Administration of Intravenous medications

1. Administration of Intravenous medications Chapter 11 Nursing 105

2. Advantages & Disadvantages of I.V. medications Advantages Provide direct access to the circulatory system A route for drugs that irritate the gastric mucosa A route for instant drug action A route for delivering high drug concentrations instant drug termination if sensitivity or an adverse reaction occurs Route of administration in patients in whom use of the GI tract is limited

3. Advantages & Disadvantages of I. V. administration cont Disadvantages Drug interaction because of incompatibilities Adsorption of the drug being impaired because of leaching into the I.V. container or administration set Errors in compounding of medication Speed shock Extravasation of a vesicant drug Chemical phlebitis

4. Common error in Administering Medications Lack of knowledge about drugs Errors in drug identity checking Mistakes in calculations, Improper use of pumps and controllers

5. Drug incompatibilities Three broad categories Physical: occur when one drug is mixed with other drugs or solutions to produce a product that is unsafe for administration Chemical: a reaction of a drug with other drugs or solutions, which results in alterations of the integrity and potency of the active ingredient Therapeutic: an undesirable effect occurring in a patient as a result of two or more drugs being given concurrently

6. I. V. Medication delivery IV medication can be delivered by Continuous infusion Intermittent infusion IV push through a locking device

7. Subcutaneous infusion Subcutaneous infusion route is used for patients unable to take medications by mouth and who have poor venous access

8. Intraspinal catheters Epidural Intrathecal Both provide superior pain control, require small doses, and produce longer periods of relief between doses while preventing many systemic side effects Alcohol must NEVER be used for site preparation or for accessing an intraspinal catheter. Only preservative-free medication can be delivered by the intraspinal routes.

9. FDA Drug Studies Phase I: clinical pharmacology and therapeutics—researchers test the new drug or treatment in a small group of people. Determine an acceptable dosage Phase II: initial clinical investigation—evaluate drug efficacy, conduct a pilot study, the drug is given to a larger population (100 to 300) Phase II: full-scale evaluation and treatment—the drug is given to an even larger group (1,000 to 3,000), the group is evaluated Phase IV: postmarketing surveillance—delineate additional information including the drug’s risks, benefits, and optimal use.