This slides, described one of the most important part in gerontology nursing

1. Safe use of medications in care
if older adults
K. L. S. Silva(RN)

2. Learning outcome
Goal/aim :
 TO IMPROVE KNOWLEDGE, ATTITUDE AND SKILLS OF THE SAFE USE OF MEDICATIONS IN
CARE OF OLDER ADULTS
Specific objectives :
AT THE END OF THIS SESSION NURSE SHOULD BE ABLE TO;
 DEFINE THE GERENTALOGICAL NURSING
 DESCRIBE BRIEFLY AIM OF THE SAFE USE OF THE MEDICATIONS IN OLDER ADULTS
 IDENTIFY THE ALTERATION OF THE PHARMACOKINATICS IN OLDER AGE
 EXPLAIN THE GIDELINES FOR SAFE DRUG USES IN OLDER ADULTS
 DEMONSTRATE HOW TO HELP TO SAFE DRUGS USE IN OLDER ADULTS

3. What is Gerontological nursing
 Gerontology
 Scientific study of the aging as a biological, physical and sociological
process
 Gerontological nursing
 a nurse who works predominantly with older people, provide nursing
care as a full member of the multidisciplinary health and social care
team, in a variety of settings where older people cared for

4. Polypharmacy
Concurrent use of multiple medications by a patient
Adverse effects of the polypharmacy and aim of the
gerontological nurse will be,
☺ To minimize the drug associated risk
☺ Ensure the safety of the drug use by adhering the
principles of safe drug use

5. Pharmacokinetics
Is the process of the drug absorption, distribution,
metabolism and excretion

6. What are the Age related changes ?
01.Absorption
☺ Route: more effective inhalation, IV, local
☺ Effective high concentration and solubility of the
drug
☺ Disease and symptoms
02. Distribution
☺ Circulatory changes
☺ Decrease serum albumin
☺ Cell membrane permeability
☺ Increased adipose tissue

7. 03.Metabolism
☺Decrease metabolism
04.Detoxification
☺Reduce secretion of enzymes
☺Reduced hepatic blood floor
05.Excretion
☺Number of nephrons units reduced
☺Reduce blood supply to the kidneys
☺Filtration get reduced

8. Pharmacodynamics
Expected biological and therapeutic effects of the
drug of the target organs or body site
Adverse effects
Drug developing some additional effects

9. Guidelines for safe drug use among older
adults
♣To keep current medication list
♣ For each drugs, herb, homeopathic remedies or
nutritional supplements notes
♣ Learn drugs reading the leaflets
♣ Be aware the drugs using many years without
adverse effects

10. ♣ Review the symptoms with the health care
provider
Periodically review the heath care provider for drug
dosage
♣ Try to manage new symptoms naturally rather
than using a another drugs
♣ Do not take new drug without consulting the
heath care provider

11. Nurse responsibility in safe and effective
use of drug administration
Nurses assistance and direct observation
Patient education
Monitoring laboratory values

12. Nurses assistance and direct observation
1.oral route
☼ enough water to swallow
☼proper positioning
☼oral cavity after swallowing
☼dentures
2.suppocittories
☼blood supply reduced to vagina and bowel ( ↓
temperature of the site, action of the drug not in
expected level & take more time to melt)
☼sometime expel out (observe & lying down long time)

13. Patient education
Cognitive impairment (forgetfulness, confusion, poor
memory→ repeat or missing drug dose)
Educational limitation
Sensory limitations(vision and hearing)
Financial limitation

14. Monitoring laboratory values
Evaluates serum values
Refer for necessary lab test
Periodical reviewing of lab test

15. HOW TO HELP TO SAFE DRUGS USE IN OLDER
ADULTS

17. Making a list
Name
Date of birth
NIC number(optional)
Diseases
Drug , dose, administrative schedule
Administrative instructions
Usual side effects
Storage instructions

19. summary
Gerontological nursing is a nurse who works predominantly
with older people, provide nursing care as a full member of
the multidisciplinary health and social care team, in a variety
of settings where older people cared for
Aim of the safe drug uses is, to minimize the drug associated
risk and ensure the use of safety drug using principles
Pharmacokinetics’ is the process of the drug absorption,
distribution, metabolism and absorption
Responsibility in safe drug uses in nurse is assistance and
direct observation, patient education and monitoring
laboratory values