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Medication.docx - Medication + Administration: Older Adults...

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Medication + Administration: Older Adults (Chapter 29)Drug NomenclatureGeneric name: identifies drug’s active ingredient (universal)Trade name: brand name, selected by the pharmaceuticalcompany-eMARs default to generic names, but may includeboth-Conversations= trade name because it is easier-Drug literatureoTrade name= capitalizedoGeneric name= lowercaseDrug ClassificationsPharmaceutical or therapeuticPharmaceutical refers to:-Mechanism of action (MOA)-Physiologic effect (PE)-Chemical structure (CS)Therapeutic refers to:-Clinical indication (understand why we areadministering the drug akapharmacotherapeutics)-Therapeutic actionMechanisms of Drug ActionPharmacokinetics: the effect the BODYhas on a drug once it enters the body1.Absorption-Drug is transferred from its site of entry into thebody to the blood stream-Portion of the drug that reaches systemiccirculation and acts on cells is thebioavailability-Influenced by: route of administration, pH, lipidsolubility, local conditions of site, dosage2.Distribution-After the drug is injected or absorbed into thebloodstreamDepends on:-Adequacy of circulation-Protein binding-Selective permeable blood-brainbarrier3.Metabolism-Change of an active drug into a new form4.Excretion
Pharmacodynamics: the effect theDRUGS has on the body-Process of removing a drug or metabolites from thebody-Kidneys-Lungs (gaseous)-Bile-Old age: impairment of kidney decreases ability toexcrete drugsTurn on, turn off, promote, or block responsesDrug-receptor interaction-Binds at receptor sitesCombination w/ other moleculesAffects cell permeabilityAlter cell environment w/ neuro hormonesAdverse drug reactionsHarmful effects that lead to injuryVS.Side effects: unintended, predictable, and toleratedRole of nurse:-Monitor for ADRs-ADR events must be documented + reported to anational database-Look for Black Box WarningsAdverse event: action that is life threatening, requiresintervention to prevent death, permanent impairment, andor leads to deathToxicity (higher risk in older adults)-Cumulative effect-Altered drug metabolism + elimination due toimpaired hepatic metabolism + renal clearanceIdiosyncratic effect: unusual or peculiar response (higher inolder adults)-Unpredictable + erratic responseAllergic effectImmune system responseSigns/symptoms:-Rash-Urticaria (hives)-Fever-Diarrhea-Nausea-VomitingSerious:anaphylactic reaction
Signs/symptoms:-Sudden + severe bronchospasm-Respiratory distress-Cardiovascular collapseTreatment:-Vasopressors-Bronchodilators-Corticosteroids-Oxygen therapy-IV fluids-AntihistaminesDrug Interactions1.Additive: similar actions, increase overall effect2.Synergistic: different MOA/sites, greater effectswhen taken together (one over the other)3.Antagonistic: combo negates and less effect thanthat of drug alone4.Interference: one drug interferes w/ metabolism ofanother (toxicity or ADR)5.Displacement: drug binds to protein-site and forcesanother to be displacedDiet supplements + herbal + natural remedies-

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Term
Fall
Professor
NoProfessor
Tags
Pharmacology, Adverse drug reaction, Subcutaneous tissue, Hypodermic needle, Subcutis

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