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1.1 Identify current legislation, guidelines, policies and protocols relevant to the administration of medication. The Medicines Act 1968 is an Act of Parliament of the United Kingdom. It governs the control of medicines for human use and for veterinary use, which includes the manufacture and supply of medicines. The Act defines three categories of medicine: prescription only medicines), which are available only from a pharmacist if prescribed by an appropriate practitioner; pharmacy medicines, available only from a pharmacist but without a prescription; and general sales list medicines which may be bought from any shop without a prescription.

The Control of Substances Hazardous to Health Regulations 2002 is a United Kingdom Statutory Instrument that states general requirements on employers to protect employees and other persons from the hazards of substances used at work by risk assessment, control of exposure, health surveillance and incident planning. There are also duties on employees’ to take care of their own exposure to hazardous substances and prohibitions on the import of certain substances into the European Economic Area. The Health and Safety at Work Act 1974 is an Act of the Parliament of the United Kingdom that as of 2011[update] defines the fundamental structure and authority for the encouragement, regulation and enforcement of workplace health, safety and welfare within the United Kingdom. The Act defines general duties on employers, employees, contractors, suppliers of goods and substances for use at work, persons in control of work premises, and those who manage and maintain them, and persons in general.

The Data Protection Act 1998 is a United Kingdom Act of Parliament which defines UK law on the processing of data on identifiable living people. It is the main piece of legislation that governs the protection of personal data in the UK. Although the Act itself does not mention privacy, it was enacted to bring UK law into line with the European Directive of 1995 which required Member States to protect people’s rights and freedoms and in particular their right to privacy with respect to the processing of personal data. In practice it provides a way for individuals to control information about themselves. Most of the Act does not apply to domestic use, for example keeping a personal address book. Anyone holding personal data for other purposes is legally obliged to comply with this Act, subject to some exemptions. The Act defines eight data protection principles. It also requires companies and individuals to keep personal information to themselves.

The Misuse of Drugs Act 1971 is an Act of the Parliament of the United Kingdom. It represents action in line with treaty commitments under the Single Convention on Narcotic Drugs, the Convention on Psychotropic Substances, and the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. No such Treaty is however in any way binding on the UK Courts or Parliament and these have not been incorporated into UK law. Offences under the Act include:

Possession of a controlled drug unlawfully
Possession of a controlled drug with intent to supply it Supplying or offering to supply a controlled drug (even where no charge is made for the drug) Allowing premises you occupy or manage to be used unlawfully for the purpose of producing or supplying controlled drugs Care Standards Act 2000 (CSA) is an Act of the Parliament of the United Kingdom which provides for the administration of a variety of care institutions, including children’s homes, independent hospitals, nursing homes and residential care homes. The CSA, which was enacted in April 2002, replaces the Registered Homes Act 1984 and parts of the Children Act 1989, which pertain to the care or the accommodation of children. The aim of the legislation is to reform the law relating to the inspection and regulation of various care institutions.

2.1 Describe common types of medication including their effects and potential side effects. Here are some examples of common medications, both in a family home and a care home setting. Ibuprofen is a non-steroidal anti-flammatory drug (NSAID) which, like other NSAID’s, reduces pain, stiffness and inflammation. It is used to relieve mild to moderate headache, menstrual and dental pain, pain resulting from soft tissue injuries, or the pain that may follow an operation. Ibuprofen can be found as a tablet, SR tablet, capsule, liquid, granules, cream or gel. Heartburn and indigestion are the most common side effects from this drug. Nausea, vomiting, rash, wheezing, black/blood stained faeces, swollen feet or ankles and ringing in the ears are rarer side effects this drug may cause. Omeprazole is a common medicine used in the care home I work in. it is an anti-ulcer drug that was introduced in 1989. It is used to treat stomach and duodenal ulcers as well as reflux oesophagitis, a condition in which acid from the stomach rises into the oesophagus.

It reduces (by about 70 percent) the amount of acid produced by the stomach and works in a different way from other anti-ulcer drugs that reduce acid secretion. Omeprazole comes in a capsule form. Common side effects are headache and diarrhoea. Rare side effects are nausea, constipation and rashes. Aspirin, a non-opioid analgesic has been in use for over 80 years, aspirin relieves pain, reduces fever and alleviates the symptoms of arthritis. In low doses, it helps to prevent blood clots, particularly in atherosclerosis or angina due to coronary artery disease, and it reduces the risk of heart attacks and strokes. Aspirin is present in many medicines for colds, flu, headaches, menstrual period pains, and joint and muscular aches. It can come in the form of capsules, tablets or suppositories. Indigestion is the most common side effect for this drug.

Nausea, rash, breathlessness, wheezing, blood in vomit, black faeces, ringing in the ears and dizziness are rare examples of side effects from this drug. Cefalexin is a cephalosporin antibiotic that is prescribed for a variety of mild to moderate infections. Diarrhoea is a very common side effect but doesn’t tend to be severe. The more rare side effects are; nausea, abdominal pain, rash, itching, swelling, or wheezing. Cefalexin can come in tablet, capsule or liquid form.

Paracetamol is one of a group of drugs known as non-opioid analgesics; it is kept in the home to relieve occasional bouts of mild pain and to reduce fever. It can come in tablet, capsule, liquid or suppository form. Paracetamol is dangerous when taken in overdose, and can cause serious damage to the liver and kidneys. Large doses of Paracetamol may also be toxic if you regularly drink even moderate amounts of alcohol. Side effects from this drug include nausea or a rash. Trimethoprim is an anti-bacterial drug that became popular in the 1970’s for prevention and treatment of infections of the urinary and respiratory tracts. It can come in tablet, injection or liquid form. Side effects from this drug are rare but may occur they are; nausea and vomiting, rash or itching, sore throat or fever. Furosemide is a powerful, short acting loop diuretic that has been in use for over 20 years.

Like other diuretic’s, it is used to treat oedema (fluid retention) caused by heart failure, and certain lung, liver, and kidney disorders. Furosemide increases potassium loss, which can produce a wide variety of symptoms. For this reason, potassium supplements are often given with the drug. It can come in tablet, liquid or injection form. Dizziness and nausea are common side effects from this drug. Lethargy, noise in ears, muscle cramps, rash and photosensitivity are more rare examples of side effects. 2.2 Identify medication which demands the measurement of specific physiological measurements Digoxin is the most widely used form of digitalis, a drug extracted from the leaves of the foxglove plant. It is sometimes given in the treatment of congestive heart failure and certain alterations of heart rhythm. Digoxin slows down the rate of the heart so that each beat is more effective in pumping blood. It can come in the form of tablets, liquid or injection.

Common side effects for this drug are; tiredness, nausea, confusion, visual disturbance and palpitations. The individual who requires this drug must have their pulse and blood pressure checked before the drug is taken in case their heart beat is already at a slow pace. Warfarin is an Anticoagulant medicine and is used to prevent and treat the formation of harmful blood clots within the body by thinning the blood and/or dissolving clots. It can come in the form of tablet or liquid. Warfarin increases the time that it takes for your blood to clot. This means that it can be used to prevent and treat blood clots from forming in veins and arteries, for example clots in your legs, lungs, brain or heart. You must have regular blood tests when taking this drug, to check how the warfarin in your blood is working – these blood tests are very important.

The extent to which warfarin is working is measured by the INR (International Normalized Ratio), a measure of the ability of your blood to prevent clotting. It is important that the blood is not thinned out too much; therefore physiological checks must be made. Insulin is used to treat Diabetes mellitus. Insulin is a hormone that is made naturally in your body, in the pancreas. It helps to control the levels of glucose (sugar) in your blood. If your body does not make enough insulin to meet its needs, or if it does not use the insulin it makes effectively, it results in the condition called diabetes mellitus (sugar diabetes). People with diabetes mellitus need treatment to control the amount of sugar in their blood.

This is because good control of blood sugar levels reduces the risk of complications in diabetes. There are many different products available. The type of insulin you are prescribed will be tailored to your needs. Insulin cannot be taken by mouth, as it is destroyed by the digestive juices in your digestive system. It is therefore given by an injection. Individual’s using this medication must test for the amount of sugar in their blood or urine regularly to make sure that they are using the right dose of insulin.

2.3 Describe the common adverse reactions to medication, how each can be recognized and the appropriate actions required. From the homely paracetamol to the morphine, all drugs come with side effects. The side effects may be minor, an inconvenience or severe. The most common set of side effects for drugs taken internally involves the gastrointestinal system. Nearly all drugs can cause nausea or an upset stomach; however, this may only happen to certain individuals. For drugs used externally, skin irritation is the most common complaint.

Side effects can vary and can fall into several categories. These categories are; Allergic reactions can happen with any drug and can range from itching to a rash. In severe cases in can cause a life-threatening anaphylactic reaction. Some drugs can’t help but trigger side effects because of their chemical build up, for example, an allergy drug ‘Benadryl’. Although it eases allergy symptoms, it also causes drowsiness and a host of other side effects, i.e. dry mouth. Some drugs have barely noticeable side effects when dosed properly. For example, Warfarin, used to prevent blood clots, is usually well tolerated, but serious internal bleeding can occur. Side effects may only pop up when certain drugs are mixed with certain other things. These might also be considered drug interactions. For example, drinking alcohol whilst on medication.

For many of these side effects it is essential to ensure the individual has lots of fluids, this is because; it will help flush out the medication from their system and will re-hydrate if they are feeling nauseous. Nausea is a sick feeling in the pit of your stomach. When you are nauseated, you can feel weak and sweaty and have too much saliva in your mouth, this can make you vomit. Vomit, it forces your stomach contents up your esophagus and out of your mouth. Most of the time, nausea and vomiting are not serious and can be treated at home, with plenty of fluids and rest.

2.4 Explain the different routes of medicine administration. Oral administration, are medications taken by mouth (in pill, capsule or liquid form) and are absorbed into the digestive system. Absorption is slow. Medications that use this option cannot be used if vomiting is occurring. Enteral administration, are medications that are administered into the rectum (via a suppository) and absorbed by the lower digestive tract. Mucosal administration, are medications that are delivered through the nose or inhaled and are absorbed through the nasal mucosa or bronchioles. Vaginal administration of a medication is also considered mucosal. Parenteral administration, are any medication administration that involves injecting a drug directly into a vein, muscle, artery, abdominal cavity, heart or into the fatty tissue beneath the skin. The speed of absorption varies but is faster than oral administration. This is used when more complete and faster absorption of a drug is needed. Percutaneous administration, are medications that are absorbed directly through the skin into the blood stream. For example, some hormone replacements are administered by patches that are absorbed slowly and evenly.

3.1 Explain the types, purpose and function of materials and equipment needed for the administration of medication via the different routes.

3.2 Identify the required information from prescriptions/medication administration charts. The information required is as follows; Full name, address and DOB of the patient. Ensure prescription is dated and still valid. Ensure it is signed by the appropriate prescriber, complete with their registration number and details regarding the address of their practice. Make sure it’s printed from a computer or written in ink if done by hand. Make sure the drug/preparation/product is named, complete with strength, dose and quantity. It should also contain the advised times to take the drug. 4.1 OBSERVATION

4.2 Explain the appropriate timing of medication e.g. check that the individual has not taken any medication recently. Food can interact with drugs in different ways, making the drugs more or less effective, it can be very important to take the drugs as recommended – before, after or with food. Taking Drugs before Food; some drugs need to be absorbed quickly to have an effect, such as, drugs to help sleep (hypnotics), drugs to reduce agitation (sedatives), and painkillers (analgesics). As food can slow the absorption of these drugs they need to be taken on an empty stomach. Taking Drugs with or After Food; some foods can delay the emptying of the stomach into the small intestine, where most drugs and nutrients are absorbed.

This means that the stomach contents, including the drug, are exposed to stomach acid for longer, which can have different effects on different drugs. The acid in the stomach can break down some drugs, therefore delayed emptying can mean that more of the drug is broken down, making less of the drug available. This makes the drug less effective. Therefore, it is important to administer the medications at the correct time to gain the most out of the drug and to avoid break down. It is also important to check that they haven’t had any medication recently that will have a negative effect on the current medication you are going to administer.

5.3 Describe how to report any immediate problems with the administration. If there are any problems with the administration I would report it to straight to the GP, telling them; the client’s name, the drug that has been given by mistake and normal medication they are on. I would them await advise from the GP and follow the instructions given. Once I have done this I would inform my manager/senior of the incident and record of it appropriately. 5.4 OBSERVATION

5.5 Explain why it may be necessary to confirm that the individual actually takes the medication and does not pass the medication to others. Medication is prescribed to prevent health problems; therefore it is extremely
important to ensure they consume the correct drug that will treat them. If they were to refuse or discard of their medication then their underlying health problems would arise, possibly causing discomfort. It’s also important to ensure the correct person takes their prescribed medication because it could be accidentally taken by another client. This could have severe results. Medication is prescribed for a health issue, for example, Digoxin to slow down the heart beat. If this was to be taken by an individual that already has a slow heart beat then the results could be fatal and severe side effects could be experienced. 5.6 OBSERVATION

5.7 Describe how to dispose of out of date and part used medications in accordance with legal and organizational requirements.

In the care home I currently work in we use the ‘Boots’ monitored dosage system. This system is a compliance aid; it was introduced in 1989 and helps to better manage service user’s medication. The system follows the current guidelines set by the Royal Pharmaceutical society of Great Britain and the National Association of Health Authorities and trusts. The National care standards commission also approves the system. Within in this system it states that any medication which has been refused prior from removal of the pack must be left in the pack and be returned to ‘Boots’ when they next pick up/deliver. Any medication that has been refused after removal from the pack has to be disposed of following the homes best practices. The care home I work in disposes of medication

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