administering medications

study of origin, properties, effects of drugs, on a living organism

• an entrance into blood stream
• speed depends on the route

movement by circulatory system to cells and tissues until peak blood levels

a chemical breakdown after use (in liver)

elimination (in kidneys)

animals, plants, minerals

most produced synthetically in lab

tablets, capsules, caplets, lozenges, creams, ointments, suppositories, transdermal patches

elixers (alcohol), emulsions, liniments, lotions, solutions, spirits, sprays, suspensions (shakes), syrups (sugar), tinctures

• dissolves in solution of alcohol/water
• sweetened or flavored

mixed of fats n oils in water

• combined w/ oil, soap, alcohol, water
• applied externally

• external, soothe,
• protect, moisten

• has 1 solution
• dissolvable

vapor type of drug

drug is solid, must shake before use

drug dissolves in alochol/water

• drug dissolves in sugar/water
• flavored

• powdered drug
• pressed into a small disc
• it can be scored

• gelatin capsule
• water soluable

• candy like
• has a case
• circular size
• dissolves on tongue

• non greasy
• semi-solid
• external

• oily,
• semi-solid
• greasy

• drug mixed w/a firm base
• melts at body temp
• put into vagina/rectum

• adhesive
• contains a drug
• applied to skin

• FDA (us food & drug administration)
• *for drugs w/o supervision

drug enforcement agency

• double lock
• count each day
• verified by two pople
• record in log
• submit to DEA

• highly potential drugs
• no medical use
• prohibited prescriptions

• high abuse potential
• highly restricted
• prescription in writing
• telephone- only allowed for immm. use. confirm w/i 72 hrs
• no refills allowed

• some potential for abuse
• accepted medical use
• low to moderate physical dependency
• moderate-high psychological dependency
• prescription written or verbal
• refilled five times w/i 6 months of date prescribed

• low potential for abuse,
• accepted medical abuse,
• has limited both physical or psychological dependency
• prescription written or verbal
• refilled 5 times w/i 6 months of date prescribed

• very low potential abuse
• accepted medical use
• low/physical/psychological dependency
• refills determined by provider,
• expires one year,
• available without prescription if under 18

united states pharmacopeia formulary  (USP/NF)

Physician's Desk Reference (PDR)

• color coded sections
• actual-size pictures (tables, capsules)

indications

anaphylactic reaction

idiosyncratic reaction

sublingual

buccal

topical

parenteral

directions to a pharmacist on prescription

subscription

the signature

phrase needed for controlled substances

• right patient
• right drug
• right time
• right dose
• right technique
• right route
• right to be educated
• right to refuse
• right documentation

• metric
• apothecary
• household

• weight-mass/heaviness
• volume-space occupied
• length- distance from point to point

decimal system based on multiples of 10

• basic units:
• weight-gram
• volume-liter
• length- meter

• micro
• milli
• centi
• kilo

• weight- microgram, milligram, gram, kilogram
• volume- milliliter, cubic centimeter, liter
• length- millimeter, centimeter

• older, less accurate
• gradually being phased out

• basic units
• weight- grain, scruple., dram, oz, lb
• volume- mini min, fluid dram, fluid oz, pint
• length- inch, ft, yard, mile

weight- grain, scruple, dram, ounce

volume- minim, fluid dram, fluid ounce, pint, quart, gallon

• least accurate
• pt. use at home
• only in volume

• plastic, disposable, safety devides
• inserts fluid into the body

• cc/ml
• used for IM inj.
• calibrated into tenths
• 1-3 cc/ml capacity

• calibrated in Unites (U)
• for insulin injections
• 50 or 100 U

• into tenths/hundreths
• (0.01) CC/ML used for PPD (tuberculin test)

other- 5-60 cc/ml for treatments

holds medicine

• rim at end of barrel
• stabilizes syringe during injection

• moveable inside barrel
• draws medicine into syringe
• pushes medicine out during inject.

connects to the syringe

part that is inserted into the tissue

• hollow inside of shaft
• medicine flows through it

• diamter of the lumen
• # increases = diameter decreases

• tip of needle shaft
• it is tapered

• depends on type of injet
• sit, size, pt.

ampule

closed glass container w/ rubber stopper

roll to mix

• small sealed glass container- single dose
• tap stem & break

adding liquid to powdered drug

• prolongs shelf-life
• follow instructions

• needle length- 1/2 to 5/8 inch
• needle gauge- 23 or 25

• upper lateral arm
• upper outer thigh
• upper back
• abdomen
• flank area

• 45 degree angle (5/8 inch)
• 90 degree angle (1/2 inch)
• cannot inject more than 1 cc/ml

• epinephrine
• insulin
• allergy injections
• depo
• MMR

• more rapid absorption
• less painful
• for concentrated drugs or irritable/damageable drugs

• immunizations
• antibiotics
• contraceptives
• vitamin b12
• corticosteroids

• delotid
• dorsogluteal (gluetus maximus muscle in buttock)
• ventrogluteal (gluteus medius muscle in hip)
• vastus lateralis (muscle in thigh)

• gauge- 18, 21, 23
• length- 1-3 inch (1 1/2 is common)
• insert 90 degree angle
• inject slowly
• aspirate!!!!
• ALLOWED- a bubble

• when skin is pulled sideways to track medicine
• inject @ 90 degree angle
• leave 1/3 of needle exposed

most common site- dorsogluteal

• three finger widths below acromion process
• 1 inch needle
• .5-1.0 cc/ml common

• find greater trochanter and posterior superior iliac spine
• make diagonal line between them

for adults/children over 3 years old

last resort- avoid sciatic nerve & arteries

left sided injection

find greater trochanter, point index finger towards the iliac spine, point pointer finger as far as possible away, inject between the two fingers

find greater trochanter, go at least one hand-width below this, and one hand-width above the knee cap

use for children under 3

anterior forearm, where skin is thin

use for skin testing or TB

needle length- 3/8th or 5/8ths

gauge- 25 or 27

Mantoux or TB tine

• ID
• 3/8 or 1/2 inch,
• gauge 26-27
• 0.10 cc/ml
• anterior forearm

• DONT cover site when finished
• read tests w/i 48-72 hours

• read w/i 48-72 hours
• read diameter horizontally across
• use mm rule
• positive- 10 mm or more
• doubtful- 5-9 mm
• negative- 5 mm or less

purified protein derivative of tuberculin

allergic rhinitis, hay fever, asthma, urticaria, contact dermatitis, eczema

• extracts of common allergens applied topically to skin (patch test)
• injected into superficial skin layers (skin prick)
• ID injection

read results 20-30 minutes after

• anterior forearm (ID testing)
• upper arm (ID testing)
• middle of back (Path and skin prick testing)

radioallergosorbent assay

draw blood, sent to outside lab

measures amount of antibodies in blood to common allergens

• Doctor       x        Form
• 1                        Dosage