ch. 7 pt. 2 Flashcards
the study of the actions or the outcome elicited by drugs when the site of action is reached
pharmacodyanmics
Pharmacodynamic effects can be
- ____
- ___
- ___
- therapeutic
- Diagnostic
- Adverse
To show the vascular lumen on an x-ray, serum iodine concentration must be ____ mg/ml
- how must it be injected
- 280-370 mg/ml
- must contain large amount of iodine
- must be injected at a rate higher than blood flow
Can adverse affects occur from ROCM
yes!
1 in 20,000-40,000 pts. die
True or false: the blood stream has a higher osmolar weight than ROCM
False:
IV administration of ROCM will cause ____.
Rise in intravascular osmotic pressure
which then fluid from extravascular space is drawn into the lumen to balance pressure
Fluid extraction from surrounding tissue occurs from where
- RBC
- Endothelium
- Extravascular space
____ is thought to be responsible for vasodilation and flushing symptoms
Less fluid outside the vessles and more fluid inside the vessels
After ROCM injection ,____ dilutes the the ROCM producing a _______ state
- Cardiovascular system
2. Intravascular hypoosmolar state
When hyperosmolar ROCM is injected into the carotid arteries, this results in _____ osmotic pressure changes
intraarterial
this then stimulate barroreceptors and chemoreceptors
these receptors cause the the ANS to slow down HR and drop aortic pressure
Pt. can then faint = vasovagal reaction
_____ reaction occurs when rocm is injected into the carotid arteries , causing intraarterial osmotic pressure changes that stiumlate barroreceptors and chemoreceptors. these receptors cause the ANS to slow down and drop aortic pressure . results in fainting
vasovagal reaction
For patients with chronic CHF, intravascular osmotic shifts can cause _____.
name 2 symptoms
Acute heart failure
- PE (pulmonary edema)
- Tachy or brady cardia
For patients with CHF who can go into acute heart failure , what 2 medications are used therapeutically
- diuretics
2. Cardiac stimulators
What is the cause of Pulseless electrical activity (PEA)
ROCM cheating to Ca ions in the cardiovascular system
High-osmolality ROCM can cause blood to thin which results in
- ___
- ____
- Bleeding
- Bruising
** does not occur with low osmolality ROCM*
Have a role in immediately life-threatening reaction mimicking an anaphylactic reaction that can occur with ROCM
anaphylactoid reactions
immediately life-threatening, systemic hypersensitivity reaction
List 2 symptoms
Anaphylaxis
- Nausea
- Vomiting
is Anaphylaxis fatal
yes if not treated immediate
____ exposure to the same substance stimulates sensitized mast cells to release dangerous chemicals
2nd
Which exposure to a substance sensitizes the mast cell for future events
1 st exposure
____ mimics anaphylactic reactions, but with no prior exposure to sensitize mast cell to ROCM
Anaphylactoid reaction
*** just as lethal as anaphylaxis
ROCM is responsible for ____% of all acute renal failure (ARF)
10 %
what is the 3rd most common cause of nonsocomial ARF
ROCM
urine output less than or equal to 400 mL/day
oliguric
Renal failure may not be reversible
urine output < 500mL/day
nonoliguric
it is a reversible short event
Patients at risk for ARF are
- ___
- ___
- ____
- pre-existing renal compromise
- Diabetes
- dehydration
4 drugs are used to prevent renal dysfunction of ROCM
- Half noramal saline
- Fendolopam
- Acetyl cystenie
- Sodium bicarbonate
this drug used to prevent renal dysfunction after ROCM is a potent vasodilatory effects for hypertensive emergencies
Fendoldopam
Prophylactic drug used to prevent renal dysfunction
Sodium bicarbonate
Rare but potentially fatal adverse effect of iodine rich ROCM is known as _____
it is caused by?
List 2 symptoms
Thyroid storm
patient who have decompensated thyrotixicosis
- Fever
- Tachycardia
___ is the condition in which Body becomes unable to tolerate thyroid hormones
Decompensated thyrotoxicosis
List 3 general adverse reactions to ROCM
- Nausea
- Vomiiting
- Flushing
List 3 adverse CNS effects
- Nervousness
- Confusion
- Anxiety
List 3 adverse effects of the site of IV
- Burning
- Pain
- Numbness
