Nursing 313-Geropharmacology and Use of Herbs and Supplements

Nursing 313-Geropharmacology and Use of Herbs and Supplements

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Geropharmacology The Use of Herbs and Supplements in Late Life
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Geropharmacology Persons 65 years of age and older are the largest users of prescription and over-the-counter medications. Because of multiple medical conditions, older adults are also more likely to take multiple medications, accumulating prescriptions as they accumulate chronic diseases. Drugs most often prescribed: cardiovascular drugs, diuretics, non-opioid analgesics, anticoagulants, and anti-seizure medications. Gastrointestinal preparations, analgesics, laxatives, cough products, nonsteroidal topical preparations, eyewashes, and vitamins are the OTC medications most commonly used by older adults.
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Geropharmacology Increased regulation and knowledge have failed to significantly reduce the number and types of inappropriate medications prescribed to older adults (See Table 12-1). More than ½ of all persons do not take their medications as prescribed related to their beliefs and understanding of illness, functional and cognitive capacity, perception about the necessity of the drugs, severity of symptoms, reactions to the medications, finances, access, alternatives and compatibility with lifestyle. Older adults are at greater risk for adverse drug events, excessive and inappropriate medication use, and non-adherence. Problems associated with medication are affected by physiological, functional, and social changes often seen in later life as well as an increase in chronic
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Pharmacokinetics To be effective a drug must be absorbed or taken into the bloodstream Drug absorption is affected by: the route of administration, the bioavailability of the drug, and the amount of drug that passes through absorbing surfaces in the body. The nurse should know the effect of food on absorption including the effects of enteral feedings. Changes in volume of saliva, gastric pH, and peristaltic movements may influence absorption of some medications increasing the potential for adverse or unpredictable events. Once the drug is absorbed It must be distributed or transported to receptor sites on target organs to have a therapeutic effect.
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Pharmacokinetics Circulatory impairment such as PVD could affect drug distribution. Healthy older adult shows only insignificant changes in plasma-binding proteins, however drugs may compete with each other for binding which could result in unbound drug exerting a much greater effect on the body when more unbound drug is available. Other late-life alterations in drug distribution are primarily related to changes in body composition e.g. decrease in lean muscle mass, increase in body fat, and decrease in total body water. Drug action is determined by the metabolic rate and the length of time the drug is active in the body.
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Pharmacokinetics Chemical structure of the drug is converted to a metabolite more easily used and excreted.
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