Medication in care

We’ve all heard of it and almost all of us have taken it in one form or another which is why it’s important to properly understand what it is, how it’s used and what its effects are on us and those we care about. Furthermore, when you consider that between 20-50% of patients don’t take their medication as prescribed and as many as 70% of residents in care experience some form of medication error per day, understand the role of medication is vital.

What is medication?

Medication is defined by the Department of Health and Human Services as a substance that is taken into or placed on the body that cures, treats, relieves or prevents a disease or symptom of a disease.

The majority of medicines are used to cure a disease and a good example of this is a group of medicines called antibiotics which are used to cure infections. Medicines are used in other ways too and can be used to treat a condition. Anti-depressants for example, are used to treat depression. In a similar way, medication can be useful for relieving symptom and pain killers do just this, by reducing or relieving pain caused by an illness or disease.

However, medicine can also be used to stop a disease from ever occurring. These are called preventative medicines and include vaccines which many of use take when we go on holiday to tropical countries.

Categories of medication

Medicines can be categories into two main groups; prescriptive and non-prescriptive or over-the-counter (OTC). Non-proscriptive medication can be bought without a prescription from your doctor, for example, aspirin.

Prescriptive medicine themselves are subcategorised into two groups; controlled medication and non-controlled medications. Controlled medication has potential to be abused by the patient, for example, those that are addictive and therefore need special controls if they are to be prescribed. Non-controlled medications are any other type of prescribed medicines.

How does medication work?

Medication can be taken in numerous ways and the route of the medication depends on its type. Oral is the most common route for medication. Medicine such as pills, capsules and liquids are taken by mouth where they pass into the bloodstream via the digestive system.

There are also medicines that are absorbed into the bloodstream via the mucous membrane of the nose and mouth. Nasal, buccal and sublingual medication is taken via the nose, cheek and the underside of the tongue, respectively.

Eye drops, as the name suggests, are applied to the eye and absorbed as a liquid to treat symptoms of both eye and ear diseases. Transdermal medication is applied as a cream, patch or lotion and is absorbed by the blood vessels close to the surface of the skin.

Topical medicines are also applied to the skin but are not absorbed. Instead, they are used to treat localised symptoms. Medicines which are injected into the body are called subcutaneous. These get absorbed from the fatty tissues into the bloodstream.

Enteral medications are passed directly into the stomach via a tube where they become absorbed into the bloodstream once they pass through the digestive system and liver.

Rectal and vaginal medicine including  suppositories, enemas and creams are inserted into the rectum or the vagina where the blood vessels can easily absorb them. Finally, inhaled medications, such as those used to treat Asthma are breathed in directly to the lungs.

Effects of medication

Once the medication has been administered there are a two effects that can take place depending on the type of medicine. Eye drops, topical creams and ointments are all examples of medicines with local effects. They tend not to enter the bloodstream, but rather only affect the area where they have been applied.

Conversely, pills, liquids, suppositories, transdermal patches and subcutaneous medicines all enter the bloodstream and act on specific organs or regions of the body. This effect is known as systemic.

How does medication affect you?

When medication is taken, we hope that they have the desired effect, i.e. to cure, treat, relieve or prevent diseases and symptoms of the disease. However, sometimes there are one or two other effects that they have on our body. These include side effects which produce other symptoms which are not related to the disease such as tiredness, dry mouth, stomach upsets and headaches.

Tolerance and dependence are other undesired effects. In the case of tolerance, the medication being used will have a decreased effect. Whereas dependence will cause the patient a physical or psychological need for the medicine.

Medicine can also interact with other medicines, creating strong or potentially harmful reactions. Other times medication can have no apparent effect whereby symptoms don’t improve or worsen. Paradoxical effect occur when the medicine works in a conflicting way to its intended effect, for example if a medicine is supposed to sedate the patient but instead, it makes them hyperactive, then this is classed as a paradoxical effect.

 The medication cycle

When administering medication, it is vital to observe the effects, to determine how the medicine is working. We call this the medication cycle. Once the medicine has been administered, observation takes place whereby the changes in physical and/or behavioural changes are perceived. Any changes that do occur are reported to practitioners, pharmacists, nurses and sometimes next of kin. The information that has been observed is then recorded and alternative medication is administered if necessary. Then the whole cycle starts again.

Medication nomenclature

Sometimes medication has different names. For example, the non-steroidal anti-inflammatory and analgesic drug ibuprofen has a number of brand names including Nurofen, Advil and Motrin. Sometimes prescriptions are labelled as the chemical drug name, but not always, and it’s important to know that you have received the correct medication, especially when treating a patient. So double check and when in doubt, ask or do research.

Reference

Web MD: http://www.webmd.com/drugs/

Medicine Net: http://www.medicinenet.com/medications/article.htm

Drugs: http://www.drugs.com/

Gov.uk: https://www.gov.uk/government/organisations/medicines-and-healthcare-products-regulatory-agency