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Pharm 101
6 Rights of Medication Administration
Right Patient
Right Medication
Right Dose
Right Time
Right Route
Right Documentation
Nursing Considerations
Three Checks
Check for Allergies
Assess the Patient
Education
2 mins
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
1 min
Peak and Trough
Peak
Highest Concentration
Trough
Lowest Level of Therapeutic Range
Obtain Before Next Dose
Half-Life
2 mins
Mixing NPH and Regular Insulin for Injection
Verify Order
Roll NPH Insulin
Alcohol to Multiuse Vials
Inject Air into NPH Insulin (Cloudy)
Inject Air into Regular Insulin (Clear)
Withdraw Regular Insulin Units
Withdraw NPH Units
Verify with 2nd Nurse
Discard if Error
3 mins
Conversions: Pounds and Kilograms
2.2 lb (pounds)
1 kg (kilogram)
Know Your Own Weight
37 secs
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
2 mins
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
2 mins
Intramuscular Medication (IM) Administration
Risks
Injury to Nerves, Bone, and Blood Vessels
Sites
Deltoid
Vastus Lateralis
Ventrogluteal
Nursing Considerations
Selection of Needle Length
Aseptic Technique for Drawing Up
Z-Track
90 Degree Angle
Max Amount (2-5 mL Adult, 1 mL Child)
Techniques to Reduce Pain
2 mins
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
2 mins
Ear Drops Medication Administration
Indications
Earwax Buildup
Ear Infections
Pulling The Pinna
Child - Back and Downward
Adult - Back and Upward
Procedure
Side-Lying with Ear Up
Instill Medication
Stay for 2-3 Minutes
Nursing Considerations
Room Temperature
May Massage Tragus
Perforated Eardrum
2 mins
Eye Medication Administration
Procedure
Supine with Neck Hyperextended
Wash Away Crusts
Cotton Ball on Cheekbone
For Ophthalmic Drops
Instill Drops into Conjunctival Sac
Repeat if Missed or Patient Blinks
5 Minutes Before 2nd Medication
For Ophthalmic Ointment
Thin Stream Along Inner Edge
Inner Canthus to Outer Canthus
2 mins
Alpha 1 Receptor
Characteristics
Gq Subunit
Increase Vascular Smooth Muscle Contraction
Increase Pupillary Dilator Muscle Contraction
Increase Intestinal and Bladder Sphincter Muscle Contraction
1 min
Alpha 2 Receptor
Characteristics
Gi Subunit
Decrease Sympathetic Outflow
Decrease Insulin Release
Decrease Lipolysis
Increase Platelet Aggregation
Decrease Aqueous Humor Production
2 mins
Beta-1 Receptor
Characteristics
Gs Protein Class
Increased Heart Rate
Increased Contractility
Increase Renin Release
Increased Lipolysis
44 secs
Beta-2 Receptor
Characteristics
Gs Protein Class
Cardiopulmonary
Increased Heart Rate
Increased Contractility
Bronchodilation
Metabolic
Increased Lipolysis
Increased Insulin
Increased Glycogenolysis
Increased Cellular Potassium Uptake
Considerations
Increased Aqueous Humor Production
Vasodilation
Decrease Uterine Tone
2 mins
P450 Inhibitors
Quinidine
Ciprofloxacin
Isoniazid
Grapefruit Juice
Acute Alcohol Use
Erythromycin (Macrolide)
Indinavir
Cimetidine
Sulfonamides
Ketoconazole
Amiodarone
2 mins
P450 Inducer
Griseofulvin
Phenytoin
Carbamazepine
Rifampin
Barbiturates
Chronic Alcohol Use
St. John's Wort
51 secs
Benzodiazepine Antidote
Antidote
Flumazenil
40 secs
Warfarin Antidotes
Antidotes
Vitamin K
Fresh Frozen Plasma
59 secs
Acetylcholinesterase Inhibitor Antidote
Antidote
Atropine
Pralidoxime
1 min
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