Chapter 11 MAT 119 Parenteral Routes Route of administration other than gastrointestinal Intramuscular IM Subcutaneous subcut Intradermal ID Intravenous IV 2 3 ZTrack Injection ID: 537187
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Parenteral Dosage of Drugs
Chapter 11
MAT 119Slide2
Parenteral Routes
Route of administration other than gastrointestinal
Intramuscular (IM)
Subcutaneous (subcut)Intradermal (ID)Intravenous (IV)
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Z-Track Injection
Z-Track
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Parenteral Routes
Used to describe drugs given by any route other than oral, sublingual, topical, or rectal
Generally associated with drugs administered by a needle
The term “parenteral” means by injection.
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Parenteral Routes
Benefits:
Good for drugs that are poorly absorbed, rapid response, patient is uncooperative, unconscious,
etc.
Disadvantage:
Expensive, require skilled personnel, is an invasive technique
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Parenteral Routes
All routes have limitations:
Limited to solutions, suspensions, and emulsions
Must be sterile (bacteria-free)pH must be maintainedMay require buffers
Volume limited (IM, ID,
Subcut
)
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Parenteral Medications
Most parenteral medications are prepared in liquid form and packaged in single, or multi-dose vials
Ampules or prefilled syringes
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Parenteral dosages
Round amount to be administered to tenths if the amount is greater than 1 mL and measure it in a 3 mL syringe
Order: Administer 1.33 mL = 1.3 mL
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Parenteral dosages
Measure amounts less than 1 mL rounded to hundredths and all amounts less than 0.5 mL in a 1 mL syringe.
Order: Administer 0.65 mL
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Parenteral dosages
Amounts of 0.5 mL to 1 mL calculated in tenths can be accurately measured in either a 1 mL or a 3 mL syringe (usually use 3 mL for IM > 0.5 mL)
Order: Administer 0.6 mL
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Calculation of Drug Dosage: Parenteral
Order:
Cleocin
150 mg IM
q 12h
Available:
Cleocin
(clindamycin phosphate) 300 mg per 2 mL
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Three Steps
Step 1: Convert
All units of measurement must be in same system and all units must be in same size
Step 2: ThinkEstimate logical amountStep 3: Calculate
Dosage on hand
=
Dosage desired
Amount on hand X amount desired
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Cleocin 150 mg IM q.12h
Available:
Cleocin (clindamycin phosphate) 300 mg per 2 mLStep 1: Convert
No conversion is necessary
Step 2:
Think
You want to give less than 2 mL
Actually, you want to give 150 mg, which is 1/2 of 300 mg and 1/2 of 2 mL, or 1 mL
Calculate to double-check your estimate
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Cleocin 150 mg IM q.12h
Available:
Cleocin (clindamycin phosphate) 300 mg per 2 mL
Step 3: Calculate
Give 1 mL
Cleocin
IM every 12 hours
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300 mg
=
150 mg
2 mL XSlide16
Calculation of
Drug Dosage: Parenteral
Order:
Robinul 100 mcg IM statSupply: Robinul 0.2 mg per mL
Convert: Equivalent: 1 mg = 1,000 mcg
0.2 mg = 0.200 = 200 mcg
Think: Give less than 1 mL about 1/2
Don’t be fooled into thinking 0.2 mg is less than 100 mcg
0.2 mg is more than 100 mcg
0.2 mg = 200 mcg
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continued
Order:
Robinul 100 mcg IM stat
Supply: Robinul 0.2 mg per mL
Step 3:
Calculate:
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continued
Give IM
Select a
1 mL syringeMeasure 0.5
mL
Robinul
0.2 mg per
mL
You have to change needles, as this is an IM injection.
Change to
1-1 1/2”
needle
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Insulin Label
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Find: Supply dosage/concentration
Total volume
Brand name
Type
Manufacturer
Label alerts
Generic Name
SpeciesSlide20
Insulin
Supply dosage of insulin is
100 units per mL
Abbreviated on label as U-100Syringe must also be U-100Accuracy is critical Nurses must understand and correctly interpret insulin order and label
The correct syringe must be selected
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Insulin Syringes
Standard U-100
50 Lo-Dose U-100
30 Lo-Dose U-100
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Interpreting the Insulin Order
Brand name, including the species and action time.
Rapid-acting (Regular)
Intermediate-acting (NPH)Long-acting (Lantus)Supply dosage (concentration and number of units to be given)
Route of administration and time or frequency
Regular insulin
only
type to be given IV
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Examples
Humulin
R Regular U-100 insulin 14 units
subcut statNovolin N NPH U-100 insulin 24 units subcut 1/2 hour ā breakfast
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Types of Insulin
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Other Delivery Systems
Insulin Pump
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Inhaled Insulin
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Insulin Sliding Scale
Insulin Dose
Glucose Reading*
No coverage
Glucose less than 160
2 units
160–220
4 units
221–280
6 units
281–340
8 units
341–400
Order
:
Humulin
R Regular U-100 insulin
subcut
a.c
. based on sliding
scale
p. 229 #26-30
*Glucose greater than 400: Hold insulin, call MD stat
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Insulin: Avoiding Errors
Check dosage with two nurses
When combination dosages are prepared, two nurses must verify each step of the process.
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