Chapter 6- Challenged to Effective Drug Therapy
Changes in Healthcare in the 21st Century : Access to medical and pharmacological information is available from many sources Consumers are taking steps to demand specific treatments and considerations Alternative therapies are being offered and advertised Financial pressures are leading to early discharge Patient teaching and home care provisions are vital
Media Influence 1990s: Legal to advertise prescription drugs directly to the person : Federal Guidelines: When the advertisement states the indication, it must also include: o Contraindications o Adverse effects o Precautions
Internet Site Evaluation :Address Identification: o .Com .Edu 0 .gov 0 .Net .Org Navigation: oIs the site easy to access and navigate or is it confusing? Contributor: o Who prepared the site and what are his or her qualifications? oIs it reviewed or is it purely commercial? Dates: oIs the site updated frequently? Accuracy/Reliability: o Is the information supported by other sites? o Is the information accurate and in agreement with other sources you have reviewed? oAre other links listed?
OTC Drugs Those "grandfathered in" not tested to the extent that new drugs are tested by today :Can mask the signs and symptoms of disease
Can interact with prescription drugs Can be taken in greater than the recommended dose o Leading to toxicity
Alternative Therapies and Herbal Medicine : Herbal medications of alternative therapies are not controlled or tested by the FDA o Advertisement for these drugs is not restricted because they are considered dietary supplements No regulation by ANY industry The active ingredient has not been released by the FDA Incidental ingredients are unknown Patients do not always mention these therapies to healthcare providers : Drug-alternative therapy interaction may occur
Off-Label Uses Definition o The use of a drug for an indication not approved by the FDA Occurrence: Off-label uses are widespread Commonly done for groups of patients for which there is little premarketing testing o Used with pediatric and geriatric population -May lead to the discovery of new use for a drug :Liability issues are not clear
Costs of Healthcare and Importance of Patient Teaching : Skyrocketing cost of medical care and drugs Huge research and equipment requirements to meet consumer demands Rising cost of health insurance Earlier discharge from hospitals
Home Care : Aging population :Increase in teaching needs - Role of the nurse is crucial as a teacher, assessor, diagnostican, and patient advocate
Cost Considerations :Finishing Antibiotics: o Due to the rising cost some patients may stop and save the remaining antibiotics for the next time they get sick
o This has contributed to the problem of resistant bacteria which is becoming more dangerous Splitting Pills Generic Drugs Ordering drugs from the internet o Often from other countries
Protecting the Environment - Medications in drinking water o Patients flushing meds, throwing them in the garbage, etc. The best way to dispose of a medication is to return it to the place it was prescribed to you at, many places such as hospitals and other government buil