Pharmacology

1
Pharmacology

• Administration of Oral and Topical Medications

2
Objectives

• Identify the advantages/disadvantages of oral
  medications.
• Identify major characteristics of oral dose
  forms.
• Identify equipment for oral medication.
• Discuss interventions related to the preparation
  and administration of oral medications.

3
Objectives

• Discuss the uses of topical preparations to the
  skin.
• Discuss general guidelines for the preparation
  and application of topical medications to the
  skin, rectal installations, and respiratory
  inhalation medication.
• Discuss interventions for ophthalmic, otic, and
  nasal medication.

4
Definitions

• Capsules small, cylindrical gelatin containers
  that hold dry or liquid medicine.
• Time-Release capsules capsules containing
  granules of medication that dissolve at different
  rates.
• Lozenges flat disks containing medication in a
  flavored base.
• Tablets dried or powdered drugs compressed into
  small disks
• Scored tablets tablets with indentations
• Enteric coated tablets tablets with a special
  coating

5
Definitions

• Elixirs clear liquids made of drugs dissolved in
  alcohol or water.
• Suspensions liquid dose form containing
  insoluble drug particles
• Syrups medicinal agents in a concentrated sugar
  solution.
• Souffle cups small paper or plastic container
• Medicine dropper used to administer eye, ear or
  nose drops.
• Meniscus curved upper surface of a liquid in a
  container

6
Oral Medications

• Advantages
• Safest
• Most convenient
• Dose forms are readily available for most
  medications
• Much of the drug can be retrieved for reasonable
  length of time after administration

7
Disadvantages

• Slowest and least dependable rate of absorption.
• Cant be used if a client is vomiting, has
  gastric suctioning, is likely to aspirate, is
  unconscious or unable to swallow.
• May cause GI irritation

8
Dosage Forms

• Capsules
• Small, cylindrical gelatin containers that hold
  dry powder or liquid agents.
• Available in a variety of sizes.

9
Timed-Released Capsule

• Provide a gradual but continuous release of a
  drug because the granules within dissolve at
  different rates.
• Should not be crushed, chewed, or emptied!!!

10
Lozenges

• Flat disk containing a medicinal agent in a
  flavored base.

11
Tablets

• Dried powdered drugs that have been compressed
  into small disks.
• Some are scored. These can be divided.
• Some are enteric coateddo not crush.

12
Suspensions

• Liquid dose form that contains solid drug
  particles dispersed in a liquid base.
• MUST BE SHAKEN WELL BEFORE ADMINISTERING.
• Antibiotics are examples.

13
Syrups

• Medicinal agents are dissolved in a concentrated
  solution of sugar. Masks the bitter taste of the
  drug.

14
Equipment

• Unit dose packaging
• All information about the medication will be
  included on the package.

15
Souffle Cup

• May be plastic or paper
• Used to transport medication to the patient room.

16
Medicine Cup

• Plastic cup has scales for measuring liquid
  medications.
• Inaccurate for measuring amounts smaller than 5
  mL.
• For volumes less than 1 mL, a tuberculin syringe
  should be used.

17
Medicine Dropper

• Used to administer eye drops, ear drops, and some
  pediatric medications.
• Should not tip upside down once you have drawn up
  the medication.

18
Syringe

• Available in Different sizes.
• Can accurately measure the medicine.
• Can be used to give medication to children.

19
Administering Oral Medicines

• Remember the six rights of medication
  administration.
• Organize your supplies.
• Verify the clients ability to take the
  medication.
• Verify the order for accuracy.
• Obtain the appropriate medication.
• Prepare medication without contaminating the
  medication.

20
Administering Oral MedicationsTablets or Capsules

• Transfer pills without touching them.
• Keep narcotics and other medications that require
  assessments separate from the others.
• Break only scored tablets.
• Crush tablets if client has trouble swallowing
  and mix with a small amount of soft food. (Do not
  crush time release cap).

21
Liquid Medications

• Mix before pouring.
• Do not contaminate bottle cap.
• Hold bottle so label is next to your palm and
  pour away from label.
• Hold medicine cup at eye level and read the
  bottom of the meniscus.
• Use a syringe for small amounts.

22
More Principles for Administration of Oral
Medications

• Administer at the correct time.
• Explain what you are doing.
• Assist the client to a sitting position. If this
  is not possible, place in a side-lying position.
• Perform any required assessments.
• Give sufficient water to swallow - 1 glass.
• Give only one pill at a time.
• Stay with the client until all pills are taken.
• Document procedure.

23
Ophthalmic Medications

• Check the medication order and the medication
  (abbreviations ou, od, os).
• Prepare the client.
• Sitting position
• Some drops may sting
• Clean the eyelid and eyelashes if necessary.
• Sterile cotton balls
• Wipe from inner canthus to outer cantus
• Administer the eye medication.

24
Administering the Medication

• If ointment is used, discard the first bead.
• Have client to look up.
• Expose the lower conjunctival sac.
• Approach the eye from the side.
• Instill drops into the outer third of the lower
  conjunctival sac.

• Ointment squeeze 2 cm of ointment into the lower
  conjunctival sac from the inner canthus outward.
• Instruct to close eyelids but do not squeeze them
  shut.
• Liquid apply pressure on the nasolacrimal duct
  for 30 seconds (keeps med from escaping).

25
Otic Medications

• The position of the external auditory canal
  varies with age. In children under three years of
  age, it is directed upward. In the adult, the
  canal is S shaped.
• Check the medication order.
• Prepare the client side-lying with ear being
  treated up.
• Clean the pinna of the ear and the meatus of the
  ear canal. (dont want anything but medication
  going into the ear).

26
Administer the Medication

• Warm the medication container in your hand.
• Partially fill the ear dropper.
• Straighten the auditory canal.
• Instill the correct number of drops along the
  side of the ear canal.

• Apply pressure a few times to the tragus of the
  ear.
• Ask the client to remain side-lying for about 5
  minutes.
• Insert a small piece of cotton loosely at the
  meatus of the canal for 15 to 20 minutes.

27
Topical Medications

• Why do we use topical medications?
• Cleanse/debride a wound
• Re-hydrate the skin
• Reduce inflammation
• Relieve localized SSs
• Provide a protective barrier
• Reduce thickening of the skin

28
Guidelines

• Before applying any preparation, thoroughly clean
  the area with soap and water and dry it with a
  patting motion.
• Wear gloves when administering skin preparations
  and always use surgical sepsis (sterile
  technique) when an open wound is present.

29
Topical Preparations

• Powder
• Suspension based lotion
• Creams, ointments, pastes and oil based lotions
• Aerosol spray
• Transdermal patches

30
Rectal Instillations

• Assist the client
• Visualize site
• Wear gloves
• Lubricate suppository/applicator
• Insert

31
Respiratory Inhalation

• Medications administered by inhalation are
  frequently given to clients with asthma,
  emphysema, or bronchitis. Example
  Bronchodilators.
• MDI a metered dose inhaler which is a handheld
  nebulizer that can be used by clients to
  self-administer measured doses of an aerosol
  medication.

32
How to use an MDI (metered dose inhaler)

• Hold the cannister upside down and tilt the head
  back slightly.
• Hold your breath for 5 to 10 seconds if possible
  after pressing down once on the medication
  cannister.
• Exhale slowly through pursed lips.
• If another puff is prescribed, wait 1 to 3
  minutes.

33
Questions?