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Drug Administration
| Term | Definition |
|---|---|
| Dose or unit (unit dose)- | measured amount of drug |
| Local effect (topical)- | drug effect stays at the site of administration |
| Systemic effect- | drug acts on many sites away from the administration site |
| Gastrointestinal/Enteral- | applied via the digestive tract (systemic effect) oral, sublingual, buccal, and rectal |
| Parenteral- | injectable method of application (systemic effect) |
| Topical/Localized- | localized administration, but not applied enteral or parenteral (limited systemic effects) Vaginal, inhalation, otic, nasal, inhaled, transdermal |
| Topical/Localized- | Ears and Eyes |
| Otic- | Ear (auricular) Administration via otic dropper directly into the ear |
| Earwax buildup | Carbamide peroxide drops- help soften, loosen, and remove earwax. |
| Ear Infection | Antibiotic drops (e.g. ciprofloxacin, gentamicin, and neomycin)- used alone or in combination with corticosteroid (acetic acid) to treat ear infections. |
| Ear swelling, irritation, inflammation | Corticosteroids (e.g. dexamethasone, fluocinolone, and hydrocortisone)- used to decrease swelling, irritation, or inflammation |
| Ophthalmic and Ocular- | Eye |
| Ophthalmic administration- | via eye dropper directly into the eye (eye drops). |
| Intravitreal administration- | via a needle into the vitreous of the eye (less common) |
| Eye redness | Vasoconstrictor to constrict or tighten small superficial blood vessels (e.g. Visine) |
| Eye infection/prevention of inflammation and eye infection post cataract surgery | Combination of corticosteroids and antibiotics in a saline solution (e.g. TobraDex) |
| Conjunctivitis (pink eye)- inflammation of the conjunctiva (inner surface of the eyelids, over the forepart of the eyeball) | Bacterial cause- antibiotics (e.g. bacitracin, AK-Spore). Viral cause- symptomatic treatment |
| Allergic symptoms (itchy, red, watery eyes) | Patanol eye drops |
| Eye dilation | Mydriacyl eye drops |
| Glaucoma | Diamox (pill formulation) |
| Dental- | mostly a local effect |
| Local anesthetics- | deaden the nerves in and around the teeth and can be applied via injection, a swish, a spray, or a gel. |
| Types of Local anesthetics: | lidocaine (Xylocaine), articaine/epinepherine (Septocaine) mepivacaine (Carbocaine) prilocaine (Citanest) bupivacaine (Marcaine) |
| Tooth whitening- | applied directly to the teeth e.g carbamide peroxide gel (same medication applied to the ear canal for wax buildup) |
| Inhalation- | taking in of air, or of breathing in a drug, which affects the airway and lungs directly, or is absorbed through the lungs for a systemic effect. |
| Example Inhalers: | Albuterol- dilates the bronchi to ease breathing during an asthma attack (local effect) Tobi- inhaled drug that treats infections (systemic effect) |
| Nebulizer- | device used to administer medications in the form of a mist that is inhaled into the lungs. It can be used in treating the symptoms of asthma. |
| Anesthesia- | the most common medication administered via inhalation with a systemic effect to begin and to maintain a general anesthesia. |
| General anesthesia- | is for pain control, often during surgery, chara. by unconsciousness, muscle relaxation, a total loss of sensation throughout the entire body. Administered using either a face mask or an endotracheal tube |
| Nitrous oxide (laughing gas)- | relieves pain and causes relaxation and forgetfulness but usually without putting a patient under, often used in dental offices. |
| desflurane (Suprane) | a potent inhalational anesthetic that is used during surgery to accomplish general anesthesia |
| Skin - | Applying medication to a specific area of the skin, or to a wound, to anesthetize it, clean it, or otherwise aid in healing is a way to topically administer some medications. |
| Lotions and emollients | Hydrate the skin and make it soft |
| Antibiotic ointments | Apply to scrapes or cuts to prevent infection (e.g. Neosporin) |
| Astringents | Draw together tissues, protect the skin, and help to stop bleeding (e.g. Calamine lotion) |
| Antifungals | Treat athlete’s foot (e.g. miconazole) and jock itch (e.g. Lamisil) |
| Cleansers | Cleans out wounds (e.g. Betadine) |
| Premedicated pads | Treatment of hemorrhoids (e.g. Tucks) |
| Sprays | To relieve pain (e.g. Dermoplast and benzocaine) |
| Antivirals | Treat cold sores (e.g. Abreva) |
| Nose- | using the inside of the nose as an administration route (Intranasal) to primarily treat medical problems related to the nose (e.g. nosebleeds, sinus congestion/swelling) |
| Examples of Nose Administration: | Flonase, Nasonex, and Afrin |
| Systemic agent- | Imitrex Nasal Spray for migraine headaches |
| Vaginal- | generally administered topically in the form of a cream or suppository |
| Antifungal Suppositories- | treat vaginal infections e.g. Gyne-Lotrimin, Monistat, and Vagistat |
| Powders, creams, sprays- | treat symptoms of vaginal infection |
| Spermicide- | cream or suppository form, inserted into the vagina to kill sperm and prevent pregnancy. |
| Progesterone- | vaginal suppository inserted into the vagina where it is assimilated into the soft tissues and then the bloodstream, raising the level of progesterone in the body (systemic effect). |
| Enteral- | “relating to or inside the intestines” and have an intended systemic effect |
| Enteral medications- | medications-assimilated into the body through the gastrointestinal system, and the primary method for getting them into the body is through the mouth. |
| Oral administration- | by mouth, then in the stomach where most pass through intestinal wall and the liver. |
| Gastroduodenal feeding tube - | is an example of enteral administration that bypasses the mouth |
| Nasogastric tube (NG tube)- | through the nose, down the esophagus, and into the stomach |
| G-tube- | A gastric or a gastrostomy feeding tube is inserted via a small incision directly into the stomach. A similar tube, also inserted (usually via laparoscopy) for feeding is a percutaneous endoscopic gastrostomy (or PEG) tube |
| Jejunostomy tube- | smaller than a gastric tube and, is inserted into the jejunum instead of the stomach |
| Rectal- | via the rectum have a systemic effect and are generally in the form of a suppository or an enema |
| Suppository- | sm plug or cone of med inserted in rectum, designed to melt at body temp, being absorbed into the surrounding soft mucosa. A suppository is considered enteral because they are assimilated through the digestive tract |
| Phenergan suppositories- | treat nausea |
| glycerin or bisacodyl (Dulcolax)- | treat constipation |
| Oral medications | can be either solids or liquids |
| long acting (LA) - Entex LA | a cold medicine which contains a decongestant and an expectorant |
| long acting (LA) - Inderal LA | a beta-blocker used to help with chest pain, prevent heart attacks, or treat other circulatory system problems |
| sustained release (SR) - Wellbutrin SR | an antidepressant. It works on the brain to treat depression |
| sustained release (SR) - Bontril SR | an appetite suppressant |
| extended release (ER) - Ultram ER | for pain management, especially those with moderate to severe pain that requires a long treatment period can be addictive used when around-the-clock management is required |
| extended release (ER) - Depakote ER | This is both an anticonvulsant and a mood-stabilizing drug. It is used for treatment of bipolar disorder, epilepsy, and migraines. |
| controlled release (CR) - Nalex CR | a cold medicine which contains the same generic medicine as Entex LA |
| extended release (XL) - Glucotrol XL | an antidiabetic medication |
| Buccal- | refers to the area inside the cheek. The buccal area has large area of smooth muscle that allows for sustained delivery. The drug is placed between the upper gums and the cheek for buccal enteral administration |
| Nicotine Gum- | Delivers doses of nicotine to the blood-vessel-rich areas of the mouth EX: NicoDerm CQ, Habitrol |
| Testosterone- | male hormone, used to treat testosterone deficiency in men. EX: Striant |
| Sublingual- | the area under the tongue near many blood vessels |
| Under the tongue (permeable) | capable of being penetrated, particularly by a liquid or a gas |
| Under the tongue (rich blood supply) | means that substances can be assimilated very quickly from here |
| Sublingual (enteral administration) | medication is placed under the tongue and is one of the fastest ways for a drug to get into the body systemically |
| Sublingual (parenteral adminstration) | administration-bypasses the gastrointestinal system, and it is both assimilated quicker and causes fewer breakdowns or change in the chemistry of the drug itself |
| Sublingual Medications: | buprenorphine SL nitroglycerin SL isosorbide dinitrate SL |
| buprenorphine SL | An opioid, ironically used for treatment of opioid dependence. A pt is given sublingual doses of narcotic buprenorphine, under a brand name such as Subutex, in order to avoid severe withdrawal symptoms |
| nitroglycerin SL | A vasodilator that relaxes blood vessels, easing the workload of the heart, often given for angina or chest pain |
| isosorbide dinitrate SL | A vasodilator used to dilate the blood vessels, which helps to both prevent and alleviate heart pain |
| Parenteral - | Intravenous Injections |
| Intravenous (IV)- | injecting medication directly into a vein using a needle and syringe. The drugs bypass the gastrointestinal system, thereby avoiding both the delay of effect and the chemical alteration that can occur. |
| IV Syringe- | contains the drug and is attached to a hollow needle, and the drug is injected directly into a vein, generally a vein in the arm |
| Peripheral IV line- | is a catheter placed into a peripheral vein to administer meds or fluids and draw blood. |
| Central IV line (or central venous line)- | Placed into a large vein, the superior or inferior vena cava, or even within the atrium of the heart itself. |
| Mediation via central line ... | is added to a large, rapidly flowing vein; the medication burns less when added to the line. Some medications, like vancomycin, are caustic and can cause phlebitis. |
| PICC (peripherally injected central catheter) line- | used when a patient will require intravenous access for a long time period; inserted through a vein in the arm and threaded upwards until it is in the superior vena cava or right atrium. |
| Total parental nutrition (TPN)- | typically administered via a central line, which delivers 100 % of the patient’s nutrition via an IV line eliminating the need for both eating and digesting. |
| TPN (total parental nutrition) is necessary when ... | a pt has undergone major surgery and their digestive system can't properly function, or when a patient is in a coma or unconscious and requires nutrition |
| Parenteral – Intravenous Injections: | Intravenous (IV)- IV Syringe- Peripheral IV line- Central IV line (or central venous line)- PICC (peripherally injected central catheter) line- Total parental nutrition (TPN)- Intramuscular (IM) Subcutaneous (SQ) Spinal |
| Methods of Infusion: | intravenous drip bolus piggyback |
| intravenous drip | This is the continuous infusion of fluid (which can be accomplished with or without medication) through any of the IV access devices and administered slowly over time. |
| bolus | The administration of medication in a single, large dose. The drug is administered all at once. |
| piggyback | Intermittent infusion. This typically involves a smaller IV bag added into the existing IV line to administer doses of medication. |
| Intramuscular (IM)- | a long needle with a large diameter to get through all the layers on top of your muscle because the needle reaches all the way inside a muscle to deliver its contents. EX: hips, gluteals, lg muscle of legs |
| Types of Intramuscular Drugs: | vaccine antibiotics follicle-stimulating hormones, hCG as protocol for in vitro fertilization |
| Subcutaneous (subcu, subq, SQ)- | a short, small diameter needle is used to inject medication through the skin, specifically the layer of fat directly under the skin. |
| Types of Subcutaneous Drugs: | insulin (insulin-dependent diabetics- systemic effect) Novocain (dental procedures-local effect) |
| Spinal- | The spinal administration route is accomplished with a needle injected directly into the spinal canal. This can achieve a different result dependent upon where in the spinal canal it is inserted. |
| Types of Spinal Administration: | Spinal block Epidural Intrathecal Instillation |
| Spinal block | delivered directly into the spinal fluid and is a one-time injection. This can be used for pain control during and after a caesarean. |
| Epidural | into the epidural space surrounding the spine |
| Intrathecal Instillation | introduced into or occurring in the space under the arachnoid membrane of the brain or spinal cord. Methotrexate is often used for cancer chemotherapy and injected into the spinal canal. |
| Drug Action - Absorption | Drug active ingredients dissolved and released into bloodstream |
| Drug Action - Distribution | Drug active ingredients circulated to various structures/tissues of the body |
| Drug Action - Metabolism | Chemical alteration of the drug to perform its therapeutic function in the body |
| Drug Action - Elimination | Removal/excretion of the drug |
| Absorption- | the active ingredients of a drug preparation are dissolved and released into the bloodstream |
| Absorption rate- | is the key to determining the amount of drug needed, the timing of the doses, and the way the drug is administered |
| Amoxicillin absorption is increased when... | taken with antacids |
| Cipro is not absorbed well when taking with foods... | containing a lot of calcium, magnesium, or iron (e.g. antacids, vitamins, or dairy products). |
| Absorption term - Half-Life | the time the total amount of drug diminishes by one half |
| Absorption term - Loading Dose | a large dose given rapidly at the beginning of treatment to reach therapeutic level quickly |
| Distribution- | Transportation of a drug via the bloodstream to other body tissue (travel the bloodstream or target a specific organ) |
| Liver- | the first organ the drug encounters |
| First change- | active form and then inactive form for elimination |
| Secondary activity- | may lead to a new treatment or to unwanted side effects |
| Factors impacting rate of drug distribution: | Proteins Fluid retention Obesity Disease states (like if the pt has CKD, this will effect it) Age |
| Metabolism- | how well your body breaks down the drug, called metabolized or chemically changed, so it can perform its therapeutic function |
| Factors impacting rate of metabolism | Age Liver and Kidney function Drugs Foods |
| Elimination- | how the drug is eliminated from the body Urine (most drugs) Feces |
| Potency- | a drug’s strength and typically used to compare drugs within a class or group that work by the same mechanism |
| Efficacy- | the degree to which a drug can produce a certain effect. Efficacy also means the degree to which a drug is able to induce an effect |
| Dilaudid (hydromorphone) is more potent than... | Morphine |
Created by:
wallace263
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