Reading Labels: Generic Names (p. 159) Given by manufacturer who develops medication One generic name Legally required on all labels Nurses need to know Less expensive than trade name version Common generics: morphine, atropine, phenobarbital, meperidine Look-alike, sound-alike: very different Hydralazine vs. hydroxyzine Trade names The generic name is given by the manufacturer that first develops the medication. Medications have only one generic name. Prescribers are ordering medications more often by the generic name, so nurses need to know the generic name as well as the trade name. Pharmacists in many institutions are dispensing medications by generic name to reduce costs. The trade name is also referred to as the brand name or proprietary name; it is the manufacturer's name for the medication. NURSING APPLICATION: How does the nurse know the difference between generic drugs? Copyright © 2011 by Elsevier Inc. All rights reserved.

Reading Labels: Form (p. 163) Type of med in package Tablets, capsules, liquids, suppositories, ointments Abbreviations or words that describe form CR (controlled release), DS (double-strength) Bar-code symbols Aid in inventory control and distribution The nurse should be able to recognize generic, trade name, and dosage strength on a medication label. Route of administration (e.g., oral, IM, IV) should be clearly indicated on the label. NURSING APPLICATION: What is the difference between controlled release and timed release? Copyright line.

Reading Labels: Precautions: Expiration (p. 166) Safety Storage Examples: Protect from light, Keep tightly closed, Refrigerate after opening Usual dosage Medication labels contain information such as the expiration date (which may be indicated with the abbreviation “Exp”). Expiration dates indicate the last date on which a medication should be used. ALWAYS read expiration dates! NURSING APPLICATION: What safety precautions will be important for Ms. Jackson? Copyright © 2011 by Elsevier Inc. All rights reserved.

Reading Labels: Combinations (p. 168) The capsule, tablet, or liquid contains two medicines within one vehicle Orders must include dosages, not just number of tabs or milliliters! Exceptions: If strength is NOT indicated on label, only one strength exists, and it can be ordered by number of tabs, caps, milliliters Some medication labels may indicate that a medication contains two or more medications. Examples of exceptions: multivitamins, Bactrim DS, Percocet If medications are combined, the order and label must give the strengths of both medications. NURSING APPLICATION: Why would a combination drug be ordered for Ms. Jackson? Copyright © 2011 by Elsevier Inc. All rights reserved.

Reading Labels: Controlled Medication Labeling (p. 168) Narcotic FDA control number Based on abuse potential Schedule I to Schedule V Written as CI, CII, CIII, CIV, CV Highest abuse potential is CI Lowest abuse potential is CV Medications considered controlled substances are classified into schedules that rank them according to their abuse potential and physical and psychological dependence. They are ranked from Schedule I to Schedule V Medications that have the highest abuse potential are on Schedule I, and medications with the lowest or limited abuse potential are Schedule V medications. NURSING APPLICATION: Is it possible for Ms. Jackson to become addicted to a medication? Why or why not? Copyright © 2011 by Elsevier Inc. All rights reserved.

Making Conversions Using Dimensional Analysis (p. 238) Identify desired unit Identify equivalent needed Write equivalent in fraction format with desired unit in numerator as first part of equation Label all factors in equation, with x being what you desire to have in the end Dimensional analysis is a conversion method that has been used in chemistry and other sciences and will be discussed in more detail in Chapter 16. Dimensional analysis involves manipulation of units to get the desired unit. This method can be used for conversion in all systems NURSING APPLICATION: What would be the advantage of using dimensional analysis to calculation the correct amount of medication to give to Ms. Jackson? Copyright line.

Making Conversions Using Dimensional Analysis (cont’d) (p. 239) Identify unwanted or undesired units and cancel, then reduce to lowest terms Must be able to eliminate all labels except for answer label; if not, recheck Perform mathematical process A simple technique with a fancy name for the process of manipulating units. By manipulating units, the nurse is able to eliminate or cancel unwanted units. It is considered to be a common-sense approach that eliminates the need to memorize a formula Note: It is key to have the equation set up correctly! NURSING APPLICATION: What would be disadvantages of using dimensional analysis to calculation the correct amount of medication for Ms. Jackson? Copyright © 2011 by Elsevier Inc. All rights reserved.

Making Conversions Using Dimensional Analysis (cont’d) (p. 239) Example: Viewed as a problem-solving method. Used for all calculations. NURSING APPLICATION: Compare this method of dosage calculation with the ratio and proportion method. Copyright © 2011 by Elsevier Inc. All rights reserved.

Making Conversions Using Dimensional Analysis (cont’d) (p. 241) Example: Order is Lasix 40 mg p.o. daily Available: 20 mg tablets Place the info in a problem on right in fraction format, matching desired unit in numerator See how dimensional analysis allows multiple factors to be entered in one equation. Stating the equivalent incorrectly will not allow you to eliminate desired units. Knowing when the equation is set up correctly is an important part of the concept of dimensional analysis. NURSING APPLICATION: What process should be used to ensure that the equation is set up correctly? Copyright © 2011 by Elsevier Inc. All rights reserved.

Making Conversions Using Dimensional Analysis (cont’d) (p. 241) Cancel "like" units on right of equation; remaining unit of measure should be what is desired You have not changed the value of the unit; you have simply rewritten the equivalency or conversion factor in a fraction format. Placing a 1 under a value does not alter the value of the number. The answer you seek is labeled x. All factors entered into the equation always must include the quantity and unit of measure. State all answers following the rules of the system. When there is more than one equivalent for a unit of measure, use the conversion factor used most often. NURSING APPLICATION: Ms. Jackson has a temperature of 101.2° F. Practice using this process to calculate the correct amount of medications for Ms. Jackson. Medications: Acetaminophen 1000 mg by mouth every 6 hours PRN for temperature greater than 100.5° F (38.1° C) or pain; not to exceed 4 g in 24 hours. The available tablets are 500 mg. Copyright line.

Dimensional Analysis Using Conversion Factor (p. 239) When a conversion factor is needed, the conversion factor is placed as the second fraction inside the equation Match numerator of conversion factor with denominator of previous fraction Identify the desired unit. Identify the equivalent needed. Write the equivalent in fraction format, keeping the desired unit in the numerator of the fraction. This is written first in the equation. Label all factors in the equation, and label your desired answer as x (unit desired). Identify unwanted or undesired units, and cancel them. Reduce to lowest terms if possible. If all the labels except the answer label are not eliminated, recheck the equation. Perform the mathematical process indicated. NURSING APPLICATION: Practice using this process to calculate the correct amount of medications for Ms. Jackson. Medications: Acetaminophen 1000 mg by mouth every 6 hours PRN for temperature greater than 100.5° F (38.1° C) or pain, not to exceed 4 g in 24 hours. The available tablets are 500 mg. Copyright © 2011 by Elsevier Inc. All rights reserved.