DRUG ADMINISTRATION

DRUG ADMINISTRATION

UPDATED 2024

Definition

A drug or medicine is a substance used for diagnosis, treatment, cure, relief or prevention of disease

Medicine is defined as a substance used to promote health, to prevent and cure disease

Purpose of Medicine

It is used for diagnosis
It treats the disease condition
To prevent health alterations
To promote health condition
To treat infections, allergic and inflammation
To relieve pain

Forms of Medications

Capsule: solid dosage form for oral care. Medicine is powder, liquid or oil of and encased by gelatin shell
Lotion: medicine in liquid suspension applied externally to protect skin
Solution: liquid preparation that may used orally, parentally or externally, can also be instilled into body organ or cavity (e.g. bladder irrigation) contains water with one or more dissolved compounds, most be sterile for parentaral use
Suppository: solid dosage form mixed with gelatin and shaped inform of pellet for insertion into body cavity (rectum or vagina)
Suspension: finely divided drug particles dispersed in liquid medium
Syrup: medication dissolved in concentrated sugar solution, may contain flavoring to make medication more palatable
Tablet: powdered dosage form compressed into hard disks or cylinders in addition to primary medication contains binders integrators, lubricates and filler

Types of Medication Action

Therapeutic effect: it is the expected or predictable physiological response a medication causes
Site: effect is the unintended secondary effects a medication predictably will cause. Side effects may be harmless or injurious
Adverse effect: there are generally considered serve responses to medication. For example, a client maybe becomes comatose when a drug is ingested
Toxic effect: may develop after prolonged intake of a medication or when a medication accumulation in the blood because of impaired. Metabolism or excretion
Idiosyncratic reaction: medicine may cause an idiosyncratic effect. This occurs when a patient over react or under reacts to a drug or has a reaction different form the normal
Allergic reaction: it is an unpredictable reaction to a drug. In this, the drug acts as an antigen and antibodies are produced. Allergy causes antigen-antibody reaction

Factors Influence the Medication Dosage

Age: infants, children and the old requires smaller dosage of a drug than that of an adult
Weight: a person of overweight requires a large dose the usual one
Male requires: large dose then females
Cumulative action of the drug: the frequency and dose of a drug administered depends upon the rate of excretion from the body
Tolerance: it is capacity of taking excessive does without producing toxic effect
Habituation: when a particular drug used continuously for a long period. The drug is withdrawn they may stop physical craving for it and show definite organic symptoms
Addition: prolonged use of alcohol and narcotics may produce an extreme form of habituation and result in a condition known addiction
Route of administration: drugs given by IV route have a very quick and immediate action

Route of Administration

The route of a drug depends on its properties, desired effect, and patient’s physical and mental condition

Oral administration: it is the most common route and the most convenient route for most patients
Sublingual: the drug is placed under the tongue and letting it slowly dissolve, e.g. nitroglycerine
Inhalations: the patient inhales the fumes in the lung to have a local and systemic effect, e.g. nitrous oxide (anesthetic effect)
Inunctions (topical application): it is the application of the drug to the skin, usually by a friction, e.g. ointment
Instillation: it is putting a drug in liquid form into the body cavity, such as urinary bladder or into body orifices such as ears, eyes and nose
Insertions: means introducing solid forms of drugs into the body orifices, e.g. suppositories are introduced into the rectum or vagina
Implantation: means planting or putting in of solid drugs into the body tissues
Parenteral administration: parenteral means giving of therapeutic agents outside the alimentary tract. It is the type if administration accomplished by a needle

Intramuscular: into the muscle

Subcutaneous: into the subcutaneous tissue

Intradermal: into the dermis

Intravenous: into the vein

Intraarterial: into the artery

Intracardiac: into the cardiac muscles

Intrathecal: into the spinal cavity

Intraosseous: into the bone marrow

Intraperitoneal: into the peritoneal cavity

Eight Rights of Giving Medication

Right Patient

Check the name on the order and the patient
Use 2 identifiers
Ask patient to identify himself/herself
When available, use technology (for example, bar-code system)

Right Medication

Check the medication label
Check the order

Right Dose

Check the order
Confirm appropriateness of the dose using a current drug reference
If necessary, calculate the dose and have another nurse to calculate the dose as well

Right Route

Again, check the order and appropriateness of the route ordered
Confirm that the patient can take or receive the medication by the ordered route

Right Time

Check the frequency of the ordered medication
Double-check that you are giving an ordered dose at the correct time
Confirm when the last dose was given

Right Documentation

Document administration after giving the ordered medication
Chart the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug

Right Reason

Confirm the rationale for the ordered medication. What is the patient’s history? Why is he/she taking this medication?
Revisit the reasons the long-term medication use

Right Response

Make sure that the drug led to the desired effect. If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant?
Be sure to document your monitoring of the patient and any other nursing interventions that are applicable

Care of Medicine and Medicine

All the medicines and drugs must be checked as they are received from the dispensary
Dangerous drugs are given by special order and every dose should be accurate
Medicine cupboard should be kept in room, near to the ward
All poisonous drugs must be kept separately in a separate cupboard and it must be kept locked and the keys should be with ward sister
Medicine for external use should be kept in a separate part of the cupboard
The cupboard should be kept in well lighted and poison bottles should be clearly labeled
There should be separate compartment for mixture, tablets, powders, etc
The container should be arranged alphabetically so that it is easy to find them
A register should be maintained to keep the account of the dangerous drugs
Check the expiry date of every drug and make sure of it before its expiry date
Emergency drugs should be kept in a place where they are readily obtained for emergency use

Rule of Administration of Medicines

Rule Regarding Labels

Administer medications only form the properly labeler container
Poisonous drugs should be labeled in red ink
Read labels of medicine 3 times and check with doctor’s order
Pour the medicine form the bottle only after shaking the bottle
Do not use the medicine that is different in color, test, odor and consistency

Rules Regarding Measuring Medicine

Always use a calibrated ounce glasses or medicine glass to measure the medicine
Always give exactly what is ordered
Make sure that the medicine glasses are clean and dry before pouring medicine
Hold the ounce glass at eye level and place thumbnail of the hand at the required level and then pour the medicine
Pour the medicine just before the time of administration into the medicine glasses

Rules Regarding Administration

Observe the five rights in giving each medication; right patient, right time, right medicine, right dosage and right method of administration
Give medicines only after checking a signed medication order by the doctor
Accept verbal orders, only in emergency to save the life of a patient
Always identify the patient before giving medication
Stay with the patient until he has taken medicine completely
An error in medication should be immediately reported to the ward sister
Use proper light while giving medicines because aim light can cause errors
Never give water after giving cough syrups. It leaves a soothing effect to prevent cough
Drugs which stimulate appetite should be given before food

Rules Regarding Recording of Drugs

Record each does if medicine soon after it is administered
Follow standard observations in recording medicine
Record time, dose and route of the medicine given
Record only those medicines, which have been administered
Record unusual effects such as allergic reactions

Precautions to be taken

Check the doctor’s order, no medicine should be given without doctor’s written order
Give the medications only form a clearly labeled container
Be sure that the medicine glasses are clean and dry before use
Shake the liquid medicine before pouring into the ounce glass
Wipe the mouth of the bottle, close it tightly and replace the bottle in the proper place after use
Pour the medicine from the bottle on the side opposite to the label
Once poured out, the medicine should not be returned to the bottle to prevent contamination of the whole medicine
Give medicine at the correct time and see that patient takes it
Always give the medicine that you have prepared yourself
Do not leave the medicine with the patient
Record after drug is given

Nurses Responsibility in Drug Administration

The nurse should know the following

The nature of the drug: that is the name classification, types of preparation, effects, dosage absorption and excretion, routes and time of administration
Essential parts of a medication order
Abbreviations and symbols used in writing a medication order
Weights and measures used
Preparation of solutions and calculation of fractional dose
Storing of medicines in proper containers
Factors of safety in the administration of medicines
Ethical and legal aspects

Legal Aspects of Drug Administration

Under the law the nurses are responsible for their work, though there is a written order
The nurses must know the minimum and maximum dose of every medicine which she gives to the patient and its effect
The nurse must know the law about the use of narcotics. These drugs must be kept in a separate cupboard the cupboard is kept locked and key is kept with the ward sister or senior nurse on duty
The special register should be maintained for narcotics drugs, which includes clear detail about the patient nurse and the doctor who ordered the narcotic drug
The nurse must observe five rights of giving medications to avoid errors
The narcotic drugs should be stocked only persons. Institutions who have licensed to do so

Scientific Principles

Almost all drugs are harm producer and are foreign materials that the body producing reactions
Additional force of water towards the glass produces a downward curve called meniscus
The human tongue presents an irregular surface and so tablets, powders and capsules produce friction and prevent easy swallowing
The sense of taste is acute and unpleasant taste may produce nausea and vomiting, the taste buds of the tongue can be partially desensitized by cold drinks
Well diluted drugs and empty stomach favor absorption of drugs. But certain drugs are irritating to mucous membrane of the stomach
Medical record is a legal one and reference for future study and research
Using common medicine glasses promote cross infection
Volatile liquids when kept open or not tightly corked diffuse through air and get decomposed
An element of error is a possibility of all human activity and commit or omit a dose of medicine means the existence of the end of life of the person
Understanding of how the drug benefits how it is to be given and side effects of the drug will help the patient to take drug regularly and a report to the physician concerned
Administration of the medicine is a therapeutic measure it will be therapeutic only, if the patient ge the desired effect of the drug