PRINCIPLES OF DRUG ACTION

Refer to your textbook Ch 2

Pharmacokinetics: Pharmacokinetics is defined as study of the body’s response to a drug.

• It is how the body handles a drug.
• It is the extent to which a drug completes the process of absorption, distribution, metabolism, and excretion.
• The ABC’s of Pharmacokinetics Click Here 

Drug Action

• Every medicine interacts with our body’s normal functioning.
  
• They don’t necessarily cause cells to create a new or different function but may slow down or speed up a normal process.
• Some drugs cause cells to die or certain parts of the cell to be destroyed.
• Drug actions: Click Here

There are 4 basic body processes that will affect drug action: Refer to your textbook pg 21-23

• Absorption
• Passage of a medication from site of administration into the bloodstream.
• Distribution
• The transportation of that drug from the bloodstream to the body tissues and intended site of action.
• Metabolism or Biotransformation
• The rate at which cells produce energy such as heat and muscle strength
• Excretion
  • The removal of waste substances from the body.
  • Drugs excreted quickly have a shorter time of effect, and if excreted slowly, longer effects.

Factors affecting Drug Action  Refer to your textbook pg 24-26

• Age
• Size
• The larger the person the higher dose required in order to achieve the desired effect.
• Diet
• Food and drug interactions, and factors that affect absorption.  For instance, antibiotics are less effective when taken with dairy products so you want the resident to take the medication two hours after dairy products or one hour before consuming dairy products.
• Gender Factors
• Pathological (disease) conditions
• Diseases can play significant roles in how medications are absorbed; if a person has liver disease, his or her body is not able to eliminate the drugs as effectively as a person without liver disease.
• Psychological (emotional) condition or attitude (a resident’s mental state is a very important factor in the success or failure of drug treatment). 
• Route of administration.
• Be aware of what drugs may be crushed and which ones are dangerous when absorbing too quickly.
• As a medication aide it is your job to assure that the medication you have administered has been swallowed, absorbed, or retained as directed by the doctor. This directly affects the treatment and is your responsibility as a medication aide.
• Time of day
• Be aware of certain drugs that should be taken in the morning, with meals, or at bedtime due to absorption and excretion.
• Drug Taking History See pg 26 of your textbook.
• If a person has taken a certain drug for years, for example, he/she may be immune to its potential or desired effect. 
• There may also be interactions with certain drug combinations that could decrease a drug's effectiveness or increase risk.
• Environmental condition

Drug Medication effects- Refer to your textbook pg 26-29

Drug dependence- Refer to your textbook pg 30-31

Psychological or emotional drug dependence is a strong desire or craving to take a drug but there are no physical symptoms if the drug is stopped. Physical dependence is when the body grows accustomed to the drug that it needs it to function. Drug abuse refers to self-administration of a drug in excessive quantities for a long period of time, and when it is taken for psychological or emotional effects rather than out of medical necessity. Abuse usually involves self-administration of drugs in chronic excess.

Commonly abused drugs include narcotics, sedatives, alcohol, tranquilizers, stimulants, and marijuana.

As a medication aide it is your responsibility for consulting with your charge nurse if you suspect drug abuse or dependence of a resident or staff member.  It does not have to mean they are stealing medications from the facility, but could include a staffer being under the influence at work.  If it is the charge nurse you suspect then refer to the Director of Nursing.  Even though we never want to think of those who supervise us as being drug dependent you do have to be aware that we are all human. If it is the Director of Nursing which you suspect then you would refer to your Administrator of the facility. 

Understand the importance of this action and that it is your job and obligation to report it and then to follow the chain of command. You never want to gossip about this to your peers or the outside public.  You also want to help the person and do the right thing in the process. Be responsible and go through the right channels to do this in the proper manner. It is everyone’s responsibility to keep the medications locked up properly, dispense only prescribed medications, and watch for signs of drug dependence and improper use of drugs.

Diverting resident's drugs for personal use is against the law and state and federal regulations. It can result in prosecution.