Theraputic

• Administration of therapeutic agents

  The administration of medicine is a grave responsibility entrusted to the nurse. The doctor by written order will indicate the drug name, amount of the drug per dose, the number of doses (tablet, capsule etc.) the route by which to be administered and the frequency.
• Nurse's role in administering medication

  • The nurse is expected to carry out these orders intelligently, promptly and with extreme accuracy.
• Principles related to the administration of medication

  • The type of drug preparation often governs the method of administration
  • The route of administration of the drug affects the optimal dosage of the drug
  • The safe administration of medications requires knowledge of anatomy and physiology as well as knowledge of the drug and the reason it has been prescribed
  • The method of administration of a drug is partially determined by the age of the patient, his orientation, his degree of consciousness and his disease
  • The element of error is a possibility in all human activity
  • Each patient has its own needs of or for explanations and support with respect to the administration of medications
• 10 rights in giving medication

  • The right patient
  • The right drug
  • The right dose
  • The right time
  • The right route
  • The right assessment
  • The right documentation
  • The right to education
  • The right evaluation
  • The right to refuse
• Criteria which the nurses judges the effectiveness of the administered drug

  • Alleviation of pain
  • Reduction of fever
  • Decrease in swelling
  • Orange colored urine
  • Increased urine output
  • Increased cardiac output
  • Produce anesthetic effect
  • Lower down blood pressure
  • Reduce anxiety
• General information about drug administration


  • Doctors should order in written the name of the drug, amount, time and frequency of giving as well as the method of administration
  • Verbal orders should be accepted only in extreme emergencies. A written order must be obtained as soon as the emergency has been controlled
  • If a physician orders a drug over the phone, A REGISTERED NURSE must take down information. On the next visit, the next visit the physician signs the written record of the verbal order
  • The nurse shall inform the doctor of any known allergies of the patient
  • The nurse should bear in mind that accuracy in the measurement of drug is vital especially in pediatrics doses where a relatively small error become magnified
• Drug computation


  1. The Physician orders 20 mg IM of a drug for a patient. The drug is available in 10 ml vial that contains 50 mg of drug. How many ml will be needed to supply the dose of 20 mg?

  2. Ampicillin oral susp. 250mg/5ml. How many ml would be measured into a medication syringe to obtain a dose of 75mg of ampicillin?

  3. Paracetamol 125mg/ 5ml. How many ml would be measured into a medication syringe to obtain 15 mg of Paracetamol?

  4. A vial contains 250mg of tetracycline HCl in a total of 2 ml of solution. How many mg of tetracycline HCl are contained in 0.6 ml of this solution?
• Abbreviations


  • BID
  • QID
  • TID
  • SL
  • HS
• Principles related to the administration of medication

  • The nurse should know the usual therapeutic effects as well as the side effects of each drug
  • The physician must be notified immediately in case of error
  • The nurse should question an order which in her judgement is erroneous. She should tactfully clarify the order with the physician who made it
  • The nurse should be knowledgeable of the patient's diagnosis or tentative diagnosis
  • Each type of drug preparation usually require a specific method of administration
  • The route of administration of drug affects the optimal dosage of the drug (IV Vs Oral)
• According to the CMS report from its investigation, Nurse V administered IV vecuronium (a neuromuscular blocking agent that causes paralysis and is often used during surgery) instead of IV Versed (a sedating agent) to an anxious patient undergoing a diagnostic scan. The patient stopped breathing, suffered brain damage, and subsequently died. Nurse V. was charged with recklessness because she overrode the automated medication dispensing system and didn't follow standard procedures in properly checking the drug name or in monitoring the patient after administering the medication.
• When and how many times do we check the drug before administering it to the patient?

  1. The first check is when the medications are pulled or retrieved from the automated dispensing machine, the medication drawer, or whatever system is in place at a given institution.

  2. The second check is when preparation of the medications for administration takes place.

  3. The third check is on the bedside before administering the medication.
• Principles related to the administration of medication

  • The administration of medication requires a knowledge in anatomy and physiology as well as knowledge of the drug and the reason it has been prescribed
  • The method of administration of drug partially determined by the age of the patient, level of consciousness and the disease process, any difficulties encountered when administering medicines should be reported promptly
  • Appropriate precautionary measures should be taken to avoid errors and accidents in the preparations and the administration of therapeutic agents
  • Physiologic activities of the body can be maintained, improves or in some instances restored by the administration of therapeutic agents
  • Person varies in the way they metabolize injected or ingested agents or the way they react to agents applied externally
  • Each patient has his/her own needs for explanations and support with respect to the administration of medicines. Some people wants to know about their medicines, other prefer not to. The amount of knowledge that a person requires is dependent upon individual circumstances
• Routes of administration


  • Oral
  • Enteral
  • Sublingual
  • Buccal
  • Parenteral
  • Subcutaneous
  • Intramuscular
  • Intradermal
  • Intravenous
  • Intraarterial
  • Topical
  • Vaginal
  • Rectal
  • Inunction
  • Instillation
  • Irrigation
  • Skin application
  • Pulmonary
• Rules in measuring medication

  • Measure the exact amount of drug ordered with calibrated equipment
  • Do not converse with anyone while preparing medication
  • Ensure adequate lighting
  • Make sure that the medicine glass is dry before pouring or measuring the medication
  • Cleanse the mouth of every bottle after use
  • Hold the medicine glass to where the medicine is t be poured
  • Measure accurately liquid medication. Bear in mind that the size of drops varies according to the size of the dose in the medicine dropper, the angle at which the dropper is held and the viscosity of the liquid
  • Use syringes in measuring medication with small volumes and if the drug manufacturer has not provided a specific measuring device
• Rules regarding labels


  • Give medications only from a clear labeled container
  • For each dose medicine prepared, read the label 3 times: before removing the bottle from the medicine cabinet, before pouring the desired amount of drug and before returning the bottle in the medicine cabinet
  • Never give a drug from an unmarked bottle or box
  • Pour medicine from the bottle on the side opposite to the label
  • Labels on medicine containers should be changed only by the pharmacist
  • If drug has 2 commonly used names, both names should appear in the label
  • Take note of the expiration date marked on the label
• Rules for giving medication

  • Give the medication at the time to which it is ordered
  • Differentiate STAT and PRN
  • Always identify the patient before giving medications
  • If the medication is refused or cannot be administered, notify the CI /NOD, and record accordingly to patient's chart
  • Remain at the bedside until the patient has taken the medicine
  • Administer only those medicine which you have prepared
  • Never give two drugs together, unless specifically ordered to do so
  • When the patient goes to the OR, all orders for medication are automatically discontinued. New orders Post-OP medications will be written by the doctor
  • When special test are being done, medications due at a particular time are omitted. They are resumes when next dose is due. (this is true for BID, TID, QID)
  • Nurses should listen carefully to the patient who questions the additional or deleting of a medication. If the patient questions the drug or dose you prepared to administer, WHAT WILL YOU DO?
• Rules in recording drug

  • Record of an ordered medication is refused and if it cannot be administered for whatever reason
  • Record each dose of medicine soon after it is administered
  • Use standard abbreviations in recording medications
  • Never record a medication before it has been given
  • Record only those medicines that you administered
  • Record effects of medications
  • Affix initials on the appropriate space of the medication sheet for those medications you actually have administered. If delayed of first dose of drug it is to be given indicate the time above your initial
• 10 commandments


  • Thou shalt know thy drug
  • Thou shalt Read the labels 3 times
  • Thou shalt Clarify thy doubts
  • Thou shalt measure the drug accurately
  • Thou shalt only think of what art thou doing
  • Thou shalt use the medication ticket always
  • Thou shalt give the drug promptly
  • Thou shalt give the drug to the right person
  • Thou shalt report errors promptly
  • Thou shalt chart only what thou hath given
• Forms of medications


  • Caplet
  • Capsule
  • Elixir
  • Enteric coated
  • Extract
  • Glycerite
  • Intraocular disk
  • Liniment
  • Lotion
  • Ointment
  • Paste
  • Pill
  • Solution
  • Suppository
  • Suspension
  • Syrup
  • Tablet
  • Tincture
  • Lonzenge