Transcript Drug Administration

PowerPoint® to accompany
Medical Assisting
Chapter 51
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
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Drug Administration
Objectives:
51-1 Discuss your responsibilities regarding drug
administration.
51-2 Perform dosage calculations accurately.
51-3 Describe how to assess the patient before
administering any drug.
51-4 Identify the “seven rights” of drug administration.
51-5 Describe the various techniques of drug
administration you may be asked to perform.
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Drug Administration
Objectives (cont.)
51-6 Compare different types of needles and syringes.
51-7 Explain how to administer an intradermal,
subcutaneous, or intramuscular injection.
51-8 Explain what information you need to teach the
patient about drug use, interactions, and adverse
effects.
51-9 Describe special considerations related to drug
administration.
51-10 Describe nonpharmacologic ways to manage pain.
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Introduction
Drug administration is one
of the most important
and most dangerous
duties.
A patient’s condition can
worsen or the patient
could die when meds
are given incorrectly.
To administer drugs safely
and effectively, you must
know and understand
principles of
pharmacology.
You should be familiar with the medications frequently
prescribed in your practice.
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Pharmacology Principles





Route of medication
administration
Dosage calculations
Techniques involved
with giving injections
Seven Rights of Drug
Administration
Patient education
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Drug Administration and Scope
of Practice


States have medical
practice acts that define
medical assistants’
exact duties
An act may specify
which drugs you are
allowed to give.

You need to research
the scope of practice
for medical assistants
in the state where you
will work.
You are responsible for knowing what you can and
cannot do when giving medications.
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Dosage Calculations

Measurement Systems:




Metric
Apothecaries
Household
Most doctors use metric
system
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Basic Calculations – Formula Method
Desired dose X quantity of dose on hand
Dose on hand
The physician orders aspirin, 10 grains.
On hand are 5 grain aspirins
10 grains X 1 tablet = 10/5 or 2 tablets
5 grains
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Basic Calculations
Work these problems:
 The physician has ordered ampicillin 1000
mg, on hand 500 mg tablets.
2 tablets
You have 500 mg scored tablets
of a drug on hand and the doctor
tells you to give 250 mg. How
much would you give?
½ tablet
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Basic Calculations –Ratio Method
Doctor orders 500 mg of ampicillin. You have 250
mg on hand.
Set up a ratio with the unknown number of tablets
and the amount of drug ordered X:500 mg
Set up a ratio with a single tablet and the amount of
drug in single tablet 1 tab:250 mg
Create a proportion and multiply the outer and then the
inner parts and solve for X. X:500 mg :: 1 tab:250 mg
Answer = 2 tablets
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Basic Calculations Fraction Method
The doctor orders 30 mg
of Adalat. Each
capsule contains 10
mg.
Set up the first fraction
with the dose ordered
and the unknown
number of capsules
30 mg
x
Set the second fraction
with the amount of
drug in a capsule
10 mg
1 cap
Then use both fractions
in a proportion:
30 mg
10 mg
x
= 1 cap
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Solve for X = 3 capsules
Preparing to Administer a Drug
Drug may be given:
 Local – applied directly
to skin, tissue, or
mucous membranes
 Systemic – routes that
allow the drug to be
absorbed or distributed
into the bloodstream


Pay close attention to
the dose, route, and
form of the medication.
To administer
medications you
require close attention
to detail, strong patient
assessment skills, and
expert technique.
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Apply Your Knowledge
Which measuring system is used the
most in pharmacology?
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Apply Your Knowledge -Answer
Which measuring system is used the
most in pharmacology?
Most doctors use the metric system when
utilizing pharmacology principles.
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Apply Your Knowledge #2
Convert 25 grams to milligrams.
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Apply Your Knowledge #2 - Answer
Convert 25 grams to milligrams.
Answer:
1. Add a decimal point to the measurement: 25. g
2. Add 3 zeroes so you can move the decimal point three
places to the right: 25.000 g
3. Move the decimal point to the right three places:
25,000
4. Change the unit: 25,000 mg
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Apply Your Knowledge #3
Calculate the dose to give for 500 mg
Augmentin®.
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Apply Your Knowledge #3 - Answer
Calculate the dose to give for 500 mg
Augmentin®.
Answer:
20 mL
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Assessment of Patient
As you interview the patient,
you must be alert to any
changes in the patient’s
condition that could affect
drug therapy.
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General Rules





Give only the drugs
the doctor orders.
If you are unfamiliar
with any aspect of
the order, consult a
drug reference book.
Wash your hands.
Prepare in a well-lit
area.
Focus on the task at
hand.



Calculate the dose
carefully.
Avoid leaving a
prepared drug
unattended.
Never give a drug
that someone else has
prepared.
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General Rules



Ask the patient to
state his name to
ensure correct
identification
Ask the patient if
they have an
allergies
Be sure the physician
is in the office when
you give the drug.



If the patient refuses
to take the drug,
flush it down the
toilet.
Do not return it to
the original
container.
If you make an error,
tell the doctor at
once.
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“Seven Rights”
1.
2.
3.
4.
5.
6.
7.
Right patient
Right drug
Right dose
Right time
Right route
Right technique
Right documentation
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Techniques of Administering
Drugs



Oral – tablets, capsules, lozenges, and
liquids
Buccal or sublingual – placed under the
tongue or between the cheek and gum
Parenteral – administration of substance
into a muscle, vein, or GI tract




Intradermal (ID)
Subcutaneous (SC)
Intramuscular (IM)
Intravenous (IV)
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Needles and Syringes

Needles



Available in different gauges –
smaller the number the larger the
gauge
Length – long enough to penetrate
the appropriate layers of tissue
Syringes



Barrel
Plunger
Sizes 3 mL, 1 mL (tuberculin or
insulin)
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Parenteral Drugs Packaging



Ampule – glass or plastic container that is
sealed and sterile (open with care)
Cartridge – small barrel prefilled with sterile
drug
Vial – small bottle with rubber diaphragm that
can be punctured by needle.
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Other Drug Administration





Inhalation -administered through the mouth or
nose.
Topical – applied direct application of a drug on
the skin.
Transdermal – use of a medication patch that will
release medication slowly and evenly
Urethral – instill liquid drugs directly into the
bladder.
Vaginal and rectal
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Educating the Patient


Reading the drug package label
Interactions




Drug – drug interactions
Drug – food interaction
Adverse effects
Effects of medication – take the drug at the
right time, in the right amount, and under the
right circumstances.
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Special Considerations


Pediatric patients – physiology and immature
body systems may make the drug effects less
predictable
Plan to observe a pediatric patients closely for
adverse effects and interactions.
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Pregnant Patients



Remember that you are
caring for two patients at
once
When you give the mother
a drug, you are also giving
it to the baby
Some drugs can cause
physical defects in the
fetus if taken in the first
three months of pregnancy
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Patients Who Are Breast
Feeding



Some drugs are excreted
in breast milk
Ingestion can be
dangerous because baby
can’t metabolize or
excrete drugs
Check drug reference
work to see if
contraindicated during
lactation
30
Elderly Patients
Age related changes in
the body
May have increased risk of:
 Drug toxicity
 Adverse effects
 Lack of therapeutic
effects
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Patients From Different
Cultures


Can affect a patient’s understanding of drug
therapy and compliance with it
Obtain drug information sheets in the
languages that are commonly spoken by
patients in your office
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Nonpharmacologic
Pain Management



Biofeedback –
equipment measures
physical indicator of
stress and relaxation
Guided imageryenvisioning calm,
nurturing place
Relaxation exercises
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Apply Your Knowledge
The physician orders you to give an IM
medication to a 2-year-old child.
What site will you use?
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Apply Your Knowledge -Answer
The physician orders you to give an IM
medication to a 2-year-old child.
What site will you use?
The vastus lateralis or the ventrogluteal.
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Summary
Medical Assistant
You must be prepared to administer drugs safely
and effectively.
You must follow the “Seven Rights of Medication
Administration”.
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End of Chapter
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