22%20guidance%20for%20staff%20on%20medicines%20used%20to%20treat%20common%20conditions.pdf

Appendix 22
Guidance for Staff on Medicines used to Treat Common Conditions
This guidance is designed to inform and support staff to understand the basic medicines used in their work. The following points apply to all medications that are administered to people 1 Medication can only be given to people by staff who have received and successfully completed level 1 and 2 training, and have been assessed as 2 Medication will only be given to the person for whom it has been prescribed. 3 All medication should be administered strictly in accordance with the prescriber’s 4 All medication should be stored as directed on the label and used within the use by date. 5 Make sure you know as much as possible about the medication you are administering. If you are unsure of any medication you can obtain information from the British National Formulary reference book, which contains information regarding use, dosage, side effects and alternative brand names. 6 Any medication administered to a person must be recorded on the appropriate Medication Administration Record sheet. (MAR sheet) and signed by the staff member after the
medication has been administered.
7 Following the administration of medication, if the person displays any side effects, advice should be sought from senior members of staff or medical advice sought (see Appendix
10a MHRA leaflet on side effects)
8 Any medication which has been purchased over the counter must be clarified with the General Practitioner before administration. Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Analgesia (Pain Killers)
These are some common medications used to control mild to moderate pain. These medications can be either prescribed or bought over the counter. Paracetamol
No more than 8 tablets in 24 hours. Take care that no other medication containing paracetamol is given at the same time e.g. ‘Lemsip’ as too much paracetamol can result in serious liver damage. Co Codamol
Ibuprofen
There are other painkillers which are similar e.g. Tramadol, Tylex, Dihdrocodeine, Codeine Phosphate. If the person is in moderate to severe pain then they will need their painkillers regularly, every 4-6 hours as prescribed. Painkillers work better if they are taken before the pain gets too bad. If the pain is not relieved seek medical advice. Sometimes normal adult doses of painkillers can be too strong for elderly people and cause confusion and disorientation. When pain is severe and stronger analgesia is needed then the following medications may be prescribed. Controlled Medication
These medications are usually given to people who are in severe pain. The medications are very strong and can be of an addictive nature; some of these medications are classified under the Misuse of Drugs (Safe Custody) Regulations 1973 and must be stored in a controlled drugs cupboard. After administration two staff must sign in a controlled drugs register and on the MAR sheet. It is important that people who are in severe pain receive their painkillers regularly. If the pain is not effectively controlled seek medical advice. Most of these medications contain morphine, which can cause nausea (feeling sick) and usually causes constipation. Oramorph (M.S.T.)
This comes in both tablet and syrup form.
Diamorphine
This is usually given via syringe driver by a needle just below the skin and administered by Community Nursing Services. Durogesic
This comes in the form of a patch which is stuck on the skin like a plaster. Anti-emetics (medicines to prevent sickness and vomiting)
Sometimes these medications can be used to prevent sickness experienced when taking medication for severe pain. Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Antibiotics
These are medications which fight infections. It is very important to finish the whole course of tablets as this helps to kill the infection completely. Some people are allergic to antibiotics, particularly Penicillin and can develop a serious reaction. The reaction begins as a flat red rash spreading over the chest and arms and may develop into severe breathlessness which will need emergency attention. If a person knows they are allergic to Penicillin or any other antibiotic this must be recorded in the Personal plan and on the MAR sheet. There is another less serious side effect of antibiotics which is diarrhoea. Fluoxicillin
Augmentin
Often used for chest and urinary tract infections Amoxycillin
Can be used for all types of infection (commonly referred to as a broad spectrum antibiotic) Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Medication for Asthma
Asthma is a disease of the lungs which results in difficulty in breathing. The tubes which we breathe through become swollen and blocked making it difficult to breathe. Two types of medications are used. The first type is a steroid which helps stop the tubes from swelling up in the first place and the second type helps clear the tubes and makes breathing easier. Medications for asthma are either swallowed in tablet form or are breathed directly into the lungs by using an inhaler or a nebuliser. Ventolin (Salbutamol)
This is inhaled via inhaler or nebuliser. Ventolin can cause a rapid heartbeat as a side effect. Atrovent, Becotide
Seretide
Flixotide
Phyllocontinos
Singulair
Prednisolone
Side effects may include headaches, palpitations, muscle cramp USE OF OXYGEN
Some service users may require Oxygen to breathe; therefore they will use some type of equipment, usually cylinders or an oxygen concentrator machine. Anyone using this equipment must have the generic risk assessment and an individual risk management plan in place while using the service, due to the dangers involved with storage and use of compressed gases. Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Sedatives
Sedatives are prescribed to service users who may be experiencing difficulties in relaxing due to anxiety, stress, and insomnia. Careful monitoring of the effect of these medications is necessary 1 They can make clients very drowsy the next day and if elderly, prone to falls. 2 They can make clients dependent on them (particularly Temazepam). 3 People can get used to them so that they do not work any more. Commonly used medication
Diazepam
Lorazepam
Night Sedation
Temazepam
recorded in the Controlled Drugs register recorded and signed for by two staff on the MAR sheet. Zopiclone
Sodium Amytal
This is another controlled drug and must be checked the same way as Temazepam. Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Anti Depressants
Anti depressants are used to treat depression and may take some time to be effective when initially prescribed. They are used to elevate mood, increase physical activity and restore interest in every day activities. Lustral (Sertraline)
Prothiadin (Dothiapin)
Prozac (Fluoxertine)
Citalopram
This can be effective with elderly people. Lithium (Priadel, Camcolit )
Used since 1940’s for manic depression, decreases the intensity and frequency of incidents of extreme excitement to deep depression Side effects can include nausea, vomiting, dyspepsia, diarrhoea The following medication is commonly used to treat people who may have mental health
concerns e.g. Dementia, Schizophrenia, Psychiatric or Psychotic illnesses
Haloperidol (Seranace)
Most widely used. Is effective in reducing violent, aggressive behaviour and hallucinations. Quetapine (Seroquel)
Risperidone (Risperdal)
Helps to alleviate distressing symptoms of acute psychiatric disorders and long term psychotic illness Clozapine (Clozaril)
Used to treat Schizophrenia. Prescribed to people who have not responded to other treatments or who have experienced intolerable side effects with other drugs Side effects may include tremor, abnormal face and body movements, restlessness Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Diuretics (Water tablets)
The heart needs to pump in a strong and regular beat to keep the circulation flowing properly around the body. If this doesn’t happen several problems develop. Blood starts to pool and this makes it lose some of its fluid into neighbouring tissues causing
swelling and discomfort. This can happen in the legs where the calves become swollen, tight and
eventually ooze clear fluid and in the lungs where clients keep coughing, become breathless and
sometimes feel that they are drowning as the amount of fluid builds up to unbearable levels. This
is called Heart Failure.
This is treated by giving the patient diuretics (water tablets). These tablets help get rid of all the excess fluid which is turned into urine and passed away. This process also helps control high blood pressure. The person will go to the toilet more frequently when they are on diuretics.
There are many different types of diuretic. Here are a few examples. Frusomide
Clients need to go to the toilet to pass urine, sometimes as soon as ½ hour after taking Frusomide. Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Medication used to treat heart conditions
Sometimes the heart must be made to beat slower and more regularly. The following medications may be used. Capoten (Captopril)
Innovace (Enalapril Maleate)
Tenormin (Tenolol)
Lanoxin (Digoxin)
Many of these tablets also help control high blood pressure. Side effects may include sleep disturbances, fatigue and stomach upset.
Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Diabetic Medication
Diabetes is a condition where the body cannot digest glucose. Glucose is the substance that is formed after digesting sugary foods and carbohydrates (bread, rice, pasta, biscuits, potatoes etc.) Insulin is the hormone required to digest glucose and some people are unable to produce this. When people cannot produce their own insulin it must be given artificially. If insulin is not given then the person will gradually lapse into a coma (hyperglycaemic or diabetic coma) and eventually die. This is called Type 1 Diabetes or insulin dependent Diabetes. Some people can produce their own insulin but not enough. Tablets can help by reducing the glucose levels or by stimulating the production of slightly more insulin, enough to make digestion possible. This is type 2 Diabetes. When people are taking insulin it is vital that care staff observe the amount they eat at every mealtime. If the person is not hungry and rejects the meal he/she must be given an alternative. This is because the dose of insulin is calculated to last for most of the day and to digest all the carbohydrate (glucose) that the person would be expected to eat. If less carbohydrate than expected is eaten there is too much insulin and this results in the client becoming confused, sweaty, aggressive and comatose (hypoglycaemic coma). The person’s blood sugar should be checked regularly as directed by the G.P. and their urine tested regularly for ketones. Medical advice should be sought if the person is ill and/or reluctant to eat or drink. Examples of tablets used for controlling diabetes are: Daonil (Glibenclamide)
Diamicron (Gliclazide)
Glucophage (Metformin)
Rastinon (Tolbutamide)
Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Medications to prevent the blood clotting
(Anti coagulants)
These are given to people who have had problems with their blood clotting. This causes problems when parts of the clot enter the circulation and block off important blood vessels resulting in a stroke if this happens in the brain and deep vein thrombosis if it happens in the legs. People who are on anti coagulant therapy are looked after by their G.P. and also by the hospital who calculate the dose of the tablets depending on the results of regular blood tests. Important points to remember for clients on anti coagulants
1 Take the tablets regularly as prescribed. 2 Contact the G.P. immediately if too many tablets have been taken by mistake. 3 Inform the G.P. of any more frequently or unusual bleeding e.g. nose bleeds. 4 Test urine weekly or more frequently if client is ill and report any result showing blood. 5 Attend the anti coagulant clinic as directed. Examples
Marevan (Warfarin)
Sunderland City Council – Medication Procedures for Adults and Older People Appendix 22
Other common conditions of people
using Adult Services
Parkinson’s Disease
This is a progressive degenerative disease that effects the nervous system, suffers can develop a tremor, shuffling gait and rigidity. Common medications are Co-beneldopa
Multiple Sclerosis (MS)
This is the degenerative wasting of muscles and can cause stiffness and rigidity of limbs. Common medication is Baclofen
Epilepsy
This is a condition that causes electrical abnormality in the brain, causing the person to have a seizure. Seizures can be very mild or very severe. Common medications are Sodium Valporate, Clobazam, Carbamazepine
A stroke occurs when the blood supply to the brain is interrupted and suffers a lack of Oxygen. A stroke may leave a person mildly or severely disabled and can affect not only limbs but speech also. Medications used to prevent strokes are Aspirin and Warfarin.
Dementia
This affects mainly older people. It is a progressive illness that affects the brain, in particular the memory. Common medications are Aricept and Galantamine.
Huntingdons Disease
This is a heredity condition that affects the nervous system and results in loss muscle tone and involuntary movements. Medications commonly used are Tetrabenazine
Sunderland City Council – Medication Procedures for Adults and Older People

Source: http://www.twca.org.uk/documents/Sunderland%20Documents/Medication%20Documents/Form%2022.pdf