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Chapter 9
Information Basic to
Administering Drugs
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Information Nursing Handbook
• Generic and trade names
• Drug classification and drug category
• Side effects and adverse effects
• Pregnancy category
• Dosage and route
• Action
• Indications
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Information Nursing Handbook (cont.)
• Contraindications and precautions
• Interactions and incompatibilities
• Nursing implications
• Signs of effectiveness
• Teaching the patient/client
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Generic and Trade Names
• Generic name: one official name
• Trade name: several brand names
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Drug Classification and Drug Category
• Drug classification: categorizes drugs by the way they
act against diseases or disorders
• *Drug category: way drugs work at the molecular,
tissue, or body system level
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Side Effects and Adverse Effects
• *Side effect: nontherapeutic reactions to drug
• Adverse effect: nontherapeutic effect
– May be harmful
– Require lowering the dosage or discontinuing the
drug
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Pregnancy Category
• A: No risk to the fetus in any trimester
• *B: No adverse effect demonstrated in animals; no
human studies available
• C:
– Studies with animals have shown adverse reactions
– No human studies are available
– Given only after risks to the fetus have been
considered
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Pregnancy Category (cont.)
• D: Definite fetal risk exists; may be given despite risk to
the fetus if needed for a life-threatening condition
• X: Absolute fetus abnormality; not to be used anytime
during pregnancy
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Action and Indication
• Action: how drug works
• *Indication: reason for using the drug
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Contraindication and Precautions
• Terms used in which the drug should be given with
caution or not given at all
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Incompatibilities
• Chemical: produces a visible sign
• Physical: may not give visible sign
• When in doubt, do not mix
– *important when medications are combined for
injection in IV administration
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Implications
• Whether drug should be taken with or without food
• What specific vital signs to monitor
• What lab values may be affected by the drug or ordered
to check a drug’s effectiveness or toxicity
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Pharmacokinetics
• Absorption
• Distribution
• Metabolism or biotransformation
• Excretion
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Absorption Factors
• Degree of stomach acidity
• Time required for the stomach to empty
• Whether food is present
• Amount of contact with villi in the small intestine
• Flow of blood to villi
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Distribution, Biotransformation, Excretion
• Distribution: drug’s movement through body fluids
• *Biotransformation: chemical change of drug into a form
that can be excreted
• *Excretion: process by which the body removes a drug
– kidney
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Factors That Affect Drug Action
• Weight
• Age
• Pathologic conditions
• Hypersensitivity to a drug
• Psychological and emotional state
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Half-Life and Therapeutic Range
• *Half-Life: time required for half of the drug to be
excreted
• Therapeutic range: quantity of drug in the blood or
serum to be effective
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Law
• *Criminal: offenses against the general public that are
detrimental to society as a whole
• Civil: concerned with legal rights and duties of private
persons
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**Malpractice
• Nurse owed the patient/client a special duty of care
• Nurse failed to meet required standards
• Claim of harm or injury resulted because the nurse did
not meet the required standard
• Claim of damages for which compensation is sought
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ethical Principles in Drug Administration
• Provide services with respect for the patient/client’s
human dignity and uniqueness.
• Safeguard patient/client’s right to privacy.
• Act to safeguard patient/client from incompetent,
unethical, or illegal practice.
• Assume responsibility and accountability for nursing
judgments and actions.
• Maintain competence in nursing.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins
Autonomy and Truthfulness
• Autonomy: self-determination
– *Responsibility to discuss drug info with the client
and to accept the clients right to refuse
• Truthfulness: obligation not to lie
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Beneficence and Nonmaleficence
• Beneficence: nurse should act in the patient/client’s best
interests
• Nonmaleficence: nurse must not inflict harm on the
patient/client and must prevent harm whenever possible
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Confidentiality, Justice, Fidelity
• Confidentiality: respect for the information that a nurse
learns from professional involvement with
patients/clients
• *Justice: maintain high standard of care
– Right drug, dose, route, time
• Fidelity: keep promises made to the patient/client
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins