This document provides an overview of administering and monitoring schedule 8 medications. It discusses the nurse's role and responsibilities when administering medications, including being aware of the drug's effects and reasons for prescription. It also covers medication preparations, routes of administration, pharmacology, adverse drug reactions, principles of safe administration, opioid analgesics, and regulations for storing and administering schedule 8 drugs.
2. Medications Drugs are substances that bring about a chemical change in the body When used for therapeutic purposes Diagnosis Treatment Cure Relief or prevention of health condition
3. Nurses Role As the person administering medications you have a number of responsibilities Key ones includes Being aware of The action of the medication The therapeutic effects Non-therapeutic effects The reason it has been prescribed
4. Medication Preparations Variety of forms for administration. Choice may depend on a number of reasons Absorption rate required Difficulties that may be experienced with swallowing Drug side-effects Patient preferences
5. Routes of Medication Most convenient and acceptable method for patients to receive medication is orally May be administered a number of other ways.
6. Drug Schedules The assigning of Drugs and Poisons into one of eight schedules is in accordance with the Standard for the uniform scheduling of drugs and poisons published by the Australian Health Ministers council. The decision on which drugs go into which group is done by the National Drug and Poisons Schedule Committee for inclusion in the relevant state or territory legislation. The Queensland Act being the Therapeutic Goods Act 1989 (Section 52B). The classifications are made according to potency, addictive qualities and suitability for ingestion by humans or animals.
7. Pharmacology The two main areas of pharmacology that specifically relate to your practice are; Pharmacokinetics and Pharmacodynamics
8. Pharmacokenetics How the body handles a drug over a period of time. It deals with the absorption, distribution, biotransformation and excretion of drugs. These processes influence the effectiveness of the drug to be effective it must be available at the site of action in the correct concentration. WHAT THE BODY DOES TO THE DRUG
10. Adverse Drug Reactions The definition described by the World Health Organisation for an adverse drug reaction is any response to a drug which is noxious, unintended and occurs at doses used for prophylaxis, diagnosis and therapy.
11. Adverse Drug Reactions While drugs may be prescribed to cure or alleviate a particular problem, because of the intricate workings of the body systems, the response to these drugs can spill over to areas where the effect is not advantageous. A term that is commonly used to refer to these is Sideeffects
12. Adverse Drug Reactions To reduce the incidence of severe reactions and to minimise the effect on your patients, it is essential that, as the nurse responsible for administering medication, you have a knowledge of the adverse effects of drugs, how to recognise them and how to prevent them.
13. Principles of Safe Medication Administration Unfortunately errors in administering medication happen all too often. To minimise the risk of these occurring a number of principles need to be followed when preparing to administer medication to a patient
14. The 5 Rights THE RIGHT TIME THE RIGHT ROUTE THE RIGHT AMOUNT/ DOSE THE RIGHT MEDICATION/DRUG THE RIGHT PATIENT ALLERGIES, EXPIRY DATE
15. Medication Storage Chemical components Schedule classification Organisation Requirements NURSES RESPONSIBILITY TO KEEP LOCKED WHEN UNATTENDED
18. Opioid analgesics Non-clinical use criminalized since 1914 Widely used in medicine as strong analgesics Analgesia derives from Greek an- without and algia pain Narcotic effects can be reversed by the drug naloxone (Narcan)
19. Advantages Despite extensive research , no other analgesics have been found that are more effective for severe pain. No upper limit to dosage and achievable pain relief as long as dose increased gradually to allow tolerance to develop to adverse reactions
20. Types of Routes and Preparations Injection can be given IV, IMI, SC and epidural Oral Mixtures and Controlled release tablets Patches for transdermal absorption Dose required intravenously and by epidural is significantly less than when given IV, IMI or orally.
21. Key Opioid Side Effects Cough suppression Decreased gastrointestinal motility
22. Common Side effects Nausea and vomiting Drowsiness, dizziness, headache Orthostatic hypotension Respiratory Depression Itchiness Dry mouth Miosis pupil constriction Urinary retention Constipation
23. Serious Side Effects CNS disturbances; Confusion Hallucinations Delirium Urticaria Hypothermia Bradycardia/Tachycardia Ureteric or Biliary spasm Muscle rigidity Myoclonus- convulsive body movements Flushing- due to histamine release
24. Opioid Side Effects Psychologic Dependence Addiction A pattern of compulsive drug use A continuous craving for an opioid
25. Tolerance Necessity for increasing the dose over time to achieve the desired clinical effect. Develops to analgesic effects sedation emetic effects euphoria respiratory depression
27. Withdrawal Syndrome Severe dysphoria Anxiety Eye tearing Rhinitis Goose bumps Sweating Nausea and vomiting Cramps and deep pains
28. S8 Storage Regulations Kept in a separate locked cabinet with keys kept in possession of an RN. Cabinet must be minimum of 10mm thick steel with continuous welding to all joints. Door of cabinet the same with pick proof lock and steel back plate.
29. S8 Regulations A Register must be kept with all drugs signed in and out and checked by two nurses: RN/EN (Med) All medications selected, administered and recorded by the SAME NURSE
30. S8 Register Information recorded includes Patients name Prescribed drug and dose Date and time of administration Balance of medication Both Nurse administering and the witness must sign the register.
31. Administration Procedure Ensure legal medication order Witness RN/EN(Med) unlocking S8 cabinet. Check drug together against order Observe removal of drug and return balance.
32. S8 Administration Accompany RN/EN (Med) to the patient Witness the administration of drug Counter sign medication sheet Assessment, monitoring and evaluation of patient for analgesic effects as well as adverse reactions. Documentation of these effects
33. REMEMBER THE ADMINISTERING NURSE IS TOTALLY RESPONSIBLE FOR THEIR ACTIONS AND IS ACCOUNTABLE IN A COURT OF LAW