MEDICATION ADMINISTRATION
A. Identify the nurse’s role in medication administration.
Teach clients about their meds & side effects
Ensure adherence w/ med regimen
Evaluate client’s ability to self-administer meds
Evaluate client’s response to meds
B. Discuss drugs regarding:
1. Nomenclature
Chemical name (ex: N-acetyl-para-aminophenol) – provides exact description, composition &
molecular structure
Generic name (ex: Acetaminophen) – mfr who first develops the medication gives name
Official name – generic name becomes the official name listed in the official publication of USP
(United States Pharmacopeia)
Trade name (ex: Tylenol™) – mfr trademarked medication name
2. Preparation – ex: Aspirin is available in capsules, tablets, EC tabs, liquid, suppositories, & topical
3. Classifications – each class contain more than one med, and some meds are part of more than one class
Effect of the medication on a body system
Symptoms the medication relieves
Medication’s desired effect
Ex: AntiDiabetic drugs – Sulfonyurea (class of hypoglycemic agents to lower blood glucose levels by
increasing insulin production of the pancreas)
C. Define mechanics of drug actions:
1. Pharmacodynamics – what the Drug does to the Body
2. Pharmacokinetics – what the Body does with the Drug
Absorption – passage of medication molecules into the blood
o Route of administration
Skin – slow due to physical makeup
Mucous membrane & Respiratory airways – quick due to many blood vessels
Oral – slow, have to pass through GI tract
IV – rapid because drugs immediately available once entered in systemic circulation
(Fastest → Slowest: IV, IM, SQ, ID)
o Solubility – Acidic meds absorb through gastric mucosa rapidly; Basic meds are absorbed in
the small intestine; Cell membrane has a lipid bilayer, therefore, highly lipid-soluble meds
easily cross & absorb quickly
Meds absorb better between meals
o Site of administration – rich blood supply, body absorbs meds rapidly
o Body surface area – larger surface area, medication absorbs faster, therefore majority of
meds are absorbed in the small intestine rather than the stomach
Distribution – once absorbed, meds get distributed to tissues & organs & specific site of action
o Circulation – once med enters the bloodstream, it is carried throughout the tissues & organs
o Membrane permeability – depend on fat-soluble or non-fat-soluble meds
, o Protein binding – serum proteins affect med distribution; Unbound meds can increase risk in
activity or toxicity
Metabolism – once distributed to site of action, it metabolizes into a less active/inactive form that is
easier to excrete
o Biotransformation occurs under the influence of enzymes that detoxify (break down), &
remove biologically active chemicals
o Biotransformation occurs w/in the Liver (lungs, kidneys, blood, & intestines also metabolize
meds)
o Liver degrades many harmful chemicals before they become distributed to the tissues
Excretion – after metabolism, meds exit the body through the Kidneys, Liver, Bowel, Lungs, & Exocrine
glands (ex: sweat, salivary, & mammary glands)
D. Identify factors that affect drugs actions
Developmental/Age
Weight – adult drug doses are based on 18-65 yrs old & 160 lbs.
Psychological – Placebo effect
Pathology – presence of disease can affect drug levels (ex: Liver disease or Renal failure)
Time of administration – food slows absorption & circadian rhythms affect drug actions
E. Identify adverse drug effects:
1. Side effects – predictable, unavoidable secondary effects produced at a usual therapeutic dose (harmless
or cause injury)
2. Adverse effects – unintended, undesirable, severe responses to meds (Health care providers report
adverse effects to the FDA using the MedWatch program)
Iatrogenic – treatment induced, Drugs that make patients sick
Drug allergy – never occur w/ 1st dose (allergies are the same as Side Effects, therefore it depends on
degree of reaction)
Drug tolerance (NOT addiction)
Cumulative effect – toxic effects develop after prolonged intake of a med & accumulates in the blood
because of impaired metabolism or excretion
Interaction
o Antagonistic – combined effect of 2 meds cancel each other out
Ex: Narcan + Demerol/Morphine (Agonist); Tetracycline + Maalox
Narcan will reverse the reactions of opiates
Agonist – ability to induce partial/full response, compete for receptor
o Synergistic – combined effect of 2 meds is greater than when given separately; sometimes
interaction is desired
Ex: Alcohol + Narcotic; Aspirin + Coumadin; Narcotic + Antiemetic
F. Compare types of drug orders:
Any drug taken at home, when admitted, are considered discontinued unless ordered
1. Standing or Routine orders – order carried out until prescriber cancels it by another order or until
prescribed number of days elapse (Self-Cancelling order)
2. PRN orders – use objective & subjective assessment & discretion
