Khan Ehsan
Florence Nightingale School of Nursing and Midwifery, King's College
Br J Community Nurs. 2010 Sep;15(9):436-44. doi: 10.12968/bjcn.2010.15.9.78099.
Medication management is a major part of nursing practice. Ensuring safety in medication management is all the more important in the community, where patients are not under constant observation of a health-care professional. One of the prime factors in maintaining safety with medication is establishing and maintaining adequate and safe drug levels in the body. Before drugs can have an effect, they are acted upon by the body; these processes change the drug, mainly to enhance its removal from the body. Study of these processes is called pharmacokinetics and includes the processes of absorption, distribution, metabolism and excretion. Pharmacokinetic processes determine the time of onset and duration of drug action. In turn drug pharmacokinetics is affected by concordance with medication regimes and systemic illness; factors which may render the medication useless or toxic. This article introduces the reader to the principles of pharmacokinetics and shows the link between pharmacokinetics and disease and administration of multiple drugs (polypharmacy). With an aim to equip the community nurse with a better understanding of how to recognize and foresee problems associated with medication management.
药物管理是护理工作的重要组成部分。在社区中,确保药物管理的安全性尤为重要,因为在社区里患者并非时刻处于医护人员的持续观察之下。维持用药安全的一个主要因素是在体内建立并维持足够且安全的药物水平。药物在产生作用之前,会受到身体的作用;这些过程会改变药物,主要是为了促进其从体内排出。对这些过程的研究称为药代动力学,包括吸收、分布、代谢和排泄过程。药代动力学过程决定了药物作用的起效时间和持续时间。反过来,药物药代动力学又会受到用药依从性和全身性疾病的影响;这些因素可能会使药物无效或产生毒性。本文向读者介绍药代动力学原理,并展示药代动力学与疾病以及多种药物联合使用(多药联用)之间的联系。目的是让社区护士更好地理解如何识别和预见与药物管理相关的问题。