Adams ch03 lecture
Transcript of Adams ch03 lecture
PHARMACOLOGY FOR NURSESPHARMACOLOGY FOR NURSESA Pathophysiological ApproachA Pathophysiological Approach
FOURTH EDITIONFOURTH EDITION
Copyright © 2014, © 2011, © 2008 by Pearson Education, Inc.All Rights Reserved
CHAPTER
Principles of Drug Administration
3
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
The Nursing Process in Drug The Nursing Process in Drug AdministrationAdministration
• Nurses are expected to understand the pharmacotherapeutic principles for all medications given to each patient.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Nurse ResponsibilitiesNurse Responsibilities
• Know classifications, actions, and side effects of drug
• Know patient details and why drug was prescribed
• Know how drug is acquired and pharmacy procedures
• Know how to prepare and administer drug safely
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Nurse ResponsibilitiesNurse Responsibilities
• Before drug is administered, the nurse must know all variables of the patient's condition.
• Be prepared to recognize and react to adverse effects
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Five Most Common Medication Five Most Common Medication ErrorsErrors
• Incomplete patient information• Unavailable drug information• Miscommunication of drug orders• Lack of appropriate drug labeling• Environmental distractions
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Allergic ReactionsAllergic Reactions
• Allergic reaction—an acquired hyperresponse of body defenses to a foreign substance– If discovered, nurse responsible for
labeling charts, informing all personnel, and placing alert bracelet on patient
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
AnaphylaxisAnaphylaxis
• A severe allergic reaction involving the massive, systemic release of histamine and other chemical mediators of inflammation that can lead to life-threatening shock
• Requires immediate treatment
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Five Rights of Drug AdministrationFive Rights of Drug Administration
• Five rights used as the basis of safe delivery of medications. They are:– Right patient– Right medication– Right dose– Right route of administration– Right time of delivery
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Three Checks of Drug Three Checks of Drug AdministrationAdministration
• Checking the drug with the MAR or the medication information system when pulling it from storage
• Checking the drug when preparing it, pouring it, taking it out of the unit-dose container, or connecting the IV tubing to the bag
• Checking the drug before administering it to the patient
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Mistakes and LiabilityMistakes and Liability
• Despite five rights and three checks, mistakes still occur.
• Nurses are held accountable for correct administration of drugs, but responsibility also rests on other positions like physician and pharmacist.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Drug ComplianceDrug Compliance
• Compliance is taking a medication in the manner prescribed by the health care provider.– Patient has an active role in ensuring
compliance.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Drug ComplianceDrug Compliance
• Factors that can cause a patient to deviate from compliance:– Cost of drug– Forgetting doses– Annoying side effects– Self-adjustment of doses– Fear of dependency
• Nurse must be vigilant in questioning patients about their medications.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Special Drug-Administration Special Drug-Administration AbbreviationsAbbreviations
• STAT – medication is to be given immediately, and only once.
• ASAP – drug should be available for administration within 30 minutes of the written order.
• PRN – drug is administered as required by the patient's condition.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.1 Drug Administration Abbreviations
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.1 (continued) Drug Administration Abbreviations
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Drug-Administration AbbreviationsDrug-Administration Abbreviations
• Do not use these abbreviations: qd, qhs, qod
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Drug-Administration Written Drug-Administration Written OrdersOrders
• Single order—drug is to be given only once at a specific time.
• Orders not written as STAT, ASAP, NOW, or PRN are called routine orders.
• Standing order—written in advance of a situation that is to be carried out under specific circumstances.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Drug-Administration ProceduresDrug-Administration Procedures
• Drug orders must be reviewed by the attending physician within specific time frames, at least every 7 days.
• Drugs may need administration during or between meals, depending on interaction with food.
• Central nervous system drugs and antihypertensives are often best administered at bedtime.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Drug-Administration ProceduresDrug-Administration Procedures
• Nurses must educate patients carefully about timing of taking medications.
• Nurses must document carefully the details of medications given to patient—after they have been given.– Refusal or omission of medication must
be documented.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Three Systems of Measurement Three Systems of Measurement Used in PharmacologyUsed in Pharmacology
• Metric—most common• Apothecary—oldest• Household
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Nurse Must Be Able to Convert Nurse Must Be Able to Convert Among All Three SystemsAmong All Three Systems
• Metric, Apothecary, and Household Approximate Measurement Equivalents
• Joint Commission (JCAHO), the accrediting organization for health care agencies, has placed apothecary measurements on its “do not use” list.
• Nurses should encourage use of accurate medical dosing devices at home.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.2 Metric, Apothecary, and Household Approximate Measurement Equivalents
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Routes of AdministrationRoutes of Administration
• Three broad routes are enteral, topical, and parenteral.– Subsets within each
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Common Protocols and Techniques for Common Protocols and Techniques for All Routes of AdministrationAll Routes of Administration
• Review medication order• Wash hands and apply gloves, if
indicated• Identify patient, check for allergies• Inform patient
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Common Protocols and Techniques for Common Protocols and Techniques for All Routes of AdministrationAll Routes of Administration
• Position patient, remove drug from prepackaging if necessary; do not leave drugs at bedside unless so instructed
• Document
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Enteral RouteEnteral Route
• Enteral route includes drugs administered:– By mouth
tablets, capsules, sublingual and buccal– Via nasogastric tube or gastrostomy
tube
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Enteral RouteEnteral Route
• Tablets and capsules most common form of drugs– Can be crushed or opened only if
manufacturer instructed; enteric-coated tablets must remain intact
• Sustained-release tablets or capsules are designed to dissolve very slowly.– Created to increase compliance by
reducing frequency of dosage
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.3 Enteral Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.3 (continued) Enteral Drug Administration
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Sublingual and Buccal Drug Sublingual and Buccal Drug AdministrationAdministration
• Tablet is kept in mouth.• Sublingual
– Medication is placed under the tongue and allowed to dissolve slowly. Rich blood supply causes rapid onset.
– Used only after oral medications have been swallowed, if multiple drugs are ordered
– No food or drink until completely dissolved
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.1a Sublingual drug administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Sublingual and Buccal Drug Sublingual and Buccal Drug AdministrationAdministration
• Buccal– Tablet or capsule placed in oral cavity
between the gum and the cheek– Preferred for sustained delivery– Generally does not cause irritation– Like sublingual drugs, buccal drugs are
formulated to bypass first-pass metabolism.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.1b Buccal drug administration
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Nasogastric and Gastronomy Drug Nasogastric and Gastronomy Drug AdministrationAdministration
• Nasogastric (NG) tube is a soft, flexible tube inserted by way of the nasopharynx with the tip lying in the stomach.– Generally for short-term treatment
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Nasogastric and Gastronomy Drug Nasogastric and Gastronomy Drug AdministrationAdministration
• Gastrostomy (G) tube is surgically placed directly into the patient's stomach.– Longer-term treatment
• Both methods generally use liquid drugs.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Enteral Drug Administration Enteral Drug Administration AdvantagesAdvantages
• Convenient• Least costly of three routes• Overdose can be countered by retrieval
of undigested medicines through vomiting.
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Enteral Drug Administration Enteral Drug Administration AdvantagesAdvantages
• Safest route because skin barrier not compromised
• Uses vast absorptive surfaces of the oral mucosa, stomach, or small intestine
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Enteral Drug Administration Enteral Drug Administration Disadvantages Disadvantages
• Difficulty swallowing by some patients• May be inactivated if tablets or
capsules crushed or opened• Can be inactivated by enzymes• Depends on patient gastrointestinal
motility and mobility• First-pass metabolism: inactivation of
drug by processing in the liver
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Topical Drugs Are Applied to Skin Topical Drugs Are Applied to Skin or Mucous Membranesor Mucous Membranes
• Applications:– Dermatologic preparations: applied to
skin—most common– Instillations and irrigations: applied into
body cavities and orifices– Inhalations: applied to the respiratory
tract by inhalers, nebulizers, or positive-pressure breathing
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Purposes of Topical DrugsPurposes of Topical Drugs
• Many intended for local effect—for example antibiotics to treat a skin infection
• Fewer side effects because generally absorbed very slowly
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Purposes of Topical DrugsPurposes of Topical Drugs
• Some given for slow absorption into general circulation, designed for their systemic effects– Systemic vs. local effect is important
distinction for a nurse.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Transdermal Delivery SystemTransdermal Delivery System
• Transdermal patches provide effective means of delivering some medications.
• Rate of delivery and dose may vary with drug.
• Avoids first-pass effect of liver and enzymes
• Full documentation by nurses applies.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.2a Transdermal patch administration: protective coating removed from patch
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.2b Transdermal patch administration: patch immediately applied to clean, dry, hairless skin and labeled with date, time, and initials
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Opthalmic AdministrationOpthalmic Administration
• Used to treat local conditions of the eye and surrounding structures
• Common indications of problems:– Excessive dryness, infections, glaucoma,
and dilation of the pupil during eye examinations
• Special procedures, sometimes even immobilization, may be needed for children.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.3 Instilling an eye ointment into the lower conjunctival sac
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Otic AdministrationOtic Administration
• Used to treat local conditions of the ear, including infections and soft blockages of the auditory canal
• Eardrops, irrigations• Usually used for cleaning purposes
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.4 Instilling eardropsSource: Andy Crawford/Dorling Kindersley.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.4 Topical Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.4 (continued) Topical Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.4 (continued) Topical Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.4 (continued) Topical Drug Administration
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Nasal AdministrationNasal Administration
• For both local and systemic administration
• Ease of use, avoids first-pass effect and digestive enzymes
• Mucosal irritation common; potential for damage
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Nasal AdministrationNasal Administration
• Often used for local astringent effect—shrink swollen mucous membranes or loosen secretions and facilitate drainage
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.5 Nasal drug administration
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Vaginal AdministrationVaginal Administration
• For treating local infections and to relieve vaginal pain and itching
• Suppositories, creams, jellies, or foams• Nurse must explain the purpose of
treatment and provide for privacy and patient dignity.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.6a Vaginal drug administration: instilling a vaginal suppository
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.6b Vaginal drug administration: using an applicator to instill a vaginal cream
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Rectal AdministrationRectal Administration
• Local or systemic administration• Usually suppository form, but
sometimes administered as enema• First-pass effect and digestive enzymes
avoided
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Parenteral Drugs Are Parenteral Drugs Are Administered via NeedleAdministered via Needle
• Types: intradermal, subcutaneous, intramuscular, intravenous
• Require aseptic technique• Nurse must have knowledge of
anatomical locations.• Nurse must know correct equipment to
use.• Nurse must know procedure for
disposing of hazardous equipment.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Parenteral LocationsParenteral Locations
• Intradermal: dermal layer of skin• Subcutaneous: deepest layers of the
skin• Intramuscular: specific muscles• Intravenous: directly into bloodstream• Advanced parenteral delivery may be
directly into body cavities or organs.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Intradermal and Subcutaneous Intradermal and Subcutaneous AdministrationsAdministrations
• Avoid the hepatic first-pass effect and digestive enzymes; offer method for those who cannot take medicine orally
• Only small volumes can be administered; injections can cause pain and swelling.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Intradermal and Subcutaneous Intradermal and Subcutaneous AdministrationsAdministrations
• Intradermal (ID) injection administered into the dermis layer of the skin– More easily absorbed than in
subcutaneous– Small amount of drug
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.7a Intradermal drug administration: cross section of skin showing depth of needle insertion
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.7b Intradermal drug administration: the administration site is prepped
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.7c Intradermal drug administration: the needle is inserted, bevel up at 10–15°
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.7d Intradermal drug administration: the needle is removed and the puncture site is covered with an adhesive bandage
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Intradermal and Subcutaneous Intradermal and Subcutaneous AdministrationsAdministrations
• Subcutaneous injection is delivered to the deepest layers of the skin.
• Used for easy access and rapid absorption
• Important to rotate injection sites• Aspiration not usually necessary, but
depends on drug
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.8a Subcutaneous drug administration: cross section of skin showing depth of needle insertion
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.8b Subcutaneous drug administration: the administration site is prepped
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.8c Subcutaneous drug administration: the needle is inserted at a 45° angle
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.8d Subcutaneous drug administration: the needle is removed and the puncture site is covered with an adhesive bandage
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Intramuscular AdministrationIntramuscular Administration
• Delivers medication into specific muscles
• More rapid onset of action than with oral, ID, or subcutaneous administration
• Can accept larger volume of medication than subcutaneous
• Injection site very important; must avoid bone, blood vessels, and nerves
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.9a Intramuscular drug administration: cross section of skin showing depth of needle insertion
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.9b Intramuscular drug administration: the administration site is prepped
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.9c Intramuscular drug administration: the needle is inserted at a 90° angle
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.9d Intramuscular drug administration: the needle is removed and the puncture site is covered with an adhesive bandage
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Four Common Intramuscular Four Common Intramuscular Injection SitesInjection Sites
• Ventrogluteal• Deltoid• Dorsogluteal• Vastus lateralis
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.5 Parenteral Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.5 (continued) Parenteral Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.5 (continued) Parenteral Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.5 (continued) Parenteral Drug Administration
continued on next slide
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Table 3.5 (continued) Parenteral Drug Administration
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Intravenous Administration (IV)Intravenous Administration (IV)
• Medications and fluids are administered directly into the bloodstream and are immediately available for use by the body.
• Fastest drug onset action, but also most dangerous method– Contaminations– Swift adverse reactions
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.10 Injecting a medication by IV push
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Three Types of Intravenous Three Types of Intravenous AdministrationAdministration
• Large-volume infusion: for fluid maintenance, replacement, or supplementation
• Intermittent infusion: small amount of IV solution arranged tandem with primary large-volume infusion; used to instill adjunct medications
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Three Types of Intravenous Three Types of Intravenous AdministrationAdministration
• IV bolus (push) administration: concentrated dose delivered directly to circulation via syringe to administer single-dose medications
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 3.11 Intravenous drug administrationSource: Paul Velgos/iStockphoto
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Parenteral Advantages and Parenteral Advantages and Disadvantages Disadvantages
• Advantages:– Bypasses first-pass effect and enzymes– Available to patients unable to take
medication orally• Disadvantages:
– Only small doses can be used– Pain and swelling at injection site