The speed of the onset of the effect, as well as the duration and severity of the action, depend on the use of drugs. Pharmacotherapy is an important part of the treatment process. There are the following types of therapy:
- replacement - compensates for the lack of biologically active substances in the body of the individual;
- pathogenetic - affects the mechanism of the onset of the disease;
- etiotropic - removes provocateurs of the disease; symptomatic - aimed at eliminating individual symptoms.
Medicines are introduced into the body of an individual in various ways.
General rules for the use of medicines
The rules for the use of medicines are based on the right choice:
- individual;
- medication;
- doses;
- injection time;
- reception method.
The introduction of drugs to the patient in medical institutions is carried out by a nurse. The adverse reaction that occurs to the drug depends on the characteristics of the patient and the sensitivity of his organs and tissues.
There are certain rules for use, which, with some exceptions, are the same both in a medical institution and when taken at home. Let us consider in more detail the procedure for the use of drugs in a hospital. The actions of the nurse are as follows:
- Giving drugs to patients is always timely.
- Read the label three times before giving the patient the medicine.
- Make a note and history of the disease, namely, indicate the time, date, trade name of the drug, dose, and route of administration.
- When administering the medicine several times during the day, be sure to observe the time interval.
- Medicines prescribed with meals are given with food. Before meals - 15 minutes before taking it. After eating - 15 minutes after the patient has eaten. On an empty stomach - at least 20 and a maximum of 60 minutes before breakfast. Sleeping pills are given 30 minutes before bedtime. Infusions, potions, decoctions and syrups are poured into graduated beakers. After use, they must be disinfected. Alcohol extracts and tinctures are measured in drops. For each name of the medicinal product, a separate pipette is taken.
Often in hospitals, medical workers lay out in advance the medicines necessary for patients for medical use in trays divided into separate cells, each of which contains the patient's last name, first name and patronymic, as well as the room number. The disadvantages of this distribution arein the following:
- There is no control on the part of the physician over the intake of drugs by patients. They may forget to take them, throw them away, etc.
- The time regime is not respected, i.e. the conditions for taking medications are not maintained - after or during meals, etc.
- High probability of error during layout.
- The patient may not know which drug is in the tray.
Features of the use of medicines for children
The use of many medicines, in accordance with the official instructions, is allowed from a certain age. The reason is that the appropriate studies have not been conducted due to the difficulty of testing them on children and newborns. When prescribing drugs to a child, the doctor must take into account the age, weight and dosage form. In addition, taking some approved drugs can lead to serious consequences. For example, the use of antibiotics in the first months after birth leads to persistent dysbacteriosis, enzyme deficiency, pseudomembranous enterocolitis.
Medicines for medical use of plant origin should also be prescribed with caution, as they can provoke irritation of the mucous membrane, and with prolonged use, cause changes at the gene level. In addition, allergic manifestations are considered the most common side effect. When choosing a dosage form for children, it is desirable to take into account their preferences. Children's forms often contain pleasantflavoring additives, which greatly facilitates the intake and does not cause dissatisfaction on the part of the little patient.
Use of drugs in the elderly and senile age
Elderly and senile age requires the use of low doses, since patients in these age groups are more likely to experience adverse reactions. Predicting the outcome of therapy in these patients is difficult. The main goal of treatment is to reduce or eliminate disease symptoms and improve quality of life. In view of the fact that many pathologies in the elderly are chronic and require constant pharmacotherapy, they should be prescribed drugs that have been shown to be safe and effective in clinical trials.
Using medications for pregnant women
In this case, before making a decision on the appointment, the doctor is guided by the following rules for the use of medicines:
- assess the risk and benefit, i.e. the drug is prescribed if the expected he alth benefit to the expectant mother outweighs the risk to the fetus;
- if there is the slightest possibility, then refrain from taking any medication in the first trimester;
- do not use drugs with low level of evidence;
- only minimum doses and single drugs are allowed.
In addition, it is necessary to fulfill the following conditions - take into account the duration of pregnancy, use those drugs that have been shown to be safe to take during the period of gestation of the baby, and the metabolic pathways are known, which will make it possible to foresee the appearance of unwantedphenomena.
Advantages and disadvantages of different routes of administration of drugs
There are several ways to use drugs: external, enteral, parenteral. Each has its pros and cons.
| How to use | Dignity | Flaws |
| Outdoor | Availability, ease of use, direct impact on the affected area | There is no possibility of accurate dosage, before use, it is necessary to examine the skin for rashes, swelling, etc. |
| Enteral | The simplest and safest, direct action on the lesion, rapid entry into the bloodstream, the possibility of introducing various dosage forms, ease of use, does not require sterility | Incomplete and slow absorption in the digestive organs, the dependence of the effect of the drug on the age and condition of the individual's body, as well as concomitant pathologies and individual sensitivity, partial inactivation in the liver |
| Parenteral | Accurate dosage, fast action, indispensable in emergency care, eliminates the barrier function of the liver and the effect of digestive enzyme substances on the drug | Injury to the dermis at the injection site (hematomas, local capillary ruptures, bruises), training of medical workers, compliance with antiseptic rules andaseptics |
Enteral route of medication
In this case, medicines are administered:
- Through the mouth is one of the easiest, most convenient and common methods of introduction. Inside, both solid (capsules, powders, pills, tablets) and liquid (decoctions, syrups, potions, tinctures) dosage forms are taken. Disadvantages of this method of administration: drugs are destroyed by intestinal and gastric juice, low rate of entry into the blood, dyspeptic disorders are possible, which are manifested by constipation, nausea, diarrhea or reflex vomiting.
- Sublingual (under the tongue) - some dosage forms are recommended to be taken only in this way, for example, "Nitroglycerin", "Glycine".
- Rectally (into the rectum) - the drug administered in this way is quickly absorbed into the bloodstream, while the liver bypasses and is not affected by intestinal juice enzymes. The entire dose of the administered agent is completely absorbed. Medications of a protein nature, as well as polysaccharide complexes and fats, have a local effect, since they do not penetrate the wall of the rectum due to the absence of enzyme substances in it. In this way, suppositories and solutions are administered with an enema.
Small patients are often reluctant to take solid form medicines due to unpleasant taste and odor and swallowing difficulties associated with the large size of capsules and tablets.
External use of medicines
With this methodthe drugs administered have a local effect. They enter the body of the individual through:
- Mucous membranes - in this case, liquid (aqueous solutions), soft (candles and ointments) and powder forms of medicines are used.
- Dermis - by rubbing, applying a thin layer, using a bandage. For these purposes, liquid, soft and solid dosage forms are used.
- The inhalation route is the intake of a drug into the body by inhalation. Drugs are administered through inhalers, turbohalers, etc.
Parenteral drug administration
The use of drugs parenterally means bypassing the digestive tract. In this case, the drug is administered:
- Intramuscular - the easiest and most affordable method.
- Intradermal - for diagnostic purposes, for example, the Mantoux test, as well as for local anesthesia.
- Intraosseously - with limb deformities, extensive burns, collapse, convulsions, terminal conditions, impossibility of intravenous administration, which is relevant in pediatric practice.
- Subcutaneous - indicated in cases where it is important to get a faster effect than oral intake, since the subcutaneous fat layer, well supplied with blood vessels, promotes active absorption of drugs.
- Into the lymphatic vessels - this method of drug administration prevents rapid metabolism, since the active substance does not pass through the kidneys and liver. It is used to point the active substance to the affectedhearth.
- Intravenous - convenient for the introduction of large volumes of medicines, as well as blood tests, blood transfusions.
- Intra-arterial - used in the terminal stages, which are the result of infectious pathology, shock, asphyxia or blood loss.
- In the articular, abdominal, pleural cavity, as well as intracardiac.
Dose forms
Depending on the method of dosing or application, the forms of medicines are different: drops, powders, tablets, lotions and others. According to the state of aggregation, liquid (extracts, solutions, mucus, decoctions, suspensions, syrups, tinctures), solid (tablets, films, capsules, dragees, granules), soft (plasters, ointments, suppositories, pills) and gaseous (aerosols) forms are distinguished.. Depending on the method of application, dosage forms are distinguished: internal, for injection and external. The latter include:
- Pastes - consist of an ointment base (castor oil, sunflower oil, peach oil, anhydrous lanolin, cocoa butter, etc.), to which solid substances with healing properties are added.
- Chatters - they are also called solutions that need to be shaken before use. The main component is water. Various powder-type substances are added to it, for example, starch, talc, zinc oxide, which greatly dry the skin. In order to avoid such a problem, oils are introduced into the talker - olive, glycerin or vaseline.
- Solutions or lotions - the basis of most of these dosage forms is water, in which active substances are dissolved,with different pharmacological activities. And also solutions can be alcohol-based or soap-based. They are used for compresses, cauterizations, lotions, rubbing, etc.
- Powders are finely ground powder of xeroform, talc, starch, etc.
- Creams are emulsions consisting of water in oil or, conversely, of a solution of oil in water. Additionally, various medicinal additives and cosmetic fragrances are introduced into them.
- Gels are colloidal semi-solid suspensions or solutions.
- Patches - are a plastic mass on a substrate, which can be paper, canvas, etc. It is able to adhere tightly to the dermis, exerting a certain effect on it and subcutaneous tissues. Patches are the progenitors of modern transdermal therapeutic systems that transport active substances through the skin for systemic effects on the patient's body.
- Ointments - unlike pastes, they have more base and less solid components.
- Aerosols or sprays are dispersed systems that have a gaseous medium. It can be from a mixture of gases, freon or nitrogen. All aerosols, depending on the particle size of the dispersed phase, are divided into low-, medium-, and highly dispersed. The use of drugs in this form allows you to spray the active substance in the body of the individual evenly.
- Varnishes are a liquid that, after application and drying, forms a thin film on the dermis. They are mainly used for deep and localizedeffects, for example, on warts, nail plates.
Conclusion
Active substances that are used in certain doses to prevent or treat any pathological condition are called drugs. And such a capacious concept as the circulation of medicines for medical use includes:
- preclinical and clinical studies;
- state registration;
- production;
- storage;
- vacation;
- destruction;
- application;
- advertising, etc.
Medicines have different effects on the body of an individual. In addition to therapeutic, they can also provoke side effects. Adverse reactions can be reduced or eliminated completely by reducing the dose or completely discontinuing the drug.
The storage and use of medicines is regulated by certain regulations that medical workers should know.
