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MEDICATION
King Saud University
College of Nursing
NUR 122
Drug administration
Medication: substance administered for the
diagnosis, cure, treatment, or relief of a
symptom or for prevention of a disease.
 Medication or drugs are given to exert
specific physiologic effects on the body.
 They play an important role in preventing,
treating, and curing illness, their
administration has become one of the most
important, complex and risk-laden aspects
of nursing care.
Routes of drug administration
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Oral: Per mouth
Sublingual: under the tongue
Buccal: against the cheek
Pareneteral: IV, IM, SC, intradermal, intracardiac,
intrathecal,intrapleural, intraosseous
 Topical: skin, eyes, ear, nose, rectum or vagina.
 Effects: local, systematic.
 Medication are prescribe by physician.
 Medication order includes the name of the drug,
the dose, the route, frequency, date and time.
Effects of Drugs
 Therapeutic effect = desired effect
– Reason drug is prescribed
 Side effect = secondary effect
– Unintended, usually predictable
– May be harmless or harmful
 Drug toxicity
– Result from overdose, ingestion of external use
drug
– Buildup of drug in blood
 Drug allergy
– Immunologic reaction to drug
– Mild to severe reactions (anaphylaxis)
 Drug tolerance
– Need increasing doses to maintain therapeutic
effect
 Drug interaction
– One drug affecting effect of another
Actions of Drug on the body
 Pharmacodynamics:
– Process by which drug changes the body
(mechanism of action).
 Pharmacokinetics:
– Study of absorption, distribution,
biotransformation, and excretion of drugs
Pharmacokinetics
 Absorption: movement from the
administration site into the bloodstream.
 Distribution: transportation of the drug from
its site to the site of action.
 Metabolism: the drug is converted by
enzymes into a less active form that can be
excreted, (most drugs are metabolized in
the liver).
 Excretion: elimination from the body. The
kidneys are the most important route.
Drug Nomenclature
 Chemical name — describes the chemical
constituents of the drug
 Generic name — assigned by the
manufacturer that first develops the drug
 Trade name — brand name given by the
company that sells the drug
Drug Preparations
 Oral:
– Capsule, pill, tablet, suspension, syrup
 Topical:
– lotion, ointment, suppository, transdermal patch
 Injectable:
- Vial, Ampoule
Mechanisms of Drug Actions
 Drug-receptor interaction — drug interacts
with one of more cellular structures to alter
cell function
 Drug-enzyme interaction — combines with
enzymes to achieve desired effect
 Acting on cell membrane or altering the
cellular environment
Factors Affecting Drug
Absorption
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Route of administration
Drug solubility
pH
Local conditions at site of administration
Drug dosage
Serum drug levels
Adverse Effect of Medications
 Iatrogenic disease: disease caused
unintentionally by medical therapy.
 Allergic effects: immunologic reaction to the
drug.
 Toxic effects
 Drug interactions
Signs and Symptoms of Drug
Allergy
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Rash
Urticaria
Fever
Diarrhea
Nausea
Vomiting
Anaphylactic reaction
Factors affecting
Medication action
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Developmental considerations
Weight
Gender
Diet
Genetic and cultural factors
Psychological factors
Illness & disease
Environment, timing of administration
Types of Medication Orders
 Standing order — carried out until cancelled
by another order
 Prn order — as needed
 Stat order — carried out immediately & once
Parts of the Medication Order
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Patient’s name
Date and time order is written
Name of drug to be administered
Dosage of drug
Route by which drug is to be administered
Frequency of administration of the drug
Signature of person writing the order
Medication Prescription
The 7 rights
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2.
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4.
5.
6.
7.
Right Medication
Right Dose
Right Rout
Right Time (b.i.d, t.i.d, q.i.d. q8h)
Right Client
Right information
Right Documentation
Controlled Substances
Required Information
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Name of patient receiving narcotic
Amount of narcotic used
The hour narcotic was given
The name of physician prescribing narcotic
Name of the nurse administering narcotic
Oral Medications
 Solid form — tablets, capsules, pills
 Liquid form — suspensions, syrups
– Oral Route — having patient swallow the drug.
– Enteral route — administering drug through an
enteral tube
– Sublingual administration — placing drug under
tongue
– Buccal administration — placing drug between
tongue and cheek
Administration of Parenteral
Medications
 Subcutaneous injection — subcutaneous tissue
(0.5-1 ml)
 Intramuscular injection - muscle tissue (1-3ml)
 Intradermal injection — corium (under
epidermis) (0.1 ml)
 Intravenous injection — into a vein
 Intracardial injection — heart tissue
 Intraperitoneal injection — peritoneal cavity
 Intraspinal injection — spinal canal
 Intraosseous injection — bone
Sites for Intramuscular Injections
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Ventrogluteal site
Vastus lateralis site
Deltoid muscle site
Dorsogluteal site
Ventrogluteal site
Vastus Lateralis site
Deltoid Site
Copyright 2008 by
Pearson Education, Inc.
Dorsogluteal Site
Copyright 2008 by
Pearson Education, Inc.
Criteria for Choosing Equipment
for Injections
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Route of administration
Viscosity of the solution
Quantity to be administered
Body size
Type of medication
Topical Administration of
Medications
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Eye: eye drops, ointments
Ears: ear drops
Nose: nasal drops
Rectal: suppositories
Skin applications: ointment, cream lotion
Medical Record Documentation
 Document & sign each dose of medication,
as soon as it is given, and the patient
response.
 Intentional or inadvertent omitted drugs.
 Refused drugs.
 Medication errors.
Type of Medication Errors
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Inappropriate prescribing of the drug
Extra, omitted, or wrong doses
Administration of drug to wrong patient
Administration of drug by wrong route or rate
Failure to give medication within prescribed
time
 Incorrect preparation of a drug
 Improper technique when administering drug
 Giving a drug that has deteriorated
Medication Errors
 Check patient’s condition immediately;
observe for adverse effects.
 Notify nurse manager and physician.
 Write description of error on medical record
and remedial steps taken.
 Complete special form for reporting errors.
Patient Teaching
1. Review techniques of medication
administration.
2. Remind patient to take the medication as
prescribed for as long as prescribed.
3. Instruct patient not to alter dosages without
consulting physician.
4. Caution patient not to share medications
with others even if they have the same
disease.