© 2009 the mcgraw-hill companies, inc. all rights reserved drug administration powerpoint®...

© 2009 The McGraw-Hill Companies, Inc. All rights reserved

Drug AdministrationDrug AdministrationPowerPoint® presentation to accompany:

Medical AssistingThird Edition

Booth, Whicker, Wyman, Pugh, Thompson


51-2

Learning Outcomes

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.


51-3

Learning Outcomes (cont.)

51.5 Describe the various techniques of drug administration.

51.6 Compare different types of needles and syringes.

51.7 Explain how to administer an intradermal, subcutaneous, or intramuscular injection.


51-4

Learning Outcomes (cont.)

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.


51-5

Introduction Drug administration is

very important and can be a dangerous duty

Given correctly – restore patient to health

Given incorrectly – patient’s condition can worsen

Medical assistant must Understand principles of

pharmacology Understand fundamentals of

drug administration Routes Dosage calculations Techniques for injection Seven rights Patient education

You should be familiar with the medications frequently prescribed in your practice.


51-6

Drug Administration and Scope of Practice States’ medical

practice acts define medical assistants’ exact duties

Know your scope of practice in the state where you will work


51-7

Dosage Calculations Measurement systems

Metric Apothecaries Household

Most doctors use the metric system


51-8

Dosage Calculations (cont.)

Basic units of volume and weight Metric system

Liter (L) – volume Grams (g) – weight

Apothecaries’ system Fluidounces, fluidram, pints, quarts – volume Pounds – weight

Household system Drops, teaspoons,

tablespoons, ounces, cups, pints, gallons, quarts – volume


51-9

Dosage Calculations (cont.)

Conversions between systems Approximate equivalents

Charts

Calculations Ratio method Fraction method


51-10

Dosage Calculations: Formula Method

Desired doseDose on hand

The physician orders aspirin, 10 grains

On hand are 5-grain aspirins

10 grains 5 grains

× Quantity of dose on hand

× 1 tablet = 10/5 or 2 tablets


51-11

Work these problems:1. The physician has ordered ampicillin 500

mg, on hand 250 mg capsules. How much would you give?

2. You have 50 mg metropolol as a scored tablet on hand and the doctor tells you to give 25 mg. How much would you give?

2 capsules

½ tablet

Dosage Calculations: Formula Method (cont.)


51-12

1. Doctor orders 500 mg of ampicillin. You have 250 mg on hand.

2. Set up a ratio with the unknown number of capsules needed and the amount of drug ordered X:500 mg

3. Set up a ratio with a single capsules and the amount of drug in a single capsule 1 tab:250 mg

4. Create a proportion, multiply the outer and then the inner parts, and solve for X.

X:500 mg :: 1cap:250 mg

Answer = 2 capsules

Dosage Calculations: Ratio Method


51-13

3. Set the second fraction with the amount of drug in a capsule

10 mg 1 cap

4. Then use both fractions in a proportion:30 mg 10 mg

x = 1 cap

1. The doctor orders 30 mg of Adalat. Each capsule contains 10 mg.

2. Set up the first fraction with the dose ordered and the unknown number of capsules

30 mgx

Solve for X = 3 capsules

Dosage Calculations: Fraction Method


51-14

Metabolism and absorption altered

Require precise calculations BSA – body surface area Weight

Dosage Calculations: Pediatric and Geriatric


51-15

Apply Your Knowledge1. Which measuring system is used by most physicians?

ANSWER: Most doctors use the metric system when working with pharmacology principles.

2. Convert 25 grams to milligrams.ANSWER:1. Add a decimal point to the measurement: 25. g2. Add 3 zeros so you can move the decimal point three

places to the right: 25.000 g3. Move the decimal point to the right three places: 25,0004. Change the unit: 25,000 mg


51-16

Apply Your Knowledge3. Calculate the dose to give

for 500 mg Augmentin®.ANSWER:

20 mL


51-17

Preparing to Administer a Drug Drugs

Local effect – applied directly to skin, tissue, or mucous membranes

Systemic effect – given by routes that allow the drug to be absorbed or distributed into the bloodstream

Pay close attention Dose Route Form of medication

Medical assistant Close attention to detail Strong patient

assessment skills Expert technique


51-18

Preparing to Administer a Drug (cont.)

Assessment Injection site

Drug allergies

Patient condition – be alert to changes that can affect drug therapy

Consent forms


51-19

Rules for administration Give only drugs the doctor orders – use drug reference, if

necessary

Wash your hands Prepare in a well-lit area Focus on task; avoid distractions

Calculate the dose carefully

Do not leave a prepared drug unattended – never give a drug that someone else has prepared



51-20

Rules for administration Identify patient properly

Physician should be in the office

Observe patient following administration

Discard any ungiven medications properly

Report error to physician immediately

Document properly



51-21

Seven Rights of Drug Administration

1. Right patient

2. Right drug

3. Right dose

4. Right time

5. Right route

6. Right technique

7. Right documentation



51-22

Apply Your Knowledge

How do you properly identify the patient before administering a drug?

ANSWER: To ensure that you have the right patient, you should check the name and date of birth on the patient record and ask the patient to state his/her name and date of birth.


51-23

Techniques for Administering Drugs Oral

Tablets, capsules, lozenges, and liquids

Slower absorption through GI tract

Buccal or sublingual Buccal – placed between the cheek and

gum Sublingual – placed under the tongue Faster absorption; bypasses GI tract


51-24

Parenteral Administration of substance into a muscle or vein Fast absorption; bypasses GI tract Safety risks

Rapid administration; rapid action Exposure to bloodborne pathogens

Methods of injection Intradermal (ID) Subcutaneous (SC) Intramuscular (IM) Intravenous (IV)

Techniques for Administering Drugs (cont.)


51-25

Needles Available in different gauges – the

smaller the number, the larger the gauge (inside diameter)

Length – long enough to penetrate the appropriate layers of tissue

Syringes Barrel Plunger With or without needle Calibrated in milliliters or units



51-26

Parenteral drug 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



51-27

Methods of injection Intradermal

Into upper layer of skin Used for skin tests

Subcutaneous Provides slow,

sustained release and longer duration of action

Rotate sites

Intramuscular More rapid absorption Less irritation of tissue Larger amount of drug Z-track method

Intravenous Not usually given by

medical assistants



51-28

Inhalation – administered through the mouth or nose Topical

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 Eye or ear – creams, ointments, drops, or irrigations



51-29

Apply Your KnowledgeMatching:

___ Absorption through GI tract A. Topical drug

___ Under the tongue B. Oral drug

___ Small bottle with rubber diaphragm C. Intramuscular drug

___ Less irritation of tissue D. Subcutaneous drug

___ Direct application to skin E. Sublingual drug

___ Need to rotate sites F. Vial

ANSWER:

F

E

D

C

B

A


51-30

Educating the Patient About Drug Administration How to read the prescription drug label

Interactions Drug-drug interactions Drug-food interactions


51-31

Adverse effects Report changes Recognize significant

adverse effects

Instructions on taking the drug At the right time In the right amount Under the right

circumstances

Educating the Patient About Drug Administration (cont.)


51-32


What should you instruct the patient about regarding drug administration?

ANSWER: The patient should be taught how to read the prescription label, drug-drug and drug-food interactions, adverse effects, and how to take the drug correctly.

Bravo!


51-33

Special Considerations Pediatric patients

Physiology and immature body systems may make the drug effects less predictable

Require dosage adjustments and careful measurements of doses

Observe pediatric patients closely for adverse effects and interactions

Administration sites and techniques may differ


51-34

Pregnant patients Remember that you are caring

for two patients

Giving the mother a drug also gives it to the baby

Check drug information sources for pregnancy drug risk categories

Special Considerations (cont.)


51-35

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 information sources for contraindication during lactation



51-36

Elderly patients Age-related changes

affect Absorption Metabolism Distribution Excretion

May have increased risk of Drug toxicity Adverse effects Lack of therapeutic effects



51-37

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



51-38


What do children and the elderly have in common in relation to drug administration?

ANSWER: Both have alterations in metabolism and absorption of drugs requiring adjustments in dosages.

Fantastic!


51-39

Charting Medications Progress notes

Administration Special problems

New symptoms Patient’s statements Patient tolerance

Be sure to have the right chart Be specific and accurate


51-40

Nonpharmacologic PainManagement Biofeedback – evokes relaxation;

helps block pain perception

Guided imagery – patient envisions being in a calm, nurturing place; promotes relaxation

Relaxation exercises – breathing techniques


51-41

Apply Your Knowledge1. You administer a medication to Mr. Max. What and where

should you chart?

ANSWER: You should chart in the progress notes the date, time, dosage, route, and name of the medication, as well as how well the patient tolerated it.

2. True or false:

___ Biofeedback involves special breathing techniques .

___ Audiotapes can be used with guided imagery.

___ Relaxation exercises are used to relax different muscle groups.

F

T

T

helps block pain perceptionANSWER:

I

M

P

R

E

S

S

I

V

E

!


51-42

In Summary Medical assistant

Administer drugs safely and effectively Conversions and calculations Patient assessment Observe general rules Follow seven rights of drug administration

Be aware of patients needing special considerations

Be aware of nonpharmacologic methods for managing pain control


51-43

End of Chapter

Words are the most powerful drug used by mankind.

~Rudyard Kipling

© 2009 the mcgraw-hill companies, inc. all rights reserved drug administration powerpoint®...

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