Medications and Their Administration

1. Medications and Their Administration Chapter 7

2. Medical Nomenclature Generic name: identifies the chemical family Trade name: given to a drug by a manufacturer PDR: physician’s desk reference; reference book that lists drugs alphabetically, by trade name and according to their uses

3. Medication Properties Pharmacokinetics: how drugs enter the body, are absorbed, reach their site of action and are metabolized; physiologic action of medication Absorption: process by which a drug enters the systemic circulation in order to provide a desired effect Distribution: means by which a drug travels from site of absorption to site of action Excretion: elimination of drugs from the body after they have been metabolized Toxicity: effect that can occur when there is impaired kidney function, dehydration or insufficient fluid intake; drugs are retained in the body and can build up; common in elderly Drug that treats toxic effects is an antidote. Pharmacodynamics: study of the effects of drugs on normal physiological functions of the body;

4. Medication Effects Idiosyncratic reaction: patient underreacts or overreacts to a drug or has an unusual reaction. Allergic reaction: occurs when a patient has been sensitized to the initial dose and develops an allergic response to the allergen and related drugs Synergistic effect: when certain drugs are taken together and produce effects far beyond the desired outcome

5. Common Medications Medications for allergic reactions: diphenhydramine (Benadryl), epinephrine (Adrenalin), methylprednisone (Solu-medrol) Solu-medrol minimizes the possibility of respiratory arrest by reducing swelling of the bronchial tree Antimicrobials: alcohol and betadine, antibiotics Anticonvulsants: prescribed for patients with chronic seizure disorders (diazepam- valium; this will be found on the crash cart) Antiarrhythmics: used to treat chronic cardiac arrythmias (lidocaine) Analgesics: pain relievers with no loss of consicousness (demerol and morphine) CNS depression Controlled substance: drugs with high potential for abuse Sedatives and tranquilizers: sleep inducing; anxiety reduction; valium and versed are common sedatives in the radiology department; can also cause respiratory depression

6. More Meds Antagonist: drug that counteracts the effects of sedatives and analgesics (Flumazenil and Narcan) Local Anesthetic: lidocaine (xyolocaine) constricts the blood vessels in a localized area Succinylcholine chloride: given as a skeletal muscular relaxant for purposes like the insertion of ET tubes; all muscles are temporarily paralyzed. Used on patients who are combative from fear, shock, intoxication. Anticholinergenics: drugs given to suppress secretions before and during surgery

7. The 5 Rights of Medication Administration Right dose Right medication Right patient Right time Right route Read all labels 3 times before administration; check the expiration date.

8. Routes of Administration Enteral route: oral, sublingual, rectal, oral and NG tube (example of sublingual is nitroglycerin under the tongue for angina pectoris) Parenteral: medications are injected directly into the body; intradermal, subcutaneous, intramuscular, intravenously (most rapid effect from administration)

9. Injection Buzz Words Ampule Vial Butterfly set Iv catheters Intermittent injection port (heparin or saline lock) Extravasation or infiltration Hydrostatic pressure Infusion

10. IV Starting Facts After injecting meds into a port, it needs to be flushed with saline or heparin Some common sites for IV placement include: median cubital vein and the basilic The proper height for IV bag or bottle is 18-20 inches above the vein Once a needle is removed from the vein, hold pressure or a hematoma may result If extravasation occurs, remove the needle and apply cold compress