Pharmacology and Medication Administration (Basic Principles)

Pharmacology is the study of drugs and their effects on the body. In emergency situations, quick and effective medication administration can be life-saving. As a phlebotomist, you won't typically administer medications, but understanding them is crucial. This section focuses on a few common emergency medications you might encounter or hear about:

• Epinephrine (EpiPen): Used to treat severe allergic reactions (anaphylaxis). It works by constricting blood vessels and opening airways. Example: Imagine a patient with a bee sting experiencing difficulty breathing and swelling; the EpiPen can counteract those effects.
• Glucose (Oral Glucose): Administered to patients with low blood sugar (hypoglycemia). Example: A diabetic patient becomes confused and weak; oral glucose can quickly raise their blood sugar.
• Oxygen: Provides supplemental oxygen for patients experiencing respiratory distress. Example: A patient struggling to breathe after a cardiac event may require oxygen via nasal cannula or mask.

The route of administration affects how quickly a drug takes effect. Understanding these routes is important for recognizing medication effectiveness and potential issues. As a phlebotomist, your exposure will be mostly to observations and potentially assisting in preparing or observing administration.

• Intramuscular (IM): Injected into a muscle (e.g., EpiPen). Provides rapid absorption. Advantage: Faster than oral administration. Disadvantage: Requires needle injection, risk of injection site complications.
• Subcutaneous (SubQ): Injected under the skin. Slower absorption than IM. Advantage: Similar to IM but can be self-administered. Disadvantage: Slower absorption.
• Oral (PO): Taken by mouth (e.g., oral glucose). Slowest absorption, useful for sustained effects. Advantage: Easy to administer. Disadvantage: Absorption can be affected by food and other factors.
• Inhalation: Breathed in (e.g., some asthma medications). Very rapid absorption into the bloodstream via the lungs. Advantage: Very rapid onset. Disadvantage: Requires specialized equipment.
• Intravenous (IV): Administered directly into a vein. Fastest method of administration. Used in critical situations in a clinical setting. Advantage: Fastest absorption, precise dosage. Disadvantage: Requires trained personnel and IV access.

Important Note: Phlebotomists typically do not administer medications via IV or IM routes in most settings. However, you need to understand the concept and be aware of their role when assisting nurses or other healthcare professionals.

Medications can interact with each other, with certain medical conditions (contraindications), and produce unwanted side effects. Understanding these is essential for patient safety.

• Drug Interactions: Occur when two or more drugs taken together alter the effect of one or both drugs. Example: Combining a blood thinner with aspirin can increase the risk of bleeding. Your Role: As a phlebotomist, you can contribute by taking a good patient history. Ask the patient about any medications they take and document them for the healthcare provider.
• Contraindications: Situations where a drug should not be used because it could be harmful. Example: Epinephrine is contraindicated in patients with severe heart disease. Your Role: You must be able to recognize or report a patient's history that may contradict medication administration, so you need to be aware.
• Side Effects: Unintended effects of a drug. Example: Drowsiness from antihistamines. Your Role: Observe and report any unexpected symptoms to the nurse or other designated healthcare professional.

Remember: Always follow established protocols. If you're unsure about a medication, never administer it. If a patient is experiencing a side effect, alert a nurse or provider immediately.

Phlebotomists play a support role. You may be involved in preparing a patient for a medication administration. The following are typical things you might encounter and the associated roles:

• Taking and Recording Patient History: Gather a comprehensive medication list, including over-the-counter drugs, and document any known allergies and health conditions. This information is crucial for healthcare professionals. Be detailed and accurate, as possible side effects may be caused by known allergens or conditions.
• Assisting with Medication Preparation: Depending on your scope of practice, you might assist by setting up medications (e.g., preparing an EpiPen or oxygen). Follow all protocols.
• Observing the Patient and Reporting: Alert the nurse or other appropriate professional about the patient's reaction to medications and document any adverse reactions. Be observant and alert. Pay attention to how the patient reacts.
• Following Safety Protocols: Understand and adhere to procedures in place at your facility, especially those related to medication storage and handling. Adhere to your scope of practice. Always follow the instructions from the nurse or provider.

This focuses on the EpiPen, since it's commonly encountered. It is an emergency drug.

• If Permitted By Scope: Some phlebotomists are trained and authorized to administer an EpiPen. If your facility allows it, it is crucial to be trained. This training usually is performed by an expert or supervisor. Always practice these actions with a trainer and in a simulated environment before administering on a real patient.
• Understanding the Action: Epinephrine is administered to stop an allergic reaction.
• Proper Administration: Follow the training provided to administer correctly, and know the correct sites.
• Post-Administration: Stay with the patient after administration, call for help, and follow facility protocols.
• Important: Check your local laws and regulations. You must have proper training and follow your facility's procedures.