2.
Generic
Universal name based on chemical ingredients
Name starts with a small letter-is longer in length & is
more difficult to pronounce
Trade Name
Name is given by Co. that develops it
Name starts with a capitol letter-is shorter in length &
is easier to pronounce
Drug Names
3.
Body system
Therapeutic use or clinical indication
Physiological or chemical action
Prescription or non-prescription
Illegal drugs
Drug Classification
4.
Drugs act in the human body in the following ways:
Change physiological activity within the body
Drugs form a chemical bond within specific sites
Drugs that interact with a receptor to cause a response
are agonists
Drugs that attach to a receptor but do not cause a
response are antagonists
Drugs that interact with a receptor to cause a response
but prevent other responses are partial agonists
Once given, all drugs go through stages
Absorption, distribution, metabolism, and excretion
Basic Principles
5.
Factors that affect drug
absorption
Absorption
Age and weight of consumer
Dry or wrinkled skin
Decreased number of hair follicles
Condition of consumer i.e. decreased cardiac output,
pain, fever
Inability to chew tablets for chewable drugs
Less saliva production
GI absorption affected by disease processes, presence
of other drugs
6.
Cont….
Distribution
Amount of body water
Decreased levels of plasma proteins
Metabolism
Decreased liver function
Genetics, smoking, diet, gender, liver disease, other
drugs
Excretion
Decreased kidney function
7.
Is the process by which a drug is transferred from its
site of body entry to circulating body fluids for
distribution. The rate depends on:
The route
Blood flow through the tissue where the drugs was
given
How well the drug can dissolve
Absorption
8.
Give oral drugs with enough fluid
Reconstitute and dilute drugs as recommended by
the manufacturer
Give drugs into the correct tissue
To promote absorption
9.
Enteral (oral, rectal, or naso-gastric)
Parenteral (bypass GI tract)
Subcutaneous
Intramuscular
Intravenous
percutaneous
Drugs are given
10.
Refers to the ways drugs are transported by
circulating body fluids to the sites of action.
Once absorbed into the blood, a drug’s distribution
is determined by:
Chemical properties
How it is affected by the blood and tissues it contacts
Distribution
11.
Is the process by which the body in-activates drugs.
The liver is the primary site for drug metabolism.
Metabolism
12.
Is the elimination of a drug from the body.
Urine and feces are the primary routes of excretion.
Excretion
13.
No drug has a single action.
When a drug is absorbed and distributed, the
desired action (expected response) usually occurs.
All drugs can affect more than one body system,
therefore side effects and adverse drug reactions can
occur.
Drug Action
14.
An unintended reaction to a drug given in a normal
dosage.
Nausea
Dry mouth
Dizziness
Blurred vision
Ringing in ears
Side effects
15.
Unintended effect on the body from using a legal
drug, illegal drug, or two or more drugs.
Rash, itching, high blood sugar (hyperglycemia) and
a reduced number of platelets (thrombocytopenia)
are common ADRs.
Drug reactions/adverse
drug reaction
16.
Is an unfavorable response to a substance that causes a
hyper-sensitivity reaction.
Most common reaction is
Uticaria (hives)
Most severe reaction is
Anaphylaxis
Severe, life threatening.
Sweating, SOB, hypotension, irregular pulse, respiratory
distress, and swelling of larynx
First exposure- mild reaction
Second exposure- severe reaction
Allergic reaction
17.
Is something unusual or abnormal that happens
when a drug is first given.
Can be considered an over –reaction to a drug
Related to the body’s inability to metabolize the drug
Idiosyncratic Reaction
18.
Age
Body weight
Metabolic rate
Illness
Willingness to take drugs
Placebo effect
Tolerance
Dependence
Cumulative effect
Factors Influencing
Drug Action
19.
Occurs when the action of one drug is altered by the
action of another drug
Increase the action of the other (potentiation)
Decrease the action of the other (antagonist)
Drug Interactions
20.
American Hospital Formulary Service Drug
Information
Drug Interaction Facts
Drug Facts and Comparison
Handbook of Nonprescription Drugs
Natural Medicines Comprehensive Database
Physician’s Desk Reference
Package Inserts
Drugs.com
Drug Information
21.
Classification
Brand Name
Generic Name
Therapeutic Use
Dose
Side Effects
Anything unusual
Any Nsg. Precautions
Drug Activity
22.
Physician
Physician’s assistant/ nurse practitioner
Pharmacist
Director of nurses
Supervisory nurse
Medication aide
Health Professionals
23.
Person’s full name
Date
Drug name
Route of administration
Dose
Frequency of use
Duration of order
Doctor’s (prescriber’s) signature
Drug order
24.
STAT order
Single order
Standing order
PRN order
Ordering methods
Written order
Verbal order
Telephone order
Faxed order
Electronic order
Drug orders
25.
All have to be approved by
Joint Commission
Institute for safe Medication Practice
Facility
Commonly used
Abbreviations
26.
Weights
Metric system (microgram, milligram, centigram,
gram, kilogram)
Apothecary system (grain, seldom used)
Household system (pound)
Volume
Metric (milliliter, centiliter, deciliter, liter)
Apothecary (minim)
Household system (tablespoon, teaspoon, cup, ounce)
Measurements in drug
orders
29. Person’s name, address, phone number
Pharmacy’s name, address, phone number
Prescription number
Date prescription filled
Original date of prescription
Doctor’s name
Brand name of drug
Generic name of drug
Manufacture’s name
Drug dosage
Amount in container
How often to take
Warnings
Number of refills allowed
Expiration date or when to discard
Information on the label
30. Person’s name, room number, identifying information
Admission form
Health history
Physical examination results
Doctor’s order form
Doctor’s progress notes
Nursing team progress notes (describes care given,
person’s response & progress)
Graphic sheet (records, measurements/observations
made daily, every shift, or 3 or 4 times a day
Flow sheet
Laboratory & x-ray reports
IV therapy record
Medical record
31.
Respiratory therapy record
Consultation reports
Surgery & anesthesia reports
Assessments/reports from social services, dietary
service, and physical, occupational, speech and
recreational therapy
Consent forms
PRN/unscheduled medication record
Continue
32.
Medication administration record (MAR)
Scheduled medications
Parental medications
STAT medications
Pre-operative medications
PRN medications (date, time, drug given, dose given,
route, reason for giving, person’s response)
Time drug given and by whom
Cont….
33.
Summarizes information in medical record
Quick, easy source of information
Updated regularly (usually in pencil)
Not formal, legal part of medical record
Destroyed when person leaves facility
Purpose of a Kardex
34.
Nurse verifies and transcribes order
Nurse decides is drug safe to give
Nurse contacts physician if order deemed unsafe, physician
may cancel or rewrite order
Transcribe (copied)
Copied to Kardex and MAR (secretary may copy)
Nurse signs, dates, times transcription on original order
Nurse sends order to pharmacy to fill
Order may
New drug
Discontinued drug
Change an order
STAT or one-time-only order
Transcribing drugs
orders
35.
Report
Person’s name, room number
Time of observation
Only what observed or did
Changes from normal
Record
What observed
What you did
Person’s response
Record administration of medication as soon as given
Sign per facility policy, date & time medication given
Report medications refused, not given; not of medication record; discard drug
Record PRN medication immediately with reason given and results
Report unusual reaction
How to accurately report
and record
36.
Four drug distribution
systems
Floor or ward stock system
Frequently used
Avoids waiting or lag time
Pros and cons
Individual prescription order system
3-5 day ordered drug
Stored in patient bin
Safe system
Pharmacist/nurse review order before drug given
Pharmacy monitors drug expiration date
Fewer drugs for drug diversion (taking person’s drug for your
own use)
STAT, PRN drugs available
37.
Cont…
Computer-controlled dispensing system
Pharmacy stocks drug cart for patients/residents on unit
Accessed by security code/password
Drug bar coded, patient ID bracelet also bar coded
Patient’s ID scanned and drug scanned (provides check of
correct drug and automatically documents drug
administration)
Unit dose system
Single-unit dose package dispensed for each dose ordered
24 hour supply (refilled every day) in nursing centers may
be for week or month at a time
Safe, cost, and time efficient
Reduces risk of drug diversion
May be color coded for different times of day
38.
Cont…
Computer-controlled dispensing system
Pharmacy stocks drug cart for patients/residents on unit
Accessed by security code/password
Drug bar coded, patient ID bracelet also coded
Patient’s ID scanned and drug scanned (provides check of
correct drug and automatically documents drug
administration)
Narcotic control systems
Regulation of controlled substances
Single-unit packages kept in locked cabinet in medication
room; or in a special container in the med cart- charge nurse
has the key which cannot be given to anyone except the
person giving the narcotic
39.
Inventoried at the end of each shift
Must be counted by 2 qualified individuals
If the count is not correct- MUST investigate
Each narcotic has its own inventory sheet which
must match the count of that narcotic
Narcotic count
40.
Drug storage
Drug cart (locked) as is the room that they’re stored in
Drugs stored in original container or unit dose package in
person’s individual bin
Some drugs may need to be stored in refrigerator; tight
containers- moisture & heat can destroy drug
Assisted living residents may store own drugs if able to self
medicate-otherwise are stored in a locked room
Controlled substances (narcotics) double locked –may be on
drug cart or separate cabinet
Emergency medications may be stored in floor or stock system
Medications for external use stored separate from those for
internal use
41.
Disposal of drugs
Disposed of because
Person refuses to take drug
Drug dropped on the floor or bed
You are to give only part of drug dispensed
Drug becomes contaminated
Person discharged
Person died
Doctor discontinued drug
Follow facility disposal policy
Do not return to stock supply
Document according to facility policy
42.
Six rights
Right drug
Read the label before removing from unit dose cart or shelf
Read label before preparing or measuring prescribed dose
Read label before returning drug to shelf or opening unit
dose packet
Right time
By drug order
Standard administration times
Blood level
Best drug absorption time
Diagnostic tests
One-time-only, PRN, STAT
43.
Six rights cont…
Right dose
Compare dose on label to MAR
Use appropriate measuring devise
Report nausea & vomiting
Correct drug calculation (may need to be nurse)
Right person
Compare person’s ID to MAR
Two identifiers
Name
Birthdate
ID number
Check for allergies
44.
Six rights cont…
Right route
Drug order gives route
Never change route
Only give as allowed to give by prescribed route
Routes
IV (most rapid onset action)
IM (next fastest onset action)
Sub-Q (probably next fastest)
Intradermal (absorption slow)
What you can give
Inhalation(fastest)
Sublingual(next fastest)
Suppository(next)
Oral (slowest onset)
Right documentation
Record as quickly as possible
Follow documentation standards
Right documentation
45.
Drug errors
Prescribing errors
Wrong drug for person’s diagnosis
Drug person allergic to
Wrong dose for person’s diagnosis
Transcription errors
Misinterpreting/misunderstanding drug ordered or
directions
Interpreting hand-writing, not legible
Using unapproved abbreviations
Omitting a drug order
Using wrong spelling
Writing wrong dates or times
46.
Drug errors cont….
Dispensing
Sending wrong drug or dose to facility
Using wrong formulation
Using wrong dosage form
Giving drugs
Giving wrong drug
Giving wrong dose
Giving an extra dose
Giving drug not ordered for person
Missing or skipping a dose
Giving a drug at wrong time
Giving drug in wrong way
47.
Safety rules for drug
administration
Follow the six rights of drug administration
Store drugs properly
Have good lighting to read Kardex, MAR
Stay focused, don’t get distracted
Keep working area clean, neat, orderly
Check container label for drug name, dose, route
Check person’s chart, Kardex, MAR, ID for allergies
Check person’s chart, Kardex, MAR for rotation schedules for drugs
applied to skin
Know why drug ordered, side effects, adverse reactions
Calculate drug dosages accurately
Identify person before giving drug
Position person for route of administration
Have correct fluids ready for person to swallow oral drugs
Stay with person to make sure drugs have been swallowed
Follow facility policy for self-administered drugs
48.
Cont…
Never leave a drug in person’s room to take later
Never leave a drug unattended
Refer questions about person’s drug or treatment plan to nurse
Do not prepare or give drug if container not properly labeled or unreadable
Give only drugs you are allowed to administer
Give drugs only prepared by pharmacist
Check drug name, dose, frequency, route, against order
Do not return unused drug to stock supply
Do not mix liquid drug with water or other fluid unless directed to
Ask nurse if you have any questions, concerns
Practice good hand hygiene
Never touch actual drug
Check drug carefully (may look alike)
Listen to patient – knows drugs best
Observe for side effects
Make sure drug cabinet/cart is locked
49.
Infection is a disease state resulting from the
invasion and growth of microbes (pathogens)
Bacteria & viruses
Medical asepsis (clean technique)
Hand washing!
Preventing Infection
50.
Guidelines set by the CDC
Prevent the transmission of infectious agents
Blood borne Pathogen Standard
Isolation Precautions
