Ch. 7 pharmacodynamics of radiopaque contrast media Flashcards
Define pharmacodynamics
study of the actions or outcome elicited by drugs when the site of action is reached.
study of the actions or outcome elicited by drugs when the site of action is reached.
pharmacodynamics
can be :
Therapeutic
Diagnostic
Adverse
Which drug can be therapeutic
Diagnostic and
adverse
Gastrografin
Adverse effects of IV ROCM depend on:
- Serum or tissue iodine concentration
2. Calcium chelating , anticoagulant & immune system stimulating abilites
to show vascular lumen on x-ray serum iodine concentration must be ______ mg/ml
280-370 mg/ml
Serum iodine concentration needs to be injected as a ____, at a _____ rate than blood flow
bolus
higher rate
1 in ______ patients dies from adverse effects of ROCM
20-40,000
ROCM has a ____ osmolar weight than bloodstream
higher
After injection of ROCM _____ system dilutes it producing intravascular hypoosmolar state
Cardiovascular system
What are the 2 receptors in the carotid arteries
- Baroreceptors
2. Chemoreceptors
vagus nerve is stimulated by ____
vascular hypertension
Hyperosmolar ROCM injection into the carotid results in _____.
Intraarterial osmotic pressure changes
Intravascular osmotic fluid shifts can cause ___
acute heart failure
What are 3 signs and symptoms of acute heart failure caused by intravascular osmotic fluid
- What is the treatment
- Respiratory difficulty
- Tachycardia/ bradycardia
- Hyper or hypotension
- Diruretics
- Cardiac stimulators
Chelate means ___?
to bind to
ROCM can chelate ( bind to) ____ ions in cardiovascular system
- What does this binding cause
calcium
- cardiac arrest
- Pulseless electrical activity (PEA)
- Sudden death due to v-tac or v-fib
What effect does high osmolality contrast have on the blood
causes blood to thin
results in bleeding or bruising
Immediately life threatning , systemic hypersensitivity reaction
Anaphylaxis
= the allergic reaction
Name 3 symptoms of anaphylaxis caused by mast cells
- Nausea
- Vomiting
- Hives
First time being exposed to an allergen is known as
Anaphylactoid reactions
Just as lethal as anaphylactoid
Second or subsequent interaction with allergen
anaphylactic
ROCM is responsible for _____ % for all acute of renal failure
10 %
What are symptoms of Acute renal failure
- Renal tubular toxicity
- Renal ichemia
- Toxic oxygen radicals
If creatinine is high this indicates ____
renal failure
List the 4 main drugs given in radiology after ROCM that prevent renal dysfunction
- Half-normal saline
- Fenoldopam
- Acetyl cysteline
- Sodium bicarbonate
What is the most preventative measure that once can perform to prevent renal dysfunction
hydration
*Use half-normal saline (.45%)
Iodine in ROCM can cause the body to become untolerable to thyroid hormones.
This is known as ____
List 2 signs
decompensated thyrotoxicosis
- Fever
- Tachycardia
List general adverse reactions to ROCM
- metallic taste
- Flushing
- Feeling of warmth
List adverse CNS effects that can occur due to ROCM
- Confusion
- Anxiety
- Nervousness
Does ROCM cross the placental barrier?
Yes
What are adverse reactions to galdolinium
- Headache
- Syncope
- Chest pain
