Medication and Medication Administration

Overview

• Discuss medication administration steps and types of medications
• Focus on routes of administration and the specific medications for different conditions

Routes of Administration

• Sublingual: Nitro placed under the tongue
• Oral: Aspirin chewed and swallowed
• Inhalation: Albuterol via nebulized treatments
• Intramuscular: EpiPen usage
• Subcutaneous: Less common, used in specific situations
• Intranasal: Narcan using a MAD device

Medication Names and Forms

• Understand chemical and generic names, e.g., Naloxone (generic) vs. Narcan (trade)
• Review different forms: pills, suspension, liquid
• Familiarize with medication administration devices: syringes, auto injectors, brist jets

Pre-Administration Checklist

1. Obtain an order (written protocol or direct order from medical control)
2. Verify proper medication by reading the label twice
3. Check for patient allergies
4. Confirm the Five Rights of Medication Administration:
   • Right medication
   • Right date (not expired)
   • Right dose
   • Right route
   • Right patient
5. Document time and amount of medication given

Specific Medications

Oxygen

• Indication: SPO2 < 94%
• Contraindication: SPO2 > 94%
• Dosage: Varies by device
  • Nasal canula: 1-6 L/min
  • Non-rebreather: 10-15 L/min
  • BVM: 15 L/min
• Action: Increases available oxygen for tissue perfusion
• Side Effects: Increased systemic resistance, decreased cardiac output

Oral Glucose

• Indication: Diabetic patients with hypoglycemia (blood glucose < 60)
• Contraindication: Unconscious or unable to swallow
• Dosage: 15 grams
• Action: Increases blood sugar levels
• Administration: Apply buccally with a popsicle stick
• Side Effects: Delayed absorption

Activated Charcoal

• Indication: Ingestion of opioids, anticholinergics, or sustained-release medications
• Contraindication: Altered mental status, ingestion of acids/alkali
• Dosage: 1 g/kg body weight
• Action: Binds and absorbs medications
• Side Effects: Vomiting, black stool

Aspirin

• Indication: Cardiac chest pain
• Contraindication: Allergy, internal bleeding
• Dosage: 324 mg (four 81 mg baby aspirin)
• Action: Prevents platelet aggregation
• Side Effects: Stomach irritation

Nitroglycerin

• Indication: Chest pain
• Contraindication: BP < 90 systolic, use of phosphodiesterase inhibitors
• Dosage: 0.4 mg sublingual, up to three doses
• Action: Vasodilation
• Side Effects: Headache, blood pressure drop

Meter Dose Inhaler (MDI) / Small Volume Nebulizer (SVN)

• Medication: Albuterol
• Indication: Difficulty breathing, asthma, COPD
• Contraindication: Altered mental status, prescription requirement
• Dosage: Follows prescription or action plan
• Action: Bronchodilation
• Side Effects: Shaking, dry mouth, headache

EpiPen

• Indication: Severe allergic reactions or anaphylaxis
• Dosage: 0.3 mg for adults, 0.15 mg for pediatrics
• Action: Vasoconstriction, bronchodilation
• Side Effects: Increased heart rate, anxiety

Naloxone (Narcan)

• Indication: Suspected opioid overdose
• Contraindication: Hypersensitivity, infant opioid exposure
• Dosage: 2 mg, can start with smaller doses
• Action: Blocks opioid receptors
• Side Effects: Chest pain, agitation

Additional Medications

• Ibuprofen (Motrin, Advil): Non-steroidal anti-inflammatory, avoid in clotting issues
• Tylenol (Acetaminophen): Pain relief, fever reduction; monitor for liver damage
• Pralidoxime Chloride and Atropine: Antidote for cholinergic toxicity, administered via auto-injector