PDR & Medication Administration

MED PREPJANET J. NELSON RN,CMA

“A Little White Pill”

Your patient brings in this tablet but has forgotten the name. What is it?

PDR Physician Desk Reference Old vs. New

Online with fee App with fee Brand and generic are combined Additional pages for US Food and Drug

contacts;poison control info. and herb and drug interactions

VARIOUS TYPES OF PDRs Herbal Dental Diagnostic Oncology Ophthalmology

PDR SECTIONS WHITE-Manufactures Index PINK-Brand and generic Index BLUE/GRAY-Product Category Color Photos-Product Identification

Category WHITE-Product Information

PRODUCT INFORMATION CATEGORY

Black Boxes Description Clinical Pharmacology Indications & Usage Administration Contraindications Warnings Precautions Dosage and Administration Overdose Adverse Reaction How Supplied Reference

Agencies/standards

FDA:DEA:Pure Food & Drug Act:Drug Standards:

OHIO laws allow for medication to be administered by:

RN DentistLPN PodiatristCMA Physcian AssistantPhysician (DO or MD)

Doctor’s Order Include:

*name of patient*date and time the order is written*name of medication*dosage to administer*route of administration*time & frequency of administration*signature of doctor

VO or PO must be signed within 24 hours

Medication FormsLIQUIDS: AqueousSuspensionSyrupTinctureElixir

SOLIDS: CapsulePillTabletTrocheEnteric Coated

SEMI SOLIDS:OintmentPasteSuppositoryCream

Routes Of Administration

Topical:Transdermal VaginalRectalSublingualBuccal InnunctionInstillationIrrigation  

Oral:

Parenteral:IMIDSQIV

Inhalation:

Doctors can administer medication by other routes

Categories of Drugs•There are hundreds of drug categories.

•Note the blue pages of the PDR, entitled “Drug Classification or Category Index”

Categories of DrugsAnalgesic AnesthesiaAntiacidAnti-arthritic (NSAIDS)AntibioticAntifungalAntiviralAnticholinergicAnticoagulantAnticonvulsantAntidiarrhealAntidiabeticAntihistamine

AntihelminthicAntineoplasticAntiemeticAntiparasiticAntiparkinsonismAntipyreticPsychiatric-antidepressants

antipsychotictranquilizerhypnotic

Cerebral SimulantsCorticosteroids (SAIDS)Contraceptive

Categories of Drugs, Cont.

AntitussiveEmeticLaxativeMuscle RelaxantVitaminsPlacebo

Synergist

Immunization as recommended by CDC and AAP

http://www.cdc.gov/nip/recs/child-schedule-color-press.pdf

DosageABBREVIATIONS

m = minimgr = grainGm, gm or G = grammL = milliliter (new approved)gtt = droptbsp = tablespoontsp = teaspoonmg = milligram

= dram= ounce

EquivalentsWeight:

60 mg = 1 gr60 gr = 1 dram8 drams = 1 ounce

Volume15 gtts = 1 mL (cc)5 mL(cc) = 1 tsp4 mL(cc) = 1 dram30 mL (cc) = 1 ounce24OmL (cc) = 1 cup500 mL (cc) = 1 pint1000 mL (cc) = 1 quart

ROMAN NUMERALS

 ARABIC ROMAN1                                                             I2                                                             II3                                                             III4                                                            IV5                                                            V6                                                            VI7                                                            VII8                                                            VIII9                                                            IX10                                                         X20                                                          XX30                                                         XXX40                                                         XL50                                                         L100                                                      C500                                                      D1000                                           M 

SIX RIGHTS

Right MedicationRight Dose or amountRight patientRight timeRight method or route of administrationRight documentation

Right of rational patient to refuse

Follow other safety rules:

Topical Application

Topical: InnunctionTransdermal

Eye Instillation:

Ear Instillation:

Nose Instillation:

Vaginal Application:

Rectal:

Orally:

Inhalation:

Parenteral:

Parts of a Syringe

The parts of a syringe that must remain sterile are:

Inside of barrelPlungerNeedle

Injection Technique

IM Injection Sites

IM Injection Sites

IM/SQ Injection Site

Intramuscular Technique

Never inject more than 5 cc/injectionSites: Dorsogluteal

Ventrogluteal Deltoid Vastus Lateralis

Syringe: 3-5 mL with 21-23 gauge needle Fill with “bubble”

Skin: Held tautInject: 90o angle and Aspirate

May massage after injection

Subcutaneous Technique

Never inject more than 2 cc/injection

Site: DeltoidAnterior thighAbdominal tissueSubscapular

Syringe: 3 cc syringe with 25-27 gauge needleSkin: “Pinch” up skin

Injection: 45o angle with bevel upward AspirateMay massage

Intradermal TechniqueNever inject more than 0.1-0.2 mL (cc)

Skin: Hold taut

Sites: anterior forearm

Syringe:1 mL (cc) with 25-27 guage needle

Inject: 15o angle (almost parallel with skin) Aspirate “Wheal” will develop Never massage

Intradermal injection

Additional Modes of Injection

Insulin Pump:Continuous Subcutaneous Insulin Infusion Sytem