1. Chapter 53 Administering Oral and Non-Injectable Medications Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

2. Routes of Medication Drugs may be administered by many different routes Providers select the route based on: – Rate of absorption desired – Distribution – Biotransformation – Elimination Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

3. Routes of Administration Oral Buccal Sublingual Drops Inhalation Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

4. Routes of Administration Intradermal Intramuscular Intranasal Intraosseous Intrathecal Intravenous Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

5. Routes of Administration Ophthalmic Otic Rectal Subcutaneous Topical Transdermal Vaginal Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

6. Prescriptions A written order prepared by a licensed provider authorizing a medication or treatment to be dispensed to the patient for self-administration Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

7. Elements of a Prescription Provider’s name and address Date of issue Patient’s name and address Drug name Dosage form Quantity prescribed Directions for use Number of refills “Dispensed as written” or if substitutions are permitted Manual signature of prescriber Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

8. Preparing Prescriptions In offices with EHR, prescribers can directly transmit prescriptions directly to the pharmacist In offices without EHR, it may be the MA’s responsibility to prepare the handwritten prescription, except for the final review and signature Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

9. Preparing Prescriptions If MA telephones prescription to the pharmacy: – Provide the pharmacist with ALL the information contained in the prescription – The pharmacist should repeat back this information to ensure accuracy Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

10. Medication Orders Medication orders are direct and complete instructions from the provider for administering medication to a patient while in the office Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

11. Elements of a Medication Order Full name of the patient Name of the medication Dosage Route of administration How often, or frequency, the medication is ordered Date and time the order is written Specific instructions Signature of the prescriber Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

12. Seven Rights of Medication Administration 1.Patient 2.Medication 3.Dose 4.Route 5.Technique 6.Time 7.Documentation Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

13. Right Patient Use TWO identifiers Ask the patient to cite his or her full name and another identifier from the chart – Do not ask the patient to reply “yes” or “no” Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

14. Right Medication Check the medication order and verify the medication at least four times: – When preparing the medication – Upon bringing the medication to administer to the patient – Prior to administering – Following administration Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

15. Medication Errors A medication error involves one or more of the following: – Correct drug given to wrong patient – Wrong drug given to the correct patient – Wrong dose administered – Drug given by the wrong route – Drug given at the wrong time Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

16. Medication Errors NEVER try to cover up a medication error Notify the provider at once The provider will to determine what steps need to be taken Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

17. Medication Documentation Who, what, where, when, why Immunization documentation – Manufacturer – Lot number – Serial number – Container’s expiration date Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

18. Using Abbreviations There are a number of abbreviations used in the health care office Spell out the words if you are unsure of the appropriate abbreviation Spell out the words if it could create any confusion as to what is being written Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

19. Error-Prone Abbreviations Joint Commission’s DO NOT USE list Institute of Safe Medication Practice’s list of error-prone abbreviations Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

20. Documenting Adverse Reactions Document any reaction to medication given, along with corrective actions taken: – Date and time – Type of reaction – Medication administered to reverse the reaction or restore function – Airway support, when applicable – Level of care – Outcome of interventions – Instructions provided to the patient Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

21. Administering Medications Oral medications are taken by mouth and intended for absorption through the digestive system Other methods are parenteral (intended for absorption outside the digestive system) Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

22. Oral Medications Oral medications come in a variety of forms: pills, tablets, capsules, caplets, lozenges, syrups, sprays, and other liquids Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

23. Oral Medications Oral medications have many advantages: – Easily prepared and administered – Easily stored – Generally more economical for the office and patient – Generally associated with lower risk and less expense than medication given by injection – Easily for patient to self-administer at home Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

24. Sublingual and Buccal Administration Sublingual: The medication (usually tiny tablets or spray) is placed under the tongue Buccal: The medication is placed or sprayed in the mouth between the gum and the cheek The medication is absorbed through the mucous membranes into the bloodstream Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

25. Parenteral: Non-injectable Routes: inhalation, nasal, ointment, otic, rectal, topical, transdermal, urethral, and vaginal Medications given by these routes may be applied directly to the affected body part or inhaled into the lungs Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

26. Nasal, Ophthalmic, and Otic Usually drops, ointments or salves Applied directly into the nose, eyes or ears Provide immediate relief or direct absorption by the target tissues Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

27. Inhalation Medications in the form of gases, sprays, fluids, or powders Breathed into the respiratory tract The patient often self-administers through a metered inhaler or nebulizer In the office, oxygen is a form of inhalation medication Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

28. Topical Medications in the form of sprays, lotions, creams, ointments, paints, salves, wet dressings, and transdermal patches Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

29. Topical Used in treating diseases or disorders of the skin or mucous membranes Must be applied as prescribed to achieve the desired effect Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

30. Rectal Most common medication forms are suppositories and enemas Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

31. Vaginal Medications in the form of creams, suppositories, tablets, douches, foams, ointments, tampons, sprays, and salves Patient education is important – Women may be uncomfortable or embarrassed – Vaginal medication should not be used during menstruation – Advise patients to use disposable panty liners to avoid medication leaking and staying undergarments or clothes Copyright ©2012 Delmar, Cengage Learning. All rights reserved.