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DRUG NAMES. ChemicalGeneric (Nonproprietary)Trade (Brand). DRUG CLASSIFICATION. Share similar characteristicsIndicates effect of medication on a body system. Drug Classification. Beta Blockers-olpropranolol (Inderal), metoprolol (Lopressor)ACE Inhibitors-prilenalapril (Vasotec

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    1. MEDICATION ADMINISTRATION One of the greatest and most dangerous sources of errors

    2. DRUG NAMES Chemical Generic (Nonproprietary) Trade (Brand)

    3. DRUG CLASSIFICATION Share similar characteristics Indicates effect of medication on a body system

    4. Drug Classification Beta Blockers -ol propranolol (Inderal), metoprolol (Lopressor) ACE Inhibitors -pril enalapril (Vasotec), lisinopril (Zesteril)

    5. Drug Classifications Cephalosporins cef- cefaclor (Ceclor), cefazolin (Ancef) Aminoglycosides -cin tobramycin, gentamicin NOT azithromycin=macrolide

    6. Pharmacokinetics How does the drug become therapeutically useful? How does the drug.. enter body; reach its site of action; become metabolized; and get eliminated from the body

    7. Pharmacokinetics ABSORPTION Passage of drug molecules into blood from site of administration

    8. Absorption Route Ability to dissolve Blood flow Body surface area Lipid solubility

    9. Pharmacokinetics DISTRIBUTION After absorption, distributed throughout the body to tissues/organs and ultimately to the site of action

    10. DISTRIBUTION Blood flow Membrane permeability Protein binding

    11. DISTIBUTION Protein Binding Degree to which the drug binds with protein affects its distribution

    12. Pharmacokinetics METABOLISM Biotransformation occurs under influences of enzymes that detoxify, degrade, and remove biologically active chemicals Why is this important?

    13. Pharmacokinetics EXCRETION After the drug is metabolized, it leaves the body through: kidneys, liver, bowel, or lungs (May be found in other secretions e.g., sweat and breast milk)

    14. Medication Actions Therapeutic effect(s) Side effect(s) Adverse effect(s) Toxic effects Idiosyncratic reaction(s) Allergic reaction(s) Medication interaction (synergistic effect)

    15. Medication Dose Responses Serum Half-Life Time it takes to lower medication concentration in serum by half

    16. Nursing Responsibilities Who is responsible? What do you need to know?

    17. Medication Order Clients full name Date/Time (med ordered) Drug name Dosage Route of administration Time and frequency of dose Signature of prescriber (physician, surgeon, nurse practitioner, physician assistant)

    18. Dosage Calculation Review conversions and drug calculations Double-check Calculations

    19. 8 Rights of Correct Medication Administration Patient Drug Dose Route Time Documentation Rationale Pts right to refuse (Traditionally 5 Rights of Medication Administration)

    20. Preparing to Administer Medications Beginning of shift (right after report) 30 minute window (before & after scheduled time) Take MAR to Pyxis or drawer Sign bottom of MAR Top to bottom, left to right

    21. Preparing to Administer (cont.) Check med THREE TIMES Dont open medication packet until at bedside Go to room with meds and MAR

    22. Proper Administration Identify client *********** Against Wristband Have patient state their name PREPARE MEDS FOR ONE PATIENT AT A TIME

    23. What do you need to know before administering meds? Assessment Findings What is the expected effect and possible side effect? WHY is patient receiving med? Does patient still need the med? (Re-assessment) Evaluate patients response to med

    24. Routes of Administration PARENTERAL vs. NONPARENTERAL

    25. Routes of Administration Oral Eye (ophthalmic) Lungs (inhaler) Skin Injection What are other routes?

    26. Parenteral Administration Injection sterile/surgical asepsis syringe needle Which size will you use?

    27. Injection Preparation Ampule Vial

    28. Subcutaneous Injections Heparin Lovenox Insulin

    29. Insulin Preparation Clear before cloudy Why?

    30. Intramuscular Injections Deltoid Vastus Lateralis Ventrogluteal Dorsogluteal

    31. Intramuscular Injections Technique Z-track Method

    32. IM Injections Z-track recommended for ALL IMs Minimizes local skin irritation by sealing medication in muscle tissue Use large, deep muscle Change needle before injection

    33. Z-track Technique (cont.) Skin taut and laterally ~ 2.5-3.5cm (1-1.5) Insert like dart (90 degree angle) ASPIRATE 5-10 seconds Inject slowly wait 10 seconds Withdraw and release skin Apply pressure Sharps container

    34. Injection Skill Practice in lab. Practice manipulating and reading syringes. Practice drug calculations. Practice site identification.

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