Medicine management: pharmacokinetic update for community nurses

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.