NBS II Lecture' material

--->Drugs Administration
Part I, September 7th & 8th 2009
By Diah Nita


Why should we concern to this.,??
Medications errors have been said to cause 150 deaths per day and 1,3 million injuries per year.

Giving the right medication toward better nursing care.

Drug’s Name and Label
Chemical name
Generic name (non proprietary)‏
Official name
Trade name (brand name)‏

Drug Classification
Body system
Therapeutic use
Mode or side of action
Molecular structure

Drug Administration Route
Oral (P.O)‏
Intravenous (I.V)‏
Intramuscular (I.M)‏
Subcutaneous (S.C)‏
Topical
Ophthalmic
Rectal (P.R)‏


Drug Administration Route
Buccal
Inhalation
Nasogastric (NG)‏
Otic
Vaginal
Sub lingual (S.L)‏

Drug Reactions
Adverse drug reactions:
Undesirable drug effects
Common/ infrequently
Mild, severe, life-threatening
Occur after first, several, or many doses

Allergic Drug Reactions
Hypersensitivity reaction.
Drug viewed as foreign substances/antigen.
Allergic symptoms.
Anaphylactic shock.
Angioedema (angioneuritic edema).


Drug Idiosyncrasy
Unusual/ abnormal reaction to a drug.
Different response from normally expected.
Over response to a drug.
Genetic deficiency

Drug Tolerance
A decreased response to a drug.
Requiring an increase in dosage to achieve the desired effect.
Takes certain drugs for a long time.
Individual users increases the dose them self.

Cumulative Drug Effects
May seen in those with liver/ kidney disease
Unable to excrete & metabolize drug
Can lead to toxicity
Sometime health provider lowers the dose.

Toxic Reactions
Administered in a large dose
Blood levels exceed the therapeutic level
Reversible/ irreversible
Aware of the signs and symptoms of toxicity of commonly prescribed drugs.


Drug Interactions
Drug-drug reaction :
Additive drug reaction
Synergistic drug reaction
Antagonist drug reaction


Drug Interactions
Drug-food interaction:
Food ---> rate + amount of drug absorbed
Tyramine + MAOI = hypertensive
Grapefruit inhibit certain drug + toxic blood levels.

Factors Influencing Drug response
Age
Weight
Gender
Disease
Route of administration

Nursing Implications
Consult appropriate references/ hospital pharmacist
Observe patients for adverse drug reactions, drug idiosyncrasy, drug tolerance.
Record all observations in the patient's record.

Literatures
Clinical Pharmacology 9th Edition by P.N Bennett (page 83-86).
Crash Course: Pharmacology by Donald Barnes (page 17-18).
Farmakologi untuk keperawatan by Jan Tambayong (page 1-9).
Fundamental of Nursing: the Art & Science of Nursing Care by Carol Taylor (page 714-772).
Introductory – Clinical Pharmacology 6th Edition by Sallys Roach (page 4-52).
Nurse’s Drug Guide by Samantha Venable (page 14-32).
Nursing Pharmacology Made Incredibly Easy.! (page 1-22)‏
Nursing Procedures Made Incredibly Easy.! (page 177-225).
Pharmacology: A Nursing Process Approach 5th edition by Joyce Lefever Kee (page 14-42).