NR I224 IFinal IExam I IStudy I Guide
➢ MED IADMINISTRATION
I
RATE IOF IABSORBTION
• When Iapplying I medications Ion Ithe Iskin, Iabsorption I is Islow Ibecause Iof Ithe
IphysicalImakeup Iof I the Iskin. I Because Iorally Iadministered I medications Ipass
Ithrough Ithe I gastrointestinal I(GI) I tract, Ithe Ioverall Irate Iof Iabsorption I is I usually
Islow.
• The I mucous I membrane Iand Ithe I respiratory Itract I have Ia Iquick Irate Iof Iabsorption.
IIntravenous I(IV) Iadministration I has Ithe I fastest Iabsorption Irate. IThe Ioral Iroute I takes
IsomeIt ime Iowing I to Ithe Ipassage Iof I medications Ithrough Ithe I GI Itract.
• The Iblood Isupply Ito I the Isite Iof Iadministration Iwill Idetermine I how Iquickly Ithe Ibody
IcanIabsorb Ia Idrug. I The Iricher I the Iblood Isupply I to Ithe Isite Iof Iadministration, Ithe I faster Ia
I medication I is Iabsorbed.
• When Ia I medication Icomes I in Icontact Iwith Ia I large Isurface Iarea, I it I is Iabsorbed Iat Ia
IfasterIrate. IThis I helps Iexplain I why Ithe I majority Iof I medications Iare Iabsorbed I in I the
Ismall I intestine Irather I than Ithe I stomach.
• Because Ithe Icell I membrane I has Ia Ilipid I layer, Ihighly I lipid-soluble I medications Icross
IcellImembranes Ieasily Iand Iare Iabsorbed Iquickly.
• Safe I medication Iadministration Irequires Iknowledge Iof I factors Ithat Ialter Ior
IimpairIabsorption Iof I prescribed I medications.
• Because Isome I medications I interact Iwith I food, I it I is Ioften Iappropriate Ito Iadminister
IthemIbefore Ior Iafter I meals, Iwith I meals, Ior Ion Ian Iempty Istomach.
EXCRETION
• What I is Ithe I main Iorgan I for Iexcretion? IKidneys
• Which Itype Iof I medications Iare Iexcreted Ithrough I the I lungs? IAnesthetic I gases, Ialcohol
• Why Ishould Icertain I medications I not Ibe Itaken Iduring Ipregnancy? IDiscuss: ISome I may
IpassIt hrough Ithe Iplacental Ibarrier Ior I mammary I glands.
• The Ikidneys Iare Ithe I main Iorgans Ifor I medication Iexcretion. ISome I medications Iescape
Iextensive I metabolism Iand Iexit I unchanged I in Ithe Iurine. IOthers Iundergo
IbiotransformationIin I the I liver Ibefore I the Ikidneys Iexcrete Ithem.
• The IGI Itract Iis Ianother I route I for I medication Iexcretion. IMedications I that Ienter Ithe
IhepaticIc irculation Iare Ibroken Idown Iby Ithe I liver Iand Iexcreted I into Ithe Ibile. IAfter
Ichemicals Ienter I the I intestines Ithrough Ithe Ibiliary Itract, Ithe I intestines Iresorb Ithem.
• Gaseous Iand I volatile Icompounds Isuch Ias I nitrous Ioxide Iand Ialcohol Iexit Ithrough Ithe I lungs.
• The Iexocrine I glands Iexcrete I lipid-soluble
I medications.ITIMING IOF IMEDICATION IDOSE
RESPONSES
I
• Onset: I Time Iit Itakes Iafter I meds Iare Iadministered I for I it I to Iproduce Ia Iresponse
, • Peak: ITime I it Itakes I for Ia I med Ito Ireach I its Ihighest Ieffective Iconcentration
• Trough: IMinimum Iblood Iserum Iconcentration Iof I meds Ireached Ijust Ibefore Ithe
InextIscheduled Idose
• Duration: ITime Iduring Iwhich I meds Iare Ipresent I in Iconcentration I great Ienough I to
IproduceIa Iresponse
• Plateau: I Blood Iserum Iconcentration Iof I medication Ireached Iand I maintained Iafter
IrepeatedIfixed Idoses
FORMS IOF IMEDICATION
• If I it I is I“scored” I(line I through Ithe Ipills), Ithey Ican Ibe Idivided Ismaller/or Isplit.
• DO INOT Isplit, Icut, Ior Idivide Icapsules, Isoftgel/gelcaps Ior I meds I labeled IER
I(extendedIr elease), IIR I(immediate I release), I LA I(long Iacting), Ietc.
TYPES IOF IMED IACTION
• Therapeutic Ieffect: I Expected IorIpredicted Iphysiological Iresponse
• Adverse Ieffect: IUnintended, Iundesirable, Ioften Iunpredictable
• Side Ieffect: I Predictable, Iunavoidable Isecondary Ieffect
• Toxic Ieffect: IAccumulation Iof I medication I in Ithe Ibloodstream
• Idiosyncratic Ireaction: IOve rreaction IorIunderreaction IorIdifferent Ireaction
I fromInormal
• Allergic Ireaction: I unpredictable Iresponse Ito Ia Imedication
• Medication I interactions: I when Ione Imedication I modifies Ithe Iaction Iof Ianother
• PLEASE Iunderstand I these Iabbreviations. IIt Ican I mix I you I up Ion Ia Itest Iquestion.
DOSAGE ISCHEDULE ABBREVIATION
Before I meals AC, Iac
As Idesired ad Ilib
Twice Ieach Iday BID, Ibid, Iq12h
After I meals PC, Ipc
As Ineeded Prn
Every I morning, IAM Q Iam
Every I hour qh IOR Iq1h
Everyday Daily Ior Iq24h
Every I4 I hours q4h
4 Itimes Iper Iday QID, Iqid, Iq6h
Give I immediately STAT, Istat
3 Itimes Iper Iday TID, Itid, Iq8h
Q/q I= Ievery
Know Ithe Idifference Ibetween Ievery I4 Ihours Ivs. I4 Itimes Iper
dayIq4h: IEVERY I4 IHOURS
I
, QID: I There Iare I24 Ihours I in Ia Iday. IIf Ithey I need I their I meds I4 Itimes Iwithin Ia I24- hour Iperiod, I24
Idivided Iby I4 I is I6. ISo, Iyou I will I give Ithe I medication Ievery I6 Ihours Ior Iq6h. ISame I with I“3 I times
IperIday”. IIt I is I24 I(hours) Idivided Iby I3. IThat I is Iq8h Ior ITID.
ORALIROUTES
Local Ior Isystemic Ieffects
Contraindications: Ipts I unable Ito Iswallow, I unconscious, Iconfused, Ior Iunable Ior Iunwilling
ItoIswallow Ior Ihold I meds I under I their I tongues, Ipts Iwith I gastric Isuction, Ibefore Itests Ior Isurgery
• Sublingual: IPlace I medication I under Ithe Itongue I until Iabsorbed
• Buccal: IPlace I medication Ibetween Icheek Iand Iteeth I until I absorbed I(usually I tablet
form)IPARENTAL IROUTES/INJECTION ITECHNIQUE
I
IM Iand IIV Iroutes I have I higher Iabsorption Irates, Ithus Iplacing Ipt Iat Ihigher Irisk I for Ireactions;
IcanIc ause Iconsiderable Ianxiety
• Intrade rmal: IMostly I used I for ITB I(tuberculosis) Iand Iallergy Itesting I– IInjection I into
ItheIdermis I just I under Ithe Iepidermis. IGiven I at I 15 I degree I angle, Iusually Icalled Ia I “bleb”.
IGiven Ion I the I inner I surface Iof I the Iforearm I (not Ithe Iantecubital!)
o I
• Subcutaneous I(SQ): I45-90 Idegree Iangle. IInjection I into Ithe Itissues Ijust Ibelow Ithe
IdermisIo f Iskin. I Upper Iouter Iarms, Iabdomen I(2 I inches I[away] I from Ithe I umbilicus/belly
Ibutton/see
➢ MED IADMINISTRATION
I
RATE IOF IABSORBTION
• When Iapplying I medications Ion Ithe Iskin, Iabsorption I is Islow Ibecause Iof Ithe
IphysicalImakeup Iof I the Iskin. I Because Iorally Iadministered I medications Ipass
Ithrough Ithe I gastrointestinal I(GI) I tract, Ithe Ioverall Irate Iof Iabsorption I is I usually
Islow.
• The I mucous I membrane Iand Ithe I respiratory Itract I have Ia Iquick Irate Iof Iabsorption.
IIntravenous I(IV) Iadministration I has Ithe I fastest Iabsorption Irate. IThe Ioral Iroute I takes
IsomeIt ime Iowing I to Ithe Ipassage Iof I medications Ithrough Ithe I GI Itract.
• The Iblood Isupply Ito I the Isite Iof Iadministration Iwill Idetermine I how Iquickly Ithe Ibody
IcanIabsorb Ia Idrug. I The Iricher I the Iblood Isupply I to Ithe Isite Iof Iadministration, Ithe I faster Ia
I medication I is Iabsorbed.
• When Ia I medication Icomes I in Icontact Iwith Ia I large Isurface Iarea, I it I is Iabsorbed Iat Ia
IfasterIrate. IThis I helps Iexplain I why Ithe I majority Iof I medications Iare Iabsorbed I in I the
Ismall I intestine Irather I than Ithe I stomach.
• Because Ithe Icell I membrane I has Ia Ilipid I layer, Ihighly I lipid-soluble I medications Icross
IcellImembranes Ieasily Iand Iare Iabsorbed Iquickly.
• Safe I medication Iadministration Irequires Iknowledge Iof I factors Ithat Ialter Ior
IimpairIabsorption Iof I prescribed I medications.
• Because Isome I medications I interact Iwith I food, I it I is Ioften Iappropriate Ito Iadminister
IthemIbefore Ior Iafter I meals, Iwith I meals, Ior Ion Ian Iempty Istomach.
EXCRETION
• What I is Ithe I main Iorgan I for Iexcretion? IKidneys
• Which Itype Iof I medications Iare Iexcreted Ithrough I the I lungs? IAnesthetic I gases, Ialcohol
• Why Ishould Icertain I medications I not Ibe Itaken Iduring Ipregnancy? IDiscuss: ISome I may
IpassIt hrough Ithe Iplacental Ibarrier Ior I mammary I glands.
• The Ikidneys Iare Ithe I main Iorgans Ifor I medication Iexcretion. ISome I medications Iescape
Iextensive I metabolism Iand Iexit I unchanged I in Ithe Iurine. IOthers Iundergo
IbiotransformationIin I the I liver Ibefore I the Ikidneys Iexcrete Ithem.
• The IGI Itract Iis Ianother I route I for I medication Iexcretion. IMedications I that Ienter Ithe
IhepaticIc irculation Iare Ibroken Idown Iby Ithe I liver Iand Iexcreted I into Ithe Ibile. IAfter
Ichemicals Ienter I the I intestines Ithrough Ithe Ibiliary Itract, Ithe I intestines Iresorb Ithem.
• Gaseous Iand I volatile Icompounds Isuch Ias I nitrous Ioxide Iand Ialcohol Iexit Ithrough Ithe I lungs.
• The Iexocrine I glands Iexcrete I lipid-soluble
I medications.ITIMING IOF IMEDICATION IDOSE
RESPONSES
I
• Onset: I Time Iit Itakes Iafter I meds Iare Iadministered I for I it I to Iproduce Ia Iresponse
, • Peak: ITime I it Itakes I for Ia I med Ito Ireach I its Ihighest Ieffective Iconcentration
• Trough: IMinimum Iblood Iserum Iconcentration Iof I meds Ireached Ijust Ibefore Ithe
InextIscheduled Idose
• Duration: ITime Iduring Iwhich I meds Iare Ipresent I in Iconcentration I great Ienough I to
IproduceIa Iresponse
• Plateau: I Blood Iserum Iconcentration Iof I medication Ireached Iand I maintained Iafter
IrepeatedIfixed Idoses
FORMS IOF IMEDICATION
• If I it I is I“scored” I(line I through Ithe Ipills), Ithey Ican Ibe Idivided Ismaller/or Isplit.
• DO INOT Isplit, Icut, Ior Idivide Icapsules, Isoftgel/gelcaps Ior I meds I labeled IER
I(extendedIr elease), IIR I(immediate I release), I LA I(long Iacting), Ietc.
TYPES IOF IMED IACTION
• Therapeutic Ieffect: I Expected IorIpredicted Iphysiological Iresponse
• Adverse Ieffect: IUnintended, Iundesirable, Ioften Iunpredictable
• Side Ieffect: I Predictable, Iunavoidable Isecondary Ieffect
• Toxic Ieffect: IAccumulation Iof I medication I in Ithe Ibloodstream
• Idiosyncratic Ireaction: IOve rreaction IorIunderreaction IorIdifferent Ireaction
I fromInormal
• Allergic Ireaction: I unpredictable Iresponse Ito Ia Imedication
• Medication I interactions: I when Ione Imedication I modifies Ithe Iaction Iof Ianother
• PLEASE Iunderstand I these Iabbreviations. IIt Ican I mix I you I up Ion Ia Itest Iquestion.
DOSAGE ISCHEDULE ABBREVIATION
Before I meals AC, Iac
As Idesired ad Ilib
Twice Ieach Iday BID, Ibid, Iq12h
After I meals PC, Ipc
As Ineeded Prn
Every I morning, IAM Q Iam
Every I hour qh IOR Iq1h
Everyday Daily Ior Iq24h
Every I4 I hours q4h
4 Itimes Iper Iday QID, Iqid, Iq6h
Give I immediately STAT, Istat
3 Itimes Iper Iday TID, Itid, Iq8h
Q/q I= Ievery
Know Ithe Idifference Ibetween Ievery I4 Ihours Ivs. I4 Itimes Iper
dayIq4h: IEVERY I4 IHOURS
I
, QID: I There Iare I24 Ihours I in Ia Iday. IIf Ithey I need I their I meds I4 Itimes Iwithin Ia I24- hour Iperiod, I24
Idivided Iby I4 I is I6. ISo, Iyou I will I give Ithe I medication Ievery I6 Ihours Ior Iq6h. ISame I with I“3 I times
IperIday”. IIt I is I24 I(hours) Idivided Iby I3. IThat I is Iq8h Ior ITID.
ORALIROUTES
Local Ior Isystemic Ieffects
Contraindications: Ipts I unable Ito Iswallow, I unconscious, Iconfused, Ior Iunable Ior Iunwilling
ItoIswallow Ior Ihold I meds I under I their I tongues, Ipts Iwith I gastric Isuction, Ibefore Itests Ior Isurgery
• Sublingual: IPlace I medication I under Ithe Itongue I until Iabsorbed
• Buccal: IPlace I medication Ibetween Icheek Iand Iteeth I until I absorbed I(usually I tablet
form)IPARENTAL IROUTES/INJECTION ITECHNIQUE
I
IM Iand IIV Iroutes I have I higher Iabsorption Irates, Ithus Iplacing Ipt Iat Ihigher Irisk I for Ireactions;
IcanIc ause Iconsiderable Ianxiety
• Intrade rmal: IMostly I used I for ITB I(tuberculosis) Iand Iallergy Itesting I– IInjection I into
ItheIdermis I just I under Ithe Iepidermis. IGiven I at I 15 I degree I angle, Iusually Icalled Ia I “bleb”.
IGiven Ion I the I inner I surface Iof I the Iforearm I (not Ithe Iantecubital!)
o I
• Subcutaneous I(SQ): I45-90 Idegree Iangle. IInjection I into Ithe Itissues Ijust Ibelow Ithe
IdermisIo f Iskin. I Upper Iouter Iarms, Iabdomen I(2 I inches I[away] I from Ithe I umbilicus/belly
Ibutton/see
