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Medication Administration 1 2 3 ,exam study guide

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MEDICATION ADMINISTRATIONA. Identify the nurse’s role in medication administration.Teach clients about their meds & side effectsEnsure adherence w/ med regimenEvaluate client’s ability to self-administer medsEvaluate client’s response to medsB. Discuss drugs regarding:1. NomenclatureChemical name (ex: N-acetyl-para-aminophenol) – provides exact description, composition & molecular structureGeneric name (ex: Acetaminophen) – mfr who first develops the medication gives nameOfficial name – generic name becomes the official name listed in the official publication of USP (United States Pharmacopeia)Trade name

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lOMoARcPSD|11232395




MEDICATION ADMINISTRATION

A. Identify the nurse’s role in medication administration.
 Teach clients about their meds & side effects
 Ensure adherence w/ med regimen
 Evaluate client’s ability to self-administer meds
 Evaluate client’s response to meds

B. Discuss drugs regarding:
1. Nomenclature
 Chemical name (ex: N-acetyl-para-aminophenol) – provides exact description, composition &
molecular structure
 Generic name (ex: Acetaminophen) – mfr who first develops the medication gives name
 Official name – generic name becomes the official name listed in the official publication of USP
(United States Pharmacopeia)
 Trade name (ex: Tylenol™) – mfr trademarked medication name
2. Preparation – ex: Aspirin is available in capsules, tablets, EC tabs, liquid, suppositories, & topical
3. Classifications – each class contain more than one med, and some meds are part of more than one class
 Effect of the medication on a body system
 Symptoms the medication relieves
 Medication’s desired effect
 Ex: AntiDiabetic drugs – Sulfonyurea (class of hypoglycemic agents to lower blood glucose levels by
increasing insulin production of the pancreas)

C. Define mechanics of drug actions:
1. Pharmacodynamics – what the Drug does to the Body
2. Pharmacokinetics – what the Body does with the Drug
 Absorption – passage of medication molecules into the blood
o Route of administration
 Skin – slow due to physical makeup
 Mucous membrane & Respiratory airways – quick due to many blood vessels
 Oral – slow, have to pass through GI tract
 IV – rapid because drugs immediately available once entered in systemic circulation
(Fastest → Slowest: IV, IM, SQ, ID)
o Solubility – Acidic meds absorb through gastric mucosa rapidly; Basic meds are absorbed in
the small intestine; Cell membrane has a lipid bilayer, therefore, highly lipid-soluble meds
easily cross & absorb quickly
 Meds absorb better between meals
o Site of administration – rich blood supply, body absorbs meds rapidly
o Body surface area – larger surface area, medication absorbs faster, therefore majority of
meds are absorbed in the small intestine rather than the stomach
 Distribution – once absorbed, meds get distributed to tissues & organs & specific site of action
o Circulation – once med enters the bloodstream, it is carried throughout the tissues & organs
o Membrane permeability – depend on fat-soluble or non-fat-soluble meds



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, lOMoARcPSD|11232395




o Protein binding – serum proteins affect med distribution; Unbound meds can increase risk in
activity or toxicity
 Metabolism – once distributed to site of action, it metabolizes into a less active/inactive form that is
easier to excrete
o Biotransformation occurs under the influence of enzymes that detoxify (break down), &
remove biologically active chemicals
o Biotransformation occurs w/in the Liver (lungs, kidneys, blood, & intestines also metabolize
meds)
o Liver degrades many harmful chemicals before they become distributed to the tissues
 Excretion – after metabolism, meds exit the body through the Kidneys, Liver, Bowel, Lungs, & Exocrine
glands (ex: sweat, salivary, & mammary glands)

D. Identify factors that affect drugs actions
 Developmental/Age
 Weight – adult drug doses are based on 18-65 yrs old & 160 lbs.
 Psychological – Placebo effect
 Pathology – presence of disease can affect drug levels (ex: Liver disease or Renal failure)
 Time of administration – food slows absorption & circadian rhythms affect drug actions

E. Identify adverse drug effects:
1. Side effects – predictable, unavoidable secondary effects produced at a usual therapeutic dose (harmless
or cause injury)
2. Adverse effects – unintended, undesirable, severe responses to meds (Health care providers report
adverse effects to the FDA using the MedWatch program)
 Iatrogenic – treatment induced, Drugs that make patients sick
 Drug allergy – never occur w/ 1st dose (allergies are the same as Side Effects, therefore it depends on
degree of reaction)
 Drug tolerance (NOT addiction)
 Cumulative effect – toxic effects develop after prolonged intake of a med & accumulates in the blood
because of impaired metabolism or excretion
 Interaction
o Antagonistic – combined effect of 2 meds cancel each other out
 Ex: Narcan + Demerol/Morphine (Agonist); Tetracycline + Maalox
 Narcan will reverse the reactions of opiates
 Agonist – ability to induce partial/full response, compete for receptor
o Synergistic – combined effect of 2 meds is greater than when given separately; sometimes
interaction is desired
 Ex: Alcohol + Narcotic; Aspirin + Coumadin; Narcotic + Antiemetic

F. Compare types of drug orders:
 Any drug taken at home, when admitted, are considered discontinued unless ordered
1. Standing or Routine orders – order carried out until prescriber cancels it by another order or until
prescribed number of days elapse (Self-Cancelling order)
2. PRN orders – use objective & subjective assessment & discretion



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