Medication Therapy
-Preparations- form in which a drug is available; determines route of
administration
-Solutions- liquid containing a dissolved drug
-Concentration- amount of drug in a certain amount of liquid
-Tinctures- made with alcohol or with alcohol with water
-Fluidextracts- alcohol extracts from plants sources
-Elixirs- solutions of alcohol and water containing 10
percent to 20 percent of a drug
-Spirits- alcohol solutions of volatile oils, or oils that
evaporate
-Syrups- heavy solutions of water and sugar, usually with
a flavoring added to disguise the unpleasant taste
of the drug
-Suspensions- liquid containing undissolved particles of a drug
-Emulsions- suspensions of oils and fats in water with an
emulsifying agent
-Magmas- contains heavy particles mixed with water that forms
a milky liquid
-Gels- similar to magmas, but they contain finer particles
-Liniments- liquid suspensions for external application to the
skin to relieve pain and swelling
-Lotions- suspensions of drugs in a water base for external use
-Aerosols- commonly delivered by oral inhalers to settle out
and must be shaken before use
-Solids and semisolids
-Ointments- drugs mixed in lanolin, a fine oil taken from the
skin of sheep, or in petroleum
-Pastes- semisolid preparations that are thicker and absorbed
more slowly than ointments
-Powders- fine, dry particles of drugs
-Tablets- drug powders that have been pressed or molded into
small disks
-Scored- they have one or more grooves down the middle
-Capsules- gelatin sheath that contains one dose of medication
-Caplets- identical to capsules in size and shape, but have the
consistency of a tablet
-Sustained-release tablets and capsules- contain several doses of
a drug
-Enteric-coated tablets and capsules- are tablets and capsules
with a special coating that keeps them from dissolving in
the acid secretions of the stomach
-Enteric coating- prevents an irritating drug from upsetting the
stomach
-Troches and lozenges- tablets designed to dissolve in the
mouth rather than be swallowed
-Suppositories- drugs mixed with a firm base, such as cocoa
butter, that melts at body temperature
-Soluble- capable of being dissolved
-Active ingredient- the ingredient in a drug that produces the
therapeutic effect
-Expiration date- date after which a drug should not be use
-Routes of administration
-Oral- given by mouth an swallowed, either alone or with a glass of
liquid
-Sublingual- placing a drug under the tongue, were it dissolves in the
patient’s saliva
-Buccal- similar to sublingual administration, except that the
medication is placed in the mouth next to the teeth
-Topical- method of applying a drug directly to the skin or mucous
membrane, usually for local effect
-Rectal- inserting medication into the rectum in the form of
suppository
-Vaginal- requires inserting a cream, foam, tablet, or suppository into
the vagina
-Inhalation- medicine is sprayed or inhaled into the nose, throat, and
lings
-Parental- involves injecting a drug into the body with a needle and
syringe; all injection material must be sterile
-Sterile- free of microorganisms
-Intradermal- medicine is injected just beneath the outer layer
of skin, dose is less than 0.3 cc
-Subcutaneous- medicine is injected into a layer of fatty tissue
that lies right below the skin, dose is approximately 1 to
2 cc
-Intramuscular- medicine is injected deep into muscle, dose is 1
to 3 cc
-Intravenous injection- placing medicine directly into the vein
-Intravenous infusion- insertion of a tube or needle into a vein
through which fluids are slowly added to the bloodstream
over a period of time
-Methods only allowed being performed by a physician;
intracardiac, intra-arterial, intrathecal, and intraspinal
-Medication order
-Patient’s full name
-Date of the order
-Name of the drug
-Dosage
-Route of administration
-Time and frequency
-Physician’s signature
-Number of refills and quantity
-Physician’s DEA number
-Types of drug orders
-Routine order- the ordered drug is administered until a
discontinuation order is written or until a specified termination
date is reached
-Standing order- outlines a specific condition in which a drug is to be
administered
-PRN order- order written by the physician for a drug to be given
when a patient needs it
Stat order- a single dose that is administered immediately
-Standard medical abbreviations- on page 74 are some common used
abbreviations
-Drug packaging
-Single or unit dose- each dose of medication is individually wrapped
or bottled
-Multiple dose- more than one dose wrapped or bottled
Storage of drugs
-Medicine room
-There is a special locked cabinet for the controlled substances
-The medication room contains a sink, a refrigerator, and
storage cabinets
-Medicine cart
-Computer-controlled dispensing system
-Medicine tray
-Keeping track of medication orders
-Kardex- card-filing system that serves as a quick reference to the
needs of a patient
-Medicine cards- small cards used for setting up medications when a
unit-dose system is not used
-Medication administration record- convenient way to document all
the drugs administered to a patient every day
-Self-terminating orders- a drug is to be given only until a certain date
or time, a special note is made on the kardex, medicine card, or
medication record
-Controlled substances- these medications must be counted and
measured at the beginning of each shift, they must sign a
special form documenting how much of the specific drug is
present. This form also must contain all patients that have
received that drug, to keep track of its administration
-Setting up medications
-Clear your mind of everything except getting the medication set up
properly
-Before handling any medications, think about cleanliness
-Setting up is the time when you need to decide whether you must
calculate a dose
-When you pour liquid medication from a bottle, pour it from the side
away from the label
-If preparing a unit-dose tablet, place the packaged tablet directly into
the medicine cup
-If preparing a dose from a bottle, pour the required number of tablets
into the bottle cap and transfer them to a medicine cup
-Decide whether the medication is to be mixed with a liquid or food
-The five rights: rules for giving medications
-Right drug
-Right dose
-Right Patient
-Right route
-Right time
-Charting medications
-Patient chart- a permanent record of care received
-Charting- keeping records of all patient care on appropriate forms
-Medication record
-Name of the drug
-Strength and/or amount of the drug
-Times at which the drug is given
-Route by which the drug is given
-Initials and signature of the health worker who administered
the drug
-Nurses’ Notes or progress notes- form for charting observations, stat
and PRN medications, and special treatments given
-The following information must be charted each time a stat or
PRN medication is administered
-Name of the drug
-Strength and/or amount of the drug administered
-Route
-Time of administration
-Results of checking vitals signs, if required for specific
drugs
-Any special information regarding the drug or the
patient
-Signature and title of the person who administers the
drug
-The POMR- problem-oriented medical record
-Ways to organize information for charting
-SOAP
-Subjective data
-Objective data
-Assessment
-Plan
-PIE
-Problem
-Interventions
-Evaluation