Administering Medications

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1 Administering Medications Pharmacology for Healthcare Professionals seventh edition Donna F. Gauwitz, R.N., Nursing Consultant Senior Teaching Specialist of Nursing University of Minnesota Minnesota and Nursing Education Specialist Mayo Clinic Rochester, Minnesota Mc Hill 1 Connect Learn

2 Brief Contents About the Author xiii Features List xxiv Preface xv The Learning System xxix Acknowledgments xx Orientation to Medications I 2 Principles of Drug Action 22 3 Measurement and Dosage Calculations 42 4 Administering Parenteral Medications Medication Therapy Vitamins, Minerals, and Herbs Antibiotics and Antifungals Drugs for the Eye and Ear 9 Drugs for the Skin 237 Drugs for the Cardiovascular System 262 Drugs for the Respiratory System 300 Drugs for the Gastrointestinal System 335 Drugs for the Urinary System and Fluid Balance 372 Drugs for the Reproductive System 397 Drugs for the Endocrine System 423 Drugs for the Musculoskeletal System 453 Drugs for the Nervous and Sensory Systems 474 Psychotropic Drugs 502 Antineoplastic Drugs Drugs for the Pediatric Patient 539 Drugs for the Patient Appendix A: Abbreviations Appendix B: Checklist s A-3 Glossary

3 About the Author xiii Features List xxiv Preface xv The Learning System xxix Acknowledgments xx I Orientation to Medications 1 Definition of Terms 3 Drug Sources 3 Drug 4 3 Drug Standards 5 Drug Names 5 Drug References 6 Preparing Your Own Drug Cards 9 Drug Legislation 10 You and the Law 14 I Review 17 2 Principles of Drug Action 22 Pharmacokinetics 24 Drug Action 24 Factors Affecting Drug Action 27 Drug Effects 30 Adverse Reactions 30 Drug Dependence or Drug Abuse? Review 37 3 Measurement and Dosage Calculations 42 Math Review: Fractions 43 Systems of Measurement 48 Apothecary System 48 Converting Measurement Systems 53 Dosage Calculations Review 65 4 Parenteral Medications 74 Orientation to the Parenteral Route 75 Standard Precautions 76 Equipment 77 Drawing Up Medications 80

4 Injection Sites 84 General Procedure for Injections 88 Special Instructions 90 Principles of Intravenous Therapy 92 Drawing Up Medication from a : Drawing Up Medication from an : Administering an Intradermal Injection : Administering a Subcutaneous Injection Administering an Intramuscular Injection 4 Review Medication Therapy Forms of Medication Routes of Administration The Medication Order Types of Drug Orders Questioning a Medication Order 123 Standard Medical Abbreviations 124 Ordering Drugs from the Pharmacy 124 Drug Packaging Storage and Disposal of Drugs Keeping Track of Medication Orders 130 Setting Up Medications 133 The Seven Rights: for Giving Medications Reading and Understanding a Medication Label 137 Charting Medications 141 The POMR 143 Principles of Charting 145 :Transcribing Medication Orders 5.2: Counting Controlled Substances Medication System Not Used an Automated 5.3: Recording the Use of Controlled Substances 5.4: Dispensing Unit-Dose Medications from a Cart Automated Dispensing System Not Used an 5.5: Filling Out an Incident Report Form or Event Report Form 5 Review Vitamins, Minerals, and Herbs 166 Recommended Daily Allowance (RDA) Vitamins 168 Minerals 173 Electrolytes 176 Herbs 176

5 Representative Drugs 6 Review 183 Vitamin and Mineral Deficiencies 7 Antibiotics and Antifungals 187 Infection and Immunity 188 Antibiotic Drugs 192 Antifungal Drugs 200 Antiviral Drugs 201 Isolation Procedures 204 Universal and Body Fluid Precautions 206 Representative Antimicrobials Review 213 Administering Medication to an Isolation Patient 8 Drugs for the Eye and Ear Structure and Function of the Eye 219 Eye Disorders 221 Drug Therapy for Eye Disorders 222 Structure and Function of the Ear 223 Ear Disorders 225 Drug Therapy for Ear Disorders 225 Representative Drugs for the Eye and Ear 227 Instilling Eyedrops and Eye Ointment : Instilling Ear Drops Review Drugs for the Skin 237 Integumentary System 239 Skin Disorders 240 Topical Medications 245 General Instructions for Medicating the Skin 249 Representative Drugs for the Skin Topical Medication to the Skin Review 258 Drugs for the Cardiovascular System 262 Cardiovascular System 264

6 Cardiovascular Disorders 269 Drugs for Cardiovascular and Disorders 275 Giving Cardiovascular Medications 283 Representative Drugs for the Cardiovascular System 285 Administering Oral, Sublingual, and Buccal Medications Review 296 I I Drugs for the Respiratory System 300 Respiratory System 302 Respiratory System Disorders 303 Nicotine Dependence and Smoking Cessation 308 Drugs for Respiratory Disorders 309 Giving Respiratory Drugs 313 Representative Drugs for the Respiratory System I Mouth orthroat Medication onto Mucous Membranes Instilling Nose Drops 322 I Using a Nasal Spray 323 I Oral Inhalation of Metered-Dose Inhalant 324 I Administering Oxygen by Mask 325 Administering Oxygen by Cannula 326 Administering Oxygen by Nasal Catheter Review 330 I 2 Drugs for the Gastrointestinal System 335 Gastrointestinal System 337 Disorders of the Gastrointestinal System 339 Drugs That Affect the Gastrointestinal System 344 Giving Gastrointestinal Medications 353 Representative Drugs for the Gastrointestinal System 356 Inserting a Rectal Suppository Review 365 Administering Medication Through a Nasogastric or 362 Drugs for the Urinary System and Fluid Balance 372 Urinary System 374 Disorders of the Kidneys and the Urinary Tract 376 Imbalances of Body Fluids, Electrolytes, and ph 379 Drugs for the Urinary Tract and Fluid Imbalances 381

7 Giving Drugs That Affect the Urinary System 384 Representative Drugs for the Urinary System and Fluid Imbalances 387 Instilling Medication into the BladderThrough an Indwelling Catheter Review 392 Drugs for the Reproductive System 397 Reproductive System 398 Disorders of the Reproductive System 403 Use of Sex Hormones in Drug Therapy 406 Representative Drugs for the Reproductive System Vaginal Medication 14 Review 418 Drugs for the Endocrine System 423 Endocrine System 425 Disorders of the Endocrine System 427 Hormone Therapy Administering Insulin 440 Representative Hormones and Hormonelike Drugs 443 Mixing and Intermediate-Acting Insulin in Review 448 One Syringe 444 Drugs for the System 453 Musculoskeletal System 454 Disorders and Drug Treatment of the Musculoskeletal System 458 Care of Patients with Musculoskeletal Disorders 463 Representative Drugs for the Musculoskeletal System Review 469 Drugs for the Nervous and Sensory Systems 474 The Nervous and Sensory Systems 476 Nervous System Disorders 479 Drugs That Affect the CNS 485 Giving Medications for the Nervous and Sensory Systems 490 Representative Drugs for the Nervous and Sensory Systems Review 498

8 Psychotropic Drugs 502 The Nervous System and 503 Mental Disorders 504 Selection and Use of Psychotropic Drugs 505 Giving Medications 511 Representative Psychotropic Drugs 18 Review 519 Antineoplastic Drugs 523 Body Systems 524 Necessary Substances 525 Immunity 526 Cancer and 526 Representative Antineoplastic Drugs Review Drugs for the Pediatric Patient 539 Drugs and the Pediatric Patient 540 Physiological Alterations in the Pediatric Patient 540 Safeguards Critical to Safe Administration of Pediatric Medications 541 What's New in Pediatric Medications Review 547 Drugs for the Patient Drugs and the 552 The Aging Process 552 Pharmacokinetics in the Older Adult 554 Obtaining a Medical and Medication History 558 Administering Medications to Older Adult Patients 559 Engaging Patients in Their Care Review 564 Appendix Appendix Checklist s A-3 Glossary / Credits

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