Drug Applications and Administration

Drug Applications

• Lecturer: Assist. Prof. Dr. Funda KARAMAN.
• The aim is to fulfill the necessary practices for drug administration.

Objectives

• Understand drug definition.
• Classify drugs.
• Know the effects of drugs on the body.
• Explain requesting, supplying, and storing drugs.
• Know the ways of administering drugs.
• Know and apply drug practices.

Content Overview

• Description of drugs
• Classification of drugs
• Modes of action of drugs
• Factors that play a role in drugs affecting the patient
• Supply and storage of medicine
• Physician medication order
• Ways of drug administration

Drug Sources and Forms

• Drugs may be sourced from animals, vegetables, minerals, or synthetic materials.
• Medicines come in different forms, each with a special content.
• Drugs are defined as chemical changes, are given to diagnose, cure, or prevent a disease.
• Drugs affect body function when taken by living organism.

Core Drug Administration

• Medication administration a core function, and is requires technical skills
• It requires knowledge of medications and skills to administer them.

Drug Classification

• Dosage forms include solid, liquid, semi-solid, and gaseous forms.
• Solids can be unit doses (tablets, capsules) or bulk dosages (tooth powder, dusting powder).
• Liquids can be monophasic (syrups, lotions) or biphasic (suspensions, emulsions).
• Semi-solids include creams, ointments, pastes, gels, suppositories, and pessaries.
• Gaseous forms include aerosols and inhalations.

Factors Affecting Drug Activity

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

Drug Interactions

• Synergism shows more efficacy when drugs are used together, for example, tuberculosis treatment.
• Additional interaction results in an increased effect of drugs when taken together.
• Potentialization means the effect of the drugs is greater than the sum of their individual effects when combined.
• Antagonism reduces the effect of one drug by another, such as naloxone to reduce the effect of narcotics.

Drug Metabolism Stages

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

Drug Supply and Storage

• Keep drugs locked in the same room.
• Drugs should be in a clean, closed, dry, and cool place.
• Tightly close bottles to prevent evaporation and moisture.
• Oily, diluted medicines should be in the refrigerator or cold, within their expiration date.
• Vaccines and serums must be kept in the refrigerator.
• Replace medicines with dirty labels.
• Expired medicines or having changed color, odor etc should not be used.
• Provide artificial lighting in the medicine cabinet location.
• Keep emergency medications in a separate compartment.
• Drugs with same effect should be kept together.
• The medicine cabinet should be large enough for all patients' medications.
• Addictive drugs (narcotics) should be kept in a double-locked cabinet.
• Narcotics should be taken and given with a signature.
• Apply a red label to poisonous drugs.

Physician Medication Order

• Physician medication orders must be in writing for safety.
• In emergencies, drug administration without a written order is prohibited legally.
• Types includes regular, request if necessary and urgent(single dose) request.

Parts of a Physician Medication Order

• Name of the patient
• Date and time
• Name of the drug
• Dose of drug
• Drug administration routes
• Drug application frequency
• Signature of the doctor

Doctor's Orders and Responsibilities

• Doctor orders are to be checked by health care professionals every morning and transferred to recording system.
• Observation sheets are used for recording.
• Check with a physician if you have any doubt of the drug request.
• Write the date, time and sign under the doctor's order for confirmation.

Rights of Medication Administration

• Right patient
• Right medication
• Right dosage
• Right route
• Right time
• Right documentation
• Right client education
• Right to refuse
• Right assessment
• Right evaluation

Detailed Rights of Patient Administration

• To administer medications correctly, the 10 rights must be ensured
• Verify patient's identification bracelet to ensure of right identity
• Ask patient to state their name and birth date, compare with information with medication charts.
• Verify patient's allergies against the chart.
• Perform a triple check of medication label and orders.
• Be aware when retrieving/preparing the medication and always check during such times.
• Verify the correct dosage/calculations from the medication concentration.
• Medication times have to be within 30 minutes before/after requested times.
• Use the proper routes of medication administration (IV, Oral) as specified by the drug.
• Ensure appropriate documentation procedures, date, time and signatures all present (if needed).
• Let client know what medication is to be expected to their body and any side effects that medication entails.
• Patients have the right to refuse, and must have the appropriate documentation for reasoning.
• Document and assess the proper notifications of drug usage for safe medication.
• After a patient's response to medication check for side effects, and proper documentation.

Basic Principles of Drug Applications

• Know the 10 rights of drug administration
• Hands should be clean and gloves should be worn
• Introduce yourself to the patient
• Inform the patient about the procedure/medication process
• Obtain verbal informed consent from the patient
• Patient confidentiality is important, and must be considered
• Patient should be positioned correctly

Necessary Precautions for Administration

• Make sure to prepare all materials before medications
• Remind patients to take medications at specified times
• The patient behavior/response to medications have to be recorded.
• A Healthcare worker should always prepare medicines.
• Illegible/errors on medication should be corrected with the doctor.
• A Doctor should have the patient's medical background and any allergies.

Considerations for Drug Applications

• Have the drug preparation is to be in a bright location
• Trays used during the drugs should be tidy.
• During preparations the drugs are secured in a location for administration.
• Triple check on medication should be checked if the correct location, pouring the drugs, and medicine box returned.
• After an administration, medications is to wait for the patient to swallow the drugs.
• Medications that cannot take, have to have permission to be administered early.
• Always ensure you have the proper knowledge of what medications is for, and what it does.
• Patients and their families are to be informed of all medications used.

Narcotic Drugs Requirements

• Keep locked
• Conduct shift changes with proper recording
• Use requires to people to verify with a sign in
• If a some ampoule is not used after opening it is to be stored and used under 24 hrs.
• Includes green and red labels prescriptions.

Drug Absorption Rates

• Intracardiac absorption takes 15 seconds
• Intravenous absorption takes 30-60 seconds
• Inhalation absorption takes 3 minutes
• Endotracheal absorption takes 3 minutes
• Sublingual absorption takes 3–5 minutes
• Intramuscular absorption takes 10–20 minutes
• Subcutan absorption takes 15–30 minutes
• Rectal absorption takes 5–30 minutes
• Intradermal absorption takes 15–30 minutes
• Oral absorption takes 30–90 minutes
• Dermal absorption time: it can change.

Drug Measurements

• 1cc = 1ml = 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

Drug Effects and Action

• Drugs could have local or systemic effects
• Drug depends on what the patient is.
• Dependent on the drug dose, route, and patient, and the metabolism.

Local Administration Sites

• Epidermal (skin)
• Conjunctival sac
• Intranasal
• Intravaginal
• External ear canal

Systemic Administration Sites

• Enteral
• Oral Administration (per oral, p.o)
• Sublingual and BuccalApplication
• Rectal Application
• Parenteral
• (SC, IM, IV)
• Inhalation
• Transdermal

Epidermal Administration

• Absorption varies on site, so application location important
• Absorption can have systemic effects (such as Corticosteroids)
• Forms of applications vary ( powder, ointments, lotion)
• Ensure the applied area is a dry surface, and ensure it is devoid previous residue.

Drug Administered on the Eye

• Care before and after application.
• No contact with medication with eyeball - Droppers especially
• Never share drug in between patients
• Follow correct eye application process, what eye and clean.
• With drops follow proper time limit

Intranasal Administration

• Position patient at a semi-fowler position.
• Do not contact medicine tip, keep safe.
• Have head elevated to help assist blood flow for absorptions

Intravaginal Administration

• Be aware of medical privacy before administration - Patient or administration is possible
• Patient appropriate position depends on medication.
• Store in cool room

Ear Administration

• In children, pull back in down position.
• In adults pull back for up position.
• Do not have drops be administered directly apply in hand first.

Systemic Application Sites

• Routes of application will vary, these are: enteral, transdermal, inhalation and parenteral.

Enteral Applications

• Applying drug to the digestive tract
• Drugs absorption is to be in the digestive tract
• Common route: Oral Application

Administration Process For Enteral

• Double Check of Medication
• The Date , Patient
• What to expect from medicines
• Ensure medication has been taken, for proper confirmation.
• What side effects to take
• After a proper dosage confirm medication has been administered.

Medication Not To Be Administer of Enteral Administration

• Medication and patients who are under situations of
• No medication in stomach
• Nausea/ or in a coma

Sublingual Drug Administration

• Needs Medication to stay in mouth.
• Has a faster/effective transport method

Buccal Drug Adminstration

• Has a higher transfer rate
• Can achieve better systemic effect

Enteral & Rectal

• High Privacy during process

Transdermal Application

• Patch or adhesive applied
• Ensure date for the correct administration
• Note time

Inhalation

• Advantage is high flow blood.
• Has a permeable membrane
• Two Types of drugs
• Has to be administered under trained individual.
• Admin through inhaler

Advantages of Inhalations

• Drugs delivered to a target point.
• Quick Transfer
• Low dose to patient
• Low side effect.

Different Drug application Inhalers

• Turbuhaler
• Aerolizer
• Handihaler
• Discus
• Metered Dose Inhaler (MDI)
• Reservoir
• Nebulizer-Nebul

Using application of Nebulizer

• Has benefits that is aids with breathing
• Helpful for musics and patients with asthma

Notes on Using applications for Neblizers

• Be wary during 2 drugs not to mix
• Always make sure chamber is up to a required clean location
• If used, Mouthwash

Parenteral application

• It is where by it avoids the therapeutic drugs

Parenteral Administration

• • Subcutaneous (SC) injection (<1ml),
• Intradermal injection: ID
• Intramuscular injection
• Intravenous injection

Steps of using Parental

• Be aware of what size needed in medication type and use/route

- Types

• Double check before administering medications. Ensure you have knowledge and correct amount. Has to he diluted with water.

Subcutaneuos injections

• Under Skin, small volumes

- For Use with

• Insulin and Hormones

Injection Sites

• Latera
• Abdominal
• Umbilical
• Scaplua
• Dorsagluteal
• SC
• Note at a 45-90
• Follow proper rotation in a spot to not scar patients