In-depth Notes on Medication Management for Nurses

Introduction

  • Health alterations compel individuals to seek relief through treatments. Medications are a common choice for alleviating symptoms and restoring health.
  • Medications: Substances prescribed by authorized practitioners (doctors, dentists, nurse practitioners) aimed at treating, relieving, or preventing health issues.
  • Collaborative medication management involves various health care providers:
    • Pharmacists: Prepare and dispense medications.
    • Nurses: Administer and educate patients on medications.
    • Dietitians: Evaluate food and medication interactions.

Nursing Roles

  • Nurses play a crucial role in:
    • Administration of medications.
    • Educating patients about medications and their potential side effects.
    • Evaluating the effectiveness of prescribed therapies.
  • Role of nurses varies by setting:
    • Home-care/community: Patients take medications independently; nurses educate.
    • Acute-care: Nurses administer and evaluate the medications often.

Medication Standards and Legislation

  • Definition: Medication is a chemical aimed for disease treatment, relief, or prevention.
  • Safe administration assumes that prescribed medications are safe within therapeutic dosages and routes, following established standards:
    • Therapeutic Goods Administration (TGA) in Australia sets regulations on medication strength, purity, and safety.
    • Medication standards in New Zealand managed by Medsafe.
Federal Legislation
  • Australia:
    • Therapeutic Goods Act 1989 (Cth)
    • Narcotic Drugs Act 1967 (Cth)
  • New Zealand: Medicines Act 1981.
Nursing Highlights
  • Controlled Substances Scheduling in Australia:
    • Schedule 1: Not in use
    • Schedule 2: Pharmacy medicine
    • Schedule 3: Pharmacist only medicine
    • Schedule 4: Prescription only medicine
    • Schedule 5: Caution
    • Schedule 6: Poison
    • Schedule 7: Dangerous poison
    • Schedule 8: Controlled drug
    • Schedule 9: Prohibited substance
    • Schedule 10: Extremely dangerous substances.

Pharmacokinetics

  • Definition: The study of absorption, distribution, metabolism, and excretion (ADME) of medications. Vital for understanding medication effectiveness.
  • Prescribing practitioners assess:
    • Dosage & route for optimal therapeutic effects.
  • Medication actions depend on ADME:
    • Absorption: Passage from administration site to bloodstream.
    • Dissolution: The time it takes for solid medications to dissolve before absorption.
    • Distribution: Movement of medications to target tissues influenced by blood flow and cell permeability.
    • Metabolism: Transformation of medications primarily in the liver; can be affected by age and health conditions.
    • Excretion: Elimination of medications primarily through the kidneys.
Absorption Factors
  • Rate of absorption varies based on
    • Blood flow, dosage form, route, drug interactions, and individual characteristics (age, diet).

Medication Nomenclature

  • Medications are identified by different names:
    • Chemical, generic (non-proprietary), official, and brand names. Example: Ibuprofen (Generic); Advil, Nurofen (Brand names).

Medication Actions

  • Medication action refers to the ability of drugs to bind with cellular receptors, causing specific effects:
    • Local effects: Impact at the application site.
    • Systemic effects: Effect throughout the body (oral medications).

Medication Administration

  • Routes of administration:
    • Oral, parenteral (ID, subcut, IM, IV), inhalation, topical, and rectal/vaginal.
Key Points in Administration
  • Oral route: The most common; requires assessment of the ability to swallow and potential for aspiration.
  • Parenteral route: Invasive; includes ID, subcut, IM, and IV.
  • Topical route: Includes many types (skin, eyes, etc.); usually provides localized effects but can have systemic effects.
Safety Guidelines in Medication Administration
  • Nurses must adhere to the Six Rights of Medication Administration:
    1. Right medication
    2. Right dosage
    3. Right person
    4. Right route
    5. Right time
    6. Right documentation

Professional and Legal Responsibilities

  • Nurses are accountable for questioning unclear or potentially erroneous medication orders.
  • All medication errors must be reported and documented accurately, including details of the error and actions taken.