Transcript Injectable Meds_Instructor_F15 (2)

Injectable Medications
Subcutaneous – Intramuscular - Intradermal
Why Give Injectable Meds??
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Patient cannot swallow
Decreased LOC
Drug inactivated by gastric juices
Desire to increase drug
effectiveness
Injectable Medications
• Parenteral drugs must be prepared,
packaged, administered in ways to
maintain sterility
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Vials, ampules
pre-filled syringes
Powder form
Check dates for possible expiration
Assess fluid for clarity & color
• Wear gloves to administer
• Engage safety device or needle guard
after use
• Never re-cap
a used needle!
Ampule, Vial & Pre-filled Syringe
Parts of a Needle & Syringe
Injectable Medications
• Vials
– Glass or plastic with needle-accessible
rubber stopper
• Ready solution or powder for reconstitution
– Single use vial
• No preservative, discard after one use
– Multiple dose vial
• May contain a preservative, used for
several doses IF asepsis maintained
• Must be labeled with date/time opened &
initials of person opening
• If drug expires, this date & time must be
labeled also
Injectable Medications
• Ampules (Ampoules)
– Sealed glass containers
– Tops must be broken to allow insertion
of needle and withdrawal of the
medication
• Safety!!!!!!!!
– Use filter needle to prevent glass in
solution
– Discard unused portion
– Discard broken ampule in sharps
container
Injectable Meds
• Pre-filled syringes
– Single dose / single use
– Most have needle attached
– Several forms of these
• Some called “Tubexes”
• May require adapter to administer
Syringes
• The larger the gauge number, the
smaller the diameter of the lumen
• The smaller the gauge number, the
larger the diameter of the lumen
– Intradermal (ie: TB skin test)
• Needle gauge 25- 28
• Needle length ½ - 5/8”
– Subcutaneous (ie: Insulin, heparin)
• Needle gauge 26-30
• Needle length 3/8, - ½”
– Intramuscular (IM)
• Needle gauge 18, 20, 21, 22, 23, 25
• Needle length 1, 1 ½, 2”
Subcutaneous Drugs
• Use appropriate type of syringe
– Insulin or Tuberculin
• Small gauge, shorter needle
– Never more than 1 mL at a site
– Use angle of needle that insures
infusion into SC and not muscle
– Do NOT aspirate
• Choose subcutaneous sites
– Rotate sites, avoid overuse and tissue
damage
***Insulin is ONLY drawn up in Insulin
syringes***
Injectable Medication Sites
SubQ Injection Sites
Intramuscular Medications
• Use appropriate sized syringe
• Use appropriate needle size
– Consider depth of site & type of solution
– Choose appropriate muscular site
• Ventrogluteal, deltoid & vastus lateralis
• Select by identifying anatomic landmarks
• Avoid use of same site repeatedly
• IM Adult: Z-Track method
Ventrogluteal
Deltoid
Vastus Lateralis
Z-TRACK INJECTION
Indications: Adult IM injections
Technique: Move skin to one
side, administer medication &
withdraw needle. Once needle
is withdrawn, displaced tissue is
allowed to return to its normal
position, preventing the solution
from escaping from the muscle
tissue
Ventrogluteal Site
Deltoid Site
Vastus Lateralis Site
Dorsogluteal Site
• Not a recommended site.
Intradermal Drugs
• Used for administration of diagnostic
agents
– Preferred site: inner aspect of forearm
• Hairless, thinly keratinized
• Upper chest or back also used
– 1 mL tuberculin syringe, 26 gauge needle
– Position needle with bevel up
– Insert through epidermis so point of
needle is almost visible under skin;
advance needle 1/8 inch under skin
– Inject (0.1 mL) until wheal appears;
withdraw needle
Technique: Remember, bevel
up, 5-10 degree angle,
advance ~ 1/8 inch, create a
wheal (bleb) & mark location
Intradermal
Sites
Reconstitution of Medication
• Used when meds would lose
potency as a liquid
• Drug label will identify diluent
needed
– Diluents commonly used are sterile
water, or sterile NS for injections
– If not found, call pharmacy for
direction!!
• Displacement Factor (possible)
– The powder and solution add volume
to the solution and  total volume of
the mixture (i.e. Directions: add 5.6mL
of sterile water, total volume of
solution is 6mL after reconstitution).
Reconstituting (Cont)
• Note the length of time the
medication is good for once it’s
reconstituted
• Directions for storing once mixed
• Date, time and initial the vial
– The medication will only be able to be
used for a specified time
– Make sure to put the expiration date
and time on the label also!
Lets practice!
1. How much
diluent do you
add?
2. What is the
meds final
concentration?
___mg/___mL
3. Order: Ceclor
500mg p.o. q12hr
How much will
you give?
More Practice!
1. How much
diluent do you
add?
2. What is the
meds final
concentration?
___mg/___mL
3. Order: Kefzol
300 mg IV bid
How much will
you give?
Last Practice!
Order Tazicef 300mg IM q 12 hr 1. How much
diluent do you add?
2. What is the final concentration for the IM
reconstituted medication? ___mg/___mL
3. How much will you give?