Basic Pharmacotherapeutic Concepts
Name
[Institutional Affiliation(s)]
Author Note
Ethical and Legal Aspects of Prescribing Medicines
Legal and Ethical Regulations
The World health organization has described various advanced approaches for the safe administration of medicines to patients. These guidelines play an important role in nursing practice as it defines ethical and medical rules to deliver safe services to patients. In the given scenario, it is important to apply major steps based on the patient’s diagnosis to administer medicines (Nanji, Patel, Shaikh, Seger, & Bates, 2016). In the given scenario, the nurse has to make sure that he has applied these rules, laws, and steps while administering medication to a patient to assess the probability of reducing poor outcomes.
Evaluation of the patient's problem
Specification of therapy objective
Selection of appropriate drug therapy
Initiation of therapy and application of non-pharmacological treatment therapy
Introduction of information, warnings, and instructions
Evaluation of therapy
Consideration of the cost of drugs
Utilization of computer and information technology for the reduction of medication errors
Factors Influencing Pharmacokinetic and Pharmacodynamic Processes
Exposure to various agents that can affect neurologic functioning has been associated with long-term effects even in the geriatric age. Many agents are known that can influence geriatric neurological functions in older people ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"AU0lXFeI","properties":{"formattedCitation":"(Organization, 2016)","plainCitation":"(Organization, 2016)"},"citationItems":[{"id":684,"uris":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"itemData":{"id":684,"type":"article-journal","title":"Medication errors","author":[{"family":"Organization","given":"World Health"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Organization, 2016). Older people are more susceptible to neurotoxic agents because of low immunity. There are pharmacokinetic and pharmacodynamic elements that are known to upsurge geriatric vulnerability to these components. Administration of certain drugs in the geriatric period can cause severe effects such as neuronal loss, decreased acceptability to induced variations and changes in neurotransmitter functions.
Ethical Implication for the Administration of Medication
While administering medication to the patients, it is important to have complete knowledge and information regarding patient disease and diagnosis because the health and well-being of the patient are important. Certain ethics have been implemented in healthcare facilities such as the right patient to be administered with the right drug. The dose of the drug should be right and should be administered through the right routine. Time is important for drug administration ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ar7nie5q7t","properties":{"formattedCitation":"(Schiff et al., 2015)","plainCitation":"(Schiff et al., 2015)"},"citationItems":[{"id":685,"uris":["http://zotero.org/users/local/p8kwKNoG/items/PL25Q82T"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/PL25Q82T"],"itemData":{"id":685,"type":"article-journal","title":"Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems","container-title":"BMJ Qual Saf","page":"264-271","volume":"24","issue":"4","author":[{"family":"Schiff","given":"G. D."},{"family":"Amato","given":"M. G."},{"family":"Eguale","given":"T."},{"family":"Boehne","given":"J. J."},{"family":"Wright","given":"Adam"},{"family":"Koppel","given":"Ross"},{"family":"Rashidee","given":"A. H."},{"family":"Elson","given":"R. B."},{"family":"Whitney","given":"D. L."},{"family":"Thach","given":"T. T."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schiff et al., 2015). It should be documented that what, when and how medicine is administered. The reason for the selection of medicine and how it will affect the health of the patient should also be considered while administering medications ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a13a1p1fdd6","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Mid-Level Practitioners Authorization by State,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Mid-Level Practitioners Authorization by State,” n.d.)"},"citationItems":[{"id":681,"uris":["http://zotero.org/users/local/p8kwKNoG/items/UX4TU96F"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/UX4TU96F"],"itemData":{"id":681,"type":"webpage","title":"Mid-Level Practitioners Authorization by State","URL":"https://www.deadiversion.usdoj.gov/drugreg/practioners/index.html","accessed":{"date-parts":[["2019",11,30]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Mid-Level Practitioners Authorization by State,” n.d.). Nurses are in direct contact with patients to take their medical history, prepare a care plan, and administration of medicine is also their responsibility. Professional ethics should be applied in administering medications to the patient. For instance, beta-blockers are used to reduce the blood pressure of the patients in certain conditions but administering these drugs in patients having asthma problems can cause serious life-threatening side effects, therefore, the complete history of the patient is very important.
Two Strategies
Strategies to address disclosure and nondisclosure of medicines are properly defined in healthcare practices. Various stakeholders are included in the administration of medicines such as physicians and nurses. The selection of the right dose of medicine to be administered is required to be discussed in detail with the patients, their parents and family members regarding outcomes and possible side effects of drugs ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"akt63473vb","properties":{"formattedCitation":"(Organization, 2016)","plainCitation":"(Organization, 2016)"},"citationItems":[{"id":684,"uris":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"itemData":{"id":684,"type":"article-journal","title":"Medication errors","author":[{"family":"Organization","given":"World Health"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Organization, 2016). It would be counted as incomplete disclosure of medical error. Nondisclosure of medication errors involves the administration of drugs and if it is wrongly administered, how a healthcare facility would address the issue and will disclose it. To apply ethical values, first the physicians and nurses need to address code of disclosure and nondisclosure of medication errors such as involvement of patient and relatives reading drug outcomes and management of errors in case of wrong administration ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a37hag168r","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Mid-Level Practitioners Authorization by State,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Mid-Level Practitioners Authorization by State,” n.d.)"},"citationItems":[{"id":681,"uris":["http://zotero.org/users/local/p8kwKNoG/items/UX4TU96F"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/UX4TU96F"],"itemData":{"id":681,"type":"webpage","title":"Mid-Level Practitioners Authorization by State","URL":"https://www.deadiversion.usdoj.gov/drugreg/practioners/index.html","accessed":{"date-parts":[["2019",11,30]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Mid-Level Practitioners Authorization by State,” n.d.). Secondly it is important to address the nondisclosure timely for example prolonged use of drugs such as anti-depressants. It is important to select those drugs that are safe to use and to discuss it with patient and lastly, wrong selection of drug should be disclosed in front of patient (depends on the condition) and prompt actions should be taken to reduce the effects of the wrong drug.
Prescription of Medicines
In the given scenario, the administration of medication that is best suited to the patient and medical diagnosis, should be the aim of the nurse. Prescriptions should be prepared according to the disease and diagnosis of the patient. Right medicine for the right disease would prevent physicians from various poor outcomes ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aod9eatc45","properties":{"formattedCitation":"(Organization, 2016)","plainCitation":"(Organization, 2016)"},"citationItems":[{"id":684,"uris":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"itemData":{"id":684,"type":"article-journal","title":"Medication errors","author":[{"family":"Organization","given":"World Health"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Organization, 2016). In the case of wrong administration of medicine, the nurse should discuss it with the physicians to apply such strategies that diminish the side effects and possibly worst outcomes of the drug administration. To disclose it to the right stakeholders is also important in the sense that it can reduce the probability of worst-case scenarios ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aqu79kjnfi","properties":{"formattedCitation":"(Klein et al., 2019)","plainCitation":"(Klein et al., 2019)"},"citationItems":[{"id":556,"uris":["http://zotero.org/users/local/p8kwKNoG/items/H4EWSP5R"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/H4EWSP5R"],"itemData":{"id":556,"type":"article-journal","title":"Evaluation of a social protection policy on tuberculosis treatment outcomes: A prospective cohort study","container-title":"PLoS medicine","page":"e1002788","volume":"16","issue":"4","author":[{"family":"Klein","given":"Karen"},{"family":"Bernachea","given":"Maria Paula"},{"family":"Irribarren","given":"Sarah"},{"family":"Gibbons","given":"Luz"},{"family":"Chirico","given":"Cristina"},{"family":"Rubinstein","given":"Fernando"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Klein et al., 2019). For example, wrong administration of antibiotics can cause serious side effects and will ultimately affect the health of patients and recovery would be slow.
Strategies to Minimize Medication Errors
The process of perception should be modified according to the requirement of healthcare facilities. For example with the new advancements, it is important to use health IT in the departments to reduce errors and mistakes of wrong medication administration ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ao84qm25m7","properties":{"formattedCitation":"(Schiff et al., 2015)","plainCitation":"(Schiff et al., 2015)"},"citationItems":[{"id":685,"uris":["http://zotero.org/users/local/p8kwKNoG/items/PL25Q82T"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/PL25Q82T"],"itemData":{"id":685,"type":"article-journal","title":"Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems","container-title":"BMJ Qual Saf","page":"264-271","volume":"24","issue":"4","author":[{"family":"Schiff","given":"G. D."},{"family":"Amato","given":"M. G."},{"family":"Eguale","given":"T."},{"family":"Boehne","given":"J. J."},{"family":"Wright","given":"Adam"},{"family":"Koppel","given":"Ross"},{"family":"Rashidee","given":"A. H."},{"family":"Elson","given":"R. B."},{"family":"Whitney","given":"D. L."},{"family":"Thach","given":"T. T."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schiff et al., 2015). An adequate record of the patient and his history can significantly help nurses to make a decision that is best suited to the patient. Health informatics can play a significant role in the record of patient's data, application of right medicines, and right care plans can be utilized timely and efficiently.
Responsibilities of Stakeholders
Pharmacists need to regulate their pharmacies according to the laws defined by the drug regulatory authorities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a19jit4kf38","properties":{"formattedCitation":"(Organization, 2016)","plainCitation":"(Organization, 2016)"},"citationItems":[{"id":684,"uris":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/EDA97FDP"],"itemData":{"id":684,"type":"article-journal","title":"Medication errors","author":[{"family":"Organization","given":"World Health"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Organization, 2016). Patients and their families should be educated and trained regarding the administration of medicines on time and according to prescription. Nurses and other stakeholders of healthcare providers should apply all regulations and provisions to administer safe medicines and wrong administration of medications should be handled timely and appropriately.
References
ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Klein, K., Bernachea, M. P., Irribarren, S., Gibbons, L., Chirico, C., & Rubinstein, F. (2019). Evaluation of a social protection policy on tuberculosis treatment outcomes: A prospective cohort study. PLoS Medicine, 16(4), e1002788.
Mid-Level Practitioners Authorization by State. (n.d.). Retrieved November 30, 2019, from https://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
The organization, W. H. (2016). Medication errors.
Schiff, G. D., Amato, M. G., Eguale, T., Boehne, J. J., Wright, A., Koppel, R., … Thach, T. T. (2015). Computerized physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems. BMJ Qual Saf, 24(4), 264–271.
