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ENVIRONMENT

APARTA, AUMAN, DEL CASTILLO, REAS, SISO

Physical setting where the drug is administered Environmental influences that may affect the stability or efficacy of certain drugs
Factors that may increase the risk of adverse effects from drug therapy

3 ASPECTS OF ENVIRONMENT RELATED TO DRUG THERAPY

PHYSICAL SETTING

most types of drugs that require STRICT MONITORING are administered here

EXAMPLES: IV digoxin inhaled tubocurarine oxytocin after labor or during emergency 5-fluorouracil for cancer patients

A. ACUTE CARE HOSPITALS

located in an Acute care facility developed to focus on the physical rehabilitation of the patient if patient requires close monitoring, he is moved back to acute care hospital

B. ACUTE REHABILITATIVE UNITS (ARUs)

developed to continue care of patients who are well enough to be discharged from the acute care facility but may be eligible for a long term facility

C. TRANSITIONAL CARE UNITS (TCUs)

refers to patient who arrives in the morning for a procedure with the expectation of returning home after the procedure is completed

D. OUTPATIENT UNITS

generally admit patients who do not require intense observation i.e. trauma patients, elderly people

E. LONG TERM FACILITIES

some drugs are safe for administering at home

Limiting factors: need close monitoring need for special monitoring equipment

F. HOME OR COMMUNITY ENVIROMENT

Some patients or family members are taught to self-administer medications: home environment is evaluated give important clues to its potential influence on: therapeutic effectiveness, patients adherence to drug regimen, and potential risk from drug therapy itself

F. HOME OR COMMUNITY ENVIROMENT

ENVIRONMENTAL INFLUENCE ON DRUG STABILITY AND EFFECTS

many drugs are sensitive to the physical environment such as excess heat,light or moisture interaction between the environment and the drug may involve the storage of the drug or effects of the environment to the Pharmacokinetics or Pharmacodynamics process affects pharmacotherapy in any environmental setting

The envirronment can also modify drug effects heat relaxes peripheral vessels and increases circulation cold constrict the blood vessels and slowing circulation High altitude puts the body under stress, and relative oxygen deprivation at high altitudes

ENVIRONMENTAL INFLUENCES ON ADVERSE EFFECT AND INJURY

Environmental chemicals are recognized as agents that cause substantial drug interaction in some people people chronically exposedto these agents metabolize some drugs more rapidly than normal It may also influnce the relationship between physiologic function, drug effects, and adverse effects or injury

alcohol, tobacco or pesticides may alter the pharmacokinetics of certain drugs and increase the patient's risk for adverse drug effects. photosensitivity is another potentially adverse effect that is associated with many different types of drugs. and it can cause partial-thickness burns in patients who works as lifeguard simple daily activities may also be affected by environmental influence of pharmacotherapy

the patient's occupation must also be considered patients who work in an environment that exposes them to industrial chemical and pesticides have the highest risk for adverse effects and drug toxicity because these environmental pollutants affect drug biotransformation

environment can influence the metabolism of substances such as drugs, chemicals, environmental pollutants and endogenous substances which is extensively metabolized in the liver before excreted in the body

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