Chapter 11 HW Flashcards
A substance that alters physiologic function, with the potential for affecting health
Drug
A drug administered for it therapeutic effects
Medication
The science of drugs, including the sources, chemistry and actions of drugs
Pharmacology
Constituents of the chemical formula
Chemical Name
Coined by the original manufacturer
Generic Name
Usually the same as the generic name
Official Name
The drug’s name in official publications
Brand or Trade Name
Condition or circumstance that indicates a drug should not be used
Contraindications
What factors determine the dosage and speed of absorption of drugs?
Route of entry, the pH of the recipient environment, the solubility of the formula, and the drug’s interaction with body chemicals while in transit.
The process by which the body alters the chemical composition of a substance
Metabolism (biotransformation)
How are drugs excreted
Through the kidneys
What are other ways drugs are eliminated from the body
Lungs, sweat glands, tear ducts, salivary glands, intestines and mammary glands
What weight are average drug doses based on
150lbs
Expected reactions to medication
Side Effects
Unexpected reactions to medication
Complication
One that develops as a result of another form of medical treatment
Iatrogenic disease
Ex: result from long-term use of a drug that damages organs or causes disorders with time
List the six rights of medication
Right patient, medication, dose, time, route, documentation
Substances introduced into the body to make an organ, the surface of an organ, or materials within the lumen of an organ visible on imaging
Contrast media
List four types of emergencies (and the signs and symptoms of each) that radiation therapist are most likely to encounter
a. Asthma attack-tightness or pressure in the chest, mild to moderate shortness of breath, wheezing, and coughing
b. Pulmonary edema-abnormal swelling of tissue in the lungs because of fluid buildup with symptoms of rapid, labored breathing; cough; and cyanosis.
c. Anaphylactic shock-nausea, vomiting, diarrhea, urticarial (hives), shortness of breath, airway obstruction, and vascular shock.
d. Cardiac arrest-when the heart stops beating suddenly and respiration and other body functions stop as a result
List three ways Pharmacologists classify drugs
a. According to the effects of the drug on particular receptor sites
b. In terms of the symptoms that the drug relieves
c. Its chemical group
Morphine and codeine (narcotics), Tylenol or aspirin (nonnarcotics)
Category of Drug: Analgesics
Purpose: Relieves Pain
Pentothal (depress the entire central nervous system so patient is unconscious); Novocain (acts only on the nerves in a small area); Lidocaine(used to treat inflamed membranes in the mouth and pharynx)
Category of Drug: Anesthetics
Purpose: Suppress the sensation of feeling by acting on the central nervous system
Ativan, Valium, Xanax
Category of Drug: Antianxiety
Purpose: Mild tranquilizers that help to calm anxious patient and relieve muscle spasms.
Penicillin
Category of Drug: Antibiotic
Purpose: Suppress the growth of bacteria
Warfarin(Coumadin) –orally
Heparine-Injection
Category of Drug: Anticoagulants
Purpose: Prevents blood from clotting too quickly
Clonazepam(Klonopin) and Dilantin
Category of Drug: Anticonvulsants
Purpose: Inhibit or control seizures
Prozac, Paxil, Lexapro, Zoloft
Category of Drug: Antidepressant
Lomotil and Imodium
Category of Drug: Antidiarrheal
Purpose: Controls gastrointestional distress
Compazine, Phenergan, Zofran
Category of Drug: Antiemetic
Purpose: Prevents nausea and vomiting
Nizoral, Diflucan, or Nystatin
Category of Drug: Antifungals
Purpose: Treats fungal infections such as yeast or thrush
Catapres, Lopressor, Serpasil
Category of Drug: Antihypertensives
Purpose: Lowers blood pressure
Ibuprofen (Motrin), Naproxen
Category of Drug: Antiinflammatory
Purpose: Reduce inflammation
Radiolucent, low atomic numbers, easily penetrated by xrays, appear darker on radiographs ex. air and carbon dioxide
Negative Contrast
Radiopaque, high atomic numbers, absorbs xrays, appear white on the ragiographs ex. barium sulfate
Positive Contrast
What are the two most common negative contrast media
Air and Carbon Dioxide
What is the most commonly used contrast agent used for gastrointestional tract examinations
Barium Sulfate
Orally and or rectally
high osmolality, a high number of particles in solution, greater contrast, increased toxicity and viscosity
Ionic Contrast Material
low osmolality, Iodides remain intact instead of splitting. Agitate cells less. No charged ions are introduce into the body. Cost more than ionic agents so often reserved for allergy prone patients
Nonionic Contrast Material
What is the purpose of getting blood work before administration of contrast?
To reduce the risk of contrast-induced nephrotoxicity and assess kidney function.
What are normal levels of BUN?
7 – 20 mg/ul
What are normal levels of Creatinine
.6 to 1.4 mg/dl
An antihyperglycemic agent given to patients with type 2 diabetes mellitus
Metformin
risks with having IV contrast: Chance of metformin associated lactic acidosis
a decreased volume of circulating blood in the body. Can occur with dehydration or bleeding.
Hypovolemia
Swelling around the injection site accompanied by cool, pale skin and possible hard patches or localized pain
Infiltration
Hives
Urticaria
difficulty breathing
Dyspnea
temporary loss of consciousness
Syncope
accidental leakage into the surrounding tissues; a discharge or escape (e.g. blood) from a vessel into the tissues.
Extravasation
the movement of a drug from the site of administration to bloodstream.
Asborption
the process of eliminating or expelling waste matter.
Excretion
the transfer of drugs from one location to another in the body
Distribution
Body’s adaptation to a particular drug and requirement of ever greater doses to achieve the desired effect
Tolerance
Reaction resulting from an immunologic response to a drug to which the patient has already been sensitized.
Allergic reaction
List the four drug administration routes most often encountered by patients receiving radiation therapy and describe how administered
- Oral (taken by mouth. Slowly absorbed into bloodstream, less potent but longer lasting than by injection)
- Mucous membrane (suppository in rectum or vagina, inhalation in a medicated mist, direct application by swabbing, Gargling, Irrigating the target tissue by flushing with sterile or medicated fluid, under the tongue)
- Topical (Applied directly to the skin, ex. transdermal patch, antiseptics, ointments, lotion, etc.)
- Parenteral
List some reasons a drug cannot be given orally
Because gastric secretions inactivate the medications or because the drugs have a bad taste or odor, damage teeth, or cause gastric distress or the patient is unable to take the drug by mouth
Suppository form using mucous membranes in the rectum or vagina, Inhalation in a mist, direct application by swabbing, gargling, irrigating the target tissue by flushing with sterile or medicated fluid
methods of introducing drugs through the mucous membrane
Route of drug administration in which the medication bypasses the gastrointestinal tract
Parenteral
List the four most common routes of parenteral administration and explain each.
a. Intradermal-shallow injection between the layers of the skin
b. Subcutaneous-a 45 or 90 degree injection into the subcutaneous tissue just below the skin
c. A 90 degree injection into the muscle used for larger amounts or a quicker systemic effect
d. An injection directly into the bloodstream that provides an immediate effect
Of the four parenteral routes, which route is used most often by therapists
IV Routes
- Most IV contrast media in simulation rooms are administered using a ___________.
Power Injector
contains a single dose of medicine. The tip is snapped off, and the drug is drawn into a syringe through a filter needle.
Ampule
has a rubber stopper, and the needle is inserted through the stopper to draw out the medicine. It may contain multiple doses
Vial
Where is the most common place for sterility to be compromised with an IV drip?
In the two ends of the tubing
What items should be included on an IV equipment tray
? Tourniquet, antiseptic swabs, gloves, a syringe, a needle, cotton balls, the correct drug, and adhesive bandages. (also, catheters, tubing, drip bottles, poles, and monitors if needed)
Where on the patient is the preferred venous access site for power injectors?
Large forearm vein
List four things that can affect the delivery rate of an IV injection
Kink in the tubing, a clot in the needle or catheter, the needle tip pressing against the vein wall, or a problem at the site of entry
List two things that determine the site chosen for venipuncture
the drug being used and the lenth of time that the IV line will be in place
What site would most likely be used for drawing blood or for injecting a single dose
Large antecubital vein in the arm
What sites are most likely to be used for long term use
Lower cephalic, accessory cephalic, and basilica veins (above anterior wrist) or basilica, metacarpal, and cephalic veins (posterior hand)
List some contraindications of using a specific venipuncture site
Scar tissue or hematoma, infection, skin lesions, burns, collapsed veins, or veins too small for the chosen gauge of needle
Injection of agents into tissues surrounding the vein instead of into the vein.
extravasation
Inflammation of the walls of the veins
phlebitis
Can be prevented by using a smaller needle so blood can flow thru it
How often should the infusion set be changed in IV therapy
Every 24-48 hours
List some things (taken from this chapter) that therapists are not legally allowed to do that are the physician’s responsibility.
Therapists cannot legally: diagnose, interpret images, reveal test results, prescribe drugs, admit or discharge patients, or order tests
What are the two most common complaints that lead to malpractice suites in radiology and oncology
False negative or False positive diagnoses, and misadministration of contrast media
List 7 items that must be included in the patient’s medical chart
a. Patient identification and demographic information
b. Medical history, including family history, allergies and previous illnesses
c. Nature of the current complaint and a report of examinations and treatments
d. Orders for and results of any test or procedures
e. Record of medications
f. Physician’s notes, instructions, and conclusions
g. Informed consent form
List some things that may be included on an informed consent form
a. Name of authorized physician
b. Description of the procedure and associated medications
c. An assurance that the purpose, benefit, risk, and any alternative options have been imparted and understood
d. An areas where patients can write in their words what the procedure entails
e. A disclaimer (which does not always hold up in court) releasing the caregiver and facility from liability if complications develop or the treatment fails
Chemo Drugs
Category of Drugs: Antineoplastic
Purpose: Chemotherapeutic agents used to treat cancer cells throughout the body
Ionic or nonionic
Category of Drugs: Contrast Material
Purpose: Enhance the visibility of internal tissues for diagnostic imaging
Dexamethasone (Decadron-often given to patients being treated to the brain)
Category of Drugs: Corticosteroids
Purpose: Reduce inflammation
Diuril or Lasix
Category of Drugs: Diuretics
Purpose: Removes fluid from cells
Metformin
Category of Drugs: Hypoglycemics
Purpose: Treats low blood sugar
Estrogen (Premarin)
Category of Drugs: Hormones
Purpose: Used to augment endocrine secretion.
Codeine, meperidine, oxycodone, methadone, and morphine
Category of Drugs: Narcotics
Purpose: Federally controlled substances that relax the central nervous system and relieves pain.
Narcan and naltrexone
Category of Drugs: Narcotic antagonists
Purpose: Used to counter the effects of narcotic drugs.
Imaging: Technetium 99m and Iodine-131 Therapeutic: Palladium 103, Iodine-125, Iridium-192, Strontium-89
Category of Drugs: Radio isotope
Purpose: Used in nuclear medicine as diagnostic imaging agents
Barbiturates such as Seconal Nembuta (addictive)l. Nonbarbiturate such as lorazepam diphenhydramine and midazolam.
Chloral hydrate (to sedate children)
Category of Drugs: Sedatives
Purpose: Calm anxious patients and relax the central nervous system.
Diazepam (valium)
Category of Drugs: Skeletal muscle relaxants
Purpose: Drugs that relax skeletal muscle
Hydrocortisone 1%, Aquaphor, Eucerin
Category of Drugs: Skin Agents
Purpose: Keeps the skin soft and supple while reducing pain and itching caused by erythema.
Adderall and Ritalin stimulate the CNS. Dopamine and to stimulate heart and treat hypotension and shock.
Category of Drugs: Stimulants
Purpose: Increases activity such as the central nervous system, heart
Chlordiazeposide and diazepam
Category of Drugs: Tranquilizers
Purpose: Relieves anxiety
Nitroglycerin
Category of Drugs: Vasodilators
Purpose: Makes the blood vessels dilate.
