Medicine may be defined as a substance used to promote
health , to prevent, to diagnose , to alleviate or cure
diseases. The safe and accurate administration of
medication is one of the major responsibility of a nurse
3. Mechanism of drug action
4. Adverse effect:
Undesirable effect other than the intended therapeutic
effect are known as adverse effect.
An allergic effect is an immune system response that
occur when body interprets the drug administration is
foreign substance and form antibody against the drug,
manifested by rashes, urticaria, fever, diarrhea, nausea,
and vomiting and the most serious allergic effect is called
an anaphylactic reaction.
5. Drug tolerance:
It occurs when the body become accustomed to the effect of a
particular drug over a period of time.
Toxic effect are specific group of symptoms related to drug
therapy that carry risk for permanent damage for death, toxicity
can occur from cumulative effect.
it is unusual or peculiar response to a drug that may
manifest itself by over response, under response for even
the opposite of the expected response. Idosyncratic effect
are the though to be result of genetic enzymes deficiency
that leads to be an abnormal mechanism of drug break
6. Drug interaction:
Drug interaction occur when one drug is affected in some
way by another drug, a food or another substance that is
taken at the same time.
example alcohol and barbiturates when taken together
create unbeneficial synergistic effect with potential
significantly increase center nervous system depression.
8. CALCULATION OF DRUG
P1 V1 = P2 V2
P1= available concentration
V1= requires volume of drug
P2= advised concentration
V2= total volume
10. Essentials of medication order
Patients full name.
Date and time.
Route of administration.
Time and frequency of administration.
Signature of physician of medication is one of the major
responsibility of a nurse
11. Types of Medication Orders
STAT order: needed immediately
Single order: given only once
PRN order: given as needed
Routine orders: given within 2 hours of being written
and carried out on schedule
Standing order: written in advance carried out under
13. Basic principles (Safety) in medication
3 checks and 8 Rights
• obtaining the container
• removing the med
• replacing the container
– Right patient
– Right dose
– Right drug
– Right route
– Right time
– Right Frequency
– Right Documentation
– Right to refuse
15. Oral Route:
Convenient - can be self- administered, pain free, easy to take
Absorption - takes place along the whole length of the GI tract
Cheap - compared to most other parenteral routes.
Less amount of drug reaches the target tissue.
Some of the drug is destroyed by gastric juices e.g. adrenaline,
Absorption has to take place which is slow, so is not preferred
It might cause gastric irritation
It might be objectionable in taste.
It might cause discoloration of teeth e.g. iron causes staining,
16. Sublingual Route
Rapid absorption takes place.
Drug is dissolved easily
Drug enters the blood directly
Spitting out of the drug removes its effect
unpalatable & bitter drugs
irritation of oral mucosa
large quantities not given
few drugs are absorbed
Person may swallow the drug
Might be unpleasant in taste.
17. Rectal Route
This route is preferred in unconscious or uncooperative
This route avoids nausea or vomiting
Drug cannot be destroyed by enzymes.
This route is preferred if drug is irritant.
This route is generally not acceptable by the patients.
18. Parenteral administration
To get rapid and systemic effect of the drug
To provide needed effect when the patient unconscious,
unable to swallow due to neurological or surgical
To give nourishment when it cannot taken by mouth
19. Types of parental administration
Intra-osseous- into bone marrow
Subcutaneous route (Hypodermic)
23. Other method of parental administration
Intra-arterial route:This method is used for
chemotherapy in cases of malignant tumors and in
Intra-cardiac route:- Injection can be applied to the left
ventricle in case of cardiac arrest.
Intra-thecal route: Intra-thecal route involves the
subarachnoid space. Injection may be applied for the lumbar
puncture, for spinal anesthesia and for diagnostic purposes
Intra-articular route: Intra-articular route involves
injection into the joint cavity. Corticosteroids may be injected
by this route in acute arthritis
24. Nursing responsibility in administration of
While preparing the drugs:
Read the physician’s orders before preparing the drug. No
medicine should be prepared without the doctors orders. Verbal
orders are carried out only in emergency.
Check medicine card against the physician’s orders. Be sure the
medicine is copied correctly on the medicine card and in the
Avoid conversation during the preparation of medicine.
Calculate the drug dosage accurately if doubt consult other
Supervisor or physician.
Give medication only from clearly labeled container.
Read the label of the medicine and compare it with the medicine
Before the medicine container taken from the shelf-
Before pouring the drugs
Before replacing the container in shelf- Check the expiry
date of the drugs along with the 3 checks
25. Make sure the medicine glasses are clean and dry before
the medicine is taken
When taking tablets and capsules do not touch them
with hand. Drop the tablets from the container to its lid
and then in to the medicine cup to be taken to the bedside
Once the medicine is poured out of bottle , it should not
be poured back in the bottle to prevent contamination of
Do not use the medicine differ in color , taste, odour and
Prepare the drug just before the time of administration of
medicine. Never leave the medicine tray without proper
26. Before administering the drugs:
Ask if patient has taken medication before
Ask for patient allergies
Review concomitant medicines, herbs and foods
Review lab values
Know right medications , dose, patient, route, time,
Explain to patient, medication’s name , purpose and
potential adverse effects.
27. During Administration:
Identify the patient correctly.
Give the drugs one by one
Stay with the patient until he has taken the medicine
Always give the medicine prepared by yourself.
Do not leave the medicine with the patient.
Medication errors must be reported according to the
policy of the hospital
28. after administration
Observe for changes in clinical status, adverse reactions
and allergic reactions.
When present, involve the family in monitoring the
Monitor for acute changes in clinical status, patient’s
subjective and objective response.
Adverse reactions and allergic reactions
If adverse reaction are present follow the hospital policy
and procedure of reporting adverse reaction of drugs .
29. Medication safety guidelines
Medications are not given without physician’s written
Do not administer a drug about which any doubt exists,
check further with the physician.
Labels must be clear if not return to pharmacy.
A nurse not to pour medication to one bottle to another,
not to put a medicine back into bottle,
Nurses are not authorized to re-label medication bottles,
Medication which loses its label or which lacks a legible
label shall be return to the pharmacy.
Nurse who administer the medications are responsible for
their own action.
Be knowledgeable about the medication that you
30. Keep the Narcotics in locked place. Narcotics are to be
checked by every shift, and the narcotic cabinet must be
Return liquid that are cloudy in color to the pharmacy
The nurse who prepares the drug administers it. Only the
nurse prepares the drug knows what the drug is.
If the client vomits after taking the medication, report this
to the nurse in-charge or physician.
Preoperative medications are usually discontinued during
the postoperative period unless ordered to be continued.
When a medication is omitted for any reason, record the
fact together with the reason.
31. When the medication error is made, report it
immediately to the nurse in-charge or physician.
Prepare medications for one patient at a time.
Do not label the medicine by patient room number or
bed number .
Chart if any nursing action done before administering(
apical heart rate, B.P, )
Check for the expected effect(therapeutic) of the drug.
Did side effects or adverse effects occur perform
indicated nursing actions . Record observations.