Drug Classifications & Forms, Medication Orders, and Legal Aspects

Welcome to Day 2 of your pharmacology journey! Today, we'll delve into the world of drugs, exploring their classifications, forms, and how they're ordered. We'll also cover your crucial responsibilities as a nurse, including the legal and ethical considerations of medication administration.

Learning Objectives

  • Identify and classify common drug categories (e.g., cardiovascular drugs, antibiotics, analgesics).
  • Differentiate between various drug forms and their appropriate administration routes.
  • Interpret common types of medication orders and understand their components.
  • Explain the nurse's legal and ethical responsibilities in medication administration, including the five rights.

Lesson Content

Drug Classifications: What Do They Treat?

Drugs are grouped based on their therapeutic use, how they work in the body, or their chemical structure. Knowing these classifications helps you understand what a medication is used for and its potential effects. Here are some common categories:

  • Cardiovascular Drugs: Treat heart and blood vessel conditions (e.g., beta-blockers for high blood pressure).
  • Antibiotics: Fight bacterial infections (e.g., penicillin).
  • Analgesics: Relieve pain (e.g., ibuprofen, morphine).
  • Antiemetics: Prevent nausea and vomiting (e.g., ondansetron).
  • Antidiabetics: Manage blood sugar levels in diabetes (e.g., insulin, metformin).
  • Antihypertensives: Manage High Blood Pressure (e.g., ACE Inhibitors, ARBs).
  • Respiratory Medications: Treat respiratory disorders (e.g., bronchodilators, corticosteroids).

Example: If a patient is prescribed Lisinopril, you know it's a cardiovascular drug, likely used to lower blood pressure. If they are prescribed Amoxicillin, it's an antibiotic used to fight infections.

Quick Check: Which drug classification is used to treat bacterial infections?

Drug Forms and Administration Routes: How Do We Give It?

Drugs come in various forms, each designed for a specific route of administration. The route impacts how quickly the drug takes effect.

  • Oral (PO): Tablets, capsules, liquids taken by mouth (e.g., amoxicillin capsules).
  • Intravenous (IV): Injected directly into a vein (e.g., normal saline).
  • Intramuscular (IM): Injected into a muscle (e.g., flu vaccine).
  • Subcutaneous (SubQ): Injected under the skin (e.g., insulin).
  • Topical: Applied to the skin (e.g., creams, ointments).
  • Sublingual (SL): Placed under the tongue (e.g., nitroglycerin tablets).
  • Inhalation: Breathed in (e.g., albuterol inhaler).
  • Rectal/Vaginal: Suppositories or creams (e.g., antiemetic suppositories).

Example: Morphine can be administered IV (fast effect) or PO (slower release and longer duration).

Quick Check: What is the most common route for giving a tablet?

Medication Orders: The Instructions We Follow

Medication orders provide the instructions for administering a drug. They must be clear, complete, and legally valid. Common components include:

  • Patient's Name and Medical Record Number (MRN): To confirm the right patient.
  • Date and Time of Order: For accurate record-keeping.
  • Drug Name: The specific medication (e.g., amoxicillin).
  • Dosage: The amount of medication to administer (e.g., 500 mg).
  • Route: How the drug should be given (e.g., PO, IV, IM).
  • Frequency: How often the drug should be given (e.g., every 8 hours).
  • Prescriber's Signature: Legally required. Orders are written by doctors, nurse practitioners, etc.

Types of Orders:
* Routine Orders: Given regularly until discontinued.
* PRN (Pro Re Nata) Orders: Given as needed, based on a specific need (e.g., pain medication).
* STAT Orders: Given immediately, only once (e.g., for an emergency).
* Single Orders: Given once at a specific time (e.g., pre-operative antibiotics).

Example: "Amoxicillin 500mg PO q8h" means give 500 milligrams of amoxicillin by mouth every 8 hours.

Quick Check: Which part of a medication order provides the directions for how often the medication should be given?

Legal and Ethical Aspects: The Nurse's Responsibilities

As a nurse, you are legally and ethically responsible for safe medication administration. This involves:

  • The Five Rights of Medication Administration: These are your fundamental safety checks:
    1. Right Patient: Verify patient's identity (name and MRN). Use at least two identifiers.
    2. Right Drug: Compare the medication label with the MAR (Medication Administration Record) 3 times. Make sure the drug is correct.
    3. Right Dose: Calculate the dose accurately. Double-check with another nurse for high-risk medications.
    4. Right Route: Ensure the medication is given by the correct route as prescribed.
    5. Right Time: Administer the medication at the prescribed time (e.g., within the 30-minute window). Consider the medication's half-life and patient's routines.
  • Safe Handling and Storage: Follow protocols for storing and handling medications, including controlled substances.
  • Patient Education: Inform the patient about the medication's purpose, dosage, side effects, and any special instructions.
  • Documentation: Accurately record medication administration on the MAR, including the drug, dose, route, time, and your initials/signature.
  • Reporting Errors: Immediately report any medication errors according to your facility's policy. Never try to cover up an error.

Quick Check: What is the primary purpose of the 'Right Patient' in the Five Rights of medication administration?

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