Common Medications for the Medication Aide

To ensure safe and effective medication management, medication aides must be knowledgeable about the medications their clients take. The drug monograph, provided by the pharmacy with each new prescription, is the first and most important source of information about the drug's uses, side effects, and adverse reactions. Medication aides should review the monograph carefully and keep it for future reference. Additional information can be found online through trusted sources such as:

• Drugs.com
• WebMD.com
• Rxlist.com
• NIH.gov (National Institutes of Health)

Before discussing medications, it is important to understand how the body works. Anatomy is the study of body parts, and physiology is the study of how those parts work together (Blanchard, 2005).

The cardiovascular system includes the heart and blood vessels, which pump blood throughout the body. Blood carries oxygen and nutrients to cells and removes waste products like carbon dioxide. Medications like antihypertensives and diuretics help manage blood pressure and heart health (American Heart Association, 2024). These medications are used to treat conditions affecting the heart and blood vessels:

• Antihypertensives: Lower blood pressure by relaxing blood vessels.
• Antiarrhythmics: Treat irregular heartbeat.
• Diuretics: Remove excess fluid from the body to treat high blood pressure and heart failure (American Heart Association, 2024). It is indicated for reducing swelling and controlling high blood pressure by helping the body eliminate extra fluid (American Heart Association, 2024).
• Anticoagulants: Thin the blood to prevent clots and reduce the risk of stroke or heart attack (Drugs.com, 2023c): Used to prevent blood clots in individuals at risk of heart attack or stroke (Mayo Clinic, 2021).
• Vasodilators: Used to treat chest pain (angina) and high blood pressure by relaxing blood vessels. 

Most side effects from cardiovascular drugs come from overdosage. Report any of the following side effects to the health care provider immediately: headache, nervousness, "pounding pulse," weakness, flushing of the skin, fainting, and lightheadedness when standing.

Important Warning: Aspirin and anticoagulants both thin the blood, increasing the risk of bleeding. If your client is prescribed both, ensure their doctor is aware.

The respiratory system involves the lungs, nose, and throat. It allows the body to take in oxygen and expel carbon dioxide. Respiratory medications such as bronchodilators help open the airways, making it easier for individuals with asthma or chronic obstructive pulmonary disease (COPD) to breathe (WebMD, 2024a). These medications help with conditions affecting the nose, sinuses, and lungs:

• Antitussives: Cough suppressants.
• Expectorants: Break up mucus in the lungs, making it easier to cough up.
• Decongestants and antihistamines: Reduce swelling in the nose and dry up mucus.
• Bronchodilators: These open the airways in conditions like asthma and COPD. They are often administered through inhalers or nebulizers and prescribed for individuals with asthma or COPD to help them breathe more easily (WebMD, 2024a).
• Antihistamines and decongestants: Reduce swelling in the nose and dry up mucus. Reduce allergic reactions by blocking histamine, which causes symptoms like sneezing and swelling (Farzam et al., 2023). They are used to treat allergies, which cause runny nose, sneezing, and itching (Farzam et al., 2023). 

Cough tip: Productive coughs (those that bring up mucus) should not be suppressed as they help clear the airways.

The gastrointestinal (GI) system includes the stomach, intestines, and other organs involved in digestion. This system helps the body process food, absorb nutrients, and eliminate waste. Medications like antacids and laxatives can help manage digestion and relieve symptoms like heartburn or constipation (Drugs.com, 2023a).

These medications treat disorders of the digestive system:

• Anticholinergics and antispasmodics: Treat ulcers and irritable bowel syndrome (IBS).
• Anti-inflammatories: Help with conditions like colitis.
• Gastrointestinal stimulants: Speed up digestion and relieve nausea.
• Antacids: Neutralize stomach acid to relieve heartburn; relieves symptoms of acid reflux and heartburn.
• Laxatives: Help with constipation by softening stool or stimulating bowel movements (WebMD, 2022b). This is indicated for individuals who experience constipation or need to clear their bowels before a medical procedure (Drugs.com, 2023b).

Medication tip: Some medications, such as Reglan (metoclopramide), must be taken with or without food and only for a limited time due to the risk of side effects.

The endocrine system is made up of glands that produce hormones, which regulate processes like metabolism and blood sugar levels. Oral anti-diabetic medications are used to help control blood sugar levels in people with diabetes (Mayo Clinic, 2021).

Endocrine medications help regulate hormone-related issues:

• Oral anti-diabetic medications: Help control blood sugar levels.
• Injectable anti-diabetic medications: Lowers blood sugar and comes in different forms, such as rapid or long-acting insulin.
• Hormonal drugs: Treat conditions affecting glands like the thyroid, adrenal glands, or ovaries.

Important Reminder: Medication aides cannot administer injectable medications. However, they can remind clients to take them if they are self-administering and assist with glucose monitoring if needed for medical records (not to determine insulin dosage).

The nervous system is a complex network responsible for coordinating and controlling all the body's activities. It is divided into two main parts: the central nervous system (CNS), which consists of the brain and spinal cord, and the peripheral nervous system, which includes all the nerves that branch out from the CNS to the rest of the body (Ludwig et al., 2022). These medications treat conditions affecting the brain and nervous system:

• Anticonvulsants: Treat seizures and sometimes psychiatric conditions (Cleveland Clinic, 2023a).
• Parkinson's medications: Control tremors and other symptoms of Parkinson's disease (Pirker et al., 2023).
• Psychiatric medications (National Institute of Mental Health [NIMH], 2023):
  • Antidepressants: Treat depression.
  • Anti-anxiety drugs: Help manage excessive worry and anxiety.
  • Antipsychotics: Reduce hallucinations, delusions, and agitation.
  • Mood stabilizers: Help regulate mood in conditions like bipolar disorder.

Warning: Some psychiatric medications can cause serious side effects, such as tardive dyskinesia, neuroleptic malignant syndrome, and Stevens-Johnson syndrome. Seek medical help immediately if these symptoms appear.

The skin system, also known as the integumentary system, is the body's largest organ and serves as the first line of defense against environmental hazards. It protects the body, helps regulate temperature, and allows the sensation of touch, pain, and pressure. The skin system consists of three primary layers: the epidermis, dermis, and subcutaneous tissue (Yousef et al., 2024). Skin medications are used to treat various skin conditions:

• Protectives and Astringents: Soothe and protect inflamed skin (Chertoff, 2019).
• Antipruritics: Relieve itching from allergies, skin conditions, or insect bites (Memon, n.d.).
• Topical corticosteroids: Reduce itching and irritation (National Health Service [NHS], 2023).
• Anti-infectives: Fight skin infections (Pfizer, n.d.).
• Antiseptics: Kill germs or fungi on the skin (Bednarek et al., 2023).
• Parasiticides: Eliminate parasites like lice or scabies (Cleveland Clinic, 2022).

Application tip: Apply these medications thinly. A small amount is often enough.

The urinary system, also known as the renal system, is responsible for filtering waste products from the blood and expelling them from the body as urine. It plays a crucial role in maintaining the body's internal environment by regulating the balance of fluids, electrolytes, and pH. The urinary system consists of four major components: the kidneys, ureters, bladder, and urethra (Johns Hopkins Medicine). Medications that treat urinary system issues, including the bladder, kidneys, and urinary tract include:

• Antibiotics: Treat urinary tract infections (UTIs) (Cleveland Clinic, 2023b).
• Diuretics: Help the body produce more urine, which can manage conditions such as kidney disease (American Heart Association, 2024).
• Analgesics: Relieve pain from UTIs but may cause urine discoloration (e.g., bright orange or blue) (Mayo Clinic, 2024). Inform the client so they are not alarmed.

Certified nursing assistants (CNAs) must be aware of common side effects to monitor clients effectively. A side effect is the body's reaction to a medication that is different from the reaction the health care provider intended. Some side effects are mild or moderate, and while bothersome, can be relieved without other problems. More serious side effects are commonly called adverse reactions. Some medications can cause severe allergic reactions, which can be life-threatening (U.S. Food and Drug Administration, n.d.).

Before giving a new medication, find out your facility's procedures for responding to changes in a client's condition! These should tell you who to call, what to document, when to call the supervisor, who should call the healthcare professional, and when to report changes.

For the first three times a client gets a new medication, you should closely observe them for at least 20 minutes or for the time ordered by the physician. Record this observation on the back of the medication administration record (MAR).

Allergic reactions can vary from mild symptoms like a rash to life-threatening emergencies such as anaphylactic shock. Recognizing the signs of allergic reactions is critical for CNAs.

Signs of mild allergic reactions:

• Rash or itching.
• Sneezing or runny nose.
• Mild swelling in certain areas, like the lips or eyelids (American Academy of Allergy, Asthma, & Immunology, n.d.).

Signs of severe allergic reactions (anaphylaxis):

• Difficulty breathing or swallowing.
• Swelling of the throat or tongue.
• Rapid heartbeat and feeling of faintness (Mayo Clinic, 2021).

Severe allergic reactions require immediate action, as they can be life-threatening.

You must be trained on how to use an EpiPen if you care for a client who may need it. Information on how to use an EpiPen may be found online here.

An EpiPen is an emergency device used to treat severe allergic reactions such as anaphylaxis. CNAs should be prepared to act quickly if a client experiences anaphylaxis.

How to use an EpiPen:

1. Remove the EpiPen from its case.
2. Hold it in your fist with the orange tip facing downward.
3. Remove the blue safety cap.
4. Press the orange tip against the client's outer thigh until you hear a click.
5. Hold the EpiPen in place for 3 seconds.
6. Massage the area for 10 seconds.
7. Call 911 immediately, even if the client feels better, as more treatment may be needed (Mayo Clinic, 2021).

AFTER AN EPIPEN IS USED, YOU MUST SEEK IMMEDIATE MEDICAL ATTENTION FOR THE CLIENT OR GO TO THE EMERGENCY ROOM.

Scenario: Ms. Jones, who is residing in a long-term care facility, is taking amoxicillin for an infection. She had already received one dose of the medication earlier this morning. After her second dose of the day, she experiences swelling in her lips, tongue, and throat.

Intervention: You, as her CNA, call for the nurse, but there is a delay in the availability of the nurse. You know this is a time-sensitive and serious matter. You administer the EpiPen and call 911. Ms. Jones started experiencing relief from the swelling, and an ambulance arrived soon.

Discussion: After the patient leaves for the hospital, the nurse confirms that your actions were correct. The EpiPen may have saved the client's life. Always ensure clients go to the hospital for monitoring after using an EpiPen.

Strengths and Weaknesses: This was the correct response. Any delay or failure to act can result in the client's death. It is important that CNAs are knowledgeable about the use of an EpiPen.

Being knowledgeable about medications, their uses, and potential side effects is crucial for ensuring the health and safety of clients. Medication aides should always refer to reliable sources and be vigilant in monitoring clients for any adverse reactions. By following proper protocols and being prepared to act in emergencies, medication aides can make a significant difference in the well-being of those they care for. CNAs play an important role in the care of clients by monitoring medications and recognizing potential side effects or allergic reactions. Knowing basic anatomy and physiology helps CNAs understand how medications work in the body. CNAs can provide safe and effective care by being familiar with common medications, their uses, side effects, and emergency procedures like using an EpiPen.

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