Medication Types and Herbal Interactions

Types of Medications

• Prescription drugs require a doctor's visit, and information can be found in a drug monograph.
• Controlled drugs have a high potential for abuse or addiction.
• OTC medications do not require a prescription.

Herbal Medications

• Herbal medications have become popular in recent years and are available OTC.
• Medication contraindications are common with herbal medications.

Herbal Medicine Interactions

• Coenzyme Q10 may help with heart damage, but can decrease blood thinning if used with warfarin.
• Cranberry treats UTIs but could increase the effect of blood thinners.
• Garlic lowers cholesterol and blood sugar but affects blood clotting/anticoagulants.
• Echinacea boosts the immune system, but use with caution with immunosuppressant drugs
• Evening primrose oil provides healthy fatty acids but may lower the seizure threshold.
• Ginseng helps decrease stress and increase energy but also decreases the effects of anticoagulants.

Active vs. Inactive Medication Components

• Inactive components include colors, dyes, coatings, and solvents.
• Active components create a therapeutic effect in medications.

Names of Medications

• Generic names are known worldwide, listed in CPS, and italicized, such as acetaminophen.
• Brand names are company-specific; Bayer uses the name Aspirin for the generic drug acetylsalicylic acid.
• Brand names usually have a capital letter, such as Aspirin.
• Brand-name Benadryl contains diphenhydramine.
• Brand-name Gravol contains dimenhydrinate.
• Brand-name Motrin contains ibuprofen.
• Brand-name Tylenol contains acetaminophen.

Adverse vs. Side Effects

• Adverse effects are unintended, dangerous effects that occur when medication is taken and are unpredictable, such as a severe allergic reaction.
• Side effects occur when a medication is taken, producing an effect other than the intended one, and are anticipated.

Allergies

• Allergies may develop later in life and we are are not always born with them.

Rights of Medication Administration

• The rights of medication administration are: right patient, right drug, right dose, right route, right time, and right/proper documentation.
• Example prescriptions include: Pt X Tylenol 325mg po q4h prn, Pt X Morphine 5mg IV q3h, Pt X Dulcolax 10mg supp pr q3d prn, Pt X Ventolin 2 puffs qid prn, Pt X Voltaren 1% gel to left knee bid.

Medication Responsibility

• The physician writes the medication order
• The administrative health professional processes it
• The charge nurse checks it
• The pharmacist fills it
• The nursing staff gives the medication.

Medication Routes

• The chosen route depends on many factors.
• Oral routes (po) include tablets, capsules, liquids, syrups, elixirs, and suspensions.
• Sublingual routes (sl) involve placing the medication under the tongue, where it absorbs through mucous membranes and does not need to be swallowed.
• Enteral routes use nasogastric or gastrostomy tubes.
• Inhalers can be dry powder or metered dose.
• Parenteral routes for injection include intramuscular (IM), subcutaneous (SC), and intravenous (IV).
• Rectal routes (pr) include suppositories, fleet enemas, creams, and lotions.
• Vaginal routes (pv) include creams, ointments, hormones, and analgesics.
• Drops (gtt) can be administered in the eye, ear, or nose, and may contain numbing agents or antibiotics.
• Topical applications include creams, ointments, powders, and lotions that work locally.
• Transdermal patches are similar to topical applications, are left on the skin to absorb, and work systemically.

IV Solutions

• IV solutions are used for replacement of lost fluids, medication administration, electrolyte balance, in emergency situations, and for blood products, with potential for electrolyte depletion.

Types of IVs

• Primary infusion.
• Piggyback.
• Saline lock.
• Direct IV.
• IV Bolus.

Types of IV Solutions

• Normal saline (NS) is available in 0.9% and 0.45% concentrations.
• 2/3 dextrose and 1/3 normal saline (2/3-1/3).
• 5% Dextrose in water (D5W).
• 5% Dextrose in saline (D5S).
• Ringers lactate (R/L).

IV Bags

• IV bags come in various sizes depending on use, including 1000 cc, 500 cc, 250 cc, 100 cc, 50 cc, and 25 cc.

Major Classes of Medications

• Medications can have multiple classifications.

Analgesics

• Analgesics are for pain relief.
• Can be prescription or over-the counter.
• May be mild, NSAID, or narcotics based.

Mild Analgesics

• Mild analgesics such as Tylenol and Aspirin are usually bought OTC in pharmacies for mild-to-moderate pain.

NSAID Analgesics

• NSAIDs, such as Advil and naproxen, are often bought OTC at pharmacies for mild-to-moderate pain.

Narcotic Analgesics

• Narcotics, such as morphine, codeine, oxycodone and T3, require a prescription for moderate-to-severe pain.

Anesthetics

• Anesthetics are used to induce a loss of feeling or awareness.
• They can be general, epidural/spinal, local, or topical.

General Anesthetics

• General anesthetics are administered during surgical procedures to completely eliminate sensation.

Epidural or Spinal Anesthetics

• Epidural or Spinal anesthetics reduce sensation to a large area that depresses the central nervous system.
• They are used with elderly patients who have a heart condition and also during labor.

Local Anesthetics

• Local anesthetics are administered when only one part of the body needs treatment.
• They are commonly used with stitches or dental work.

Topical Anesthetics

• Topical anesthetics create a numbing effect.
• Topical anesthetics are commonly used for dental pain with infants or muscle aches.

Antibiotics

• Antibiotics can be bactericidal or bacteriostatic and were first developed as penicillin in 1941.
• Antibiotics have a broad spectrum.
• Antibiotics include Penicillin's, sulfonamides, cephalosporin's, tetracycline's.
• Antibiotic resistance can result from antibiotic abuse.
• Testing includes culture and sensitivity (C&S).

Antifungal

• Antifungal medications treat athlete's foot.

Antituberculars

• Antitubercular medications require 2-3 drugs to treat tuberculosis.

Antivirals

• Antivirals destroy viruses.
• They treat cold sores (Acyclovir), influenza, and HIV.

Antiemetics

• Antiemetics relieve nausea.
• Gravol, Zofran, and Maxeran are examples of antiemetics.

Antipyretics

• Antipyretics reduce fever.
• Tylenol and Advil are examples of antipyretics.

Antitussives

• Antitussives reduce coughs.
• Benylin and Robitussin are examples of antitussives.

Anticoagulants

• Anticoagulants prevent or delay clotting.
• Coumadin and heparin are examples of anticoagulants.
• They help those with a history of blood clots or those likely to develop them, i.e. DVT, MI.
• Can also be used to treat or prevent thrombophlebitis.

Anticonvulsants

• Anticonvulsants prevent or reduce seizures.
• They are indicated for epilepsy, and include Gabapentin.
• An EEG is a diagnostic test related to seizure disorders.

Psychiatric Medications

• Antidepressants prevent or relieve depression.
• Tranquilizers are used to calm someone anxious/agitated without decreasing consciousness.
• Antipsychotics treat pathologies, such as drug-induced psychosis, schizophrenia, and extreme mania.

Antihistamines

• Antihistamines reduce the effects of histamine, and treat allergies.
• Flonase, Allegra, and Benadryl are examples of antihistamines.

Cardiovascular Drugs

• Cardiovascular drugs treat hypertension, angina, heart attacks, CHF, arrhythmias, and high cholesterol.
• Other cardiovascular drugs include diuretics ("water pills") and antihypertensives.

Endocrine Drugs

• Endocrine drugs treat disorders of the endocrine glands.
• Hypothyroidism is treated with levothyroxin, growth hormones, oxytocin
• Antidiabetic medications treat type 1 or type 2 diabetes, such as Metformin and Lantus.

Gastrointestinal Drugs

• Gastrointestinal drugs relieve GI disorders, such as indigestion, heartburn, and diarrhea.
• They can inhibit and neutralize the secretion of gastric juices.
• Tums and Pepcid are examples of gastrointestinal drugs.

Respiratory Drugs

• Respiratory drugs treat respiratory disorders, such as asthma, bronchitis, and COPD.
• Ventolin, Beclomethasone, and Atrovent are examples of respiratory drugs.

Sedative/Hypnotics

• Sedatives/hypnotics depress the CNS to promote drowsiness and sleep.
• Lorazepam and Imovane are examples of sedative/hypnotics.

Stimulants

• Stimulants increase the activity of a body system.
• Caffeine and Ritalin are examples of stimulants.
• These are often used in tx of ADHD..

Quiz Questions

• Take an antiemetic for nausea.
• Take an analgesic for a headache.
• Take a general anesthetic for major surgery.
• Take an antidepressant for depression.
• Take an antibiotic for bacterial meningitis.
• Take an antifungal for athlete's foot.
• To treat or prevent blood clots, take and anticoagulant.
• Topical anesthetics - numbing effect locally, General anesthetics - completely eliminates sensation
• The Rights of Medication Administration: right patient, right drug, right dose, right route, right time, right/proper documentation Medications responsibility chain: Physician writes order, health administrative professional processes order,charge nurse checks the order, pharmacist fills the order and the nursing staff gives the medication.

Overview of different types of medications, including prescription, controlled, and over-the-counter drugs. Focus on the increasing popularity of herbal medications and potential contraindications. Discussion of interactions between herbal medicines and drugs, such as Coenzyme Q10, cranberry, garlic, echinacea, evening primrose oil, and ginseng.