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Medication Reconciliation Overview

The Importance of Medication Reconciliation

Medication reconciliation refers to a formal procedure for developing the most accurate and complete listing possible of a patient’s recent medicines and comparing it to those included in the drug orders or patient records. The aforementioned process is done to avert medication errors such as drug interactions, dosing errors, duplications, and omissions. These errors may arise from the inadequate understanding of one’s present and past medical treatment.

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The Strategies to Prevent Medication Errors

Healthcare practitioners may utilize patient identifiers, highlight crucial conditions and diagnoses, verify reactions and allergies, update patients’ current drugs, and standardize weight and height measurements to avoid medication errors. Physicians also need to have adequate drug information; this can be reinforced by maintaining medication references, distinguishing high-alert medications, and establishing guidelines. Alhagh et al. (2016) further underscore the importance of effective communication, e.g., the use of electronic systems as an approach to avoiding medication errors. Proper storage and labeling of drugs, quality patient education, and proper drug devices can also be used to prevent these errors.

The Effect of Maturation on the Elements of Pharmacokinetics

High gastric pH in young infants and neonates has a protective effect/influence on acid-labile medications and accounts in part, for the increased beta-lactam antibiotics’ bioavailability. During the neonatal phase, the gastric emptying period is longer than that of an adult; it is partly liable for the delayed absorption of orally administered sulfonamides, digoxin, and phenobarbital (Anker et al., 2018). Developmental modifications in the activity of intestinal medication transporters and metabolizing enzymes can potentially alter drugs’ bioavailability. Age-dependent changes in pancreatic enzymes’ activities and biliary function can compromise the body’s capacity to solubilize and absorb specific lipophilic medications.

Plasma protein binding of medications is typically decreased in infants and neonates. Reduced protein binding may trigger a high drug distribution from plasma to the body. Developmental changes which occur in enzymatic systems, according to Anker et al. (2018), have been supported by age-related modifications in the clearance of multiple drugs and metabolic ratios. Glomerular filtration rate (GFR) increases depending on the chronological age since delivery. For medications excreted primarily through glomerular filtration, initial dosage adjustments can be made by decreasing dosage or elevating dosing intervals. Tubular secretions evaluated by p-aminohippurate’s renal clearance are lowered at birth to around 20-30 percent of adult volume but mature by fifteen months.

References

Alhagh, E., Gorgich, C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Global Journal of Health Science, 8(8), 220–227. Web.

Anker, J., Reed, D. M., Allegaert, K., & Kearns, L. G. (2018). Developmental changes in pharmacokinetics and pharmacodynamics. The Journal of Clinical Pharmacology, 58(S10), S10 – S25. Web.

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