Nursing Assignment on Medication Administration and Pharmacology

This nursing assignment covers topics like medication administration, legal and regulatory frameworks, pharmacodynamics, pharmacokinetics, drug toxicity, and drug administration routes. It discusses the importance of familiarizing with state and territory drugs and poisons legislation, scheduling of medicines and poisons, and the four stages of drug action. It also explains the different drug administration routes and the side effects of various drugs.

Running Head: NURSING ASSIGNMENT
Nursing assignment
Name of the student:
Name of the university:
Author note:

1NURSING ASSIGNMENT
Question 1-
Employers and Enrolled Nurses should ensure that the EN is familiar with the state
and territory drugs and poisons legislation. They should know the relevant health department
and health service policy requirements as well as relevant workplace policies, procedures and
protocols. An enrolled nurse must have successfully completed medication administration
education at some stage in their career.
Question 2-
Legal and Regulatory frameworks in health organization is a fundamental
underpinning of good research practice that researchers operate within the law and regulation.
Legal framework sets a general plan of action, used to guide desired outcomes and is a
fundamental guideline to help make decisions. The purpose of healthcare policy and
procedures is to communicate to employees the desired outcomes of the organization.
Regulatory framework is necessary to promote a legal, regulatory and administrative
framework for the safety of vaccines at national, regional and international levels. It is
essential to ensure compliance and to provide safe health care to every individual who
accesses the system.
Question 3-
Scheduling of medicines and poisons is a national classification system that controls
how medicines and poisons are made available to the public. Medicines and poisons are
classified into Schedules according to the level of regulatory control over the availability of
the medicine or poison required to protect public health and safety. The schedules are
published in the Standard for the Uniform Scheduling of Medicines and Poisons (Gauld, et
al., 2015). The schedules are adopted under the Controlled Substances (Poisons) Regulations
2011.

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Schedule 2- Pharmacy Medicine -Hydromorphone
Schedule 3- Pharmacist Only Medicine- Phendimetrazine
Schedule 4- Pharmacist Only Medicine- Darvon
Schedule 8- Controlled Drug- Alfentanil
Question 4-
 Capsules- Swallow with gulp of water; stored in a cool, dry place
 Drops- By gently squeezing the dropper to the affected area; stored in a cool dry place
 Inhalants- Administered by sniffing, huffing, bagging, or inhaling; stored at room
temperature away from light
 Liquid medication- Administered with food or on an empty stomach; stored in
refrigerator.
 Lotions and creams- Applied thinly and evenly to affected area; stored at cool
temperature.
 Ointments- Applied thinly and evenly to affected area; stored at cool temperature
 Patches- Apply to clean, dry, hairless skin; stored at room temperature
 Powders- By mixing with soft food and water; stored at a cool, dry place.
 Tablets- By chewing or swallowing: stored in a cool, dry place
 Wafers- Single dose treatment; stored at or below -20°C (-4°F)
 Suppositories- By inserting into rectum; stored in a cool dark place
Question 5-
Pharmacodynamics- it is a branch of pharmacology concerned with the effects of
drugs and the mechanism of their action. It described as what the body does to a drug, refers
to the movement of drug into, through and out of the body.

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Pharmacokinetics- the branch of pharmacology concerned with the movement of
drugs as what a drug does to the body, involves receptor binding, postreceptor effects, and
chemical interactions.
Pharmaco-therapeutics- It is a branch of Pharmacology, which is defined by
Merriam-Webster as “the study of the therapeutic uses and effects of drugs” this is a study of
beneficial and adverse effects of drugs.
Question 6-
Polypharmacy- Polypharmacy is the concurrent use of multiple medications by a
patient. It refers to the use of a large number of medications, commonly considered to be the
use of five or more. Polypharmacy is often associated with a decreased quality of life,
including decreased mobility and cognition (Masnoon, et al., 2017).
It is a consequence of having several underlying medical conditions, hence it is more
common in elderly patient. Polypharmacy is most common in the elderly, affecting about
40% of older adults living in their own homes. About 21% of adults with intellectual
disability are also exposed to polypharmacy.
Question 7-
A first-pass effect is defined as the rapid uptake and metabolism of an agent into
inactive compounds by the liver, immediately after enteric absorption and before it reaches
the systemic circulation. All drug dose absorbed from the gastrointestinal tract is first
delivered to the liver by the portal vein. A fraction of the drug can then be metabolized in the
liver before it even reaches the systemic circulation. Therefore the oral bioavailability of the
drug is reduced. Although a first-pass effect can occur in a variety of tissues, including the
intestines and uterus, it is most often observed with the liver.

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Question 8-
The half-life of a drug is a pharmacokinetic parameter that is defined as the time it
takes for the concentration of the drug in the plasma or the total amount in the body to be
reduced by 50%. t depends on the dose ratio D (loading dose/maintenance dose) (Gunaydin,
et al., 2018).
D is also known as the accumulation index, D= 1/1-e-ke.t where ke is the elimination constant
(Ke=ln2/T1/2), and t the dosing interval
For a dose ratio of 2, dosing interval equals the drug biological half-life (T1/2)
For a dose ratio >2, dosing interval is < drug half life
For a dose ratio <2, dosing interval is > drug half life
Question 9-
Drugs can be smoked, snorted, inhaled, injected, swallowed as pills, or applied
through transdermal means (applied to the skin). Drugs undergo four stages within the body:
absorption, distribution, metabolism, and excretion. After a drug is administered, it is
absorbed into the bloodstream. The circulatory system then distributes the drug throughout
the body where the drug moves to and from the blood and various tissues of the body (for
example, fat, muscle, and brain tissue). After the drug has had its effect, then it is
metabolized by the body. The drug is then excreted, primarily through urine or faeces.
Question 10-
Bioavailability refers to the extent and rate at which the active moiety (drug or
metabolite) enters systemic circulation, thereby accessing the site of action. Bioavailability of
a drug is largely determined by the properties of the dosage form, which depend partly on its
design and manufacture. Differences in bioavailability among formulations of a given drug

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can have clinical significance; thus, knowing whether drug formulations are equivalent is
essential. Bio-availability of drugs is 100% by IV injection because the drug is administered
directly into the vascular space. It is also one of the preferred routes of administration to
rapidly achieve therapeutically effective drug concentrations.
Question 11-
Receptors are typically glycoproteins located in cell membranes that specifically
recognize and bind to ligands. Most drugs act by being either agonists or antagonists at
receptors that respond to chemical messengers such as neurotransmitters. An agonist binds to
the receptor and produces an effect within the cell. An antagonist may bind to the same
receptor, but does not produce a response, instead it blocks that receptor to a natural agonist.
A partial agonist can produce an effect within a cell that is not maximal and then block the
receptor to a full agonist (Di Pizio, et al., 2017). Antagonism may be competitive and
reversed by higher concentrations of agonist.
Question 12-
 Drug toxicology- Drug toxicology is studying the harmful effects of therapeutic drugs.
 Anaphylactic reaction- Anaphylaxis is a serious allergic reaction that is rapid in onset
and may cause death
 Adverse reaction- An unwanted effect caused by the administration of a drug. The
onset of the adverse reaction may be sudden or develop over time.
 Contraindication- A contraindication is a specific situation in which a drug,
procedure, or surgery should not be used because it may be harmful to the person.
 Precaution- a measure taken in advance to prevent something dangerous, unpleasant,
or inconvenient from happening.
 Side effects- A secondary, typically undesirable effect of a drug or medical treatment.

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Question 13-
 Right medication- Always check the medication label with the physician’s orders.
 Right dose- Confirm appropriateness of the dose using a current drug reference.
 Right route- Confirm that the patient can take or receive the medication by the
ordered route.
 Right time- Double-check that the ordered dose is provided at the correct time.
 Right person- Confirming the name and order of the patient by asking fir two
identifiers.
 Right expiration date- The actual prescription should be mentioned and informed to
the patient.
 Right to refuse- The legally responsible party for patient’s care has the right to refuse
any medication.
 Right prescription- Never document before medication is administered
Question 14-
 Oral- Through the mouth; glimepiride
 Sub–lingual- Placed under the tongue; nitroglycerin
 Buccal- Placed between gums and cheeks; nitroglycerine
 Dry powder inhalers- delivered to lungs as inhaled through mouth; Aerolizer
 Metered dose inhaler- placed between mouth and teeth and then inhaled slowly;
Fluticasone propionate
 Nebulisers- Oral, intramuscular or intravenous routes; albuterol
 Oxygen therapy- Through tubes resting in nose, a face mask, or a tube placed in
trachea, or windpipe; hyperbaric oxygen therapy.
 Sub cutaneous injection- Needle Injected into the tissue layer between the skin and
the muscle; opioids.

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 Intramuscular injection- Injected into the muscle; Haloperidol
 z- track injections- Injected into the large muscles Enteral administration- percutaneous gastronomy (peg) as well as nasogastric tubes-
through a tube inserted in the abdomen into the stomach; digoxin Intranasal, including nebulised medicine- administered through nose; antihistamines
 Ocular- given into the eye through dropper; natacyn
 Rectal- Adminstered through rectum; Valium
 Sub cutaneous injection- injected underneath the skin; morphine
 Topical, including transdermal- applied to body surfaces; Pimecrolimus
 Vaginal- inserted into vagina; Gyne-Lotrimin
 Ventro-lateral injection technique- injected between knuckles of index and middle
finger.
Question 15-
A marketed drug has three names: a chemical name, a generic name, and a brand
name. The chemical name is a scientific name based on the compound's chemical structure
and is almost never used to identify the drug in a clinical or marketing situation. The generic
name is used to identify a drug during its useful clinical lifetime. The company that patents
the drug creates the brand name (trademark).Generic drugs have the same active ingredients
as brand name drugs already approved by the Food and Drug Administration (FDA) but is
only provided after the patent on the brand name expires (Nardi & Ferraz, 2016).
Answer to the question number 16:
Classification Drug Name Administration
route
Side effects
Beta-blockers Acebutolol Oral Tiredness, dizziness
Calcium channel Amlodipine Oral Dizziness, lightheadedne

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blockers ss,
Anti-
Hypersensitive
Hydrochlorothiazide Intravenous male sexual dysfunction
Diuretics Lasix (Furosemide) Oral Blistering, peeling, red
skin rash
Anti-Cholesterol Atorvastatin Oral Liver problem, memory
problem
Anti-clotting Warfarin Intravenous Red or brown urine,
Black or bloody stool
Sedatives Amobarbital (Amytal) Intramuscular
injection/
Intravenous
Agitation, confusion
Antidepressants Citalopram (Celexa,
Cipramil)
Intramuscular tunnel vision, eye pain
or swelling,
Antipsychotic aripiprazole (Abilify) Oral drowsiness, nausea
Antibiotics Amoxicillin. Oral Nausea, vomiting,
Vitamins/
Minerals
Cyanocobalamin Injection numbness or tingling in
your hands or feet
Anti-Reflux Rabeprazole
(Aciphex)
Oral Acute Interstitial Nephrit
is
Anti-emetics dolasetron (Anzemet) Intravenous Nausea & vomiting
Oral
hypoglacemics
Amaryl (glimepiride) Oral Nausea and upset
stomach
Aperiences Bumex (bumetanide) Oral Headache, nausea
Inhaled
Medications
Fluticasone-
Salmeterol
Inhale/Nasal Hoarseness, throat
irritation,
Analgesics Aspirin Oral Upset
stomach and heartburn

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Respiratory
Medications
Albuterol (salbutamol
)
Inhale throat dryness or
irritation, or unusual
taste
Anti-
Inflamamtory
Naproxen (aleve) Oral Stomach ache,
Constipation
Anesthetics Diprivan (propofol) Injection Hypersalivation, Nausea
Anti-Viral Acyclovir Oral headache, or vomiting
Ophtalmic Optimyxin
Ophthalmic
Ointment blurred vision
Anti-Parkinsons Sinemet (carbidopa-
levodopa)
Oral Chest pain, asthenia
Anti-epileptic Diamox
(Acetazolamide)
Oral Loss of appetite,
stomach upset
Contraceptive
medications
Apri (Desogestrel-
Ethinyl Estradiol)
Oral breast tenderness,
swelling of the ankles
Scenario 1:
Immediately after surgery, the patient remains in the recovery room for a few hours.
The patient is given medications to prevent pain and infection.
The administrative route of oxycodone is oral and efficacy of this drug will be
determined by the patient condition with regard to relief of pain.
Alternative route for pain relief is nonoral route for opioid administration. The
classification and storage conditions of medicine in PRN chart is provided in the Table
below:
Drug name Classification Storage condition
Paracetamol Anti-pyretic, mild analgesic Should be stored in dry

10NURSING ASSIGNMENT
and cool place.
Oxycodone Opioid Should be stored in dry
and cool place.
Metoclopramide Used for the treatment for
stomach and esophageal problems
Should be stored in dry
and cool place.
Oxycodone will not be used as it is one tablet short. Respective medical practitioner
should be consulted for the change of medication.
Scenario 2:
Stopping medication can cause unwanted effects and most should be reduced
gradually. Rethink provide useful guidance for people considering stopping their medication.
By not following the prescriber's orders correctly, the patient will experience decreased
effectiveness of treatment which can lead to the worsening of their condition.
Nurse interventions could improve medication adherence among this population. The
patient should be consulted and convince to take his medicine regularly and to not stop his
medication.
In rare cases, an allergy to penicillin can cause an anaphylactic reaction, which can be
deadly. This type of reaction usually happens within an hour after you take penicillin.
Symptoms include difficulty breathing, hives, wheezing, dizziness, loss of consciousness,
rapid or weak pulse, skin turning blue, diarrhea, nausea, and vomiting. The patient is allergic
to penicillin and is taking the medicine Amoxicillin which belongs to the penicillin group.
Therefore, changing of the medicine Amoxicillin should be discussed with RN.
Scenario 3:

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Blood sugar control is one of the most important parts of type 2 diabetes management
and people with type 2 diabetes eventually need to take insulin by injection.
Education about insulin administration and type of Insulin:
Rapid Acting
Onset: 10-30 minutes
Peak: 30 minutes- 3 hours
Duration: 3-5 hours
-Fast/short Acting
Onset: 30 minutes-1 hour
Peak: 2-5 hours
Duration: Up to 12 hours
-Intermediate Action
Onset: 1.5-4 hours
Peak: 4-12 hours
Duration: Up to 24 hours
-Long Acting
Onset: 1-4 hours
Peak: minimal peak
Duration: Up to 24 hours
Education about nutritional changes and monitoring:
A patient’s glucose should be checked once when the patient wakes up, before meals, and
before going to bed.
Educate about maintaining a healthy weight and keeping active

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Healthy weights are calculated based on height and sex of the patient. Other ways to monitor
the size of the patient is to use a BMI calculator or measure waist circumference.
The patient need consider the two most important things for his/ her household to
remember are:
1. Wash your hands, and often.
2. Try not to touch your eyes.
It’s also helpful to change towels and pillowcases often, and use hot water when you wash
them.
Medications for conjunctivitis are: Bleph (sulfacetamide sodium), Moxeza (moxifloxacin).
Yes, Insulin should be administer to the patient and the dosage would be 15 units of
insulin.

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References
Di Pizio, A., Levit, A., Slutzki, M., Behrens, M., Karaman, R., & Niv, M. Y. (2016).
Comparing Class A GPCRs to bitter taste receptors: Structural motifs, ligand
interactions and agonist-to-antagonist ratios. In Methods in cell biology (Vol. 132, pp.
401-427). Academic Press.
Gauld, N. J., Kelly, F. S., Emmerton, L. M., & Buetow, S. A. (2015). Widening consumer
access to medicines: A comparison of prescription to non-prescription medicine
switch in Australia and New Zealand. PloS one, 10(3), e0119011.
Gunaydin, H., Altman, M. D., Ellis, J. M., Fuller, P., Johnson, S. A., Lahue, B., & Lapointe,
B. (2018). Strategy for Extending Half-life in Drug Design and Its Significance. ACS
medicinal chemistry letters, 9(6), 528-533.
Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017). What is
polypharmacy? A systematic review of definitions. BMC geriatrics, 17(1), 230.
Nardi, E. P., & Ferraz, M. B. (2016). Perception of the value of generic drugs in São Paulo,
Brazil. Cadernos de saude publica, 32, e00038715.