all right this video is going to be talking about medication and medication administration um the steps that we're going to be taking prior to giving our patient medication and what medications that will be given to these patients so now we're looking at routes of administration um we have multiple different routes uh you'll be using medications via sublingual like Nitro under the tongue or orally aspirin getting the patient to chew it up and then swallow it um you'll use inhalation with albuterol um they'll be getting nebulized treatments inter muscular that is going to be whenever you're using that EpiPen um and doing that Administration in a patient thy we you guys don't really do a whole bunch of subcutaneous but in certain situations you may be able to do subcutaneous injections and then last but not least intranasal that's going to be when we're giving our patients Naran using a mad device to get a nice spray over the mucosal membranes other things that I want you guys to kind of take a look at is look at the chemical and generic names of the medications um that way whenever you're seeing the different versions and different names of a medication you know uh exactly what that is for instance nxone is Naran nxone is going to be the generic name whereas uh Naran is going to be the trade name that's specifically given by the company um also take a look at the different forms that medication comes in um like in a pill form or in a suspension or liquid form make sure that you're familiar with that and all the different medication administration devices like syringes Auto injectors um and brist Jets just make sure that you go ahead and review those and how to use all of those prior to starting to administer uh medications in class so um to administer medication to a patient there's a couple of things that we want to do prior to giving our patients medication one of those is going to be obtain in order um most of the time we'll have uh written protocols that we're going to follow so that's how we're going to get most of our orders but on occasion you may have to reach out to medical control to get a direct order from them um make sure that whenever you go in your bag you're grabbing a proper medication make sure you read the label and check it twice you know um we don't want to make a mistake and give our patients the wrong medication definitely ask about allergies um if they're allergic to anything even though by the time you're given medication you should have done a sample history on your patient um we still want to make sure that we double check about allergies just to be safe and then we're always going to check the five rights of every medication prior to Administration we want to make sure that we have the right medication we have the right date as in it's not expired we have the right dose um so make sure that you go through and learn all the different doses for all of our medications we'll kind of go over some of that in a second um make sure it's the right route um like I talked about on the previous slide and then make sure that it is the correct patient sometimes we do have medications that we assist our patients with so make sure that whenever you're administering those medications to the patient that you're verifying that that medication belongs to them prior to Administration and last but not least we need to document everything we definitely want to make sure that we're writing down the time that we give our medications and how much medication that we gave the first medication we're going to go over is going to be oxygen oxygen is uh fairly simple if the patient spo2 is under 94% then we want to be administering these patients oxygen um the only contraindication to it is if our patient has a spo2 greater than 94 we do not want to be administering Pat oxygen to these patients um remember too much of anything is a bad thing for the dosage um depending on what device you're using to give oxygen to your patient you're going to switch up the amount of liters per minute that you're going to be giving the patient so for the nasal canula is going to be 1 to six um lers per minute for the N breather is going to be 10 to 15 liters per minute and then last but not least for the BVM it's going to be 15 lers per minute um the action is pretty simple all we're doing is increasing the available oxygen um to the patient for their tissues to be profused right um side effects if you do give too much of it it can cause increased systemic resistance right and decrease cardiac output this is part of the reason why we do not want to give oxygen if it's not needed for oral glucose this is going to be the medication that we're giving to our diabetic patients who are experiencing hypoglycemia so um first first thing to knowe is that sometimes um it's known as oral glucose glutose or instag glucose just dependent on um who's asking about it so like I said previously make sure that you are familiar with the different names for your medications so indication is going to be a patient that has altered mental status and has a history of diabetes um and their blood glucose levels are under 60 we will not give this medication to any patient who is completely unconscious or who is so altered that they are not able to follow commands or able to swallow the dosage for it is 15 gram it's kind of easy with this particular bottle of glucose um to kind of remember because it's glucose 15 um so make sure that you are aware of how many grams um of glucose that you're given to your patient so that you can document that the action is it just increases the amount of sugar that's available in the blood um for this we want to make sure that we use like a popsicle stick we want to apply it to the inside of our patient's uh cheek um this is given buul um so that it can absorb into those mucosal membranes and get into the bloodstream a little bit quicker um the side effect is that basically that is just delayed that's the big thing it's going to take a while for it to get in and it's going to take a while for it to start working um if you're giving it buy like I just said it's going to kind of start acting a little bit faster but if your patients just swallowing it it can take up to 20 minutes for you to see the full effects of the oral glucose this is activated charcoal it has a couple of different names um superchar insta acti do liquid Char are just some of the names um trade names that it has um this medication we're not really using much a lot of companies don't actually have it on the truck anymore but there is a possibility that you guys will be using it so you need to be familiar with it because it's within your scope of practice um it is going to be administered for patients who have recently ingested either opioid or anticholinergics or some other type of medication with a sustained release so we want to go ahead and get this on board what it's going to do is it's going to bind to that medication and absorb it so that it no longer releases into the patient's bloodstream we do not want to give this to our patients who have alter menal status or anybody who swallowed any type of acids or alkaly um we also want to not administer this to patients who do not have the ability to swallow or if they have taken cyanide um the medication is in the form of it is going to be premixed with water it's like a powder that's mixed with water it's a total of 12.5 G mixed in water um and we're going to give our patients one gram per kilogram of weight um so the normal adult dose is around 25 to 50 gram maybe not so much in Louisiana but um on average that's uh going to be the dosage and then for infants and children it's about 12.5 gram so just make sure that that you're getting your patients weight if you feel like you need to administer activated charcoal side effects of activated charcoal we're not really going to see this all the time um but they may have dark or black stool um one that we may actually see is going to be it could cause our patient to vomit so kind of keep that in mind and be prepared for that if you administer activated charcoal to your patient this is aspirin it's a pretty common medication so it has a lot of different trade names um you may hear it called ASA um you may hear it called beay or St Joseph those are some of the more common trade names for this medication we're going to be administering it to our patients who have cardiac chest pain um we do not want to give this to patients who are just complaining of pain like I have a headache or something like that and we just give them an aspirin we're only going to be giving it to our patients with cardiac related chest pain the contraindications for this is going to be anybody with a known allergy or hypers sensitivity to this drug and then any patient with any type of internal bleeding um like patients who may have an aortic dissection or some type of a GI bleed we want to hold back on administering this medication to the patient maybe reach out to medical control and see what they want you to do in that situation it comes in the form of a tablet it's a chewable um and we're going to give between 81 to 3 325 Mig normally we're going to take four of those 81 MGR baby aspirins and get our patients to chew it up that's going to give them about 324 milligrams of aspirin which is very close to our Max D so we'll be really happy with that if your patient has already taken their aspirin like they take a baby aspirin every day you can still administer all four aspirin pills to them but if they had like literally just taken it right before you came you can give them the slightly altered dose but there's nothing wrong with giving them all four aspirin at any time um the action of aspirin is just that it's a platelet aggregate so what it's going to do is it's going to stop the platelets from being able to stick to each other basically stopping a clot that's inside of their heart from getting worse um we definitely want this because we don't want a complete blockage um because that's going to cause even more problems for our patient some of the side effects of it is primarily just stomach irritation right um so just kind of keep that in mind if your patients start complaining of an upset stomach after taking an aspirin that's not abnormal um just continue to treat the patient and reassure them that that's a normal side effect of the medication now we have nitroglycerin nitroglycerin is kind of the Buddy for aspirin right this goes with our chest pain patients also um sometimes our patients are prescribed this um this is a medication that you will be only assisting the patient with taking um it's not normally carried in your bag because it is an assist medication the patient has to be prescribed it in order for you to be able to administer it um it also has multiple different names like nitrat or nitroid um just kind of keep in mind that it's all still the same thing as you can see on this bottle it says Nitro Mist so depending on the manufacturer it kind of changes and depend depending on what form it comes in the name also changes um this comes in both peel and liquid form and it also comes in the form of a paste um but for you guys you're mainly going to be seeing it in that peel form because that's what's going to be prescribed to the patient they're going to take that little peel and put it under their tongue this is the medication that we're going to be administering sublingually to our patients Contra indications for this is going to be any patient who has a blood pressure under 90 systolic so we don't want to give it to them because this can cause their blood pressure to drop um we also do not want to be giving this medication to anybody who has any type of erectile dysfunction medication on board or phospho diaster medications keep in mind that that medication is not only given for erectile dysfunction F but it's also been given for patients who have pulmonary hypertension that's what they were originally made for but um they found out that it had a side effect that was a whole lot better to Market and would make them a lot more money so keep that in mind um when administering this medication the dose is going to be4 millgram sublingual um and you can give this medication three times um about 3 to 5 minutes apart each and the action of it is just it's doing vasil dilation so it's going to make that vessel get bigger so if there's some type of a blockage there and the vessel gets bigger now blood is able to flow past the blockage and get to the tissues that need to be profused some of the side effects is going to be a headache patients May complain of a headache they may also see a drop in their blood pressure um or they may complain of some burning or stinging around the administration site um that is all normal kind of be mindful of that you may even give your patient a heads up like hey you may start getting a headache after I give you this medication that's normal the medication that we're looking at now is going to be our meter dose inhaler and our small volume nebulizer um the medication that goes inside of those is going to be out butol um we're going to kind of go over these to kind of simultaneously because they administer that same medication things to kind of keep in mind with this is there's going to be a plethora of names for albuterol so with the metad do inhaler you have provent venin um some of the ones that you may see or know about a lot and then they have other versions that come in a powdered form and then they have other versions um that are mixed with another medication called ipot Tropi so just be mindful that this medication comes in a whole bunch of different forms and mixtures the indication for this is going to be our patients that's having difficulty B breathing specifically our COPD or asthma patients that have some wheezing indicating that they have some Bronco constriction going on Contra indications to this is going to be patients with alter mental status they need to be able to follow commands right we also do not want to be giving the meter dose inhaler to patients who they're not prescribed to so make sure that whenever you're administering this medication that you're looking at the prescription checking to see whose name is on it prior to administering it to a patient sometimes with our asthma patients or COPD patients they may have like a action plan if they're having an exasperation of their symptoms um make sure that you take a look at that because that may change the dosage that they're supposed to get this is an assist medication so you just follow whatever dosage that is on the medication or that's on their action plan from their doctor um the MDI the form is going to be in an aerosolized form whereas the nebulizer is going to be a liquid form we're going to have like these little vials of Albuterol mixed with water um that's going to be 2.5 mgam which is going to be inside of that vow mixed with about three three CC of water and we'll empty that into the chamber and screw everything together and connect it to oxygen to administer it to our patient the action for this one is going to be a Bronco dilation so like we talked about a second ago our patients who are experiencing these breathing problems have Bronco constriction so the way that we fix that is by giving them a beta 2 Agonist that's going to cause Bronco dilation and it's going to decrease the resistance in those Airways and help them get that air and that oxygen down to the vei whether they can have gas exchange some of the side effects is going to be headache they may get shakes um they may have a dry mouth nausea um or a headache so just kind of keep that in mind when you see that with the patient um that these are normal side effects for this medication this is our EpiPen auto injector um it comes with multiple different names EpiPen EpiPen Jr being the version that's going to be for Pediatric patients and then twinject so make sure that you're familiar with all of those different names um this medication is going to be given for patients showing signs and symptoms of moderate to severe allergic reactions or anaphylaxis that has is respiratory distress and um showing signs and symptoms of anaphylactic shock for this medication the dose is going to be3 milligrams IM injection or intramuscular injection um and then for the Pediatric patients it's going to be 0.15 milligrams IM injection uh things to keep in mind with this medication is that if the patient is greater than 66 pounds then we're going to give them the adult version or adult dose of the medication and that the side effects can sometimes be pretty strong with the increased heart rate possibly pale skin dizziness chest pain Headache nausea vomiting or cause your patient to become anxious um and that's primarily because of the action that it's doing right it's causing vasil constriction it's causing Bronco dilation um it's increasing the capillary permeability to kind of get those fluids to shift back to where they're supposed to be um so just kind of keep all of those things in mind when administering Epi it's a very very strong and very very potent drug this is nxone or otherwise known as Narcan um most people kind of recognize it by the Narcan name just keep in mind that loxone and Narcan are the same medication this is going to be given to our suspected overdose um opioid overdose patients um for our patients that have that respiratory depression associated with that opioid overdose um Contra indications for it is going to be any type of hypers sensitivity and also uh another thing to note is if there's an infant that was born addicted due to the mother's addiction we don't really want to give it to those patients because it can cause severe withdrawal symptoms for them um liquid form is what it comes in we're going to attach that Bristol jet um that's on the screen and put that mad device on top of it to administer the medication to our patient basically what it's going to do is cause it to make like a nice little mist and we're going to administer the medication I in this medication can also come in the form of an auto injector that you can give an IM injection um so kind of keep that in mind know the equipment that you have on your unit the dosage for it is going to be 2 milligrams um we can give it in smaller doses or increments though so a lot of times we like to start off with4 milligrams and then just kind of work our way up to two um with children is going to be 1 mgram so same thing for them start with that smaller Doses and work your way up um like I said our goal is to get that respiratory drive back up and running on its own the action of this medication is that it's going to bind to those opiate receptor cells and stop the narcotic from binding to it which is going to allow them to get their respiratory drive back side effects of this medication is going to be chest pain nausea vomiting irregular heart rate seizures and agitation and possible combativeness so we want to make sure that whenever we're giving this medication that we're not slamming it on our patient we're giving it at a nice low rate to try to minimize the side effects that we're getting so that is the end of our Mainline medications that we give to our patients we also have these other medications that you could potentially give to your patients ibuprofen Tylenol and prid oxy chloride with atropine um so we're going to go over those just briefly with ibuprofen um another name for it could be Molin or Advil it's a insid a nonsteroidal anti-inflammatory drug it's used to treat pain um fever and uh reducing inflammation right um things to keep in mind with this drug it does have anti-platelet aggregating factors so we don't want to really give it to any patients who have any type of blood clotting problems or if they have some type of GI bleed or ulcer um because it can cause them to bleed uh we also do not want to be giving this medication to anybody who has a known allergy or hypers sensitivity to the drug as far as dosage is concerned kind of refer to your local protocols to figure out exactly what dosage of this medication you should be giving for Tylenol we have um another name for it is going to be a seed of Menin that is going to be the generic name for Tylenol so you may see that on some of the bottles um it is used to treat pain relief um and to treat fever um again this can be used in conjunction with the ibuprofen um alternating between the two or it can be used in place of it if the patient has a hyper sensitivity to ibuprofen keep in mind that this medication if they take too much of it can can cause liver damage so we want to be mindful of that if a patient has taken a whole bunch of Tylenol already prior to our arrival we do not want to be administering them more Tylenol we also do not want to administer this medication to anybody who has a known allergy or hypers sensitivity to this strug and so for prid doxine chloride and atropine it's a coleric toxicity antidote so for instance if anybody has been exposed to a whole bunch of pesticides um and then there's some other chemical agents um we do not want to we want to get this medication on board to reverse those effects so it blocks the parasympathetic nervous system and reverses the effects of coleric poisons and drugs okay the atropine in it is going to block the receptor sites and keep the poison from being able to bond to the receptor sites so this medication is administered in an auto injector type form it's called Duo do sometimes is another name that you may hear from it is going to inject both of those drugs through one needle at the same time deep into the muscle so for the first dose for this medication it's going to take about 10 to 15 minutes for it to come into effect if you do see that you need to give additional doses um you're going to administer two additional single doses for the second dose so the same amount of medic medication that was in that auto injector but you're going to do it twice and you're going to do it in Rapid succession um reach out to your local instructors or look at your local protocols to see if this medication is in there so that you can see the dosages for it