drug ad

• Medication


  A substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease
• Types of drug preparations

  • Aerosol spray
  • Caplet
  • Capsule
  • Cream
  • Elixir
  • Gel or jelly
  • Liniment
  • Lotion
  • Lozenges
  • Ointment
  • Paste
  • Pill
  • Powder
  • Suppository
  • Syrup
  • Tablet
  • Transdermal patch
• Common mild allergic responses

  • Skin rash
  • Pruritus (itching)
  • Rhinitis (excessive watery discharge from nose)
  • Lacrimal tearing (excessive tearing)
  • Nausea, vomiting
  • Wheezing and dyspnea (shortness of breath)
  • Diarrhea
• Routes of administration


  • Oral
  • Sublingual
  • Buccal
  • Rectal
  • Vaginal
  • Topical
  • Transdermal
  • Subcutaneous
  • Intramuscular
  • Intradermal
  • Intravenous
  • Inhalation
• Oral route


  • Most convenient
  • Usually least expensive
  • Safe, does not break skin barrier
  • Administration usually does not cause stress
  • Inappropriate for clients with nausea, vomiting, unpleasant taste/odor, reduced GI motility, unable to swallow, before certain tests/procedures
  • Can discolor teeth, harm tooth enamel, irritate gastric mucosa
• Sublingual route


  • More potent than oral as drug directly enters blood and bypasses liver
  • Drugs must remain under tongue until dissolved and absorbed, may cause stinging/irritation
• Buccal route


  • Same as for sublingual
• Rectal route


  • Can be used when drug has objectionable taste/odor, provides local therapeutic effect
  • Dose absorbed is unpredictable, may be perceived as unpleasant
• Vaginal route


  • Provides local effect, may be messy and soil clothes
• Topical route


  • Few side effects, drug can enter body through abrasions and cause systemic effects, leaves residue on skin that may soil clothes
• Transdermal route


  • Prolonged systemic effect, few side effects, avoids GI absorption problems, onset faster than oral
  • Verify previous patch removed to avoid overdose
• Subcutaneous route


  • Absorption is slower (advantage for insulin), must use sterile technique, more expensive than oral, can only administer small volume, can irritate tissues and cause pain, can produce anxiety
• Intramuscular route


  • Can administer larger volume than subcutaneous, drug is rapidly absorbed
  • Can produce anxiety, must use sterile technique, breaks skin barrier
• Intradermal route


  • Absorption is slow (advantage in allergy testing), amount administered must be small, breaks skin barrier, must use sterile technique
• Intravenous route


  • Rapid effect, limited to highly soluble drugs, drug distribution inhibited by poor circulation
• Inhalation route


  • Introduces drug throughout respiratory tract, rapid localized relief, can be used for unconscious clients
  • Drug intended for localized effect can have systemic effect, only for respiratory system
• Types of medication orders

  • Stat order (immediate, one time)
  • Single order (one time at specified time)
  • Standing order (may be indefinite or for a set number of days)
  • PRN order (as needed)
• Essential parts of a medication administration record/ticket

  • Full name of client
  • Date ordered
  • Name of drug
  • Dosage
  • Frequency
  • Route
  • Nurse's signature
• Example medication order
• Process of administering medications

  1. Identify the client using at least two identifiers

  2. Inform the client about the medication

  3. Administer the drug as prescribed

  4. Provide adjunctive interventions as indicated

  5. Record the drug administration
• Guidelines for safe drug administration

  • Question any illegible or incorrect orders
  • Be knowledgeable about medications
  • Use only clearly labeled medications
  • Do not use cloudy or discolored liquid medications
  • Calculate doses accurately
  • Administer only personally prepared medications
  • Identify client correctly
  • Do not leave medications at bedside
  • Take special precautions for certain medications
  • Record omitted medications and reasons
  • Report medication errors immediately
  • Check expiration dates
• 3 checks for safe medication administration

  1. First check: Read MAR, verify client info, check label against MAR, check expiration

  2. Second check: Recheck label against MAR while preparing medication

  3. Third check: Recheck label on container against MAR before giving to client
• Color coded medication ticket (BJRMH protocol)

  • Once daily (white)
  • Twice a day (pink)
  • Thrice a day (yellow)
  • Four times a day (blue)
  • Every 4 hours (blue)
  • Every 6 hours (green)
  • Every 8 hours (red)
  • As necessary (orange)
• Ten rights in medication administration

  • Right medication
  • Right dose
  • Right time
  • Right route
  • Right client
  • Right client education
  • Right documentation
  • Right to refuse
  • Right assessment
  • Right evaluation
• Commonly abbreviated terms for drug frequency

  • TID (ter in die - three times a day)
  • BID (bis in die - twice a day)
  • QID (quarter in die - four times a day)
• 3 Checks for Safe Medication Administration


  1. Check the label on the container against the MAR before taking the medication

  2. Check the label on the container against the MAR before returning it to storage

  3. Check the label on the container against the MAR before giving the medication to the client
• Color Coded Medication Ticket (BJRMH Protocol)

  Frequency and corresponding color of ticket: Once daily (white), Twice a day (pink), Thrice a day (yellow), Four times a day (blue), Every four hours (blue), Every 6 hours (green), Every 8 hours (red), As necessary (orange)
• Ten (10) Rights in Medication Administration

  • Right Medication
  • Right Dose
  • Right Time
  • Right Route
  • Right Client
  • Right Client Education
  • Right Documentation
  • Right to Refuse
  • Right Assessment
  • Right Evaluation
• Commonly Abbreviated Terms - Drug Frequency

  • TID (ter in die - three times a day)
  • BID (bis in die - twice a day)
  • QID (quarter in die - four times a day)
  • OD (omni die - once a day or daily)
  • PRN (pro re nata - as needed or as necessary)
  • HS (hora somni - hours of sleep or at bedtime)
  • STAT (statim - immediately)
  • q 12 hrs (every 12 hours)
  • q 6 hrs (every 6 hours)
  • q 8 hrs (every 8 hours)
• Commonly Abbreviated Terms - Route

  • p.o (per orem - orally)
  • SL (sublingually)
  • AS (auris sinistra - left ear)
  • AD (auris dextra - right ear)
  • AU (auris utraque - both ears)
  • OD (oculus dexter - right eye)
  • OS (oculus sinister - left eye)
  • OU (oculus uterque - each eye)
  • IM (intramuscularly)
  • SQ (subcutaneously)
  • ID (intradermal)
• Methods of Calculating Dosages

  1. Basic Formula: D = Desired dose, H = Dose on hand, V = Vehicle

  2. Ratio & Proportion Method: Set up equation with unknown quantities on left, known quantities on right, multiply extremes and means

  3. IV Incorporation: Calculate amount of medication to incorporate into IV solution
• Parenteral Administration of Medications


  • Common nursing procedure
  • Routes: Subcutaneously (SC or SQ), Intramuscularly (IM), Intradermal (ID), Intravenous (IV)
• Syringe


  3 parts: Tip, Barrel, Plunger
• When handling a syringe, the nurse must avoid letting any unsterile object touch the tip, inside the barrel, shaft of the plunger, or shaft/tip of the syringe
• Syringe Sizes


  1 to 3ml - for injections, 10/20/50ml - for adding meds to IV solutions or irrigating wounds
• Needles


  • Made of stainless steel, usually disposable
  • 3 parts: Hub, Shaft, Bevel
  • Characteristics: Slant/length of bevel, Length of shaft, Gauge/diameter of shaft
• Appropriate Needle Sizes


  • For subcutaneous injection: #24 to #26 gauge, 3/8 to 5/8 inch long
  • For intramuscular injection: #20 to #22 gauge, 1 to 1 1/2 inch long
  • For slender adults & children: Usually require shorter needle
• Ampule


  Glass container designed to hold a single dose of drug, has constricted neck
• Preparing an Ampule


  1. Break at constricted neck using ampule opener or sterile gauze

  2. Aspirate fluid into syringe using filter needle/straw to prevent glass particles
• Steps in Preparing Meds from an Ampule

  1. Check MAR

  2. Organize equipment

  3. Perform hand hygiene

  4. Prepare ampule for drug withdrawal

  5. Withdraw medication