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Chapter 53 Administering Oral and Non-Injectable Medications Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Routes of Medication • Drugs may be administered by many different routes • Providers select the route based on: – Rate of absorption desired – Distribution – Biotransformation – Elimination Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Routes of Administration • • • • • Oral Buccal Sublingual Drops Inhalation Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Routes of Administration • • • • • • Intradermal Intramuscular Intranasal Intraosseous Intrathecal Intravenous Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Routes of Administration • • • • • • • Ophthalmic Otic Rectal Subcutaneous Topical Transdermal Vaginal Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Prescriptions • A written order prepared by a licensed provider authorizing a medication or treatment to be dispensed to the patient for self-administration Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Elements of a Prescription • Provider’s name and address • Date of issue • Patient’s name and address • Drug name • Dosage form • Quantity prescribed • Directions for use • Number of refills • “Dispensed as written” or if substitutions are permitted • Manual signature of prescriber Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Preparing Prescriptions • In offices with EHR, prescribers can directly transmit prescriptions directly to the pharmacist • In offices without EHR, it may be the MA’s responsibility to prepare the handwritten prescription, except for the final review and signature Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Preparing Prescriptions • If MA telephones prescription to the pharmacy: – Provide the pharmacist with ALL the information contained in the prescription – The pharmacist should repeat back this information to ensure accuracy Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Medication Orders • Medication orders are direct and complete instructions from the provider for administering medication to a patient while in the office Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Elements of a Medication Order • • • • • Full name of the patient • Date and time the order is written Name of the medication • Specific instructions Dosage Route of administration • Signature of the prescriber How often, or frequency, the medication is ordered Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Seven Rights of Medication Administration 1. 2. 3. 4. 5. 6. 7. Patient Medication Dose Route Technique Time Documentation Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Right Patient • Use TWO identifiers • Ask the patient to cite his or her full name and another identifier from the chart – Do not ask the patient to reply “yes” or “no” Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Right Medication • Check the medication order and verify the medication at least four times: – When preparing the medication – Upon bringing the medication to administer to the patient – Prior to administering – Following administration Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Medication Errors • A medication error involves one or more of the following: – Correct drug given to wrong patient – Wrong drug given to the correct patient – Wrong dose administered – Drug given by the wrong route – Drug given at the wrong time Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Medication Errors • NEVER try to cover up a medication error • Notify the provider at once • The provider will to determine what steps need to be taken Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Medication Documentation • Who, what, where, when, why • Immunization documentation – Manufacturer – Lot number – Serial number – Container’s expiration date Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Using Abbreviations • There are a number of abbreviations used in the health care office • Spell out the words if you are unsure of the appropriate abbreviation • Spell out the words if it could create any confusion as to what is being written Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Error-Prone Abbreviations • Joint Commission’s DO NOT USE list • Institute of Safe Medication Practice’s list of error-prone abbreviations Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Documenting Adverse Reactions • Document any reaction to medication given, along with corrective actions taken: – Date and time – Type of reaction – Medication administered to reverse the reaction or restore function – Airway support, when applicable – Level of care – Outcome of interventions – Instructions provided to the patient Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Administering Medications • Oral medications are taken by mouth and intended for absorption through the digestive system • Other methods are parenteral (intended for absorption outside the digestive system) Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Oral Medications • Oral medications come in a variety of forms: pills, tablets, capsules, caplets, lozenges, syrups, sprays, and other liquids Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Oral Medications • Oral medications have many advantages: – Easily prepared and administered – Easily stored – Generally more economical for the office and patient – Generally associated with lower risk and less expense than medication given by injection – Easily for patient to self-administer at home Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Sublingual and Buccal Administration • Sublingual: The medication (usually tiny tablets or spray) is placed under the tongue • Buccal: The medication is placed or sprayed in the mouth between the gum and the cheek • The medication is absorbed through the mucous membranes into the bloodstream Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Parenteral: Non-injectable • Routes: inhalation, nasal, ointment, otic, rectal, topical, transdermal, urethral, and vaginal • Medications given by these routes may be applied directly to the affected body part or inhaled into the lungs Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Nasal, Ophthalmic, and Otic • Usually drops, ointments or salves • Applied directly into the nose, eyes or ears • Provide immediate relief or direct absorption by the target tissues Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Inhalation • Medications in the form of gases, sprays, fluids, or powders • Breathed into the respiratory tract • The patient often self-administers through a metered inhaler or nebulizer • In the office, oxygen is a form of inhalation medication Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Topical • Medications in the form of sprays, lotions, creams, ointments, paints, salves, wet dressings, and transdermal patches Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Topical • Used in treating diseases or disorders of the skin or mucous membranes • Must be applied as prescribed to achieve the desired effect Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Rectal • Most common medication forms are suppositories and enemas Copyright ©2012 Delmar, Cengage Learning. All rights reserved. Vaginal • Medications in the form of creams, suppositories, tablets, douches, foams, ointments, tampons, sprays, and salves • Patient education is important – Women may be uncomfortable or embarrassed – Vaginal medication should not be used during menstruation – Advise patients to use disposable panty liners to avoid medication leaking and staying undergarments or clothes Copyright ©2012 Delmar, Cengage Learning. All rights reserved.
