Transcript wise_7e_powerpoint_chp_53

Chapter 53
Administering Oral and
Non-Injectable Medications
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Routes of Medication
• Drugs may be administered by many different
routes
• Providers select the route based on:
– Rate of absorption desired
– Distribution
– Biotransformation
– Elimination
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Routes of Administration
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Oral
Buccal
Sublingual
Drops
Inhalation
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Routes of Administration
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Intradermal
Intramuscular
Intranasal
Intraosseous
Intrathecal
Intravenous
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Routes of Administration
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Ophthalmic
Otic
Rectal
Subcutaneous
Topical
Transdermal
Vaginal
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Prescriptions
• A written order prepared by a licensed
provider authorizing a medication or
treatment to be dispensed to the patient for
self-administration
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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
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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
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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
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Medication Orders
• Medication orders are direct and complete
instructions from the provider for
administering medication to a patient while in
the office
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Elements of a Medication Order
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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
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Seven Rights of
Medication Administration
1.
2.
3.
4.
5.
6.
7.
Patient
Medication
Dose
Route
Technique
Time
Documentation
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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”
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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
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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
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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
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Medication Documentation
• Who, what, where, when, why
• Immunization documentation
– Manufacturer
– Lot number
– Serial number
– Container’s expiration date
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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
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Error-Prone Abbreviations
• Joint Commission’s DO NOT USE list
• Institute of Safe Medication Practice’s list of
error-prone abbreviations
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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
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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)
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Oral Medications
• Oral medications come in a variety of forms:
pills, tablets, capsules, caplets, lozenges,
syrups, sprays, and other liquids
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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
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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
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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
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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
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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
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Topical
• Medications in the form of sprays, lotions, creams,
ointments, paints, salves, wet dressings, and
transdermal patches
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Topical
• Used in treating diseases or disorders of the
skin or mucous membranes
• Must be applied as prescribed to achieve the
desired effect
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Rectal
• Most common medication forms are suppositories
and enemas
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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
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