Drug Activity and Interaction

• Drugs are obtained from four main sources: animal, vegetable, mineral, and synthetic
• Drugs are chemical changes given to diagnose, cure, or prevent disease
• Drugs are substances that change body functions when taken by a living organism
• Medicines come in different forms, each with a special content
• Drug administration requires technical skills
• Drug administration requires adequate knowledge of medications

Factors Affecting Drug activity

• Growth period (newborn, elderly)
• Weight
• Gender
• Genetic & cultural factors
• Psychological factors
• Illnesses
• Environment
• Treatment time
• Adverse drug effects
• Individual differences

Types of Drug Interaction

• Synergism: Shows more efficacy when two or more drugs used together (e.g., tuberculosis treatment)
• Additional: Increases the effect of drugs on the body by taking the same effective drug together
• Potentialization: The effect of two drugs given together is more than the sum of the effects of these drugs alone
• Antagonism: Reduces the effect of a drug by another drug (e.g., naloxone reduces the effect of narcotics)

Drug metabolism completed in 4 basic stages:

• Absorption
• Transport (distribution)
• Change (disintegration)
• Excretion (elimination)

Supply and Storage of Drugs

• Keep drugs locked in the same room
• Store drugs in a clean, closed, dry, and cool place
• Tightly close bottles to prevent evaporation and moisture
• Keep oily, diluted medicines in the refrigerator/cold, within their expiration date
• Vaccines and serums should be kept in the refrigerator
• Replace any medicine with a dirty label
• Medicines that are expired or have changed color, odor, or appearance should not be used
• Install artificial lighting in the medicine cabinet
• Emergency medications should be in a separate compartment
• Keep medicines with the same effect together
• Medicine cabinets should be large enough for all patients' medications
• Addictive drugs (narcotics) should be kept in a double-locked cabinet, and their administration should be signed
• Place a red label on poisonous drugs

Physician Medication Order

• It must be in writing for safe drug administration
• Drug administration is prohibited legally except in emergencies without a written order
• Regular request
• Request if necessary
• Urgent request (single dose request)

Parts of a Physician Medication Order

• Patient's name
• Date and time
• Name of the drug to be administered
• Dose of the drug
• Drug administration routes
• Drug application frequency
• Signature of the doctor who wrote the order

Steps For Doctors

• Doctor orders are checked by health care professionals every morning, and hours are adjusted/transferred to their recording system
• Observation sheets are used for recording
• Necessary to consult a physician if there is any doubt about the request
• After checking, the date, time, and signature should be put under the doctor's order

Rights of Medication Administration

• Right Patient: Check ID bracelet, state their name and birth date, compare medication order to ID bracelet and stated name/birth date, and verify allergies
• Right Medication: Check medication label 3 times: retrieving, preparing, and before administering, always check with physician's orders, never administer if prepared by another person/unlabeled
• Right Dosage: Check label for concentration, compare dose with order, triple-check calculations, use another nurse, and verify the dosage is in range
• Right time: Verify medication schedule, check date, time, and specified period, Check last dose given and administer it within 30 minutes of the schedule
• Right route: Verify the medication route, and only administer it via the specified route
• Right documentation: Never document before the medication is administered, including medication, dosage, route, date, time, signature, and, when appropriate, the signature of other nurses
• Right client education: Inform patient of the medication being administered, desired effects, side effects, and known allergies
• Right to refuse: The legally responsible party has the right to refuse, and inform of consequences, verify it's understood, notify physician and document this
• Right assessment: Properly assess patient to determine if safe/appropriate, notify physician, and document the reason if the medication wasn't administered
• Right evaluation: Assess for adverse side effects, effectiveness of medication, compare the prior with post medication status, and document the patient’s response

Basic Principles of Drug Applications before Applying

• Know the 10 rights of drug administration
• Wash hands and wear gloves
• Introduce oneself to the patient
• Inform the patient about the procedure
• Obtain verbal informed consent from the patient
• Take patient confidentiality into consideration
• Properly position the patient

Steps to Remember

• Materials should be in the tray
• Verify the patient takes their medications
• Observe the patient before/after administration
• Healthcare worker prepares the medicines
• Correct/fix the medical order if the doctor is incorrect/illegible
• Enquire about the patient’s drug allergy

Consider in Drug Applications

• The drug preparation environment should be bright
• Medicine tray should be tidy
• After preparation, medication should be stored in a safe place
• Ensure accuracy by triple-checking: taking from the bottle, pouring into the glass, and replacing the bottle
• Check patient ID and wait for the patient to swallow oral medications
• Necessary to administer the medication ASAP if the patient can’t take it and have sufficient knowledge about the drug
• We should inform the patient and family about medication

Narcotic tracking

• Must be kept locked and counted each change and numbers should be recorded
• Required to sign it if used by two nurses
• Any ampoule not used right away needs to be destroyed/stored in a syringe for use within 24 hours
• Green-red prescription drugs in this group

Drug Absorption Rate

• Intracardiac: 15 seconds
• Intravenous: 30-60 seconds
• Inhalation: 3 minutes
• Endotracheal: 3 minutes
• Sublingual: 3-5 minutes
• Intramuscular: 10-20 minutes
• Subcutan: 15-30 minutes
• Rectal: 5-30 minutes
• Intradermal: 15-30 minutes
• Oral: 30-90 minutes
• Dermal: Can Change

Measurements for medicine

• 1 cc = 1 ml = 10 dizy = 100 unit = 20 drops
• 4-5 ml = 1 dessert spoon
• 15 ml = 1 tablespoon
• 250 ml = 1 glass of water
• 100ml = 1 tea glass

Administration for medicine

• Drugs have local or systemic effects after being taken into the body
• It's related to the way the drug is administered
• Effects depend on the patient, the dose, the route, and the drug's metabolism

Local vs Systemic shapes

• Local application shapes: Epidermal, Conjunctival sac, Intranasal, Intravaginal, External ear canal,
• Systemic Pharmaceuticals shapes: Enteral, Parenteral, Transdermal, and Inhalation

Epidermal Information

• Application to the skin differs among the site
• Topical application may have systemic effects (corticosteroids)
• Powder, ointment, cream, oil, and lotions are forms of medicine for this way
• Make sure the skin is clean and dry, remove any residue of previous medication, shake the lotion, and warm medicine

Information about the eye

• Eye care is important before application from inner canus-the eyeball
• Don’t have the dropper come into contact with.
• Doesn’t matter if one patient is going to use the drug for another one?
• One patient should not use it for another patient the eye must be healthy before a diseased one

Intranasal

• The patient has to be in a supine or semi Fowler position
• Does it have contact of the drug?
• The doctor has to not make contact with the mucosa
• The head should be hyperextended

PATIENT PRIVACY !!! intravaginal

• Tablets cream or suppositories Tablet, foam, and the patient needs to put into appropriate position
• Tablets cream or suppositories and in the fridge
• They must be hated before
• in the palms

Ear medicine

For children pull it down, and in adults, pull up Drops need to be hated too

Entenal, parenteral, inhalation, and transdermal

• 1 Enteral Oral (p.o) and Buccal Application Rectal
• 2 Tran dermal
• 3 Inhalation
• 4 parenteral (SC, IM IV ID)

The person needs to make sure it’s the write medication

• When they put in the box it needs to be 21/ The person needs to touch the pill
• Make sure the client is at the bed and the patients ID
• Make a report and check for medication as you put it one by one
• They can’t have trouble with the ability to get the medicine

Air cannot be swallowed through administration

• 1 unconscious patients
• 2 if they can't swallow the food
• 3 no swallow response
• 4 vomiting
• 5 deharia
• 6 convulsions

Sublingual

• The tongue tongue has many blood vessels to make absorption go up, so This gets to circulation The drug needs to be chewed to be swallowed
• Since the mucosa is reach in Limp, doesn’t need to go through liver, get to be circulated system

Beccal

• The drugs get into the gums to take with them and have the same time

Intramuscular injections

• That’s all
• It needs to go into the thigh or the bottom portion
• It needs to be in a 45 to 50 angle with the paper being that’s where you can see the patient clearly

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