Tag Archive for: instructor-jaime.hannans

This past weekend, I interviewed some of my friends and family members regarding medications and supplements they are taking. Being that the majority of my friends fall into the young adult age group, the majority of them said no, they do not take any medications or supplements. Only one said yes, in which she is taking Iron and vitamin B complex supplements. Of my family members, my mom takes Metformin, and both she and my dad take Lozartan and Atorvastatin. My sister on the other hand takes Methimazole. All the people who said yes were able to verbalize the purpose of their medications. However, to my surprise only my sister knew the side effects of the drugs they were taking. Subsequently, I was able to educate the people who said “no,” about some of the side effects of each drug they are using. I was able to educate my friend about constipation as the side effect of iron supplements and that she should take it with orange juice or some juice with vitamin C to increase absorption. We also discussed how vitamin B12 helps with DNA synthesis and Hgb production. I was also able to educate my parents about the side effects of Lozartan and how it can cause hypotension and hyperkalemia, which can lead to arrhythmias. I also educated my mom about the importance of stopping Metformin 48hrs prior to injection of contrast dye for a CT scan due to the risk of renal failure. My dad also used to take Garcinia Cambocia, which is an herbal diet pill that decrease the sensation of hunger but can also cause hyperkalemia, Hypercalcemia and Hypermagnesia. Therefore, I was able to also educate him on the danger of taking Garcinia Cambocia and Lozartan and the high risk for developing Hyperkalemia leading to manifested as arrythmias or irregular heartbeats. As for the Atorvastatin medication, my dad then was also able to recall and verbalize side effect of malaise. Lastly, my sister was also able to verbalize hypothyroidism manifested as fatigue, depression, constipation, as the side effects of Methimazole. Of all people taking supplements and medications, non of them knew the generic, brand name or safe dose of the drugs/supplements they are taking.

Medication Education

This is something that happened to me recently. My friend has IBS and told me she had to go for a cortisone injection and was going to the Doctor’s office to get the injection. I noticed my friend has ben exhibiting the signs and symptoms f a cold over the last couple of says. My first question was. Has anybody educated you on cortisone? Has anybody told you about the side effects and when not to take it?. At this point my friend said what most people say. No, my Doctor told me to take it so I will take it. At this point I brought Skyscape up on my phone and showed her. Cortisone suppress the immune system and care should be taken when exhibiting sign and symptoms of colds and flu. So when she read it she called her Doctor and told him what was happening and he noted that the injection could wait a couple of days until she felt better.

My wife’s grandfather had a stroke and was put on a medication regiment of 16 medications. As a result he ended up in assisted living. When he came to visit my wife’s mother she was responsible for giving him all this medication. I asked if anybody trained her on how to give all this medication and she said. I just read the labels and give it when it is due. This was shocking to me. We trust healthcare providers and just follow the instructions. But I feel we must be educated on how to take medications correctly. Especially when it comes to a multi-medication regiment. When I looked at the medication it was overwhelming. The only thing that was listed was when to take, how to take it, and whether or not to take with food. For the side-effects and interactions I had to go online to find the information. I used pocket pharmacist an Application on my phone to check the medications and was surprised that some of the medications did have interaction warnings. Granted your Doctor has training and education in this regard but we should not just blindly follow instructions and take medications. We should always be part of the conversation and ask question, we should do research and ask more questions. I know a little knowledge can be a dangerous thing but if your healthcare provider practices Holistic medicine they would be happy to have you ask questions

The two sedatives I have seen used in clinical are propofol and versed. The two times I saw propofol used were for short-term procedures (an ankle reduction and a pediatric liver biopsy). These were not sustained sedations that required sedation vacation. The one patient I worked with that did require sedation vacation was a young woman who was the pedestrian in a pedestrian vs car accident. She had greatly increased ICP and a poor glascow coma scale on arrival. When I worked with her she had been in the PICU for 1 week and was still intubated and being sedated with versed. Sedation was important for her because of her ICP, but they had started weaning protocol and sedation vacation a couple days previous to my shift. Each morning they would reduce the versed drip and turn off the ventilator to assess the patients breathing efforts and neuro function. According to Skyscape, versed used for sedation of intubated and mechanically ventilated patients is dosed 0.02-0.1 mg/kg/hr IV. I didn’t get to witness a sedation vacation, but from talking with the nurse about it a few thoughts come to mind:

The nurse will need to keep the half life of the drug in mind when they begin to titrate            down as some drugs need to be reduced sooner than others (ie versed vs propofol). The nurse should be prepared to titrate throughout the sedation vacation if needed according to response, agitation, etc. Nurse and RT must collaboratively assess respiratory function; RT should measure ABGs. Comfort and ease of breathing should be supported with positioning and medications if possible, such as bronchodilators and/or pain medication.