FUNDA SL

• Absorption


  The process by which a drug passes from its site of administration into the bloodstream
• Factors That Affect Drug Absorptions

  • Blood flow
  • Pain
  • Stress
  • Foods
  • Exercise
• Absorption


  • Transport of drug molecules is faster through a single layer of cells
  • Drugs applied to the mucous membrane will be absorbed faster than those applied on the skin
  • Liquid drugs are absorbed faster than solid drugs
  • Acidic drugs are best absorbed in the acidic environment
  • Alkaline drugs are best absorbed in alkaline environment
  • Drugs administered in high concentration tend to be more rapidly absorbed than the drugs administered in low concentrations
  • Bolus dose is given to obtain rapid effect of a drug
  • An active drug may be combined with another substance from which it is slowly released, or may be prepared in vehicle that offers relative resistance to the digestive action of the stomach contents
• Distribution


  The transport of a drug from its site of absorption to its site of action
• Factors That Affect Drug Distribution

  • Plasma-Protein Binding
  • Volume distribution
  • Barriers to Drug Distribution
  • Obesity
  • Receptor Combination
• Plasma-Protein Binding


  • Medications connect with plasma proteins (albumin) in vascular system
  • Strong attachments have a longer period of drug action
  • Clients with reduced plasma proteins could receive a heightened drug effect
• Volume distribution


  • Client with edema has enlarged area in which a drug can be distributed, and may need an increased dose
  • Smaller dose may be needed for client with dehydration
• Barriers to Drug Distribution

  • Blood Brain Barrier: To pass through this barrier, drug must be lipid soluble and loosely attached to plasma proteins
  • Placental Barrier: Shields from the possibility of adverse drug effects. Many substances, like drugs, nicotine and alcohol do not cross the placental barrier
• Obesity


  Body weight plays a role in drug distribution because blood flows through fat slowly, thus increasing time before drug is released
• Receptor Combination


  • A receptor is an area on a cell where drug attaches and response takes place
  • A receptor is usually protein or nucleic acid. Other receptors are enzymes, lipids, and carbohydrate residues
  • Drugs can have agonist or antagonist effect
  • Agonist will connect itself to the receptor site and cause pharmacological response
  • Antagonist will attempt to attach but because attachment is uneven, there is no drug response
  • There can be competition at receptor site when more than one drug tries to occupy it
• Metabolism or Biotransmission


  • A sequence of chemical events that change a drug to a less active form after it enters the body. Also called detoxification
  • The liver is the principal site of drug metabolism
  • Oral medications: Go directly to the liver via the portal circulation before entering the systemic circulation
  • Many medications become entirely inactivated by the liver the first time they go through it
• Factors That Affect Drug Metabolism

  • Age
  • Nutrition
  • Insufficient amounts of major body hormones
• Excretion


  • The process by which drugs are eliminated from the body
  • Most important route of excretion for most drugs is kidneys
• Factors That Affect Drug Excretion

  • Renal excretion
  • Drugs can affect elimination of other drugs
  • Blood concentration levels
  • Half life
• Physiologic Changes Associated with Aging that Influence Medication Administration and Effectiveness

  • Altered memory
  • Less acute vision
  • Decrease in renal function resulting in slower elimination of drugs
  • Less complete and slower absorption from gastrointestinal tract
  • Increased proportion of fat to lean body mass which facilitates retention of fat soluble drugs and increases potential for toxicity
  • Decreased liver function, which hinders biotransformation of drug
  • Decreased organ sensitivity
  • Altered quality of organ responsiveness, resulting in adverse effects becoming pronounced before therapeutic effects are achieved
• Principles in Administering Medications

  • Observe the 14 Rights of drug administration
  • Practice asepsis. Wash hands before and after preparing medications
  • Nurses who administer medications are responsible for their own actions. Question any order that you consider incorrect (maybe unclear or inappropriate)
  • Be knowledgeable about the medications that you administer
  • Keep narcotics in locked place
  • Use only medications that are in clearly labeled containers. Re-labelling of drugs is the responsibility of the pharmacist
  • Return liquid that are cloudy in color to the pharmacy
  • Before administering the medication, identify the client correctly
  • Do not leave the medication at the bedside. Stay with the client until he actually takes the medications
  • The nurse who prepares the drug administers it. Only the nurse who prepared the drug knows what that drug is. Do not accept endorsement of medications
  • If the client vomits after taking the medication, report this to the nurse in- charge or physician
  • Preoperative medications are usually discontinued during the postoperative period unless ordered to be continued
  • When a medication is omitted for any reason, record the fact together with the reason
  • When a medication error is made, report immediately to the nurse in- charge or physician. To implement necessary measures immediately. This may prevent any adverse effects of the drug
• Factors Affecting Medication Action

  • Developmental Factor
  • Gender
  • Culture, Ethnic, Genetic Factor
  • Diet
  • Environment
  • Psychological Factor
  • Illness and Disease
  • Time of Administration
• Standard Timings of Medication Administration

  • Once a day: 06:00am or 08:00am
  • Two times a day or every 12 hours: 08:00am and 06:00pm
  • Three times a day or every 8 hours: 08:00am, 01:00pm, 06:00pm
  • Four times a day or every 6 hours: 08:00am, 2pm,08:00pm,2pm
• The Abbreviations


  • Ac
  • PC
  • PO
  • NPO
  • D/C
  • Ad Lib
  • Gtts
  • U
  • Pre. Op
  • Post. Op
  • Tab.
  • Inj.
  • OD
  • BD or BID
  • TID or TDS
  • HS
  • QID
  • Q1H
  • Q2H
  • Q3H
  • Q6H
  • Q8H
  • Q12H
  • PRN
  • STAT
  • PC
  • AC
• Route


  • ID
  • IM
  • SC
  • IV
  • PO
  • SL
  • PV
  • PR
• Medication Administration


  • Pharmacist role
  • Nurse's Role
  • Health Care Provider's Role
• Medication Error


  Any preventable event that may cause inappropriate medication use or jeopardize patient safety
• When an error occurs:

  • First assess the patient's condition, then notify the health care provider
  • When patient is stable, report the incident
  • Prepare and file an occurrence or incidence report
  • Report near misses and incidents that cause harm
  • During transitions in care, reconcile medications
• Nursing Process: Assessment


  • Through the patient's eyes
  • History
  • Patient's current condition
  • Patient's attitude about medication use
  • Factors affecting adherence to medication therapy
  • Patient's learning needs
• Nursing Diagnosis


  • Impaired Health Maintenance
  • Lack of knowledge (Medication)
  • Nonadherence (Medication Regimen)
  • Adverse Medication Interaction
  • Complex Medication Regimen (Polypharmacy)
• Planning


  • Goals and outcomes
  • Setting priorities
  • Teamwork and collaboration
• arm


  During transitions in care, reconcile medications
• Nursing Process: Assessment


  1. Through the patient's eyes

  2. Consider patient's preferences and values

  3. Assess patient experiences

  4. History

  5. Allergies

  6. Medications

  7. Diet history

  8. Patient's perceptual or coordination problems

  9. Patient's current condition

  10. Patient's attitude about medication use

  11. Factors affecting adherence to medication therapy

  12. Patient's learning needs
• Nursing Diagnosis


  • Impaired Health Maintenance
  • Lack of knowledge (Medication)
  • Nonadherence (Medication Regimen)
  • Adverse Medication Interaction
  • Complex Medication Regimen (Polypharmacy)
• Planning


  1. Organize care activities to ensure the safe administration of medications

  2. Goals and outcomes

  3. Setting priorities

  4. Teamwork and collaboration
• Implementation


  1. Health promotion

  2. Acute care

  3. Avoidance of distractions

  4. Special considerations
• Evaluation


  1. Through the patient's eyes

  2. Patient outcomes
• 14 Rights of Drug Administration

  • Right Drug
  • Right Patient
  • Right Time/ Frequency
  • Right Dose
  • Right Route
  • Right Education and Information
  • Right to Refuse Medication
  • Right Assessment
  • Right Documentation
  • Right Evaluation
  • Right Principle of Care
  • Right Approach
  • Right Prescription
  • Right Nurse Clinician
• Right Principle of Care

  Observe the proper standards of preparing medications and observing the right of the patients. As a nurse, we need to treat our patient with dignity & respect. Encourage patient in decision- making and communicate about their clinical condition and treatment options.
• Right Approach


  The nurse's manner should be appropriate for the patient's age to whom the drug is being administered, especially when the patient is a child. However, the nurse should also be patient with older patients.
• Right Prescription


  It is the responsibility of the nurse to confirm right order of the physician with the right patient, right medication, with the right dose and route, the correct frequency of the medication and the signature of the ordering physician.
• Right Nurse Clinician


  Only the licensed registered nurse has the right to prepare and administer the medication to the right patient and must be responsible and accountable on her own actions.
• Nurses are legally required to document medications that are administered to patients.
• The nurse is mandated to document which of the following?

  • Medication before administering it.
  • Medication after administering it.
  • Rationale for administering it.
  • Prescriber rationale for prescribing it.
• Medication Ticket