MEDICATIONS

MEDICATIONS/ DRUGS ADMINISTRATION

• A medication is a substance administered for

the diagnosis, cure, treatment or relief of a
symptom or for prevention of disease.
• In the health care context, the words
medication and drug are generally used
interchangeably. The term drug also has the
potential meaning of an illegally obtained
substance such as heroin, cocaine or
amphetamines.
 Storage of medicines

During the storage of medicines, certain

guidelines must be followed. They are;
• Three cupboards are usually used for their
storage and all cupboards, as far as possible,
should be outside the actual ward and should
be kept under lock always.
• Store medicines and lotions for external use
only in cupboard I
• Keep medicines for internal use only cupboard
II
• Store medicines which are classified as
dangerous drugs in cupboard III
 Cupboard 1
• Identify bottles containing drugs and lotions
with distinctive label clearly, ‘for external use
only’. Examples of other substances which
may be applied externally to the body are
calamine lotion and methylated spirit
• If the drugs and lotions contain poisonous
substances, identify them with a red label
marked “poison” and keep them in bottles
with ridged surface.
Cupboard II- Drugs for internal use only.

• Many mixtures, pills, sachets, and tablets are

kept in this cupboard and some of these
substances may be controlled by law
• They can only be obtained by the public with a
written medical prescription.
• Paste a label clearly indicating drugs for
internal use only.
• In hospital they must be kept in locked
cupboards.
• Label all containers clearly
 Cupboard III
• Dangerous drugs, in order to control the illicit
use of the drug of addiction a number of drugs
have been designated dangerous. Their use is
controlled by law and new additions to list are
made from time to time. Such drugs include:
Opium, Morphine, Cocaine, Pethedine, etc.
• Label cupboard III as “poison cupboard” or
“DDA cupboard” Dangerous Drug Act and
keep it locked all the time.
• The key of this cupboard must be kept with
the nurse in- charge on duty or senior nurse
on duty
• None of the DDA drugs must be administered
without prescription by the doctor.
• Each dose of the drugs administered must be
entered into a special register provide for the
purpose.
• In this book must be written the following
details ;
• Patient’s name
• Name of drug and dose
• Time of giving the drug
• Name of the nurse giving the drug and
the date
 RIGHTS OF DRUG ADMINISTRATION
• In the administration of medications / drugs
Seven “Rights’ must be observed, these
include;
• Right medication: The medication given is the
medication prescribed.
• Right Dose: The dose prescribed is appropriate
for the patient.
• Right time: give the medication at the right
frequency and at the time prescribed
according to local policy. Medication given
within 30 minutes before or after the
scheduled time are considered to meet the
right time standard.
• Right route: give the medication by the
prescribed route. Make certain that the route
is safe and appropriate for the patient.
• Right patient: medication is given to the
intended patient.
• Right Documentation: document medication
administration after giving it, not before. If time
of administration differs from prescribed time,
note the time on the chart and explain reason
• Right to refuse medication
 Oral medication administration
• Oral administration is the most common, least
expensive and most convenient route for most
patients. In oral administration the drug is
swallowed. Because the skin is not broken as it
is for an injection, oral administration is also a
safe method.
• The major disadvantages are possibly
unpleasant taste of the drugs, irritation of the
GIT mucosa.
• For this method the drug may be in the form
of; mixtures, tablets, capsules powders,
sachets etc
Intramuscular administration of drugs
• This is the introduction of drugs into the
muscle.
Reasons why drug is introduce into the dermis
• When large amount of the drug is required and
the drug is likely to damage the superficial
tissue
• When quick absorption is a priority
• When the drug would be altered by digestive
juice e.g insulin
 Syringes
• Syringes have three parts, the tip which
connects with the needle, the barrel or
outside part on which the scales are printed
and the plunger which fits inside the barrel.
When handling a syringe you may touch the
outside of the barrel and handle of the
plunger.
• However you must avoid letting any unsterile
object contact the tip or inside of the barrel,
the shaft of the plunger or the shaft or tip of
the needle.
 Types of syringes
• There are several types of syringes, different
size and shape the three most commonly used
types are standard hypodermic syringe, the
insulin syringe and the tuberculin syringe.
• An insulin syringe is similar to a hypodermic
syringe, but the scale is specially designed for
insulin.
• A tuberculin syringe was originally designed to
administer tuberculin.
• it is a narrow syringe, This type of syringe can
also be useful in administering other drugs e.g
a small or precise measurement is indicated
(e.g pediatric dosages).
 needle
Needles are made up of stainless steel and most
of them are disposable.

Parts of a needle
• A needle has three parts; the hub which fits
into the syringe, the cannula or shaft which is
attached to the hub; and the bevel, which is
the slanted part at the tip of the needle.
Preparing injectable medications.
• Injectable medications can be prepared by
withdrawing the medication from an ampoule
or vital into a sterile syringe,
 Ampoules and vials
• Ampoules and vials are frequently used to
package sterile parenteral medications.
• An ampoule is a glass container usually
designed to hold a single dose of a drug. It is
made of clear glass and has a distinctive shape
with a constricted neck
• Ampoules vary in size from 1- 20ml or more.
• Most ampoules necks have coloured marks
around them indicating where they can be
open.
• To access the medication in an ampoule the
ampoule must be broken at its constricted
neck.
 The vial
• It is a small glass bottle with sealed rubber cap.
Vials come in different size from single to multi-
dose vials.
• To access the medication in a vial, the vial must
be pieced with a needle in addition air must be
injected into it before the medicine is
withdrawn. Failure to inject air before
withdrawing medication leaves a vacuum within
the vial and that makes withdrawing difficult.
• Several drugs (e.g penicillin) are dispensed as
powers in vials a liquid (solvent or diluents)
must be added to a powdered medication
before it can be injected. The technique of
adding a solvent to a powdered drug to
prepare it for administration is called
reconstitution.
•
Preparing medications from ampoules
• Medication chart
• Ampoule of sterile medication
• Antiseptic swabs
• Syringe and needle
• Filler needle
 Preparation of single dose ampoule
solution
• Check the medication administration chart,
• Check the label on the ampoule carefully
against the chart to make sure that the correct
medication is being prepared.
• Organize the equipment.
• Wash hands and observed other
appropriate infection control procedures.
• Inspect the solution for cloudiness or particles
if present, discard and follow hospital
guidelines on what action to take e.g return
drug to pharmacy.
• Flick the upper stem of the ampoule several
times with a fingernail. This will bring all
medication down to the main portion of the
ampoules.
•
• Partially file the neck of the ampoule to start a clean
break or cover the neck of the ampoule with sterile
swab and snap it open.
• Inspect the solution for glass fragments if present
discard.
• withdraw the required amount of solution tilting the
ampoule
• replace the guard on the needle and tap the syringe
to dislodge any air bubbles then expel air
• Change the needle.
 Preparing medication from vials
• Medication chart
• Antiseptic swabs
• Vial of sterile drug
• Needle and syringe
• Sterile water or normal saline if drug is in
powered form.
 steps
• Check the medication administration check
the label on the vial carefully
• Read the label on the medication
• Organize the equipment
• Wash hands and observe other
appropriate infection control procedures.
• Clean the rubber cap with the chosen
antiseptic and let it dry
• Insert the needle into the cap and vent the
bottle.
• Add the required amount of sterile water.
• Remove the needle and syringe
• Place sterile wool ball over the venting needle
• Shake well and inspect the content
• When the solution is clear, clean the rubber
cap and withdraw the prescribed amount.

• When the correct volume of medication is

obtained, withdraw the needle from the vial
and replace the cap over the needle
• Expel any air bubbles that may be present by
tapping the syringe barrel dislodge the air
bubbles in the syringe.
• Change the needle.
 Sites of I.M drug administration
• Upper outer quadrant of the gluteus
• Anterior lateral aspect of the middle third of
the thigh
•
 NB

• Review medication orders, and check for drug allergies

• Maximum amount of fluid should be determined by

client's muscle mass and site to be injected. Use 2 inch
needle with obese client to ensure that medication is
injected into a large muscle.
• If amount to be injected for adults is > 5 cc or children
> 3 cc: divide dose into two syringes to administer.