Safe drug use main wala

By Mrs. Rani R. ShettyAsst. Professor

L.T.C.N

INTRODUCTIONThe older population uses a large number and variety

of medications. The number of drugs used by elders increases with age ( Kaufman et al 2002).

Most commonly used drugs Cardiovascular agents AntihypertensiveAnalgesics Acute arthritic agents Sedatives Laxatives Antacids.

All the above drugs can cause variety of adverse effects.

REASONS FOR ADVERSE REACTIONSAge related differences in

Absorption Distribution MetabolismExcretion of drugs.

Age related differences inBiological and Therapeutic effect of drugs at the site of action or on

the target organ.

MEASURES TO IMPROVE ABSORPTION Encourage exercises as it stimulates circulation.

Use of heat and massages will increase blood flow at the absorption site.

Prevent fluid volume deficit, hypothermia, and hypotension.

Do not administer preparations that neutralize gastric secretions if a low pH is required for drug absorption.

Monitor for drug-drug and drug-food and drug-herb interactions.

Measures to Improve Distribution of Drug Maintain the Following

Normal circulation.

Normal membrane permeability.

Normal Body Temperature.

Normal S. Albumin and protein levels.

Monitor for: Dehydration. Hypoalbumineamia. Serum levels of the drug. Serum creatinine levels.

Measure to Improve Metabolism, Detoxification and Excretion of Drugs

Maintain the following Normal liver functions.Normal Kidney functions.Normal Circulation

Monitor for:Biological half-life of the drug.Hydration Status.Normal body temperature.Renal functions.

Encourage exercise and adequate Fluid intake.

Monitor for Adverse Reactions Elderly has a high risk for adverse reactions.

One needs to remember the following facts regarding adverse reactions The sign and symptom of an adverse reaction to a given drug may differ

in older persons.

A prolonged time may be required for an adverse reaction to become apparent in the older adults.

An adverse reaction to a drug may be demonstrated even after the drug has to been discontinued.

Adverse reactions to a drug that has been used over a long period without problem can develop suddenly.

An elderly may exhibit varying degrees of mental dysfunctions to commonly used drugs.

Even most subtle changes in mental states could be linked to a medication and should be reviewed.

Mental and cognitive problems arising from adverse reactions of drugs should not be treated with drugs.

Safe Practices Check List Before administering drug to an elderly ask for

drug history.

Check the prescriptions for appropriateness of dosages, consider whether the dose is the lowest.

Consider whether the drug is really needed.

Instead of a sedative, warm milk and a back rub is given to induce sleep.

If a person had a bowel movement, withhold laxatives.

Check how long a patient is on a particular medicine and can it be discontinued.

Check whether a person is allergic to a drug, before administering it.

Check for new signs of drug reaction.

Check whether the drug can have interaction with other drugs, herbs or food items.

Check for any instructions accompanying the drug administration.

Use the preferable routes like IV, inhalation or local application.

If the elderly cannot swallow the tablet/capsule, then use the liquid form of the drug.

Instead of suppositories, local application is preferred.

Check for Hypovolemia, Hypothermia and Hypotension.

Encourage exercise to enhance absorption.

Maintain low pH by providing neutralizing agents in oral medication.

Monitor S. Albumin, Creatinine and Urine Creatinine clearance levels.

Monitor for adverse reactions, even after the drug is discontinued.

Educate the client and care givers about medication, self administration, ways to improve compliance.

Schedule administration of drug around certain activities of daily living to avoid forgetfulness.

ConclusionUse Drugs cautiously in Older People.

The benefits of a drug should outweigh the risks and adverse reactions.

It should do more good than harm.

Encourage Life Style changes such asDiet modification.Regular exercise.Effective stress management techniques.Regular schedules for sleep, rest and elimination.

Avoid over the counter medication and drug dependence.