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Pharmacology

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Usually only a small amount of the drug is given. Used for allergy, TB tests & for vaccinations. ... Medication label contains strength of solution. Multidose ... – PowerPoint PPT presentation

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Title: Pharmacology


1
Pharmacology
  • Parenteral Medications

2
Objectives
  • Identify the types of parenteral medication
    administration.
  • Discuss and select equipment for parenteral
    medication.
  • Discuss the guidelines for parenteral medication
    administration.
  • Identify common sites of administration for
    parenteral medication.

3
Objectives
  • Discuss guidelines for administration of insulin
    and heparin therapy,.
  • Discuss guidelines for reconstituting medications
    from powders or crystals.
  • Calculate and measure the correct dose of
    reconstituted medication.
  • Determine shelf life for reconstituted meds.
  • Calculate doses in a multi-dose vial.

4
Parenteral Medications
  • Parenteral refers to any other route of
    administration other than Gastrointestinal
    (enteral).
  • Intradermal (ID)
  • Subcutaneous (SC or SQ)
  • Intramuscular (IM)
  • Intravenous (IV)
  • Intra-arterial
  • Intra-articular
  • Intrathecal

5
Characteristics
  • Absorbed more quickly than oral medications.
  • Are irretrievable once injected.
  • Must be prepared very carefully to prevent errors
  • Must use aseptic technique to administer
    parenteral medications.

6
Equipment - Syringes
  • Parts
  • Tip
  • Barrel
  • Plunger
  • Types
  • Standard (Hypodermic)
  • Insulin
  • Tuberculin
  • Pre-filled unit-dose system
  • Safety syringe
  • Needles systems

7
Equipment - Needles
  • Parts
  • Hub
  • Cannula or shaft
  • Bevel
  • Variables
  • Slant or length of the bevel
  • Length of the shaft
  • Gauge
  • SQ, IM and ID average sizes

8
Medication Containers
  • Ampoule
  • Clear or brown glass container
  • Single dose medicine
  • Unused portion must be discarded
  • Vary in size
  • Vial
  • Single dose
  • Multiple dose

9
Forms of Parenteral Medications
  • Liquid
  • Powder powdered medication must have liquid
    added/mixed to reconstitute before medication can
    be given.

10
Intradermal Injections
  • Usually only a small amount of the drug is given.
  • Used for allergy, TB tests for vaccinations.
  • Common sites
  • Inner lower arm
  • Upper chest
  • Back beneath scapula

11
Intradermal Injections
  • Administration
  • Use small syringe with a short needle (25-27,
    1/4 to 5/8 long)
  • Hold at a 15 angle with bevel up.
  • Drug produces a small bleb just under the skin.
  • Do not massage area of injection site.

12
Subcutaneous Injections
  • Usually a small amount of drug - up to 1 ml.
    Absorption is slower drug action usually takes
    longer than IM/IV routes.
  • Verify drug is labeled for SQ route
  • Used for vaccines, insulin, heparin as well as
    other drugs.

13
Subcutaneous Injections
  • Common Sites
  • Outer aspect of the upper arm
  • Anterior aspect of the thigh
  • Abdomen
  • Scapular area of the upper back
  • Upper ventrogluteal dorsogluteal areas

14
Subcutaneous Injections
  • Administration
  • Type of syringe
  • Needle size length
  • Determine length of needle by pinch test
  • ½ width of pinched skinfold
  • Determine angle of insertion by pinch test
  • 1 inch 45 degree / 2 inch 90 degree
  • Rotate injection sites
  • Avoid areas of lumps, bumps bruises.

15
Intramuscular Injections
  • Drugs injected into the muscle are more quickly
    absorbed because of a greater blood supply to
    muscle tissue.
  • The muscle can take a larger volume of drug
    without discomfort.
  • Amount varies based on muscle size and condition.

16
Intramuscular Injections
  • Adults can tolerate up to 3 ml of medication in
    the gluteal muscles.
  • Recommended amount for the deltoid muscle is 1
    ml.
  • Labeled for IM use.
  • May be used for all types of medications
    analgesics, etc..

17
Intramuscular Injections
  • Common sites
  • Ventrogluteal site
  • Vastus lateralis site
  • Dorsogluteal site
  • Deltoid site
  • Rectus femoris site

18
Intramuscular Injections
  • Administration
  • 2 - 5ml syringe
  • Size length of needle
  • 21-22, 1 1/2 in / adults /gluteal
  • 23-25, 1 in / adults / deltoid
  • Large for viscous drugs
  • Longer for obese/ shorter for emaciated
  • 22-25, 5/8 - 1 in, infants/child

19
Insulin - Administration
  • Medication supplied in units
  • U - 100 - means 100 units/ml
  • U - 500 means 500 units/ml
  • Specialized Insulin syringe
  • Given SQ or IV

20
Insulin - Types of Syringes
  • 30 unit
  • 50 unit
  • 100 unit
  • Insulin pens

21
Insulin - Types
  • Rapid-acting Humalog
  • Short-acting Regular
  • Intermediate acting NPH, Lente
  • Long-acting Ultra Lente
  • Premixed Intermediate short acting mixtures
    (70/30 or 50/50)

22
Insulin - Typical Order
  • Name of Insulin
  • Type of Insulin
  • Number of units to be given
  • Time to be given
  • Route of administration

23
Insulin - Guidelines
  • Read orders thoroughly
  • Use an insulin syringe
  • Read labels carefully
  • Regular insulin is clear
  • Should always be drawn up first
  • Check with another RN
  • orders, label amount

24
Insulin - Mixing
  • Regular insulin should be drawn up first
  • Only mix insulin with name made by same company
  • Draw up exactly as ordered
  • Sliding - scale insulin
  • based on BS levels
  • Intravenous Insulin

25
Heparin
  • Administration
  • Supplied in units
  • Must be given IV or SQ
  • Various strengths available
  • Fast - acting
  • Antidote - protamine sulfate
  • Dose based on lab values
  • Incompatible with other drugs
  • DO not interrupt or delay

26
Heparin - Guidelines
  • Small, short needle, SQ
  • Change needle (avoid bruising)
  • 0.2 ml
  • SQ dose not to exceed 1 ml
  • Double check order, dose, vial, amount
  • Use TB syringe (ml side)
  • Know symptoms of overdose
  • DO NOT aspirate or massage

27
Heparin
  • IV flushes
  • Flush intermittent infusion devices with heparin
    flush solution after each medication
    administration or every 8 to 12 hours
  • IV infusion
  • Depends on PTT levels
  • Intermittent or continuous
  • Ordered in units per hour

28
Medication from Powder Crystals
  • Dilution
  • Directions on vial.
  • Gives amount of diluent total volume after it
    is dissolved.
  • Medication label contains strength of solution.
  • Multidose vial (label appropriately)
  • Directions for storage

29
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