
- HOB at least 30 degrees (semi-Fowler)
- assess for potential aspiration - can you take a sip of water
- opening packaged meds
- offer 1-3 pills at a time
- administration of solids and liquids (liquids measured in cup or syringe, tablets or solids may need to be cut in half or crushed as long as not extra release, etc.)
- always supervise swallowing (to make sure they swallow it and can swallow it)
- gloves whole time
avoid po meds if
- changes in LOC
- NPO status (may be NPO with meds = nothing except meds)
- altered GI function
– NG tube with suction (po won’t be absorbed)
– N/V - dysphagia
meds not to crush, split, or chew
- enteric coated: EC
- sustained release: SR
- time released: TR
- controlled delivery: CR
- sublingual: SL
- buccal
if need to crush
- crush if having trouble swallowing
- look for do not crush
- may use pill crusher in original/alternative package
- mix in applesauce or ice cream
- call pharmacy
- don’t rush to crush
pill splitting
- split pills bc ___
- clean pill splitter with alcohol swab before and after use
- use gloves
- remove pill from package
- position pill to be split where scored
topical meds
medications applied to body surfaces or mucous membranes
- skin application
- eye instillation
- ear instillation
- vaginal instillation
- rectal instillation
types of topical meds
- powders
- creams/pastes/gels/ointments
- drops
- ointments
- aerosols or sprays
- medicated patches
- suppositories
administering topical meds
- assess area prior to application: for cuts, rashes bc med won’t go on there (unless specifically to treat the rash)
- clean previous and present area well
- avoid shaving: bc you could cut the skin and then can’t put med there
- measure if needed
- apply as directed: wear gloves
- cover (?)
transdermal medicated patches
remove and clean previous area before replacing the patch
- proper removal and replacement: new one not in same spot bc could cause irritation
- date, time and initial: before patch put on
- wear gloves whole time
- most are do not cut - know med
- remove for MRI, AED
- avoid heating pads
suppositories
- explain procedure
- left lateral side-lying (SIMS)
- don gloves - remove packaging
- prep the med: lubricant
- relaxation techniques: deep breath
- proper insertion: 1-1.5 inches for adults
- patient teaching: don’t go to bathroom, don’t push even though feel like it, prob around 15 minutes to absorb
vaginal medications
- explain procedure
- position: lithotomy (if incontinent, may have to clean them up before giving)
- don gloves - remove packaging
- proper insertion/application: 2-3 inches in, done gently, may be done digitally sometimes, may not have applicator
- patient teaching
– patient may administer own
– may need perineal pad
(ex: yeast infections, hormone creams)
administering eye meds
- know the med and why
- explain procedure and instructions
- don gloves
- position of pt and eyelid: laying down, supine
- instill as prescribed: lower bottom of eyelid, drop in conjunctive or squeeze into bottom lid,
- tip of bottle or tube must not touch eye or lashes (contamination)
- tissue to inner part of eye, apply pressure for 1 minute so doesn’t go systemic into nose
(no tissue for cream,
common use for eye infections like pink eye (conjunctivitis), glaucoma)
