Polypharmacy, Adverse Drug Reactions, and Drug Calculations

Outline:
Hour One I. Introduction: Medications and the senior population II. Overview: What is polypharmacy? 1. Incidence 2. Causes a. Over-the-counter medications b. Herbal medications c. Multiple healthcare providers d. Infrequent review of medication regimen e. Adverse medication reactions f. Age-related changes i. Liver ii. Kidneys iii. Nutrition iv. Obesity v. Dehydration 3. Complications and consequences a. Geriatric syndrome b. Poor medication compliance c. Quality of life 4. Learning Engagement Activity: Questions (True/False) III. Medication: adverse medication reaction 1. Unexpected 2. Unintended 3. Undesired 4. Preventable 5. Impact on the healthcare system 6. Case studies a. Case study 1: Susan b. Case study 2: Jim c. Case study 3: Joni IV. Medication: Side effects 1. Unrelated effect 2. Known and predictable 3. Patient choice 4. Physician and pharmacy interventions 5. Impact on the healthcare system 6. Case studies a. Case study 1: Bob b. Case study 2: Jaclyn c. Case study 3: Steven 7. Learning engagement: Case study with multiple-choice questions 8. Learning engagement: Mix and match differentiating factors of side effects and adverse drug reactions V. Medication order review 1. Who is ultimately responsible for writing orders a. Paper b. Electronic 2. Transcription a. Unacceptable abbreviations 3. PRN medications 4. Brand name vs. generic name 5. Medication labeling a. Prescription label components b. Over-the-counter label components and labeling requirements VI. PRN medications 1. Labeling 2. Provider orders 3. Dosing implications VII. Learning engagement: identify correct components of a prescription label VIII. Six rights of assisting with self-administration of medications 1. Right drug 2. Right dose 3. Right time 4. Right route 5. Right person 6. Right documentation a. Case study: John IX. Documenting medications 1. Medication administration record 2. Medication log 3. Altering medications X. Assisting with medications 1. Commonly used abbreviations 2. Common volume conversions 3. Medication calculation 4. Learning engagement: medication calculation (liquid) 5. Learning engagement: medication calculation (tablet) 6. Learning engagement: medication calculation (insulin) 7. Learning engagement: medication calculation (syringe compatibility) XI. Pharmacy 1. Resource 2. Services 3. Communication XII. Summary and conclusion XIII. Final exam (post-test)

Holly Carlson, MS, RN, CCRN, was a subject matter expert for Relias. She has 25 years of healthcare experience in both acute and post-acute healthcare environments. Her experience includes leadership and management across the healthcare spectrum. She has owned and operated an assisted living business. Carlson's clinical practice includes acute care, long-term acute care, home health and hospice. Carlson has served for over a decade in various board positions for State Nursing Associations, including president. She has been a nurse planner for multiple continuing education events and has experience as a leader in the design and implementation of an ANCC-CNE accredited approver unit for a multi-state nursing consortium. Carlson is certified as Critical Care Registered Nurse.    Disclosure: Holly Carlson, MS, RN, CCRN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.