Medication Administration and Pharmacology Cram Notes

Module 1 – Preparing for Medication Administration

• Key Components of Medication Competence

  • Definition: Medication competence is the ability to administer medications safely and correctly, which depends on four main components: knowledge, skill, legal awareness, and reflective practice.

  • Antecedents: Factors that contribute to building medication competence include:

  • Education: Theoretical and practical learning concerning medications.

  • Supervision: Guidance and oversight from experienced practitioners.

  • Adherence to Policy: Following established protocols and guidelines to ensure safety and compliance.

  • Consequences: The impact of medication competence is reflected in:

  • Safe Administration: Correctly administering medications to avoid errors.

  • Patient Safety: Protecting the well-being of patients during treatment.

  • Professional Accountability: Taking responsibility for medication management and its effects on patients.

• Drug Formulations:

  • Various types of drug formulations affect the pharmacokinetics of medications, including:

  • Tablets: Common oral dosage forms.

  • Solutions: Typically administered intravenously (IV) for quicker absorption.

  • Patches: Transdermal forms that allow for slow, sustained release of medication into the bloodstream.

  • Classification: MIMS classifies drugs primarily by their therapeutic class (e.g., cardiovascular agents).

• Generic vs. Brand Names:

  • Generic Names: Refers to the active ingredient (e.g., paracetamol).

  • Brand Names: The trade name under which the medication is marketed (e.g., Panadol).

  • Importance of Using Generic Names: Promotes safety by ensuring clarity and consistent communication among healthcare professionals.

• Poison Schedules in Australia:

  • S2: Pharmacy Medicine

  • S3: Pharmacist Only

  • S4: Prescription Only

  • S8: Controlled Drug

  • S5 - S7: Categories for hazardous use.

• Medication Calculations:

  • General Formula:

  • ext{Dose} = rac{ ext{Desired}}{ ext{Stock}} imes ext{Volume}

  • For Body Weight:

  • ext{Dose} = ext{mg/kg} imes ext{weight (kg)}

  • Important Considerations: Always check units and confirm patient identity prior to administration.

• Legal Prescription Requirements:

  • Must include:

  • Patient Name

  • Date

  • Drug Name

  • Dose

  • Route

  • Frequency

  • Prescriber Signature

• National Inpatient Medication Chart (NIMC):

  • Components include:

  • Patient ID

  • Allergies

  • Prescriber Details

  • Dose/Frequency Boxes

  • Administration Record

  • Emphasis on ensuring that documentation is legible and complete.

• Active Recall Questions:

  • Q: What are the key antecedents of medication competence?

  • A: Education, supervision, policy adherence.

  • Q: Why use generic drug names?

  • A: Ensures consistency and avoids duplication/confusion.

  • Q: What is a Schedule 8 medication?

  • A: A controlled drug requiring strict record and storage (e.g., morphine).

  • Q: How is a legal medication order verified?

  • A: Check all required fields (patient, drug, dose, route, time, signature).

  • Q: What is the formula for calculating dose?

  • A: ext{Dose} = rac{ ext{Desired}}{ ext{Stock}} imes ext{Volume}

Module 2 – Quality Use of Medicines and Patient Safety

• Quality Use of Medicines (QUM):

  • Definition: The practice of using medicines safely, effectively, and judiciously while ensuring that the benefits significantly outweigh the associated risks.

• The Six Rights (Queensland Health):

  • Right Patient: Confirming patient identity to ensure correct administration.

  • Right Medication: Administering the correct medication as prescribed.

  • Right Dose: Ensuring the correct dosage as per the order.

  • Right Route: Administering medication via the correct method (oral, IV, etc.).

  • Right Time: Ensuring medication is given at the correct time and frequency.

  • Right Documentation: Accurately recording all medication administrations in patient records.

• Medication Errors:

  • Types include:

  • Wrong Drug

  • Wrong Dose

  • Wrong Patient

  • Wrong Route

  • Wrong Time

  • Prevention: Strategies include implementing double-check systems, ensuring clear labeling, and utilizing reporting systems for errors.

• Clinical Decision-Making:

  • Involves the integration of:

  • Critical Thinking

  • Patient Assessment

  • Evidence-Based Practice

  • The goal is to ensure safe and effective medication administration for each patient.

• APINCHS:

  • Purpose: Identifies high-risk medication categories, which include:

  • A: Anti-infectives

  • P: Potassium & other electrolytes

  • I: Insulin

  • N: Narcotics

  • C: Chemotherapeutics

  • H: Heparin & anticoagulants

  • S: Systems (e.g. concentrated solutions)

• Active Recall Questions:

  • Q: What does QUM stand for?

  • A: Quality Use of Medicines.

  • Q: List the Six Rights.

  • A: Patient, medication, dose, route, time, documentation.

  • Q: Name three types of medication errors.

  • A: Wrong drug, wrong dose, wrong route.

  • Q: What is APINCHS used for?

  • A: Identifying high-risk medication classes.

Module 3 – Pharmacology and Pharmacotherapeutics

• Pharmacodynamics:

  • Definition: The study of how drugs affect the body, primarily through mechanisms such as:

  • Receptor binding

  • Enzyme inhibition

  • Modulation of cell function.

• Adrenergic Agonists:

  • Effect: Stimulate the sympathetic nervous system, resulting in increased heart rate (↑HR) and blood pressure (↑BP).

  • Examples: Adrenaline (epinephrine) is a common adrenergic agonist.

• Adrenergic Antagonists (beta-blockers):

  • Effect: Reduce heart rate (↓HR) and blood pressure (↓BP).

• Pharmacokinetics (ADME):

  • Absorption: The process by which drugs enter the bloodstream.

  • Distribution: How drugs spread through body fluids and tissues.

  • Metabolism: The conversion of drugs into active or inactive forms.

  • Excretion: The removal of drugs from the body.

  • Influences: Factors affecting pharmacokinetics include: age, organ function, and route of administration.

• Half-Life:

  • Definition: The time required for the plasma concentration of a drug to reduce to half its original value.

  • Importance: Affects the dosing interval of medications, especially for maintaining therapeutic levels.

• Bioavailability:

  • Definition: The proportion of a drug that reaches systemic circulation.

  • Notable Point: IV administration has 100% bioavailability.

• Cholinergic Agonists:

  • Effect: Stimulate the parasympathetic nervous system, leading to increased salivation and decreased heart rate (↓HR).

• Cholinergic Antagonists (anticholinergics):

  • Effect: Opposite of cholinergic agonists; they decrease salivation and increase heart rate.

• Chemical Mediators:

  • Histamine: Promotes inflammation and allergic reactions.

  • Prostaglandins: Involved in pain, fever, and inflammation processes.

  • Nitric Oxide: Acts as a vasodilator.

• Antihistamines:

  • Mechanism: Block histamine receptors, leading to reduced allergy symptoms.

  • Side Effects: First-generation antihistamines can cause sedation.

• Active Recall Questions:

  • Q: What are the four pharmacokinetic stages?

  • A: Absorption, Distribution, Metabolism, Excretion.

  • Q: Effect of adrenergic agonists?

  • A: Increase heart rate, blood pressure, and pupil dilation.

  • Q: What does half-life determine?

  • A: How often the drug must be given.

  • Q: What do prostaglandins do?

  • A: Cause pain, fever, and inflammation.

Module 4 – Pharmacology and Body Systems

• Cardiovascular System:

  • Classes of Drugs:

  • Antihypertensives

  • Antiarrhythmics

  • Diuretics

  • Anticoagulants

  • Mechanisms of Action:

  • Beta-blockers: Decrease heart rate (↓HR).

  • ACE Inhibitors: Decrease vasoconstriction.

  • Diuretics: Decrease fluid levels in the body.

  • Nursing Responsibility: Continuous monitoring of blood pressure (BP), heart rate (HR), and electrolytes.

• Urinary System:

  • Indications for Medication Use: Treatment of urinary tract infections (UTIs) and fluid retention.

  • Mechanism of Action: Diuretics increase urine output.

  • Potential Side Effects: Risk of dehydration and electrolyte imbalances.

• Respiratory System:

  • Classes of Drugs:

  • Bronchodilators (e.g., salbutamol)

  • Corticosteroids

  • Mechanism of Action: Medications work to relax airway smooth muscle.

  • Common Side Effects: Tremors and tachycardia (increased heart rate).

• Endocrine System (Diabetes Focus):

  • Key Drugs:

  • Insulin

  • Metformin

  • Mechanisms of Action:

  • Insulin lowers blood glucose levels (BGL).

  • Metformin reduces hepatic glucose output.

  • Nursing Considerations: Monitoring blood glucose levels (BGLs) and signs/symptoms of hypoglycemia.

• NSAIDs & Narcotics:

  • NSAIDs:

  • Mechanism: Inhibit prostaglandins to reduce pain and inflammation.

  • Risks: Potential for gastrointestinal bleeding and renal complications.

  • Narcotics:

  • Mechanism: Act on opioid receptors within the nervous system.

  • Risks: Can lead to respiratory depression and dependency.

• Gastrointestinal System:

  • Classes of Drugs:

  • Antacids

  • Proton Pump Inhibitors

  • Laxatives

  • Mechanism of Action: Medications aim to reduce stomach acid or promote gastrointestinal motility.

• Antibiotics:

  • Types:

  • Penicillins

  • Cephalosporins

  • Macrolides

  • Tetracyclines

  • Mechanism of Action: Antibiotics primarily inhibit cell wall or protein synthesis within bacteria.

  • Risks: Antibiotic resistance, allergic reactions, and gastrointestinal upset.

• Active Recall Questions:

  • Q: What do ACE inhibitors do?

  • A: Block the conversion of angiotensin I to angiotensin II, leading to lowered blood pressure.

  • Q: What’s a key nursing check for diuretics?

  • A: Monitor electrolytes and hydration status.

  • Q: What’s the main risk associated with NSAIDs?

  • A: Risk of gastrointestinal bleeding and renal impairment.

  • Q: Which antibiotics inhibit cell wall synthesis?

  • A: Penicillins and cephalosporins.