Enhancing Medication Compliance through Dynamic Communication Process

1. Pharmacology Day 1 Elizabeth Keele, RN/BSN

2. Course Objective #2 • Describe the dynamic process between the giver and the receiver of medications, which promotes positive medication compliance.

3. “Dynamic Process”

4. dy·nam·ic • dīˈnamik/ • adjective • 1. ( process or system) characterized by constant change, activity, or progress.

5. “Dynamic Process” • Giver • Receiver

6. “Mutual process” • Key characteristics: • Knowledge • Teaching • Communication • Observation skills • Evaluation skills

7. Turn to your neighbor and take turns… • Describing the dynamic process between the giver and the receiver of medications, which promotes positive medication compliance. • (Course objective #2)

8. Course Objective #1 • Identify limitations/deficits commonly seen in D.D. clients that prevent them from asking questions or reporting adverse effects regarding medications they receive.

9. Limitations to “mutual process” of medication administration • Understanding • Communication • Awareness • Knowledge • Teaching • Communication • Observation • Evaluation

10. Limitations to “mutual process” of medication administration • The NURSE must “account and compensate” for these limitations

11. Medication Administration is… • Invasive • Risk to benefit

12. Turn to your neighbor and take turns • Identify limitations/deficits commonly seen in D.D. clients that prevent them from asking questions or reporting adverse effects regarding medications they receive. • (Course objective #1)

13. Course Objective #3 • Describe the importance of patient teaching with regard to prescribed medication regimen.

14. Why is patient teaching important?

15. Teaching / Learning Process • Teaching • Interactive process • Learning • Acquiring new knowledge • Motivation • Desire

16. 3 Domains of Learning • Cognitive • Intellectual activities • Affective • Attitudes & beliefs • Psychomotor • Physical skills

17. Turn to your neighbor and… • Describe the importance of patient teaching with regard to prescribed medication regimen. • (Course objective #3)

18. Course Objective #4 • Describe the electrochemical processes of the central nervous system, which allow CNS drugs to cause their desired effects.

19. Course objective #12 • Explain how chemicals and electrical impulses interact to make up the electrochemical properties of the nervous system.

20. The nervous system consists of: • Divided system • Central Nervous System (CNS) • Brain & Spinal Cord • Peripheral Nervous System (PNS) • Nerves (peripheral & Cranial)

21. Nervous System • Controls and coordinates the body • By transmission of electrical impulses (Electrical-chemical system)

22. Nerve Impulse • The nervous system is powered by electrical and chemical energy • K+ • Na+ • Cl- • (Ca+)

23. Course objective #9 • Differentiate between afferent and efferent neuron.

24. Neuron • Basic functional unit • Afferent neuron • Sensory • Carry info from PNS  CNS • Efferent neuron • Motor • Carry into from CNS  PNS

25. Neuron structure • Cell body/ Soma • Nucleus • Neurotransmitters synthesized • Dendrites • Carry impulses toward the cell body • Axons • Carry impulses away from the cell body

26. Cool Fact Damaged Neuron • CNS = • Irreversible • PNS = • will repair itself if the cell body is not destroyed

27. Course Objective #10 • Describe the role played by neurotransmitters in nerve impulse transmission within the synapse.

28. Synaptic Junction • Neuron connect to each other end to end • Where two neurons come together • Synaptic junction • Synapse • Inter-neuron space

29. Anatomy of the NS • Synapse = the space between one neuron & the next Pre-synaptic neuron Post-synaptic neuron

30. Synaptic Junction • Terminal end of Axon = Pre-Synaptic Vesicles • Nerve impulse reaches the vesicle  release substance  neurotransmitters (nt) into the synaptic junction • Nerve impulses must have a receptor site

31. Synaptic events • Electrochemical message received • Vesicle opens • NT are released into synapse • NT finds its receptor site that it fits into on the next neuron • Activation of receptor  nerve impulse in post-synaptic vessel • Re-uptake of NT • MAO action

32. Neurotransmitters • Synthesized in the soma • Special Properties • Excitability • Inhibitory • 30+ neurotransmitters

33. Course objective #11 • Describe the role played by monoamine oxidase in nerve impulse transmission within the synapse.

34. Monoamine oxidase (MAO) • ENZYME • Released into the synaptic space • Action • breakdown or inactivates NT  • Result • i NT levels

35. Course Objective #5 • Differentiate between the following neurotransmitters: • Acetylcholine • Norepinephrine • Dopamine • Serotonin • Gamma-aminobutyricacid • Glycine

36. Neurotransmitters • Synthesized in the soma • Special Properties • Excitability • Inhibitory • 30+ neurotransmitters

37. Excitatory Neurotransmitters • Serotonin • Sleep • Sensory perception • Temperature • Mood • Inhibits pain

38. Excitatory Neurotransmitters • Dopamine • Subconscious movement • Fine motor skills • Emotional responses

39. Excitatory Neurotransmitters • Norepinepherine • Maintains arousal • Overall activity • Mood • Acetylcholine • Vital for short term memory

40. Inhibitory Neurotransmitters • Cholinergic • Stabilizers

41. Inhibitory Neurotransmitters • Gammaamniobutyricacid • GABA • #1 • h concentration in • brain • Stop/slow firing of neurons • Glycine • h concentration in • Spinal Cord

42. Inhibitory Neurotransmitters • Dopamine • Basal Ganglia • Dopamine & Acetylcholine are opposites which work together to create homeostasis

43. Course Objective #6 • Identify psychiatric disorders that appear to be related to the body’s inability to regulate the availability of neurotransmitters.

44. h or i Neurotransmitters • Imbalance  disease or disorder

45. Schizophrenia • hdopamine

46. Depression • i Serotonin

47. Alzheimer’s Disease • i acetylcholine

48. Generalized Anxiety Disorder • Norepinephrine • Serotonin

49. ADHD(Attention deficit hyperactivity disorder) • Imbalance • Norepinephrine • Dopamine

50. Drug Addictions • Affects dopamine areas of the brain