Oral medication

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-Presented By Ms. Meena
( Assistant Professor)
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ORAL MEDICATION
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INTRODUCTION

• The safe and accurate administration of medicine
  is the nurses most important and prime
  responsibility.
• Drugs are primary means of therapy for the
  clients with health problems.

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Medicine

• A substance that is used in treating disease or
  relieving pain and that is usually in the form of
  a pill or a liquid.

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Classification of drugs a/c to their action

• Analgesics
• Anaesthetics
• Antipyretics
• Anti inflammatory
• Antibiotics
• Anti -pruritics

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• Aseptic
• Antifungal
• Anti-diarrhoeal
• Anti-emetics
• Anti-tubercular
• Coagulants
• Diuretics

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Common forms of drug preparation

• Aqueous solution
• Aqueous suspension
• Capsule
• Lotion
• Mucilages

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• Ointment
• Paste
• Powder
• Syrup
• Tablet
• water

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Form Of Medication
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Types of order

• Standing order
• PRN orders
• One time order or single order (OD)
• Stat order(STAT)
• Telephone verbal fax order

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Dosage

• A drug is the amount of drug administered at one
  time
• Minimum dose
• Maximum dose
• Lethal dose

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• The minimum dose is the smallest quantity of drug
  that will produce an effect in body.
• The maximum dose is the largest quantity that can
  be administer at once time without producing harm
  to the body.

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• Lethal dose is larger than the maximum dose which
  will have poisonous effect on the client(death of
  the patient)

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Factors which modify Dosage of drugs

• Age
• Weight
• Sex
• Physical condition
• Tolerance
• Route of administration
• Addiction

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Routes of administration THROUGH MOUTH

• Oral medication
• Sublingual administration
• Buccal administration

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Oral administration
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sublingual
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Oral medication

• Administration of medicine through mouth for
  prophylactic and therapeutic effect.

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Purpose

• To promote health.
• To prevent illness.
• To help in diagnosis.
• To alleviate illness.
• Therapeutic purpose.

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Indication

• Who is not having any swallowing problems.
• Conscious person
• Who is not undergone for any oral surgery

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Contra-indication

• Alteration in normal function of GI tract like
  vomiting.
• Reduced GI motility.
• Surgical resection of a portion of GI tract.
• Inability to swallow

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• Patient with gastric suction/aspiration
• Prior to certain tests/surgery
• Unconscious/confused patients
• Patient with gag reflex

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• Oral cancer
• Before diagnostic tests operation

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Principles

• Right patient
• Right medication
• Right dose
• Right time
• Right route

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• Right education
• Right documentation
• Right to refuse
• Right to assessment
• Right to evaluation

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• Therapeutic effectiveness
• To ensure in the safety in the administration of
  medicine.

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General instruction

• Before administration
• Identification of patient
• Check label of container
• Shake well before use
• Check for any change in colour

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After administration

• Record only medicine which have administered.
• Record date, time, name dose
• Never record medicine before it is given

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Articles

• Articles

• Rationale

• A tray containing a towel
• A medicine glass( ounce glass, teaspoon, dropper)

• To protect patients clothing
• To measure medicine

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• Articles

• Rationale

• A glass of drinking water or water in a feeding
  cup
• A gauze piece

• To swallow the medicine
• To wipe outside of bottle

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• Articles

• Rationale

• Mortar pestle
• A kidney tray paper bag
• A medicine card

• To crush or powder the tablets if necessary
• To discard waste
• To write the medication prescribed for the
  patient

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• Articles

• Rationale

• Scissors
• Medication tray
• Bowl

• Cutting strips
• To keep all articles
• To keep medicine

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procedure

• Steps

• Rationale

• Wash hands with soap and water.
• Read physicians prescription and enter it in the
  medicine card.

• To prevent cross infection
• For giving a correct dose to the patient at right
  time, for convinient administration by staff
  students.

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• Steps

• Rationale

• Take out the medicine from the staff after
  reading the medicine card.
• Check the medicine from shelf after reading
  medicine card.

• To check the possibility of pouring a wrong
  medicine.
• To ensure the right and vailid medicine.

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• Steps

• Rationale

• Do not touch the medicine with hands.
• Pour the syrup from the side of bottle away from
  the label. Do not pour excess amount.

• To prevent contamination.
• Prevent spoiling of the label.

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• Steps

• Articles

• Place the card with medicine on tray.

• To prevent mistakes in giving drugs.

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• Steps

• Rationale

• Identify the patient
• Give proper position(sitting)
• Administer medicine

• To prevent error which may occur.
• For easy administration and absorption.

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• Steps

• Rationale

• Stay with patient until he has swallowed
  medicine.
• Provide water for drinking after medicine.

• Ensure that he has taken medicine.
• Helps in swallowing the solids medicine.

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Drug calculation formulas

• Amount to administer
• desired dose(D)/dose on hand(H)quantity(Q)

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Clarks rule

• Child dose
• Adult dose(weight/150)

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Youngs rule

• Child dose
• Adult doseAge/(Age12)

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Drug excretion

• It is the process of removing the drug or its
  metabolites from the body.
• Kidney plays a major role in excretion of drug
  metabolite .
• Lungs intestine also helps in the drug
  excretion.
• Damage to the kidney can adversly affect the
  excretion of drug.

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Special consideration

• Administration of medicine which can not irritate
  the stomach mucosa with light snacks.
• Administration of medicine with a light snacks.
• Administration of medicine with water
• Do not administer water after giving cough syrup
  follow 10 rights.

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Side effects

• Allergic reaction
• Skin rash
• Pruritis
• Rhinitis
• Urinary system
• Renal damage
• Anuria (lt100 ml)
• Oliguria(gt500 ml)
• Haematuria

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• Cardio vascular system
• Hypotension
• Hypertension
• Nervous system
• Abnormal involuntary movements
• Tremors
• Dystonia
• Alteration in muscle tone

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• GI System
• Irritation of gastric mucosa
• Small bowel ulceration
• Constipation

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toxicity

• High levels of drugs in the blood stream produce
  toxic effects.
• Toxicity can affect and permanently damage to
  organs. (nephrotoxicity , neurotoxicity)

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Storing of medicine

1. To stock the medicines, each ward should be
   provided with a medicine cabinet.
2. The medicine cabinet should to kept in a separate
   room adjacent to the nurses room.

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• Hand washing facilities
• Separate compartments for different categories
• Alphabetically arrangement

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• No drugs should be stored without labels
• Check for medicine colour.
• Check expiry date of medicine.

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• Keep drugs in refrigerator.
• Cabinet must be clean always.
• Oily medicine should be kept in separate tray.

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• Hand washing facilities
• Separate compartments for different categories
• Alphabetically arrangement

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Nursing responsibilities

• Nurses are responsible for their own action
  regardless of a written order.
• All the nurses must know the minimum and maximum
  dose of every medicine that they administer.

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• The nurses are responsible for ensuring that they
  have knowledge to ensure the correct
  administration of drugs.
• Medication chart are legal documents.
• Follow 10 rights of drug administration

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• Nurse should check any drug allergy to the
  patient.
• Check the form of drug available
• Assist the patient in sitting position
• Stay with the patient until swallow medicine.

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Thank you