In Chapters 3 and 4 the general principles of pharmacokinetics and pharmacodynamics were addressed. This chapter builds on these principles and looks at specific groups and situations. After reading this chapter you should be able to:… ● Identify groups of patients at extra risk of interactions, explain why, and relate this to nursing practice. ● Identify groups of patients at more risk of adverse events from medications, explain why, and relate this to nursing practice. ● Understand why some patients might be at higher risk and how this might be managed…. This chapter will look at a range of patients from the perspective of the nurse administering medicines. Whilst care must be taken when administering medication to any patient, there are groups of patients where the risk of problems occurring as a result of having to take medication are higher and it is therefore even more important to be vigilant. For some patients the treatment will have to be altered to reduce risk. While this is not the responsibility of the student nurse it is their responsibility to be vigilant to changes in the patient and to report this to trained staff. There are some circumstances in which the risk to patients is always higher because the treatment they are receiving carries more risk. For example, patients undergoing cancer chemotherapy are receiving drugs which tend to be highly toxic. While the risk of some degree of harm is high, this is justified by the great benefit that patients can derive. However, it is vital that every effort is made to reduce risk. Similarly there are features of care in acute settings such as operating theatres and intensive care units that could increase the risk to patients (Neale et al, 2001 ). Staff may be under acute pressure, so it becomes harder to follow all the steps in a routine.
