Pharmacology and Medication Administration
Principles
Advanced pharmacology questions test applied knowledge: indication, dose, route, rate, contraindications, interactions and monitoring. Know the medications within your scope, their classes and mechanisms at a practical level, and the observations required before and after administration. Understand the rights of administration - right patient, drug, dose, route, time and documentation - and the checks that prevent error.
Concepts to master
- Routes and bioavailability: why the same drug behaves differently by different routes, and which route a presentation dictates.
- Dose calculation and weight-based dosing: unit conversion, concentration versus dose, and paediatric weight-based calculations.
- Contraindications and cautions: allergy, comorbidity, interacting medications, and vital-sign thresholds.
- Adverse effects and management: recognise a reaction and know the immediate response.
- Documentation and reporting: record the drug, dose, route, time, effect and any adverse event.
- Storage and handling: check expiry, integrity and correct preparation.
Traps
The commonest traps are confusing concentration with dose, mixing units (mg versus micrograms), and forgetting to reassess after administration. Others include choosing a route that is contraindicated by the presentation, ignoring an interacting medication in the history, and assuming a documented allergy is irrelevant because the reaction was mild.
Rule of thumb
Calculate, check, administer, reassess, document. For any calculation, write out the units and confirm the concentration before drawing up; a second check is cheap compared with an error.
Worked example
A weight-based dose is required. Identify the prescribed dose per kilogram, confirm the patient's weight, convert to the available concentration, and verify the volume makes sense against the syringe. After administration, reassess the relevant parameter and record drug, dose, route, time, response and any adverse effect.