Unit 2- medication administration

The study of Pharmacology is a very large topic, but for the purposes of this CRMA course, we will look at ​the basics of some common medications, along with the typical side effects of these medications on the ​body systems.

Topics:

• 5 sources of medication ingredients
• How meds are named- chemical, generic, brand, official
• The 8 "rights" of med administration

This intro to Unit 2 will help you understand the “language” used to by licensed prescribers to write ​medication orders:

• medical abbreviations- shorthand used in healthcare
  
• Metric measurements- milligrams and milliliters
  
• types of medication orders
• classification- medication purpose/use
  
• categories- how meds are organized
  

Glossary of terms

• Administer- to “give”; we administer/give medications to our clients
  
• Bubble pack- individually packaged pills in a card with clear plastic “bubbles”. Each pill can be ​“popped” out when meds are to be given
  
• CRMA- Certified Residential Medication Aide, an unlicensed support staff role in the State of Maine to ​administer (give) non-injectable medications in the residential care setting
  
• Discontinue/ discontinued (D/C)- if the prescriber (doctor) wants to stop giving a med to a client, or if ​all med doses have been completed, the
  
• MAR- medication administration record; a documentation tool used to record each time a med is ​given or missed
  
• Order- written directions by a licensed prescriber to give medications or treatments
  
• Prescriber- refers to the licensed healthcare professional who is legally authorized to write official ​medication orders- can refer to a variety of titles: doctor, physician, practitioner
  

5 sources of medication ingredients

Medication ingredients come from 5 sources, just like all material products-

1.plants- herbs

2. animals or humans– hormones, insulin

3. mineral- vitamin/ mineral supplements

4. microorganisms– antibiotics

5. man-made– synthetic drugs

How medications are made

In this video, learn how medications are produced in the factory- notice the organization and teamwork within the workplace. You will now be part of this world-class industry that strives for excellence in everything we do, both at work and in our personal lives.

How medications are named

Medication names- meds are named in 4 progressive stages of production, just like any other retail product-

1. chemical name- when first produced in the factory

(with a long chemical name you can’t pronounce!)

2. generic name- wholesale

3. brand name- retail

4. government– generic name with a numeric code

The 8 "rights"

The “8 rights” are the key points to remember every time you give a med:

1. The right resident- know who the med is for and be aware of their allergies

2. The right med- know what the med is: generic/brand name, classification, potential side effects

3. The right dose- know the correct amount of tablet milligrams or liquid milliliters to give

4. The right route- know where/how the med should enter the body: by mouth, eyes, ears, skin etc.

5. The right time- know when the med should be given

6. The right reason- know why the med is given

And we keep in mind......

7. The client has the right to refuse- clients have the legal privilege to know their meds and refuse them

8. The right documentation- know how to complete all documentation associated with giving meds

The 8 "rights"

Medical abbreviations- short terms from the Latin language

Routes- how the med enters the body

• PO= oral/ by mouth
  
• SL= sublingual/ under the tongue
• nasal= nose
• inh= inhaled through nose of mouth
• opth= opthalmic/eye
• otic= ear
• topical= outer layer of skin
• inj= injection/ inner layer of skin
• PR= rectal
• Vag= vaginal

here's a graphic of "the 5 senses" to help you remember some routes

Eye/ Ear routes

TIME ABBREVIATIONS

The "right time" is the only "right" that is not always specific

Q= EVERY

QD= EVERY DAY (USUALLY MEANS IN THE AM)

BID= TWICE DAILY

TID= THREE TIMES DAILY

QID= FOUR TIMES DAILY

QOD= EVERY OTHER DAY

AC= BEFORE MEALS

PC= AFTER MEALS

QHS= AT BEDTIME

PRN= AS NEEDED

STAT= IMMEDIATELY

Other abbreviations

NPO= NOTHING BY MOUTH- THIS USUALLY APPLIES TO A PERIOD OF TIME BEFORE BLOOD TESTS OR SURGERIES

SUPP= SUPPOSITORY, CNA BE RECTAL OR VAGINAL

C= WITH

S= WITHOUT

GTT(S)= DROP OR DROPS

Measurements

There are 3 types of medication measurements:

1. Metric- milligram and milliliter
2. household (teaspoon/tablespoon)
3. apothecary -old European system
   

Measurements

milligram= 1/1000 of a gram

Solid weight– tablets are made of medicinal compressed powder, the most common type of pill used to deliver oral medication, dissolve in the GI tract. The concentration of medicine is often measured in the solid metric unit - milligram

1000 microgram/mcg =1 milligram/ mg

1000mg = 1 Gram

1000 Grams= 1 Kilogram

Measurements

milliliter= 1/1000 of a liter

Liquid volume– elixirs, syrups, solutions, easy to swallow, absorbs quickly.

The concentration of medicine is often measured in liquid metric unit- milliliter

1000 Milliliter/ml = 1 Liter

1000 Liters = 1 Kiloliter

gtt(s)= abbreviation for liquid drop(s)

Dose= overall amount of med within a time range

Strength= individual amount of med per unit

example:

Tylenol 325mg, give 2 tabs twice daily

The overall dose is 650mg

The individual strength is 325mg per tab

Twice daily, so overall daily dose= 1300mg

Types of medication orders

A medication order is legal, written directions provided by a licensed prescriber for a specific medication to be administered to a specific person. The medication order must include the rights #1-#6, with a signature and date.

routine order

Med is given consistently on a regular schedule

PRN order

Med is given “as needed” when the resident requests it

standing order

Meds for general care and comfort, over-the-counter meds, ordered in a group list

one-time order

Med is ordered for just one dose

STAT order

Med ordered to be given immediately, usually for an acute emergency

Classification of meds

Meds are classified by their purpose: , why is the prescriber ordering the medicine?

Examples: an analgesic for pain, an antidepressant for depression, and antihypertensive for hypertension

You have this list in the email attachments

with the course info and links

Categories - how meds are organized

Controlled narcotic meds

These meds are in the schedule 2 group with a high potential for abuse and addiction, must be double locked and counted at the beginning and end of each shift. Orders for controlled meds legally expire in 1 month.

Non-controlled meds

These meds are in the schedule 3-5 group with a low potential for abuse and addiction, require to be single locked. Orders for non-controlled meds expire in 12 months.

Unit 2- medication administration

Watch or just listen to the video for a review of getting started with medication administration. this video is from a prior class so it is not exactly aligned with this class, but the overall information is the same.

How many times do you check the med label to the order transcribed onto the MAR???

3 times with each med:

before during and after

you remove a med from the container, every med, every time!