MEDICATION ADMINISTRAION

MODULEThere is NO place for medication errors in healthcare

CHASING ZERO

<a>https://www.youtube.com/watch?v=MtSbgUuXdaw<a/>

COMMON ADMITTING DX & MEDICATIONS

298.9- Psychotic disorder NOS: Haldol, Abilify, Clozaril, Seroquel, Risperdal, Zyprexa, Mellaril, Zeldox, Clozapine, Ativan, Klonopin, Xantex, Invega Sustenna, Abilify Maintenna, Safras, Latuda, Fanapt

311- Depressive disorder: Celexa, Prozac, Paxil, Zoloft, Lexapro, Wellbutrin, Remeron, Effexor, Elavil, Buspar, Restoril, Ativan, Klonopin, Xantex

296.8- Bipolar disorder: Lithium, Risperidone, Carbamazepine, Divalproex, Valium, Ativan, Klonopin, Xantex

296.3- Major depressive disorder, recurrent: Celexa, Prozac, Paxil, Zoloft, Ativan, Klonopin, Remeron, Effexor, Elavil, Buspar, Restoril, Xantec

295.7- Schizoaffective disorder: Haldol, Abilify, Ativan, Zoloft, Clozaril, Klonopin, Seroquel, Risperdal, Zyprexa, Mellaril, Zeldox, Clozapine, Xantex, Valium, Invega Sustenna, Abilify Maintenna, Safras, Latuda, Fanapt

LONG ACTING INJECTABLES

People whose illnesses are treated with long-acting injectable antipsychotic medications are more likely to continue their medications than people who take their medications on a daily basis by mouth.

Evidence-based research proves that people who receive treatment with long-acting injectable agents are less likely to be hospitalized for their illness.

People who take their anti-psychotic medication's by injection are unable to intentionally or unintentionally overdose

Invega Sustenna- atypical antipsychotic

Abilify Maintenna- atypical antipsychotic.

ADVERSE REACTIONS

Constipation, sedation, urinary retention, sexual dysfunction, suicidality, dizziness, somnolence

Akathisia, dystonias, tremors, photophobia, sun-sensitivity

Dry mouth, weight gain, nausea, drowsiness, insomnia

Tachycardia, hypotension, difficulty concentrating, diarrhea

Neuroleptic malignant syndrome: signs and symptoms include agitation, ALOC, hyperreflexia, pallor, muteness, muscular rigidity, impaired breathing, tachypnea, and diaphoresis. This is a rare but potentially fatal side effect.

EXTRAPYRAMIDAL SYMPTOMS

EPS includes a number of involuntary muscle contractions that influence gait, movement, and posture. These drug-induced side effects that can be problematic for people receiving anti-psychotic medications

Symptoms can be acute, delayed, or overlap which makes diagnosing a challenge.

Akathisia, dystonia, pseudo-parkinsonism, dyskinesia

Prevention interventions include selective prescribing of anti-psychotic agents, close monitoring, prompt management of symptoms, and thorough client education

SITE SELECTION FOR EMERGENCY MEDICATIONS

Vastus lateralis Divide the thigh into thirds and injection goes into the middle third

(medial lateral portion of the muscle). 1-4 mL of medication

Ventrogluteal Locate the greater trochanter with heel of your hand, then spread

your middle and index fingers to make a V. Insert the needle between the two fingers at a 90 degree angle (remove fingers prior to administering injection).

1-4 mL of medication

Deltoid Insert the needle 2.5-5cm below the acromial process at a 90

degree angle No more than 0.5-1.0 mL of medication

Site Selection for Emergency Medications

Dorsalgluteal is NOT the preferred site for IM injections, and there is wide agreement in the literature that the ventrogluteal site is preferable (Small, 2004).

Literature on injection procedure found that injury to the sciatic nerve is associated with the use of the dorsalgluteal site for injection, because the sciatic nerve commonly courses this site. Additionally, contact with the superior gluteal artery is possible when using this site for injection.

When giving gluteal injections, it is safest to use to upper outer quadrant, and the choice of site for injection must be based on good clinical judgment, using the best evidence available and individualized client assessment.

EMERGENCY MEDICATION“B-52”

A patient who poses a threat to themselves or to others requires some form of restraint. The use of medication to calm a patient, restrict their movement, or sedate them is a chemical restraint.

Haldol, Ativan, Benadryl

The patient does not have to consent to emergency medications. A registered nurse or a physician may order the emergency medication

Emergency medications are offered PO first and if refused an IM will be given

Monitor the patient for adverse reactions and emotional reaction

CONTROLLED SUBSTANCES

Xantax, Klonpin, Ativan, Valium, Ambien

Controlled substances are drugs that have some potential for abuse or dependence.

Regulated by the federal Controlled Substances Act (CS) – this helps the US Government fight against the abuse of these drugs.

Many medications used in the facility are Schedule IV drugs have a low potential for abuse relative to the drugs ins Schedule III, II, and I. Abuse of Schedule IV drugs may lead to limited physical dependence or psychological dependence compared with Schedule III, II, and I drugs.