DRUG
ADMINISTRATION
Presented by Dr.Bushra Elshafie
Glossary of Terms
• Medications: substances given to the patient to help
him/her be better.
• Documentation: writing down the facts.
• Contraindication-factor that does not allow
administration of drug
• Side effect-undesirable and often unavoidable effect
that occurs. Effects are not the original reason for
administering the drug.
• Interaction-good or bad effects that occur with
administration of multiple drugs. Can increase or
decrease effects of one or both meds.
• Allergy-systemic reaction to a drug involving the
immune response
The Six Rights of Drug Administration
• Right Person
• Right Drug
• Right Dose
• Right Time
• Right Route
• Right Documentation
Routes to administer medications
• Enteral (via digestive tract)
• Oral (by mouth, PO)
• 10-90 minutes to begin working
• Affected by digestion and absorption
• In form of :
Capsules
Tablets
Enteric coated/time-release capsules and tablets
Emulsions
Lozenges
Suspensions
Syrups
Mucous membranes
• Sublingual (under the tongue, SL)
3-5 min
Place the pill or direct spray between the underside of the tongue and
the floor of the oral cavity.
• Rectal (via the rectum, RE)
• 5-30 minutes
Buccal Medication Administration
• Place the medication
between the patient’s
cheek and gum.
Med routes (cont)
• Parenteral
Inhalation (IH)
Endotracheal (ET)
Transdermal (TD)
Time for effects variable based on medication
Subcutaneous (SQ)
Intramuscular (IM)
Intravenous/Intraosseous (IV/IO)
Medication delivery through the airway
• Inhalation
Takes effect in 2-3 min
Given by hand held nebulizer (HHN) or metered dose inhaler (MDI)
• Endotracheal
Takes effect in 2-3 min
Must double IV dose and flush with saline
Narcan, Epinephrine, Lidocaine, Atropine
Small volume nebulizer
Metered dose inhaler
Parenteral (injectable)
• Intravenous injections
• Intramuscular injections.
• Subcutaneous
• Intraosseous
• Intradermal injection
Intramuscular and Subcutaneous
• Intramuscular
Takes effect in 10-20 min
Delivery
• 90 degree angle, 1 ½ inch minimum needle
• Subcutaneous
Takes effect in 15-30 min
Delivery
• 45 degree angle, 1/2-1 inch needle
Eye Drop Administration
• Use a medication
dropper to place the
prescribed dosage
on the conjunctival
sac.
Nasal Medication Administration
Aural Medication Administration
• Manually open the
ear canal and
administer the
appropriate dose.
Syringes and Needles
• Syringes are used for IV push and in the
preparation of infusions, are made of glass or
plastic
• Glass syringes are more expensive
• use limited to medications that are absorbed by plastic
• Plastic syringes
• are less expensive
• are disposable
• come from the
manufacturer sterile
Syringes and Needles
• Needles are made of stainless steel or aluminum
• needle lengths range from 3/8 of an inch to 6 inches
• needles come in gauges ranging from 30 to 13 (higher the
gauge, smaller the lumen)
• After use, needles must be discarded in a
designated sharps container
Types of Parenteral Drug Containers
• Glass ampules
• Single and multidose vials
• Nonconstituted syringes
• Prefilled syringes
• Intravenous medication fluids
Vials
• Powders are reconstituted by introducing a
diluent (e.g., sterile water for injection)
• Vials are closed systems
• the amount of air introduced
should be equal to the volume
of fluid removed
• an exception to this guideline
is the withdrawal of
cytotoxic drugs from vials
Ampules
Infection control
• Prevent infection.
• By giving intravenous, intramuscular, subcutaneous and
Intraosseous injections we break one of the most potent
defense mechanisms of the body so we need to minimize
the risks.
• All body fluids are considered infectious until prove
otherwise.
Infection control
1. Make sure all the packages are intact.
2. Clean your hands.
3. Wear body substance isolation equipments when
needed.
4. Clean the area you are going to inject in.
5. Proper disposal of wastes after the procedure.
body substance isolation equipments
Hand Hygiene PPE
Clinical waste
There are 10 elements to
Standard Precautions
Patient Care Equipment
Linen
Occupational
Environment
Exposure Spillages
Isolation Cough etiquette
Skin cleansing
• Clean skin does NOT require cleansing
• Visibly dirty skin need only be washed with soap + water
• If alcohol and other disinfecting agents are used, skin must
be allowed to dry as these could inactivate live vaccines
Needle Handling Precautions
• Minimize the tasks performed in a moving ambulance.
• Immediately dispose of used sharps in a sharps
container.
• Recap needles only as a last resort.
Documentation
• Medication
• Dose
• Time
• Route
• Person who administered
• Effects
• List good, bad, expected, and unexpected effects
Medication Administration and Documentation
• Record all information concerning the patient and
medication including:
• Indication for drug administration
• Dosage and route delivered
• Patient response to the
medication—both positive and negative
Before every procedure you should:
1. Greet the patient.
2. Introduce your self.
3. Explain to the patient what are you going to do.
4. Take permission.
5. Position of the patient.
