Features of the use of medicines

The effect of a drug on the body can change under the influence of many factors. We list the main ones that quantitatively and qualitatively change the effect of drugs:

– Physiological factors.

– Features of individual pharmacokinetics of drugs.

– The time of taking medications depending on the intake and nature of the food, the influence of environmental factors.

-Genetic factors affecting drug bioavailability and efficacy.

-Drug interactions when taking multiple medications.

– Concomitant pathological changes in organs (liver, kidneys, gastrointestinal tract).

– The sensitivity of the patient to the drug.

-Compliance of the patient to the treatment prescribed by the doctor.

The genetic characteristics of the organism. Newborns and the elderly are more sensitive to the action of many drugs than middle-aged people. A genetically determined enzyme deficiency can cause unusual drug reactions (idiosyncrasy).

Body weight. In some cases, for greater accuracy, the dosage of medicinal substances is based on 1 kg of weight or body area. This is especially true for children in the first year of life.

individual sensitivity. Sensitivity to drugs in humans varies greatly. For some, it may be too high.

Age. The sensitivity of children to drug-induced changes in water and electrolyte metabolism, acid-base balance is subject to some fluctuations, therefore, depending on age, the dosage of drugs changes accordingly.

Elderly patients may respond unusually due to disturbances in the distribution, inactivation and excretion of the drug due to age-related anatomical and physiological changes in the body, as well as due to concomitant diseases. Therefore, dosing drugs for patients of elderly and senile age should be strictly individual.

Nutrition value. Taking drugs orally (by mouth) is the most natural way to use medications: solutions, emulsions, suspensions, mixtures, tablets, dragees, capsules, etc. One of its drawbacks is the inability to quickly provide and maintain the required concentration of drugs in the body. Under the influence of gastric juices, enzymes, food masses, a number of drugs are partially inactivated, adsorbed, and enter into chemical interaction.

On the other hand, the food mass protects the mucous membrane of the gastrointestinal tract from the irritating effect of many medications. Therefore, the time of oral administration of drugs is important in relation to food intake, the dosage form of drugs, as well as the composition of products, their physicochemical properties.

In many cases, when using drugs, a certain diet is necessary, for example, in the treatment of diabetes, in the treatment of certain poisonings, etc. The interaction of drugs with food should also be taken into account.

You can not drink antibiotics with milk and other dairy products because they contain a large amount of calcium, the interaction with which reduces the therapeutic effect of antibiotics. Milk inactivates tetracycline preparations, since the calcium contained in milk forms an insoluble compound with the components of the drug.

Milk reduces the effectiveness of proteins similar in structure to proteins.

drugs – caffeine, antiulcer drugs (cimetidine, ranitidine), cardiac glycosides. It is not recommended to drink enzyme-containing preparations (mezim, pancreatin) with milk.

At the same time, drugs such as antipyretic, anti-inflammatory, hormones are recommended to be taken with milk to reduce their irritating effect on the mucous membrane of the alimentary canal. Iodine preparations, indomethacin, vitamins A, D, E, K, reserprin are also recommended to be combined with milk.

To neutralize the irritating effect, sometimes it is advisable to drink the medicine with kissel. However, it is worth remembering that it slows down absorption.

Cranberry and grapefruit juice delay the elimination of drugs from the body and contribute to overdose. Grapefruit juice is very poorly combined with many drugs, since the components of the juice, affecting the enzyme systems of the liver, change the action of a large group of chemicals, leading to unpredictable consequences from taking drugs.

Vegetable and acidic fruit juices significantly reduce the effectiveness of many antibiotics, such as ampicillin, sumamed, erythromycin, negate the effect of taking antacids that reduce the acidity of gastric juice. And vice versa, they increase (up to the toxic effect) the activity of nitrofurans (furagin, furazolidone), aspirin, paracetamol, ibuprofen.

You can not drink juices rich in organic acids, alkaline drugs: antacids, cardiac glycosides, sulfonamides. And at the same time, drugs that are acids in their chemical nature (the same aspirin) should not be taken with juices, as this will increase the irritating effect on the gastric mucosa (up to damage).

St. John’s wort neutralizes the effects of drugs, such as oral contraceptives.

Tea and coffee combined with medications can cause hyperactivity, insomnia and chronic sleep deprivation. All caffeinated drinks (coffee, Pepsi and Coca-Cola) should not be consumed with drugs at all (especially with antibiotics, antiulcer drugs), this can cause overexcitation of the nervous system, trembling, exacerbation of gastric problems. It is best to drink medicines with boiled water in a volume of ½-1 glass.

The nurse should explain to the patient who received prescriptions and recommendations from the doctor:

– the importance of observing the time (before and after meals) and the frequency of taking medications;

– if medicines are recommended to be taken with food, then what foods and why is it undesirable to use at this time;

– the better to drink a particular medicine (most medicines are best with warm water);

– to drink a tablet, chewing or not;

– Is it necessary to treat the oral cavity after taking the medicine;

If the doctor indicates the time and method of use that differ from those indicated in the instructions for use of the medicinal product, it is necessary to strictly follow the doctor’s recommendations.

The method of taking medication depends on the time of intake and the nature of the food:

– when using drugs per os, it must be taken into account that the presence of food in the gastrointestinal tract can promote the absorption of some drugs and prevent others;

– when prescribing antacids for the treatment of gastric and duodenal ulcers, it should be borne in mind that when taken on an empty stomach, they act for about half an hour, and when taken 1 hour after a meal – for 3-4 hours;

– anticholinergics have the longest antisecretory effect when taken 1 hour after a meal, although they can be recommended to be taken half an hour before a meal.

Thus, the time of taking drugs inside is often not strictly fixed and should be determined depending on the properties of the drug, its tolerance and the functional state of the patient’s body.

In this regard, in each case, when a patient needs to be prescribed several drugs for medical reasons, the sequence and time of taking each drug should be carefully determined.

On an empty stomach – this is taking the medicine in the morning 20-40 minutes before breakfast or 4 hours after eating and one hour before eating. On an empty stomach, the drug acts faster: a high concentration of the active substance in the blood is reached in a short time. For some drugs, such a schedule is simply necessary because:

– drugs such as penicillin and erythromycin will not work otherwise; since acidic gastric juice destroys them;

medicines containing calcium form insoluble precipitates with food acids;

– preparations of lily of the valley and strophanthus, consumed with food, are digested with it, without having any therapeutic effect.

Before meals this means that you need to drink a pill at least 15 minutes before a meal, and most often 30-40 minutes at all. Before meals it is recommended to take:

enveloping agents that are prescribed for gastritis (for example, almagel);

-choleretic drugs in order to ensure the timely release of bile.

During meals , they drink medicines that improve the digestive process, for example, panzinorm, pepsin. Also, laxatives and some diuretics are taken with meals.

Immediately after eating , they take those drugs that irritate the mucous membrane of the stomach and intestines, as well as drugs that are components of bile (allohol, lyobil).

After a meal – this means that in order to obtain the best therapeutic effect, you should take the tablet 2 hours after a meal. It is not easy to ensure the full absorption of vitamins A, D, E and K (fats and bile are needed at the same time).

All fat-soluble vitamins should preferably be taken after a meal.

Before bed means 30 minutes before bed. At this time, drugs with a hypnotic effect are taken. If an anesthetic is prescribed along with sleeping pills, it is recommended to take it 15-20 minutes before taking sleeping pills.

No instructions on the insert – it means that the medicine belongs to the bulk of the drugs and should be taken 30 minutes before meals to reduce the destructive effect of the digestive enzymes of the stomach and intestines and maintain effectiveness.

It is undesirable to crush multicomponent tablets (sedalgin, citramon, pentalgin), as well as prolonged action tablets (sustak, nitrong, etc.), as they are covered with polymer films of different colors and different degrees of solubility. You can not pour powders from gelatin capsules (Essentiale, Nootropil), because they have an unpleasant taste, smell, and have an irritating effect. In addition, the capsule serves as a kind of protection for the dosage form from premature destruction, forcing it to be absorbed in the desired section of the intestine.

Do not break tablets that do not have separating grooves: this can lead to a violation of the dosage, affect the absorption of the drug or cause irritation of the gastric mucosa. Do not mix several drugs in one syringe.

You can not take alcoholic beverages at the same time as medicines. Alcohol changes how drugs work in the body, which can lead to serious consequences.

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