-Check med label at least 3x prior to administration
-Explain to pt. which med you are administering and show it to them (sometimes they
know their own meds well and may stop you from handing them the wrong drug!)
-Waste high-alert drugs with someone else watching!
conversation/distraction while preparing meds
Safety : terminology, when not to crush PO meds, high alert meds, etc.
Look alike/sound alike drugs : part of why it is so important to scan meds and check
labels multiple times! Atenolol vs. albuterol; carvedilol vs. captopril ; epinephrine vs.
norepinephrine, etc.
Crushing: medications that should never be crushed include buccal, sublingual,
sustained-release and enteric-coated. Too much of the medication will be released into
the blood stream too quickly. This increases the risks of overdose/SEs and means there
could be a period of time where you won't be benefitting at all
High-alert: insulin, opiates and narcotics, injectable potassium chloride (phosphate),
,intravenous anti-coagulants (heparin, warfarin) and sodium chloride solutions above
0.9%
Mnemonic: Islands On Neptune, Pretty Cool Spot
Forms and routes: which routes work more quickly, less quickly?
Forms:
• Tablets/Capsules
• Liquids
• Transdermal
• Topicals
• Instillations (drops)
• Inhalations
• Nasogastric/Gastrostomy Tubes
• Suppositories
• Parenteral
Routes: IV, IM, SC, PR, PO, inhalation, transdermal
, IV most rapid onset, inhalation can also be quite rapid. Oral largely dependent on
first-pass effect, not as reliable. Don't have to worry as much about first-pass for rectal.
Transdermal avoids first-pass all together and is longacting but absorbed very slowly
Pharmacokinetics
study of how the body handles a drug that has been introduced into its system.
Absorption distribution, metabolism and excretion
Pharmacodynamics
what the drug does to the body. Potency, half-life, duration of action, etc.
Absorption
the movement of unmetabolized drug from administration site to body circulatory
system
Bioavailability
the degree to which a substance/drug becomes totally available to its intended
biological sites
Distribution
the reversible movement of a drug from one site in the body to another, via blood to
different tissues
Metabolism
the process of biotransformation-usually by enzymes-in which one chemical species is
changed into another
Excretion
excretion-the removal of drugs from the body, either as a metabolite or unchanged drug
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