PSW Medication Assistance

• Medication management, part II, builds upon the foundational knowledge of medication management.
• The content emphasizes the PSW's role in assisting clients with their medications, and the importance of understanding pharmacology and different routes of medication administration.

PSW role in medication management

• PSWs assist clients with medication by "helping clients with their medications" and "administering medication."
• In situations where the PSW job description, employment policies, and provincial or territorial law allow it, the PSW can assist.
• PSWs must be properly trained, supervised, and monitored.
• The PSW remains ultimately accountable for their actions.
• PSWs should help clients self-administer their medications and understand the mechanical function.
• The PSW remains outside of the scope when it comes to education, judgment, and knowledge

Pharmacology Basics for PSWs

• A fundamental understanding of pharmacology for common medication classes is required.
• Pharmacology knowledge also requires some math skills

Medication Defined

• A chemical substance that causes a specific effect on the client.
• It is prescribed to achieve a desired result in the client's body
• Medication also involves treatment, health promotion, or illnessprevention

Routes of medication administration

• Oral route: Includes sublingual administration.
• Buccal administration involves dissolving a substance inside the cheek.
• Sublingual administration involves dissolving a substance under the tongue.
• Topical route: Medication is applied onto the skin to produce effects.
• Advantages include being one of the safest routes because the drug cannot produce poisonous effects.
• Advantages include it showing local effects where drugs act only at the site of application and not on the whole body.
• Examples of topical route medications include: powders, ointments, lotions
• Nasal route: Drugs are delivered by the nose.
• Nasal route can be used to clean poisons from the stomach
• Nasal Route can be used for delivery of nutrition by bypassing the mouth
• Sinus medication, nasal sprays like Narcan are administered through the nasal route
• Parenteral route: Includes intramuscular (IM) and subcutaneous (SC) injections, as well as intravenous (IV) injection.
• Insulin is administered to patients with diabetes
• Quick actions are achieved for response in the patient and the medication is given directly into blood vessels
• Only a small amount of drug is needed compared to other routes as there is no wastage of drugs by metabolism
• Medications which are not absorbed in the stomach are can be given through this route
• Disadvantages: Risky route as once drug is given cannot be retrieved
• Disadvantages: Can induce pain during injections and cause wound or abscesses frequent injections
• Disadvantages: An expensive route as you need supplies to administer an injection
• Vaginal route: Used only for people with vaginas.
• It is used for local infection in the genital parts.
• Anal route: Involves passing medication into the anus to affect the large intestine.
• Useful for cases of irritable bowel syndrome via enema administration .
• Via eye: Eye/Ear and nose drops
• Inhalation: Aerosols/inhaler
• Oral: Capsules, lozenges, tablets
• Oral liquids: Elixirs, suspensions, syrups
• Topical: Ointment/Creams, transdermal disc, or patches

The role of medications

• Medications can interfere with microorganisms, such as germs, that invade the body.
• Medications can destroy abnormal cells that cause cancer through Chemotherapy, biological or antiangiogenic therapy
• Medications can replace deficient substances, such as hormones or vitamins.
• Medications can change the way that cells work in the body.
• If substances like amino acids, proteins, vitamins, and minerals are deficient or missing, health conditions can develop, such as scurvy, anemia, and pernicious anemia.
• An infection occurs when microorganisms, such as bacteria or viruses, invade the client's body.
• Various types of defects can occur.
• Medications used to treat infections can kill germs directly or prevent them from multiplying and growing.
• Deficiency disorders can develop due to lack of hormones in the body.
• Hormones regulate many functions in the body, and a deficiency in one or more hormones can cause serious health problems.
• For example: diabetes (insulin deficiency) and hypothyroidism (thyroid hormone deficiency).
• Aging cells, genetics, wear and tear on the body, and lifestyle issues such as smoking, lack of exercise, poor eating habits, and environmental stress/pollution all cause abnormalities

Medication Processes

• Route is how the medication enters the body.
• PSWs usually assist clients with the oral route, or by mouth.
• Absorption occurs as the medication enters the bloodstream.
• Distribution of the medication travels throughout the body to reach the intended tissues to cause the desired effect.
• Metabolization occurs after medication has accomplished its desired effect; it is broken down or metabolized, usually by the liver or kidneys.
• Excretion is removal of the medication from the body.
• The medication's removed in urine or stool

Drug Interactions

• Occurs when medications interact with other drugs or substances in the body, such as alcohol.
• May cause negative effects on a client, therefore it's important to observe any kind of drug interactions.
• Drug synergism: The combined effect of two drugs is greater than the effect of either drug being given alone.
• Drug antagonism: The combined effect of two drugs may counteract the effect of the other drug.

Medication Administration Practices

• Pills should be poured into medicine cups.
• Syrups should be poured into plastic medication cups.
• Community facilities use Medication Administration Records (MAR).
• The MAR is a legal document listing the client's prescribed medications and care provided.
• The PSW is essential to checking both the client's MAR and care plan before assisting the client with their medications.
• MARs and/or care plans may contain important information that the PSW needs to be aware of and follow.
• The PSW must appropriately document on the client's MAR the care they provide with respect to the client's medications.

Case study: Managing Medication for Mrs. Tika

• Mrs. Tika is an 82-year-old widow living in a senior residence who manages her own medications.
• Has chronic conditions: Hypertension, diabetes, arthritis, sees various specialists, and fills medications at her local pharmacy.
• The PSW notices multiple pill containers and that Mrs. Tika struggles to recall taken medications on a home visit
• The home visit results in Mrs. Tika experiencing dizziness, fatigue, and nausea 30 minutes into the PSW's shift.

Questions on managing medication for Mrs. Tika

• What steps should be taken if a patient exhibits symptoms like dizziness, fatigue, and nausea during a home visit?
• What strategies can a personal support worker use to prevent risks associated with polypharmacy in elderly patients like Mrs. Tika?
• What other preventative methods can be done to prevent risks with associated with polypharmacy from a collaborative standpoint?