Managing Medications

Any drug that a patient takes will cause a series of chemical and physical effects in their system. All drugs have the following properties:

• absorption
• distribution
• metabolism and
• excretion.

Properties describe a drug's

•  onset
•  dosage
•  length of action and
•  availability.

All of these properties impact the body's ability to metabolize the medication.

Before a drug can get into the system, it needs to be absorbed into the bloodstream. Only after it dissolves can the drug be absorbed and produce an effect.

Doses must be based on the patient's:

•  body weight
•  age and
• condition.

The rate at which a drug is metabolized varies from person to person. The patient's age is an important factor. Elderly patients usually have decreased liver and kidney function. Underlying disease conditions may also affect drug action and effect. Body weight is another important factor.

The storage of drugs can alter their potency. Drugs should be stored in tight-fitting containers and kept out of direct sunlight. Some medications must be refrigerated. Many drugs should not be stored in bathrooms because of constantly changing humidity.

The timing of drugs is very important. Some medications are given either before or after a meal. If you're taking a large quantity of vitamins, it is often preferable to eat a small meal beforehand. Also, with the current popularity of herbal supplements and vitamins, it is important for the prescribing physician to know about these over-the-counter products to avoid any adverse interactions.

Drug interactions occur when a medication is given with or shortly after another drug and alters the effect of either or both drugs. For example, one drug may stimulate the metabolism or excretion of another. Not all interactions are beneficial.

Adverse Reactions can be hazardous or even fatal. Drug hypersensitivity or allergies are the result of an immune response that occurs in the body when a drug is given to a susceptible patient. One of the most dangerous of all drug hypersensitivities is penicillin allergy. In the most severe form it can become fatal. To be alert to adverse reactions, you need to be aware of minor changes/symptoms in the patient's status. Such minor changes may be an early warning sign of toxicity. Your ability to recognize the signs and symptoms of drug allergies and to report them to the prescribing physician immediately is of utmost importance.

In order to ensure the continuous action of prescribed medications, you can use a mediset that divides the medication doses into morning/evening slots by the day of the week. This is the best way to eliminate confusion and potential overdose or under-dosing, particularly with the elderly or those with dementia.

The five rules for drug administration are:

1. The right person
2. The right drug
3. The right route
4. The right dose and
5. The right time.

Remember, 60% of all hospital admissions are from taking incorrect medication. This includes recently discharged patients.

Know why the doctor is prescribing the drug and take it as ordered. If there seems to be a problem, please consult your physician. Never get the attitude that you (the patient) know more than 6your physician.