Principles of Drug Administration Quiz

Principles of Drug Administration

• Repeated drug administration may lead to decreased effectiveness; increasing the dose can be required.
• Nurses should verify drug calculations with a second nurse if uncertain.
• Medications should be prepared and administered solely by the nurse who prepared them.
• Medication labels must be checked, and written orders should be compared to the medication sheet.
• Patient identification is crucial; verify with ID bands and ask the patient for their name.
• Follow the "10 Rights" of medication administration:
  • Right medication, right dose, right time, right route, right client, right client education, right documentation, right to refuse, right assessment, and right evaluation.
• Right education involves informing the patient about the medication, expected responses, side effects, and monitoring requirements.

Safe Administration Practices

• Oral medications are most convenient; do not administer if the patient is vomiting or has difficulty swallowing.
• Avoid crushing sustained-action drugs or enteric-coated tablets.
• Encourage patients to take large amounts of water with enteric-coated medications to aid swallowing.
• Parenteral medications provide a more rapid response than oral forms.

Health Teaching for New Medications

• Include desired effects, dietary restrictions, storage guidelines, and written administration instructions for newly prescribed medications.

Otic Administration Techniques

• For children, administer ear drops backwards and downwards; for adults, administer backwards and upwards.

Pharmacokinetics

• Pharmaceutic Phase: Initial stage for oral medications.
• Drug Absorption: Process where drugs enter the bloodstream.
  • Liquid forms absorb faster than solids.
  • Drugs tend to absorb better in acidic environments compared to alkaline.
• Drug Distribution: Occurs when drugs circulate in the bloodstream.
• Drug Metabolism (Biotransformation): Primarily happens in the liver, potentially reducing drug effectiveness (First Pass Metabolism).
• Drug Excretion: Mainly occurs through the kidneys.
• Excipients: Substances that help enhance drug dissolution and attributes.

Drug Half-Life

• Defines the duration for the drug concentration to reduce by half.
• Determines frequency of dosing; e.g., Ibuprofen has a half-life of 2 hours.

Pharmacodynamics

• Study of drug effects on the body.
• Drug Affinity: How strongly a drug binds to its receptor.
• Drug Efficacy: Drug's ability to activate its receptor.
  • Agonist: Activates receptors.
  • Antagonist: Inhibits receptor activity.
• Maximal Efficacy: Maximum therapeutic response achievable.
• Potency: Amount of drug required for effect; a more potent drug achieves the same effect at a lower dose.
• Therapeutic Index (TI): Ratio of toxic dose (TD50) to effective dose (ED50); a higher TI indicates a safer drug.

Drug Action Parameters

• Onset: Time to first observable drug effect.
• Peak: Highest concentration of the drug; monitor for effects and side effects at this point.
• Duration of Action: Time drug maintains therapeutic effect.

Sympathetic Nervous System Activities

• Responsible for "fight or flight" response.
• Increases heart rate, blood pressure, and dilates pupils.
• Neurotransmitters involved include epinephrine and norepinephrine.
• Alpha and Beta Receptors: Target various physiological responses.
  • Alpha 1: Vasoconstriction, increases blood pressure.
  • Beta 1: Increases heart rate and contractility.
  • Beta 2: Causes bronchodilation.

Parasympathetic Nervous System Activities

• Responsible for "rest and digest" functionality.
• Decreases heart rate and blood pressure while increasing GI activity.
• Neurotransmitter is Acetylcholine affecting nicotinic and muscarinic receptors.
  • Muscarinic actions increase salivation and gastrointestinal motility.

Additional Patient Management

• Monitor for hypotension, bradycardia, or bronchospasm with cholinergic medications.
• Antidotes for excessive dosing may include Atropine.
• Manage neuromuscular blockers to facilitate muscle relaxation when indicated.