Chapter 11 Pharmacology and Drug Administration WS Flashcards
What is the difference between and drug and a medication.
- A drug is a substance that alters physiologic function, with the potential for affecting health.
- A medication is a drug administered for it therapeutic effects.
Define Pharmacology
The science of drugs, including the sources, chemistry, and actions of drugs.
List the 4 seperate names given to each drug and explain
- Chemical name(constituents of the chemical formula)
- generic name (coined by the original manufacturer)
- official name (usually the same as the generic name)
- and brand or trade name (the drug’s name in official publications)
Define contraindications.
Condition or circumstance that indicates a drug should not be used.
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.
What is Metabolism (biotransformation)?
The process by which the body alters the chemical composition of a substance
how are most drugs excreted?
through the kidneys
List some other ways drugs are eliminated from the body
- Lungs (for those drugs broken down into gases),
- sweat glands,
- tear ducts,
- salivary glands,
- intestines,
- and mammary glands.
What does the rate of excretion depend upon?
The body’s systems, the drug’s half-life, and concentration in the tissues.
List the patient-related variables that affect a patient’s response to drugs
- age
- weight and physical condition
- gender
- personal and emotional requirements
what weight are average drug doses based on?
150 lbs
List the drug-related variables: nontherapeutic reactions to drugs.
- allergic reaction
- tolerance
- cumulative effect
- idiosyncratic effects
- dependence
- drug interactions
What is the difference between a side effect and a complication?
- Side effects-expected reactions to medications.
- Complications-unexpected reactions to medications.
What is an iatrogenic disease?
One that develops as a result of another form of medical treatment. Ex. can result from long-term use of a drug that damages organs or causes other disorders with time. Ex. secondary neoplasis and thrombocytopenia result from radiation therapy and chemotherapy
List the six rights of medication administration.
Right patient, medication, dose, time, route, documentation
What is contrast media?
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
List four types of emergencies that radiation therapist are most likely to encounter.
- asthma attack
- pulmonary edema
- anaphylactic shock
- cardiac arrest
signs and symptoms of an asthma attack
tightness or pressure in the chest, mild to moderate shortness of breath, wheezing, and coughing
signs and symptoms of a pulmonary edema
abnormal swelling of tissue in the lungs because of fluid buildup with symptoms of rapid, labored breathing; cough; and cyanosis.
signs and symptomes of anaphylactic shock
nausea, vomiting, diarrhea, urticarial (hives), shortness of breath, airway obstruction, and vascular shock.
signs and symptoms of cardiac arrest
when the heart stops beating suddenly and respiration and other body functions stop as a result.
list the three ways pharmocologist classify drugs
- According to the effects of the drug on particular receptor sites
- In terms of the symptoms that the drug relieves
- Its chemical group
which drug category relieves pain
analgesics
which drug category are: Morphine and codeine (narcotics), Tylenol or aspirin (nonnarcotics)
analgesics
which drug category Suppress the sensation of feeling by acting on the central nervous system
anesthetics
which drug category are: Pentothal; Novocain; Lidocaine
anesthetics
which drug category is used as a mild tranquilizers that help to calm anxious patient and relieve muscle spasms.
antianxiety
which drug category are: Ativan, Valium, Xanax
antianxiety
which drug category suppresses the growth of bacteria
antibiotics
which drug category is penicillin
antibiotic
which drug category prevents blood from clotting too quickly
anticoagulants
which drug category are: Warfarin(Coumadin) –orally
Heparine-Injection
anticoagulants
which drug category: Inhibit or control seizures
anticovulsants
which drug category are Clonazepam(Klonopin) and Dilantin
acticovulsants
which drug category are: Prozac, Paxil, Lexapro, Zoloft
antidepressants
which drug category controls GI distresss
antidiarrheal
which drug category are: Lomotil and Imodium
antidiarrheal
which drug category prevents nausea and vomiting
antiemetics
which drug category are: Compazine, Phenergan, Zofran
antiemetics
which drug category treats fungal infections such as yeast or thrush
antifungals
which drug category are: Nizoral, Diflucan, or Nystatin
antifungals
which drug category lowers blood pressure
antihypertensives
which drug category are: Catapres, Lopressor, Serpasil
antihypertensives
which drug category reduces inflammation
antiinflammatory
which drug category are: Ibuprofen (Motrin), Naproxen
antiinflammatory
which drug category are chemotherapeutic agents used to treat cancer cells throughout the body
antineoplastic
which drug category are: chemo drugs
antineoplastic
which drug category enhances the visibility of internal tissues for diagnostic imaging
constrast media
which drug category are: ionic and nonionic
constrast media
which drug category reduces inflammation, besides antiinflammatories
corticosteriods
which drug category are: Dexamethasone (Decadron-often given to patients being treated to the brain)
corticosteriods
which drug category removes fluid from the cells
diuretics
which drug category are: diuril or lasix
diuretics
which drug category is used to treat low blood sugar
hypoglycemics
which drug category are: metformin
hypoglycemics
which drug category is used to augment endocrine secretion.
hormones
which drug category is premarin
hormones
which drug category is federally controlled substances that relax the central nervous system and relieves pain.
narcotics
which drug category are: Codeine, meperidine, oxycodone, methadone, and morphine
narcotics
which drug category are used to counter the effects of narcotic drugs
narcotic antagonists
which drug category are: Narcan and naltrexone
narcotic antagonists
which drug category is used to calm anxious patients and relax the central nervous system.
sedatives
which drug category are: Barbiturates such as Seconal Nembuta (addictive)l. Nonbarbiturate such as lorazepam diphenhydramine and midazolam.
Chloral hydrate (to sedate children)
sedatives
which drug category is used in nuclear medicine as diagnostic imaging agents
radioactive isotopes
which drug category are: Imaging: Technetium 99m and Iodine-131 Therapeutic: Palladium 103, Iodine-125, Iridium-192, Strontium-89
radioactive isotopes
which drug category is used to relax the skeletal muscles
skeletal muscle relaxants
which drug category are: Diazepam (valium)
skeletal muscle relaxants
which drug category keeps the skin soft and supple while reducing pain and itching caused by erythema.
skin agents
which drug category are: Hydrocortisone 1%, Aquaphor, Eucerin
skin agents
which drug category increases activity such as the central nervous system, heart
stimulants
which drug category are: Adderall and Ritalin stimulate the CNS. Dopamine and to stimulate heart and treat hypotension and shock.
stimulants
which drug category relieves anxiety
tranquilizers
which drug category are: Chlordiazeposide and diazepam
tranquilizers
which drug category makes the blood vessels dilate
vasodilators
which drug category are: Nitroglycerin
vasodilators
describes the two basic categories of contrast
- Negative—radiolucent, low atomic numbers, easily penetrated by xrays, appear darker on radiographs ex. air and carbon dioxide
- Positive—Radiopaque, high atomic numbers, absorbs xrays, appear white on the ragiographs ex. barium sulfate
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? And how is it administered?
Barium Sulfate. It can be delivered orally or rectally.
List some of the hazards and inconveniences of barium sulfate.
- It requires additives to facilitate ingestion and prevent clumping and it must be concentrated to coat the organs
- If it is too thick, barium sulfate will not flow easily and it is difficult to swallow.
- It can irritate the colon and cause cramping.
- It can stimulate the body to absorb too much fluid, thus leading to hypervolemia or pulmonary edema.
- Barium sulfate can cause constipation or peritonitis if used in patients with a perforation of the colon or vaginal rupture
Describe some of the differences between ionic contrast media and nonionic contrast media.
- Ionic-high osmolality, a high number of particles in solution, greater contrast, increased toxicity and viscosity
- Nonionic –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.
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
what is metformin?
An antihyperglycemic agent given to patients with type 2 diabetes mellitus
Explain why a patient taking Metformin might have some 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
urticaria
hives
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
absorption
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
describe minor reactions to contrast media
those that usually require no treatment: nausea, retching, and mild vomiting
describe moderate reactions to contrast media
those that require some form of treatment, but involve no serious danger for the patient and response to treatment is usually rapid: ex. fainting, chest or abdominal pain, headache, chills, sever vomiting, dyspnea, extensive urticarial, and edema of the face and/or larynx
describe severe reactions to contrast media
those for which there is fear for the patient’s life, and intensive treatment is required ex.8syncope, convulsions, pulmonary edema, life-threatening cardiac arrhythmias, cardiac or respiratory arrest
List the four drug administration routes most often encountered by patients receiving radiation therapy
- oral
- mucous membrane
- topical
- parenteral
taken by mouth. Slowly absorbed into bloodstream, less potent but longer lasting than by injection
oral administration
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
mucous membrane administration
Applied directly to the skin, ex. transdermal patch, antiseptics, ointments, lotion, etc
topical administration
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.
List some methods of introducing drugs through the mucous membrane
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.
Define Parenteral
Route of drug administration in which the medication bypasses the gastrointestinal tract.
List the four most common routes of parenteral administration and explain each.
- Intradermal-shallow injection between the layers of the skin
- Subcutaneous-a 45 or 90 degree injection into the subcutaneous tissue just below the skin
- Intramuscular- A 90 degree injection into the muscle used for larger amounts or a quicker systemic effect
- Intravenous- 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 route
List three methods of IV administration
1) Continuous infusion where medication is mixed with a large volume of IV solution and given gradually over a period of time (safest),
2) piggybacked (added) onto the main IV line by means of a special valve so that the medication can be administered intermittently at prescribed levels,
3) bolus or push of a concentrated dose of medication injected by a syringe directly into the vein or through a port.
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 thought the stopper to draw out the medication, it is usually contains more than one dose
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)
What two things determine which instrument should be used for IV injection.
Explain.
Type of medication and physical characteristics of the patient.
One time injection of 30mL or less can use a regular needle (18-20 gauge) depends on viscosity of drug and size of patient’s vein. An infusion that takes place during a longer period of time requires a butterfly set taped to the skin
Where on the patient is the preferred venous access site for power injectors?
large forearm
Describe the two different types of venous catheters .
narrow tube inserted through a hollow needle and other has the needle through the tube (generally longer and thinner and can be inserted deeper into the vein and is commonly used for antineoplastic drugs. After the catheter is in place and taped down, the needle is removed.
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,
- 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.
List some signs of infiltration and some reasons for it.
Signs: swelling, cool, pales skin and hard patches of localized pain.
Reasons: catheter or IV needle has pulled out of the vein and the fluid has seeped into the adjacent subcutaneous tissue. Also if the IV bottle is hung too high, the hydrostatic pressure is so great that the vein cannot absorb the fluid quickly enough and the fluid saturates the surrounding tissue
What is extravasation.
Injection of agents into tissues surrounding the vein instead of into the vein
List some other hazards of IV infusion.
Allergic reaction, air embolism caused by failure to eliminate air bubbles in the equipment, a metabolic or an electrolyte imbalance, edema caused by the dressing being too tight at the site or too much fluid, speed shock from too rapid a delivery, drug incompatibility, thrombus, and phlebitis.
What is phlebitis?
And how can it be prevented?
Inflammation of the walls of the veins.
By using a smaller needle so the blood can flow around 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
Describe how a written error should be corrected?
Do not erase it or use correction fluid. Instead draw a line through it (so the original stays legible) and initial it.
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
