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Chapter 35 Safe Medication Use

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Title: Airgas template Author: Jim Ely Last modified by: Jon Created Date: 2/15/2001 7:07:27 PM Document presentation format: On-screen Show (4:3) Company – PowerPoint PPT presentation

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Title: Chapter 35 Safe Medication Use


1
Chapter 35 Safe Medication Use
2
Drugs Commonly Used by Older Adults
  • Cardiovascular agents
  • Antihypertensives
  • Analgesics
  • Antiarthritic agents
  • Sedatives
  • Tranquilizers
  • Laxatives
  • Antacids

3
Pharmacokinetics and Pharmacodynamics
  • Pharmacokinetics
  • The absorption, distribution, metabolism, and
    excretion of drugs
  • Pharmacodynamics
  • The biologic and therapeutic effects of drugs at
    the site of action or on the target organ
  • Drugs behave differently in older adults.
  • Careful dosage adjustment and monitoring are
    needed.

4
Factors Altering the Absorption of Drugs
  • Age-related changes
  • Route of administration
  • Concentration and solubility of drug
  • Diseases and symptoms

5
Measures to Maximize the Absorption of Drugs
  • Encourage Exercise.
  • Stimulate circulation and increase blood flow at
    the absorption site.
  • Prevent fluid volume deficit, hypothermia, and
    hypotension.
  • Avoid preparations that neutralize gastric
    secretions if a low gastric pH is required for
    drug absorption.

6
Measures to Maximize the Absorption of Drugs
(cont.)
  • Monitor drugdrug and drugfood interactions.
  • Monitor drug-herb interactions.
  • Use the most effective administration.

7
Drugs Having Increased Biological Half-Life
  • Antibiotics
  • Barbiturates
  • Cimetidine
  • Digoxin
  • Salicylate

8
Conditions That Decrease Metabolism of Drugs
  • Dehydration
  • Hyperthermia
  • Immobility
  • Liver disease

9
Risk of Adverse Reactions in Elders
  • Symptoms can appear differently in older persons.
  • A prolonged time may be required for an adverse
    reaction to become apparent.
  • Adverse reactions can be demonstrated after a
    drug has been discontinued.
  • Adverse reactions can develop to drugs that have
    been used for a long period without problems.

10
Questions Nurses Should Ask About Patient
Medications
  • Why is the drug ordered?
  • Is the smallest possible dosage ordered?
  • Is the patient allergic to the drug?
  • Can this drug interact with other drugs, herbs,
    or nutritional supplements that are being used?
  • Are there any special instructions accompanying
    the drugs administration?
  • Is the most effective route of administration
    being used?

11
Precautions in Drug Administration
  • Do not crush enteric coated tablets.
  • Assure suppositories have been melted, not
    expelled.
  • Avoid cardiac overload from too rapid IV
    administration.

12
Older Adults Response to Drugs
  • Increased myocardial sensitivity to anesthesias
  • Increased central nervous system receptor
    sensitivity to narcotics, alcohol, and bromides

13
Risk Factors for Medication Errors
  • Multiple medications
  • Cognitive impairment
  • Visual and hearing deficits
  • Arthritic or weak hands
  • History of noncompliance with medical care
  • Lack of knowledge about medications
  • Limited finances

14
Risk Factors for Medication Errors (cont.)
  • Illiteracy
  • Lack of support system
  • History of inappropriate self-medication
  • Expired or borrowed medications in the home

15
Alternatives to Medications
  • Lifestyle changes
  • Diet modifications
  • Regular exercise
  • Effective stress management techniques
  • Regular schedules for sleep, rest, and
    elimination
  • Alternative therapies

16
Source
  • Eliopoulos, C. (2005).  Gerontological Nursing,
    (6th ed.).  Philadelphia Lippincott, Williams
    Wilkins (ISBN 0-7817-4428-8).
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