PowerPoint to accompany

Medical Assisting
Chapter 51

Second Edition

Ramutkowski Booth Pugh Thompson Whicker

Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Drug Administration
Objectives:
51-1 Discuss your responsibilities regarding drug
administration.
51-2 Perform dosage calculations accurately.
51-3 Describe how to assess the patient before
administering any drug.
51-4 Identify the seven rights of drug administration.
51-5 Describe the various techniques of drug
administration you may be asked to perform.
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Drug Administration
Objectives (cont.)
51-6 Compare different types of needles and syringes.
51-7 Explain how to administer an intradermal,
subcutaneous, or intramuscular injection.
51-8 Explain what information you need to teach the
patient about drug use, interactions, and adverse
effects.
51-9 Describe special considerations related to drug
administration.
51-10 Describe nonpharmacologic ways to manage pain.
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Introduction
Drug administration is one
of the most important
and most dangerous
duties.
A patients condition can
worsen or the patient
could die when meds
are given incorrectly.

To administer drugs safely

and effectively, you must
know and understand
principles of
pharmacology.

You should be familiar with the medications frequently

prescribed in your practice.
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Pharmacology Principles

Route of medication
administration
Dosage calculations
Techniques involved
with giving injections
Seven Rights of Drug
Administration
Patient education
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Drug Administration and Scope

of Practice

States have medical

practice acts that define
medical assistants
exact duties
An act may specify
which drugs you are
allowed to give.

You need to research

the scope of practice
for medical assistants
in the state where you
will work.

You are responsible for knowing what you can and

cannot do when giving medications.
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Dosage Calculations

Measurement Systems:

Metric
Apothecaries
Household

Most doctors use metric

system

Basic Calculations Formula Method

Desired dose X quantity of dose on hand
Dose on hand
The physician orders aspirin, 10 grains.
On hand are 5 grain aspirins
10 grains X 1 tablet = 10/5 or 2 tablets
5 grains
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Basic Calculations
Work these problems:
The physician has ordered ampicillin
1000 mg, on hand 500 mg tablets.
2 tablets
You have 500 mg scored tablets
of a drug on hand and the doctor
tells you to give 250 mg. How
much would you give?
tablet
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Basic Calculations Ratio Method

Doctor orders 500 mg of ampicillin. You have 250
mg on hand.
Set up a ratio with the unknown number of tablets
and the amount of drug ordered X:500 mg
Set up a ratio with a single tablet and the amount of
drug in single tablet 1 tab:250 mg
Create a proportion and multiply the outer and then the
inner parts and solve for X. X:500 mg :: 1 tab:250 mg
Answer = 2 tablets

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Basic Calculations Fraction Method

The doctor orders 30 mg
of Adalat. Each
capsule contains 10
mg.
Set up the first fraction
with the dose ordered
and the unknown
number of capsules
30 mg
x

Set the second fraction

with the amount of
drug in a capsule
10 mg
1 cap
Then use both fractions
in a proportion:
30 mg
10 mg
x
=
1 cap
Solve for X = 3 capsules

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Preparing to Administer a Drug

Drug may be given:
Local applied directly
to skin, tissue, or
mucous membranes
Systemic routes that
allow the drug to be
absorbed or distributed
into the bloodstream

Pay close attention to

the dose, route, and
form of the medication.

To administer
medications you
require close attention
to detail, strong patient
assessment skills, and
expert technique.
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Apply Your Knowledge

Which measuring system is used the
most in pharmacology?

13

Apply Your Knowledge -Answer

Which measuring system is used the
most in pharmacology?
Most doctors use the metric system when
utilizing pharmacology principles.

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Apply Your Knowledge #2

Convert 25 grams to milligrams.

15

Apply Your Knowledge #2 - Answer

Convert 25 grams to milligrams.
Answer:
1. Add a decimal point to the measurement: 25. g
2. Add 3 zeroes so you can move the decimal point three
places to the right: 25.000 g
3. Move the decimal point to the right three places:
25,000
4. Change the unit: 25,000 mg
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Apply Your Knowledge #3

Calculate the dose to give for 500 mg
Augmentin.

17

Apply Your Knowledge #3 - Answer

Calculate the dose to give for 500 mg
Augmentin.

Answer:
20 mL
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Assessment of Patient
As you interview the patient,
you must be alert to any
changes in the patients
condition that could affect
drug therapy.

19

General Rules

Give only the drugs

the doctor orders.
If you are unfamiliar
with any aspect of the
order, consult a drug
reference book.
Wash your hands.
Prepare in a well-lit
area.
Focus on the task at
hand.

Calculate the dose

carefully.
Avoid leaving a
prepared drug
unattended.
Never give a drug
that someone else has
prepared.
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General Rules

Ask the patient to

state his name to
ensure correct
identification
Ask the patient if
they have an
allergies
Be sure the physician
is in the office when
you give the drug.

If the patient refuses

to take the drug,
flush it down the
toilet.
Do not return it to
the original
container.
If you make an error,
tell the doctor at
once.
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Seven Rights
1.
2.
3.
4.
5.
6.
7.

Right patient
Right drug
Right dose
Right time
Right route
Right technique
Right documentation
22

Techniques of Administering
Drugs

Oral tablets, capsules, lozenges, and

liquids
Buccal or sublingual placed under the
tongue or between the cheek and gum
Parenteral administration of substance
into a muscle, vein, or GI tract

Intradermal (ID)
Subcutaneous (SC)
Intramuscular (IM)
Intravenous (IV)

23

Needles and Syringes

Needles

Available in different gauges

smaller the number the larger the
gauge
Length long enough to penetrate
the appropriate layers of tissue

Syringes

Barrel
Plunger
Sizes 3 mL, 1 mL (tuberculin or
insulin)

24

Parenteral Drugs Packaging

Ampule glass or plastic container that is

sealed and sterile (open with care)
Cartridge small barrel prefilled with sterile
drug
Vial small bottle with rubber diaphragm that
can be punctured by needle.

25

Other Drug Administration

Inhalation -administered through the mouth or

nose.
Topical applied direct application of a drug on
the skin.
Transdermal use of a medication patch that will
release medication slowly and evenly
Urethral instill liquid drugs directly into the
bladder.
Vaginal and rectal
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Educating the Patient

Reading the drug package label

Interactions

Drug drug interactions

Drug food interaction

Adverse effects
Effects of medication take the drug at the
right time, in the right amount, and under the
right circumstances.
27

Special Considerations

Pediatric patients physiology and immature

body systems may make the drug effects less
predictable
Plan to observe a pediatric patients closely for
adverse effects and interactions.

28

Pregnant Patients

Remember that you are

caring for two patients at
once
When you give the mother
a drug, you are also giving
it to the baby
Some drugs can cause
physical defects in the
fetus if taken in the first
three months of pregnancy

29

Patients Who Are Breast

Feeding

Some drugs are excreted in

breast milk
Ingestion can be dangerous
because baby cant
metabolize or excrete drugs
Check drug reference work
to see if contraindicated
during lactation

30

Elderly Patients
Age related changes in
the body
May have increased risk of:
Drug toxicity
Adverse effects
Lack of therapeutic
effects
31

Patients From Different

Cultures

Can affect a patients understanding of drug

therapy and compliance with it
Obtain drug information sheets in the
languages that are commonly spoken by
patients in your office

32

Nonpharmacologic
Pain Management

Biofeedback
equipment measures
physical indicator of
stress and relaxation
Guided imageryenvisioning calm,
nurturing place
Relaxation exercises
33

Apply Your Knowledge

The physician orders you to give an IM
medication to a 2-year-old child.
What site will you use?

34

Apply Your Knowledge -Answer

The physician orders you to give an IM
medication to a 2-year-old child.
What site will you use?
The vastus lateralis or the ventrogluteal.

35

Summary

Medical Assistant
You must be prepared to administer drugs safely
and effectively.

You must follow the Seven Rights of Medication

Administration.
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End of Chapter

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