Administration of Medication in Hospitals - Assignment Example

? Pharmacology Administration of medication in hospitals requires a lot more than giving patients their medication. According to the AFH rules, caregivers must always be aware of every patient’s medication administration schedule, why the patient is being given the medication, its effects and any side effects that could arise. Medication administration process includes getting medical orders, writing medical orders on the (MAR) medical administration record, comparing the medical orders with the ones on the MAR to ensure they are correct, delivering and administering the medication to the patients, monitoring the patient’s progress and recording, storing and getting rid of expired, unused and contaminated medication. Potential issues in the system in which a mistake could be made includes staff not understanding the orders given. This could lead to patients being given the incorrect drugs, which could means disastrous effects to the health of the patient. This however can be prevented by an RN through double checking drugs that are of high alert through making independent calculations. Medications referred to as high-alert drugs are those that have a very high chance of causing disastrous effects on the patients when used in error. In addition, the RN could take their time off in between rechecking the calculations. This will give them time to relax and recheck the drugs when they are not fatigued to ensure they take the correct orders. There is a significant effect of food on drugs prescribed by health professionals to their patients. Food might have an effect on the extent and rate of absorption of the drugs particularly after oral administration (McLachlan & Ramzan, 2006). Being able to fully comprehend what kind of effect food has on different types of medicines helps health professionals be able to give patients the correct advice of whether to take the medicines with food or not. Generally, taking food together with medicine usually delays absorption of the drugs; nevertheless, the effect depends on the drug, the kind of food and its formulation. There are those drugs that come with strict guidelines of whether they should be taken with meals or not. Food especially that has high fat content usually slows down the emptying of the gastric, which might delay absorption of the drug. This means that if there is a delay of the drug going to the small intestine absorption into the systemic circulation becomes difficult. The effect food has is determined by the pharmacokinetic and physicochemical features of the drug (McLachlan & Ramzan, 2006). An example is the antiretroviral drug saquinavir, which is very poor in dissolving in water; therefore health professionals advice their patients to take it with food in order to allow enhancement of bile to dissolve it aiding absorption. Absorption of saquinavir works much better after having a heavy breakfast; taking it on an empty stomach could result to therapeutic failure. Food also has an effect of drug toxicity especially when they are mixed. For example, when it comes to blood pressure and MAO inhibitors drugs, taking them with chocolate or peanut butter could be disastrous (American heart organization, 2013). Other foods like grapefruit also interfere with certain prescription drugs and therefore should not be taken with drugs meant to lower blood pressure. This is because grapefruit juice can lead to an increase of the medicines in the body causing negative side effects. When it comes to timing of meals, there is also an effect especially when comes to foods containing dairy products. Dairy products contain calcium and minerals which when taken with some certain medicines reduce absorption into the blood from the gut. Therefore, this can only be prevented by time spacing. Patients are advised to take dairy products an hour before or some two hours after taking the medication. Patient aged 42 years is suffering from high blood pressure and is put under blood pressure medication. The doctor has prescribed diuretics (water pills) so that they can remove excess sodium and water from his body. Patient is also put under beta-blockers that work by blocking hormonal and nerve signals to both the blood vessels and heart, therefore lowering blood pressure. There are certain foods that affect drug absorption with a good example of licorice, which is known to reduce the blood pressure drugs efficiency. The patient has been also advised to stay away from grape fruits since they lead to medicine levels to greatly increase in the body thus causing him to have more side effects that could be deteriorate his health (American heart organization, 2013). Drug metabolism can be described the process whereby the body breaks down and changes medication into active chemical substances. The liver is the major site of drug metabolism since is the organ that takes the active role when it comes to digestion, metabolism, detoxification as well as substance elimination from the body (Thompson, 2012). There are enzymes in the liver that chemically change the components of drugs and make them into metabolites. Thereafter the metabolites are attached to other substances to be excreted via the body fluids, body fluids or re-absorption by the intestines. The liver family isoenzymes, which are known as cytochrome P-450 are extremely important in drug metabolism. The enzymes CYP2C9, CYP3A4, CYP2CP, CYP2D6 and CYP1A2 have catabolic action on the substances and thus break them down into metabolites. As a result, they usually reduce the medication concentration in the bloodstream. The metabolic rate usually differs from one person to another and therefore for some people drug dosages work much more effectively and quickly than others do (Thompson, 2012). Patients who have liver problems are highly advised to make it known to the healthcare professional any time they are purchasing over the counter drugs. Reason being there could be a risk of having a drug-to-drug interaction. Bioavailability can be defined as an absorption subcategory and is the fraction of the dose of a drug reaching the systemic circulation. Anytime a drug is administered intravenously, the bioavailability should be 100 percent (Le, 2013). Nevertheless, if it is given through other means like oral generally its bioavailability goes down or differs from one patient to another. Therapeutic equivalence means that drug products when administered to one patient using the same dosage regime have similar adverse and therapeutic effects. Differences in bioavailability pose a great concern for drugs that have a narrow therapeutic index. Reason being, therapeutic nonequivalence poses great adverse effects to the patients and they are less efficient (Le, 2013). Drugs that have a narrow therapeutic index could mean that the patient is taking an under dose which means he or she is not receiving the right treatment as required. Therapeutic index is the ratio of the toxic concentration in its maximum quantity to the median effective concentration. There are different causes of low bioavailability and the main cause is oral dosages of drugs that are slowly absorbed and are poor water-soluble. References McLachlan. A & Ramzan, I. (2006). Meals and medicines. Retrieved on 20th November 2013 from http://www.australianprescriber.com/magazine/29/2/40/2 Thompson, D.C. (2012). The role of liver transporters in drug-drug interaction. Retrieved on 20th November 2013 from http://www.sigmaaldrich.com/technical-documents/articles/biofiles/liver-transporters-in-drug-drug-interactions.html American heart organization, (2013). Medication interactions: Food, supplements and other drugs. Retrieved in 20th November 2013 from http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Medication-Interactions-Food-Supplements-and-Other-Drugs_UCM_437377_Article.jsp Le, J. (2013). Drug bioavailability. Retrieved on 20th November 2013 from http://www.merckmanuals.com/professional/clinical_pharmacology/pharmacokinetics/drug_bioavailability.html Read More