Banning, M. 　著

内容

目次

Chapter 1: Older People and Their Medicines: Health Objectives andHealth Initiatives. Development of the National Service Framework (NSF) forolder people. Management of medicines. The NHS Improvement Plan. Building asafer NHS for patients; the role of medication safety. Prescribing drugs.Dispensing medicines. Access to medicines- out of hours. The administrationof drugs. Helping patients and carers to safely self administer medicines athome or in care homes. Community Matrons and the management of medicines.Patient case study. Chapter 2: The Physiology of Human Ageing. Homeostasisand ageing. Ageing and the cardiovascular system. Changes to the vascularsystem. Changes to cardiac tissue. Changes to cardiovascular function andcontrol. Changes to cardiovascular cells. Implications for practice. Hepaticageing. Changes to hepatic tissue. Changes to hepatic cells. Changes tohepatic molecular biology. Implications for practice. Renal ageing. Changesto tubular function. Implications for practice. Ageing and the immune system.Changes to organs and tissues. Changes to immune cells. Changes to immunemolecules. Ageing and the inflammatory response. Chapter 3: The Applicationof Applied Pharmacology to the Older Person. Drug absorption. Factors thatalter the absorption of drugs. Drug distribution. Drug metabolism. Factorsaffecting drug metabolism. Drug excretion. Biliary excretion.Pharmacodynamics. Receptor agonism. Pharmacodynamics and the effects ofageing. Chapter 4: Medication Management and the Older Person. Medicationreview and the older person. Medication review structure. The SingleAssessment Process. Trigger questions. Care plans. Health care professionalinvolvement. Prescribing practice. Principles of prescribing for the olderperson. Rational prescribing and prescribing support. Conclusions.Implications for practice. Chapter 5: Medication Errors and the Older Person.Introduction. The extent of the problem. The UK perspective. The potentialdangers of medication errors. Definitions of medication error. Classificationof medication errors. Causes of medication error. Forms of medication error.Medication errors that arise due to the supply and administration ofmedicines. Factors contributing to the development of medication errors. Thenurse prescriber's role in the prevention of medication errors. Prescriptionwriting education. Preventative measures involving prescriptions.Computerised prescribing systems. Conclusions. Implications for practice.Chapter 6: Concordance with Medication and Older People. Introduction.Difficulties establishing a rationale. Characteristics of the non-concordantindividual. Psychological theory. Medication related issues that underpinnon-concordance. i. Polypharmacy and complicated medication regimens. ii.Lack of education. iii.Patient comprehension of the need to adhere toprescribed medication. administration protocols. Promoting concordance withmedication regimens. Patient self-medication schemes. The prescriber's rolein the augmentation of concordance with medication for. older people. The artof teaching. Teaching practicalities. Reinforcing education. Barriers toteaching. Time management difficulties. Planning early discharge.Comprehension of applied pharmacology and therapeutics. Conclusions.Implications for practice. Chapter 7: Neurophysiology, and Neuropathology ofAgeing. Introduction. In search of a nerve cell. Neurochemicals and synaptictransmission. Major neurotransmitters in the brain. The dynamic neurone,plasticity and memory. Changes in neuronal activity and communication in theageing brain. What causes cellular damage with ageing. Neuropathology ofAlzheimer's disease. Pharmacological strategies. Neuropathology ofParkinson's disease. Pharmacological approach in the treatment of PD.Conclusions. Implications for practice. Chapter 8: The Management of theOlder Person with a Long-term Condition. Introduction. Government policy andlong-term conditions. The NHS Improvement Plan. The evolvement of thecommunity matron. The education and training of the community matron. Casefinding and case management. Interprofessional working. Lay carer's role. Thefuture management of older people with long-term conditions. Conclusions.Implications for practice. Chapter 9: The Community Pharmacist's Role in theManagement of Older People and their Medicines. Introduction. Education andtraining Community pharmacy contractual framework. Repeat dispensing.Medicine Use Reviews (MUR's). Medication Review. Services to residentialhomes Swallowing difficulties Domiciliary visiting schemes. Compliance aids.Physical problems. Prescribing support Multidisciplinary working.Conclusions. Implications for practice.