UNIT 2 Pharmacology

14 RIGHTS OF ADMINISTRATION

The Two Most Frequently Used Methods To Dispense Drugs

the drugs are dispensed to all patients from the same containers.

drugs are individually wrapped and labeled for single doses for each patient

a principle of which is the individual having the knowledge necessary to make a decision. An informed patient and family is critical to preventing medication errors.

is the process of comparing a patient's medication orders to all of the medications that the patient has been taking. The purpose is to avoid errors (e.g., omissions, duplications, dosing errors, drug interactions).

Some medications can be crushed; consult with the health care provider or pharmacist. Do not crush any medication that has the suffix:

What pregnancy category:
No risk to fetus. Studies have not shown
evidence or fetal harm

What pregnancy category:
No risk in animal studies, and well-controlled
studies in pregnant women are not available.
It is assumed there is little to no risk in pregnant women.

What pregnancy category:
Animal studies indicate a risk to the fetus
Controlled studies on pregnant women are not available. Risk versus benefit of the drug must he determined

What pregnancy category:
A risk to the human fetus has been proved. Risk versus benefit of the drug must be determined.
It could be used in life-threatening conditions.

What pregnancy category:
A risk to the human fetus has been proved. Risk
outweighs the benefit and drug should be
avoided during pregnancy

Difference of Quinidine and Quinine

Difference of Hydroxyzine and Hydralazine

Pharmacology abbreviation:
ā

Pharmacology abbreviation:
ac

Pharmacology abbreviation:
AD

Pharmacology abbreviation:
AS

Pharmacology abbreviation:
AU

Pharmacology abbreviation:
bid

Pharmacology abbreviation:
-
c

Pharmacology abbreviation:
cap

Pharmacology abbreviation:
EC

Pharmacology abbreviation:
elix

Pharmacology abbreviation:
h or hr

Pharmacology abbreviation:
hs

Pharmacology abbreviation:
IM

Pharmacology abbreviation:
IV

Pharmacology abbreviation:
IVP

Pharmacology abbreviation:
NG

Pharmacology abbreviation:
про

Pharmacology abbreviation:
OD

Pharmacology abbreviation:
oint

Pharmacology abbreviation:
OS

Pharmacology abbreviation:
ОТС

Pharmacology abbreviation:
OS

Pharmacology abbreviation:
OU

Pharmacology abbreviation:
-
p

Pharmacology abbreviation:
pc

Pharmacology abbreviation:
per

Pharmacology abbreviation:
po

Pharmacology abbreviation:
pr

Pharmacology abbreviation:
prn

Pharmacology abbreviation:
q

Pharmacology abbreviation:
q1h

Pharmacology abbreviation:
q2h

Pharmacology abbreviation:
qd

Pharmacology abbreviation:
qh

Pharmacology abbreviation:
qid

Pharmacology abbreviation:
-
s

Pharmacology abbreviation:
SL

Pharmacology abbreviation:
SR

Pharmacology abbreviation:
supp

Pharmacology abbreviation:
syr

Pharmacology abbreviation:
tab

Pharmacology abbreviation:
tid

Pharmacology abbreviation:
bid

Pharmacology abbreviation:
p.o =

Pharmacology abbreviation:
I.M. =

Pharmacology abbreviation:
S.Q/ S.C =

Pharmacology abbreviation:
I.V=

Pharmacology abbreviation:
I.D =

Pharmacology abbreviation:
Intrathecal =

Pharmacology abbreviation:
p.c. =

Pharmacology abbreviation:
a.c =

Pharmacology abbreviation:
O.D =

Pharmacology abbreviation:
O.S =

Pharmacology abbreviation:
O.U =

Pharmacology abbreviation:
E.T =

Pharmacology abbreviation:
I.J =

means that the nurse gives the patient the appropriate medications and instructions that are kept at the bedside and then go home with the patient on discharge. Patients are responsible for taking their medication according to the instructions.

A variety of forms and routes are used for the administration of medications, including:

Routes of Entry:
Most Rapid Ways Meds/Toxins Enter Body

80% of all drugs consumed are given ___

Oral drugs are available in:

come in different forms and drug strengths. Most of these are scored and thus can be readily broken when half of the drug amount is needed

When the patient has difficulty taking tablets, this form of the medication is given. This can be in a suspension, syrup, elixir, or tincture.
-poured into a medicine cup that is calibrated in ounces, teaspoons, tablespoons, and milliliters

are gelatin shells that contain powder or
time-release pellets (beads)

These drugs pass through the stomach into the small intestine where the drug’s coating dissolves and then absorption occur.

capsules and controlled-release capsules should not be crushed and diluted, because the medication will be absorbed at a much faster rate than indicated by the manufacturer

The patient holds the medication between the cheek and molar teeth, where it is rapidly absorbed into the bloodstream and reaches the svstemic circulation without being metabolized by the liver. This site is used for ___ tablets to relieve ___

The patient places the tablet under the tongue, where it dissolves, is rapidly absorbed through the blood vessels, and enters the systemic circulation. This site is used for ___ tablets to relieve___

The ___ is the slightly concave curved line of a dose of liquid.

Meaning of OGT

Meaning of PEG

To administer eardrops, straighten the external ear canal by pulling ___ on the auricle in children younger than 3 years of age

To administer eardrops, straighten the external ear canal by pulling ___ on the auricle in older children and adults

is stored in a patch placed on the skin and absorbed through skin, having a systemic effect.

These drugs provide more consistent blood levels than oral and injection forms and avoid GI absorption problems associated with oral products.

TYPES OF PARENTERAL ROUTES INCLUDE:

(under the skin)

(into the fatty tissue)

(within the muscle)

(in the vein)

(in the bone)

Effect of Intramuscular

Usually more rapid effect of drug than with subQ route
• Used for solutions in oils and deep IM for irritating drugs

The ___ is the preferred site for adults and toddlers with gluteal muscle development associated with firmly established walking.

Effect of Subcutaneous

Sustained effect; absorbed mainly through capillaries; usually slower in onset than with IM route

Used for observation of an inflammatory (allergic) reaction to foreign protein

prevents medication from leaking back into the subQ tissue. It is frequently advised for medications that cause visible and permanent skin discoloration

Which site is preferred for the Z-Track Injection Technique

More rapid than IM or subQ routes

Fluids, crystalloids, blood products, and medications administered into the bone marrow enter circulation through the network of venous sinusoids

is usually a small glass container with a self-sealing rubber top. they can be used over time

is a glass container with a tapered neck for snapping open and using only once

Certain drugs lose their potency in liquid form; therefore manufacturers package these drugs in powdered form. They are reconstituted using a diluent (bacteriostatic water or saline) before administration.

Drug labels on vials and ampules provide the following information:

The ___ are used primarily for intermittent infusion therapy to irrigate the intermittent infusion device for maintaining patency and to administer IV medication through the IV tubing device.

The ___ is a 1-mL slender syringe with markings in tenths (0.1) and hundredths (0.01). It is also marked in minims

The ___ has the capacity of 1 mL; however, insulin is measured in units, and insulin dosage must not be calculated in milliliters. Insulin syringes are calibrated as 2-unit marks, and 100 units equal 1 mL

Needle size has two components:

An ___injection is usually used for skin testing to diagnose the cause of an allergy or to determine the presence of a microorganism.

The choice of syringe for intradermal testing is the ___ syringe with a ___-gauge needle.

In intradermal injection, the needle is inserted with the bevel pointing ___ at a ___ to ___ degree angle. Do not aspirate. Test results are read ___ to ___hours after the intradermal injection.

The amount of drug solution administered subQ is generally ___ to ___mL at a __, __ or __ degree angle.

two types of syringes used for subQ injections are the:

Insulin bottles and syringes are ___ to avoid error.

The angle for administering insulin depends on the amount of fatty tissue. For an obese person, the angle may be __ degrees; for a very thin person, the angle may be __ to __ degrees.

Types of Insulins

Insulins are clear like:

Insulins are cloudy (NPH) because of the substance ___, which is used to prolong the action of insulin in the body.

Only ___ insulin can be given IV as well as subQ. The source of insulin is ___ or ___

Insulin is categorized as:

Rapid-acting (__,__,__) and fast-acting (___) regular insulin can be given both intravenously and subcutaneously.

___-acting and ___-acting insulins can only be administered subcutaneously

is also clear but takes longer to start working compared with rapidacting insulins. It is administered 15 to 30 minutes before meals and is effective for 6 to 8 hours. It is usually given before the meal, but it is sometimes given during or after the meal.

___and ___ are brand names for fast-acting human insulin.

is administered 30 minutes before the meal (breakfast) and becomes effective in 1 to 2 hours. Its duration of action in the body is 12 to 18 hours. This type of insulin contains protamine, which prolongs the action in the body. It is cloudy because of the protamine added to the regular insulin. It can only be given subcutaneously.

acts within 1 to 2 hours and lasts in the body for 18 to 24 hours.

This vial is tall and has a green top.
is usually administered in the evening or at bedtime; however, it can be administered once or twice a day subcutaneously.

This vial is taller and narrower than the other types of insulin.
It has a purple top and purple print on the label.
is usually administered at bedtime, and the incidence of nocturnal hypoglycemia is not common.

___ and ___cannot be mixed with other insulins or given intravenously.

has become popular for patients with diabetes who mix fast-acting and intermediate-acting insulins.

For commercially premixed combination insulins, the rapid-acting and intermediate-acting insulins are:

For commercially premixed combination insulins, the fast-acting and intermediate-acting insulins are:

This injection is absorbed more rapidly than those given by subQ injection.

location for intraosseus:

A volume of drug solution ___ than 3 mL causes increased muscle tissue displacement and possible tissue damage. Occasionally __ mL of selected drugs, such as ___ ___, may be injected into a large muscle, such as the ___.

The needle gauges for IM injections are:
__ & __ for thick solutions and
__ & __ for thin solutions.

IM injections are administered at a__-degree angle.

is used to administer fluids that contain water, dextrose, vitamins, electrolytes, and drugs.

Intravenous (IV) fluid is used to administer fluids that contain:

Many drugs administered IV irritate the veins, so these drugs are diluted in __mL to __mL of fluid.

Two methods are used to administer IV fluids and drugs:

This method replaces fluid loss, maintains fluid balance, and serves as a vehicle for drug administration.

This method is used primarily to give IV drugs.

Nurses have an important role in the preparation and administration of IV solutions and IV drugs. The nursing functions and responsibilities during drug preparation include the following:

The health care provider orders the type and amount of IV solution in liters over a ___ or in ____

The nurse calculates the IV flow rate according to the:

the number of drops per milliliter, is normally printed on the packaging cover of the IV set.

A set that delivers large drops per milliliter
(10 to 20 gtt/mL)

is one set that delivers small drops per milliliter (60 gtt/mL).

At times, IV fluids are given at a slow rate to ___

The reasons for ordering KVO include:

KVO is usually regulated to deliver __ mL/h

The drug solution is usually infused over a period of 15 minutes to 1 hour.

Two IV sets available to administer IV drugs are:

This route is often referred to as IV push

Clinically, it is the preferred route for patients with poor muscle mass or decreased circulation or for a drug that is poorly absorbed from the tissues

Medications administered by this route have a rapid onset of action, and calculation errors can have serious, even fatal, consequences.

These are set to deliver a prescribed rate of IV solution. If the flow rate is obstructed, an alarm sounds.

This has pressure for the infusion and the height of the liquid above the infusion site

In pumped systems, ___ or ___ pumps are the most common.

These pumps are the preferred choice for medium and large volume intravenous or enteral infusions, although some are designed specifically to operate at low flow rates for
neonatal use.

These are used to administer drugs or infusions
in small or medium volumes, and are calibrated
for delivery in millilitres per hour, typically 0. I to
99 mL/hour.

Are typically syringe pumps, as the total volume of drug infused can usually be contained in a single-use syringe.
Patients are able to deliver a bolus dose themselves. Immediately after delivery the pump will refuse to deliver another bolus until a pre-set time has passed. The pre-set bolus size and lockout time, along with background (constant drug infusion) are pre-programmed by the doctor. Once programmed, access to the control of the pump is usually restricted. A feature is a memory log, which enables the clinician to determine when, and how often, the patient
has made a demand and what total volume of drug has been infused over a given time.

These are syringe pumps designed for use in anaesthesia or sedation and must be used only for this purpose; they are unsuitable for any other use

designed to allow patients to continue receiving treatment or therapy away from a hospital, thereby leading a normal life during treatment.
These are miniature versions of syringe pumps which are battery driven.

These pumps are designed to deliver drugs accurately over a certain period of time (usually 24 hours).
small and compact, can be carried easily by the patient, and avoid the need for numerous
injections throughout the day.

Give at least 10 HIGH-ALERT MEDICATIONS

Both the pregnancy and lactation subsections will have three principal components:

For toddlers not walking alone for at least 1 year, what site is preferred?

Use the __ syringe for amounts <0.5 mL.

Use the ___ to draw up the medication from a glass vial or ampule.

When medications cannot be taken by mouth because of :

Sizes for intramuscular:
Needle: __- to __-gauge; __-gauge for blood products; __to __ inches long

Sizes for Subcutaneous:
Needle: __- to __-gauge; __ to __ inch long Syringe: __ to __mL
Injected dose: usually __ to __mL

Sizes for Intradermal:
Needle: __- to __-gauge; __ to __ inch long Syringe: __mL calibrated

For Intradermal, preferred areas are lightly pigmented, thinly keratinized, and hairless, such as the:

Sizes for Z-Track Injection Technique:
Needle: __- to __-gauge; __ to __ inch long Syringe: __ to __mL
Injected dose: usually __ to __mL

The most common gauge numbers of needles range from __ to __. Needle length varies from
__ inch to __inches.

When the patient has difficulty taking tablets, the liquid form of the medication is given. The liquid form can be in a

In powdered Drug Reconstitution, certain drugs lose their potency in liquid form; therefore manufacturers package these drugs in powdered form. They are reconstituted using a ___ (___) before administration.

An intradermal injection is usually used for skin testing to diagnose the cause of an allergy or to determine the presence of a microorganism. The choice of syringe for intradermal testing is the tuberculin syringe with a __-gauge needle.

Examples of the calibrated cylinder (chamber) with tubing