Safe drug use main wala

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  • 1. By Mrs. Rani R. Shetty Asst. Professor L.T.C.N
  • 2. INTRODUCTION
    • The 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
      • Antihypertensive
      • Analgesics
      • Acute arthritic agents
      • Sedatives
      • Laxatives
      • Antacids.
      • All the above drugs can cause variety of adverse effects.
  • 3. REASONS FOR ADVERSE REACTIONS
    • Age related differences in
      • Absorption
      • Distribution
      • Metabolism
      • Excretion of drugs.
    • Age related differences in
      • Biological and
      • Therapeutic effect of drugs at the site of action or on the target organ.
  • 4. 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.
  • 5.  
  • 6. 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.
  • 7. 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.
  • 8.  
  • 9. 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.
  • 10. 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.
  • 11.
    • 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.
  • 12.
    • 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.
  • 13.
    • 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.
  • 14. Conclusion
    • Use 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 as
      • Diet modification.
      • Regular exercise.
      • Effective stress management techniques.
      • Regular schedules for sleep, rest and elimination.
    • Avoid over the counter medication and drug dependence.
  • 15.