Medication administration for older adults

Medication administration for older adults

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Medication administration for older adults is crucial to monitor because older adults respond differently to medications. Medications can have interactions with biological substances which may cause a change in therapeutic effect or increase adverse interaction effects (Miller, 2019). Nicotine is it biological substance that can interact with many prescribed medications and over-the-counter medications. Nicotine affects the therapeutic effect of many medications. Because of this, it is important to increase medication dosage or adjust the dosage to achieve a therapeutic effect. The two drugs that cause an interaction with nicotine are aminophylline and olanzapine.

Aminophylline, a bronchodilator, is a medication used for lung diseases. Nicotine and aminophylline have an interaction. When a person smokes and is taking aminophylline, their dose may be increased because nicotine increases the clearance of aminophylline (Soifer, 2019). However, when a person who is an avid smoker suddenly stops, aminophylline may increase and a reduction of 20 to 35% dose may be done to prevent toxicity (Soifer, 2019). A nurse may need to monitor the patient for major toxic effects like vomiting and restlessness (Soifer, 2019). Other side effects may be hay fever and convulsions. These should be reported to the provider. Nurses should also discontinue that drug if toxicity is established because of the toxic effects of irreversible damage and possible death (Soifer, 2019).

Olanzapine is another medication that interacts with nicotine. Olanzapine is an antipsychotic which is used to treat schizophrenia or bipolar disorder. Nicotine increases the clearance of olanzapine (Soifer, 2019). Therefore, smokers may need an increased dose. If smoking cessation occurs while taking olanzapine, a reduction in the dose may be necessary because an increase in blood levels of olanzapine may cause toxicity. Smoking cessation also increases reports of extrapyramidal symptoms (Soifer, 2019). Nurses should monitor olanzapine plasma levels. The nurse should also monitor for EPS symptoms like acute dyskinesias and dystonic reactions, tardive dyskinesia, Parkinsonism, akinesia, akathisia, and neuroleptic malignant syndrome (Soifer, 2019).