Medication: Any chemical preparation used in medical treatment to cure illness or relieve symptoms. ?Medications work by controlling changes in biochemical or physiological processes in the body by altering body fluids, cell membranes or interacting with receptor sites Therapeutic Evaluation: Involves making a judgement of the medications safety and effectiveness. Monitor via blood screening Pharmacology: Study of the action of medications in living organisms Pharmacotherapy: The use of medications to treat disease Pharmacodynamics: What the medication does to the body.
Pharmacokinetics: What the body does to the medication. There are 4 major actions: ? Absorption ?Distribution ?Metabolism ?Excretion Factors affecting absorption: ?Form of medication (liquid/solid/gas) ?Food – Can delay absorption ?Acidity of the stomach – May stop or limit For absorption to occur the correct form of medication must be given by he intended route. Side effects: Are the known and sometimes expected reactions to a medication ? If side effects become worse the dose may have to be reduced, ceased or intervals between doses increased Adverse Reaction: Unpredictable and not related to usual effects of medication ?
Can be caused by an allergy or genetic disorder ?Responses include rashes, swelling, jaundice Toxicology: Study of the nature, properties, identification, effect and treatment of poisons, including adverse medication reactions Organ responsible for drug elimination: Kidneys Organ used for metabolism: Liver Polypharmacy: A client who is on 5 or more medications Medications Interaction: Medications interact with other drugs Factors that create change when it comes to administration of drugs: ? New technologies ?Popularity of medicines ?Availability ?New uses ?Improves understanding of diseases.
Quality use of medicines (QUM) Goal of pyramid relies on 4 faces 4 faces of pyramid: ?Health Professionals (nurses, pharmacists, doctors) ?Regulatory (government, policy, developers) ?Consumers ?Industry (medication companies 3 levels of pyramid: ?Level 1 Awareness ?Level 2 Knowledge and skills ?Level 3 Action and evaluation Acts of Parliament: ?Poisons Act 1964 ?Controlled Substances Act 1984 ?Health Practitioner Regulation National Law Act (2009) Preparing Medications Medications are produced in three forms: ?Solids ?Liquids ?Gases Solids: Can be administered via oral, topical, rectal or vaginal routes ?
Tablets ?Capsules ?Lozenge ?Ointments ?Cream ?Paste ?Powder ?Suppositories ?Pessaries Liquid: Three types, mixtures, suspensions and emulsions ?Mixtures ?Syrups ?Elixirs ?Drops ?Tinctures ?Liniments ?Paint ?Suspensions ?Emulsions Gaseous: Used in specific circumstances, and can relate to any of the following ? Oxygen ?Anaesthesia – local or general Medication orders to be valid: ?Clients full name ?Date of medication order ?Name of medication (generic) ?Form of medication ?Dosage or strength required ?Route ?Frequency ?Duration ?Signature of prescriber ?Special considerations (before or after food).
6 Rights: ?Right Dose ?Right Patient ?Right Documentation ?Right Medication ?Right Time ?Right Route Additional Rights: ?Right effect ?Never administer a medication you do not know ?Clients rights/education 9 Schedules Schedule 1: Blank Schedule 2: Pharmacy Medicines Schedule 3: Pharmacist Only Medicines Schedule 4: Prescription Only Medicines Schedule 5: Caution Schedule 6: Caution or Poison Schedule 7: Dangerous Schedule 8: Controlled Drug Schedule 9: Prohibited Substances Schedules 4 and 8 are most important to nurses Mediation Groups Antacid: Neutralise Stomach Acidity ?Magnesium Hydroxide (Mylanta).
?Calcium Carbonate (Cal Sup) Analgesic: Pain relief ?Paracetamol (Panadol) ?Ibuprofen (Nurofen) Anti-biotic: Destroy Bacteria ?Flucloxacillian (Staphlex) ?Amoxicillian (Amoxil) Anti-coagulant: Prevent or delay coagulation of blood ?Heprin (Caprin) ?Warfarin sodium (Marevan) Anti-convulsant: Control Seizures ?Sodium Valproate (Epilim) ?Lamotrigine (Lamogine) Anti-depressant: Prevent or relieve depression ?Ecsitalopram (Lexapro) ?Citalopram (Celapram) Anti-emetic: Alleviate nausea and vomiting ?Prochlorperazine (Stemzine) ?Metoclopramide (Maxalon) Anti-histamine: Reduce allergy symptoms
?Loratadine (Claratyne) ?Fexofenadine (Fexotabs) Anti-hypertensive: Reduce High Blood Pressure ?Ramipril (Tryzan) ?Metoprolol (Minax) Anxiolytic: Reduce anxiety and nervousness ?Diazepam (Valium) ?Oxazepam (Alepam) Beta Blocker: Reduce speed of heartbeat ?Atenolol (Noten) ?Bisoprolol (Bicor) Bronchodilator: Widen Bronchioles ?Salbutamol (Asmol) ?Tiotropium Bromide (Spiriva) Cardiac Glycoside: Increase force of heart contraction ?Digoxin (Sigmaxin) Corticosteroids: Reduce inflammatory response ?Prednisolone (Solone) ?Prednisone (Panafcort) Decongestant: Eliminate or congestion ?Pseudoephedrine (Sudafed).
Diuretic: Increase formation of urine ?Frusemide (Lasix) ?Spironolactone (Spiractin) Insulin Preparation: Replace hormone Insulin ?Insulin Aspart (Novorapid) ?Insulin Lispro (Humalog) Laxative: Faecal softening & evacuation of bowel ?Docusate with Senna (Coloxyl with Senna) ?Lactulose (Actilax) NSAID: Reduce Inflammation ?Ibuprofen (Nurofen) ?Diclofenac (Fenac) Psychotropic: Alleviate psychiatric illnesses ?Olanzapine (Zyprexa) ?Clozapine (Clopine) Sedative: Promote sleep ?Temazepam (Temaze) ?Promethazine (Phenergan) Vaccine: Immune system to produce antibodies ?Influenza Vaccine (Fluvax).
?Hepatitis A and B (Twinrix) Vitamins & Minerals: Enhance metabolic functioning ?Potassium Chloride (Slow K) ?Zinc Sulfate (Zincaps) ?Thiamine Hydrochloride (Vitamin B1) Pain Management What is pain: Discomfort. What the patient says it is. Describe the “Wong Baker Chart”: Combines pictures of faces to allow pain to be rated by the user. Describe the “ladder”: ?Mild Pain = Non-Opioids ?Moderate Pain = weak Opioids ?Severe Pain = Strong Opioids IV Therapy Fluids Used: Fluid depends on purpose. Generally IVT solutions contain dextrose or electrolytes mixed in various proportions with water. Isotonic Fluids:
?5% Dextrose, Normal Saline, Lactated Ringers. ?Do not cause red blood cells to shrink or swell. ?Expand extracellular fluid ?Monitor patients for signs of fluid overload Hypotonic Fluids: ?Replace cellular fluid ?Provide free water for excretion of body wastes ?Saline solutions are used to treat hypernatraemia Hypertonic Fluids: ?Contain high amounts of dextrose ?Administered to meet calorie requirements ?Causes cells to shrink Need to now: ?0. 9% Sodium Chloride ?CSL Compact Sodium Lactate (Heartmans) ?4% Dextrose 1/5 Saline Monitor an IV: ?PIVAS = Peripheral intravenous Assessment Score.