Chapter 15 Flashcards by hang c cao

What is a drug?

Any chemical substance that produces a biologic response in a living system

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Drug are

Chemical substances that are NOT required for normal maintenance of body function.
Aid in the diagnosis, treatment, or prevention of disease

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After a drug has been administered it is called

Medication

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Pharmacology

The science concerned with the origin, nature, effects and uses of drugs.
The study of drug actions and drug interactions with living organisms.

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Classified system of drug names

Chemical Name
Generic Name
Trade Name

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Chemical Name

Identifies the actual chemical structure of the drug
Often complex
Not important to the technologist

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Generic name

Name given to the drug before its official approval for use
One generic name for each drug
Simpler name
Derived from chemical name
Never capitalized
Usually best known by

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Brand Name

Name given to a drug manufactured by a specific company
Short & easy to remember
Name may or may not reflect chemical structure of the drug

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Trademark is

Brand name, trade name or proprietary name

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Chemical sample

2-diphenylmethoxy-N,N-dimethyle-thylamine

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Generic Sample

Diphenhydramine

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Brand sample

Benadryl

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Classification -Drug Action

Function
Drug families
Similar chemical actions are group 
Analgesics
Antiinflammatories
Not totally reliable
One drug may have several different physiologic effects on the body

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Drug Forms

The manner in which the chemical agent is transported into the human body
Single drug available in different forms to facilitate delivery and action under a variety of conditions

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Drug form samples

Tablet
Capsule
Inhalant
Suppository
Solution
Suspension
Transdermal patches

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4 Routs of drug

Oral
Topical
Sublingual
Parenteral

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Oral rout

Most common
Patient must be conscious
Absorption time is longer

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Topical rout

Directly onto skin
Absorbed into bloodstream
Transdermal patch

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Sublingual rout

Under the tongue and not swallowed

Rapid absorption for immediate onset

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Parenteral rout

Administered by injection or by a route other than the GI tract
Common routes

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Relieve pain without causing a loss of consciousness

Analgesics

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2 groups of Analgesics

Nonnarcotic (nonopioids)

Narcotic (opioids)

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Nonnarcotic (nonopioids)

Mild to moderate pain

Acetaminophen (Tylenol), Motrin, Advil

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Narcotic (opioids)

Moderate to severe pain

morphine, oxycodone, demerol

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Act on the CNS to produce a loss of sensation

Anesthetics

2 types of Anesthetics

General anesthetics | Local anesthetics

General anesthetics

Produce muscle relaxation and loss of consciousness – surgical procedures propofol (Diprivan)

Local anesthetics

Block nerve conduction from an area of the body to the CNS

Antianxiety

Used in the treatment of anxiety Act on the CNS to calm or relax the anxious patient diazepam (Valium); lorazepam (Ativan)

Anticoagulants

Inhibit clotting of the blood or increase the coagulation time Use primarily to prevent or treat thromboembolic disorders Heparin (IV) Coumadin (Oral)

Interventional procedures

Monitor closely for hemorrhage

Used to treat Type 2 diabetes metformin (Glucophage) IVP exam

Antidiabetic

Prevents and treats nausea & vomiting Before onset of symptoms prochlorperazine (Compazine) ondansetromn (Zofran)

Antiemetic

Treat allergic disorders; upper respiratory tract infections & the common cold

Antihistamine

2 groups of Antihistamine

Sedating antihistamines | Nonsedating antihistamines

Sedating antihistamines

diphenhydramine (Benadryl)

Nonsedating antihistamines

loratadine (Claritin)

Increase the amount of urine excreted by the kidneys CHF patients furosemide (Lasix)

Diuretic

Causes blood vessels to constrict Increasing heart action & BP norephinephrine (Levophed)

Vasoconstrictor

Causes blood vessels to dilate | nitroglycerin

Vasodilator

Contrast Media

30% of all imaging examinations involve the use of contrast media in order to visualize a body part or system

Contrast media is classified as

Drug

Contrast media is absorbed

Into the systemic circulation and may produce a physiologic response

3 Routes of administration

IV or intravenous Oral Rectal

IV contrast administered in a large dose over several minutes

Bolus (use w/CT scan

IV contrast administered over an extended period of time

Infusion

When an anatomical area is filled or outlined by a Positive contrast media, the area will appear white on the image All positive contrast media except barium contain iodine

Radiopaque

Negative contrast media making the area appear darker on the image Air or gas

Radiolucent

What is the most common type of contrast used to image the GI system

Barium

Does not dissolve; remains suspended in solution | Barium(56) and iodine(53) both contain high atomic numbers

Chemical structure is

different for ionic & nonionic contrast | Differs in the number of particles in solution; not the number of iodine compounds

The iodine provides

the contrast or density difference between an organ and its surrounding tissue

Weight of the ion | Can cause side effects for patients

Osmolality

Ionic contrast have a higher

osmolality (hyperosmotic to body fluids)

Nonionic contrast has

an osmolality closer to human plasma | Less likely to cause reactions

Adverse reactions

Range from mild to severe

Vasovagal response

Reaction to the procedure and not the contrast agent; high anxiety

Most reactions to IV contrast media occur within

the first five (5) minutes after administration | A delayed reaction is also possible

Five rights of drug administration | Golden rules of drug administration

``` Right drug Right amount Right patient Right time Right route ```

Equipment for Venipuncture

``` Needle Tourniquet Alcohol wipes or antiseptic solution Tape or tegaderm Gauze Contrast Syringe Bandaid ```

Plastic syringe

Tip – needle attaches Barrel – body of syringe Plunger –part that fits into the barrel Vary in size: 1 – 50 mL size capacity

Luer-Lok syringes

Locking device on the tip to hold needle firmly in place

Needle

Stainless steel

3 Components of needle

Hub Cannula or shaft Bevel

Part that attaches to the syringe

Hub

Length of metal part

Cannula or shaft

Sharp slanted tip of the needle

Bevel

Gauge

(viscosity of fluid determine size) Thickness or diameter of the needle 14 to 28

Length (area for injection/condition of patient determine)

Measurement in inches of the shaft portion | ½ to 4 ½ inches

The smaller the diameter of the shaft of the needle

the larger the gauge number will be. 25 gauge needle has a very small diameter 18 gauge needle has a large diameter

Which gauge is often used to draw a drug or solution into a syringe but seldom used to inject into the patient

18 gauge

Package labeled 20g/1 ½ indicates that

the needle is 20 gauge and 1 ½ inches long (length)

Bevel Varies from

long to short

subcutaneous & intramuscular injections

Long bevel

intravenous injections

Short bevel

Bevel always

Sealed glass container designed to hold a single dose | Intended for one use

Ampule Container

Small glass bottle with a sealed rubber cap and metal band; plastic cap Different sizes; multiple doses within one

Vial container

Opening an Ambule

Hold upright and flick top with a finger until all the drug is in the bottom of the ambule Gauze is wrapped around the indented neck and the top is snapped off Discard any unused contrast

Opening A Vial

Remove plastic cap from top of vial Determine amount to be withdrawn and draw up same amount of air into syringe Attach needle to syringe

Insert needle into vial and inject air

Fluid will replace air in syringe | Place tip of needle above level of fluid before injection of air to prevent air bubbles in the solution

Vein Selection

Carefully assess area to determine best location for venipuncture

Things to consider for Vein Selection

``` Type of contrast Length of procedure Bolus or infusion Age and physical condition of patient Medical history ```

Never use .........for Vein Selection

the anterior wrist | Extreme pain and damage may result to radial nerve

Venipuncture Procedure

Retract and anchor vein distally with finger. Hold needle @ a 20 to 30 degree angle with bevel up for proper insertion (hold the vein tie w/fingers) Look for blood return in flashback chamber and advance catheter into vein (separate the needle ?? Secure catheter and release tourniquet Connect syringe or tubing to catheter