Chapter 15: Pharmacology

Question 0

Patient Care

Drugs arrive in the heart for what?

Answer 0

Systemic circulation

Question 1

Patient Care

Drugs are metabolized by what?

Answer 1

The liver

Question 2

Patient Care

What does CRL stand for?

Answer 2

Crown rump length

First trimester

Question 3

Patient Care

What are three contrast agents?

Answer 3

Definity

Levovist

Sonovue

Question 4

Patient Care

Word two reasons where we use contrast in the United States??

Answer 4

Left ventricular opacification
Endocardial border delineation

Both mean the same thing I want to brighten up the ventricle so I can see the heart walls better

Only contrasts approved by the FDA

Question 5

Patient Care

What is the definition for pharmacology?

Answer 5

The study of drug actions and drug interactions with living organisms

Question 6

Patient Care

What are three categories of pharmacology?

Answer 6

Drugs or medications

Biologics

Alternative therapies

Question 7

Patient Care

What is the definition of drugs?

And what two responses do you get from drugs?

Answer 7

Chemical agent capable of producing biological responses and bodies

Desirable therapeutic or Undesirable adverse

Question 8

Patient Care

What is the definition of Biologics?

Answer 8

Agent naturally produced in animal cells, microorganisms, or by the body itself

Question 9

Patient Care

What are three types of Biologics?

Answer 9

Hormones

Natural body products

Vaccines

Question 10

Patient Care

What are alternate therapies?

Answer 10

(Can be considered unconventional)

Natural plant extracts
Herbs
Vitamins
Minerals
Dietary supplements
Therapeutic techniques

(These are not monitored by the FDA so you need to tell your doctor everything)

Question 11

Patient Care

To administer drugs a health healthcare professional must do what?

Answer 11

• Know safe dosage
• Safe route of administration
• Limitations of the drug administered
• Side Effects
• Potential adverse and toxic reactions
• Indications and contradictions

Question 12

Patient Care

What are some indications and contradictions?

Answer 12

Indications
• See left ventricle better

Contradictions
• If they have a perflutrin allergy
• Cardiac shunt or hole in the heart

Question 13

Patient Care

How do you activate definity with a viral mix?

Answer 13

Put vile into shake for 45 seconds until milky white

NKA means no known allergies

After shaking for 45 seconds you have to use the vile with in 24 hours if not you need to re-shake it for another 45 seconds

Question 14

Patient Care

Drug standards and control

Laws that regulate drug protection and sale:

Answer 14

• Food and drug administration (FDA)
• Food, drug and cosmetic act
• Childhood vaccine act
• Prescription drug user fee act
• Dietary supplement health and education act
• FDA modernization act
(Drugs in the US have to be approved by the FDA)

Question 15

Patient Care

Over the counter drugs (OTC) are considered what?

Answer 15

These are considered safe for self administration

Question 16

Patient Care

What needs to be included in patient history

Answer 16

OTC drugs and alternative medications

Question 17

Patient Care

Alternative dietary and herbal supplements:

Answer 17

• Not regulated by the FDA

* May cause adverse reaction with prescribed medications

Question 18

Patient Care

What is the definition of addiction?

Answer 18

Overwhelming feeling of physical need for a particular drug that must be met at all costs

Question 19

Patient Care

What does it mean to be dependent on a drug?

Answer 19

A physical or psychological need for a particular drug

Question 20

Patient Care

What happens if you are physically dependent on a drug?

Answer 20

If drug is not taken it can cause withdrawal symptoms

Question 21

Patient Care

What are three types of drug sources?

Answer 21

• Natural (ex. Hormones) or synthetic (ex. Chemical) sources
• Animal or plant sources
• Microorganisms

Question 22

Patient Care

United States the main developer of the drug has exclusive rights for how many years?

Answer 22

17

• Then the generic brand of the drug will come out

Question 23

Patient Care

No other company can produce the drug until the expiration date of how many years?

Answer 23

17

Question 24

# Patient Care What is the chemical name of a drug?

Answer 24

Represent exact chemical formula and always remain the same Rarely used in daily chemical practice

Question 25

# Patient Care What is the generic name of a drug?

Answer 25

* It is the most often used name * Name given to drug before officially approved for use * Sign by United States adopted name counsel * Less complicated easier to remember * Used by FDA to describe drug

Question 26

# Patient Care Need to know A drug does not change what?

Answer 26

Cellular structure

Question 27

# Patient Care What are four reasons for administration of a drug?

Answer 27

* Diagnose disease conditions * Relieve undesired symptoms * Prevent disease * Cure disease

Question 28

# Patient Care Drug actions What four things are done to the drug while in the body?

Answer 28

Absorbed by body, distributed in body, metabolized by body then excreted by body

Question 29

# Patient Care Need to know What is the definition of peak concentration level?

Answer 29

Drug continues to be absorbed until it peaks | Once it peaks it will no longer be absorbed

Question 30

# Patient Care Need to know What is the definition of maximum therapeutic response?

Answer 30

Time during which the drug attains the desired effect (How long will it take to work) (Time during which the drug is of the body in an amount large enough to be therapeutic is the duration of action)

Question 31

# Patient Care Need to know Drugs must be in what form to be absorbed

Answer 31

Liquid

Question 32

# Patient Care Need to know Solider tablet drugs must go through what phase?

Answer 32

Pharmaceutics | Solid form broken into tiny particles to be dissolved by the body

Question 33

# Patient Care Need to know Enteric coating tablets go through pharmaceutic phase in the what?

Answer 33

The small intestine not the stomach

Question 34

# Patient Care Need to know What is the definition of pharmacokinetics?

Answer 34

Processes that control absorption, distribution, metabolism and excretion of drugs

Question 35

# Patient Care Drug interactions are specific to each person depending on what factors?

Answer 35

Age, nutritional status, ethnicity, physical condition, and means status, data mining, gender, weight, and environmental factors

Question 36

# Patient Care Need to know What is the definition of bioavailable?

Answer 36

The amount of drug to actually reaches systemic circulation

Question 37

# Patient Care Pharmacokinetics What is the definition of passive diffusion?

Answer 37

Needs no cellular energy (no ATP required to get drug through cell), the drug moves across cell membranes from an area of lower concentration to higher concentration than concentrations are equal transport is complete

Question 38

# Patient Care Need to know Most drugs work and what type of diffusion?

Answer 38

Passive diffusion

Question 39

# Patient Care What is lipid solubility?

Answer 39

Most important factor for determining if the drug will cross cell membranes

Question 40

# Patient Care Which vitamins are fat soluble?

Answer 40

Vitamins A, D, E and K | So these are the vitamins that you can overdose on

Question 41

# Patient Care Which vitamin is water-soluble?

Answer 41

Vitamin C | So this vitamin just goes through the kidneys and are excreted through urine

Question 42

# Patient Care What information should you find out during patient assessment?

Answer 42

Past medical history, patient age, liver disease or renal disease Prior anaphylactic reactions, LMT and possible pregnancy or nursing, aspirin sensitivity, diabetes mellitus, sickle cell, hypotension, pheochromocytoma, seizures, medication, seafood allergy, allergies

Question 43

# Patient Care We must be prepared to initiate rapid response or code blue team. What is the difference?

Answer 43

.

Question 44

# Patient Care Once the patient is injected with contrast, what is our role?

Answer 44

Monitor for normal response or reaction make sure you know the location of the crash cart In adverse reaction immediately stop IV and apply warm compresses to reduce pain and tissue damage.

Question 45

# Patient Care What are some side effects of the contract,?

Answer 45

``` A Warm feeling Nausea and vomiting Headache Injection site pain Metallic taste ```

Question 46

# Patient Care If the side effects start to happen what can you do?

Answer 46

You can slow the rate of infusion | Observe patient closely and use therapeutic indication

Question 47

# Patient Care What are some mild adverse reactions?

Answer 47

Nausea and vomiting, cough, feeling of warmth, headache, dizziness, shaking, itching, pallor

Question 48

# Patient Care What can you do when these mild adverse reactions take place?

Answer 48

Notify radiologist or RN Stay with patient and use therapeutic communication Assist in administration of anti-histamine or subcutaneous epinephrine

Question 49

# Patient Care What are the symptoms of the severe anaphylactic reaction?

Answer 49

``` Dyspnea due to laryngeal edema Hypotension Seizures Cardiac arrhythmia Lack of response Cardiac arrest ```

Question 50

# Patient Care What would you do if your patient was having severe anaphylactic reaction?

Answer 50

Call code blue Notify radiologist and RN Prepare to use AED /do Be Prepared to administer oxygen and intravenous medication

Question 51

# Patient Care Anaphylactic reactions can also be from iodinated contrast agents, What is Our role?

Answer 51

Never leave patient alone Reaction may occur quickly and without warning even with normal prior administration Can occur after patient leaves the hospital.

Question 52

# Patient Care A patient can have an anaphylactic reaction once they leave the hospital so explain to patient that if the following occur return to the hospital immediately:

Answer 52

``` Fever Joint pain Malaise Urticaria, which is hives Difficulty breathing Swollen lymph nodes ```

Question 53

# Patient Care Under universal precautions you should never administer a drug with out what?

Answer 53

The physicians order

Question 54

# Patient Care Under universal precautions what should you do if you are not familiar with the drug?

Answer 54

Consult pharmacist or reliable source

Question 55

# Patient Care Under universal precautions what are five rights of drug administration?

Answer 55

``` Right patient Right drug Right Dose Right route Right time ```

Question 56

# Patient Care What are some key points of universal precautions?

Answer 56

Read all drug labels, double check name, strength and dosage It's drug appears cloudy get pharmacist to approve first Know expiration date Do not use If expiration date is unmarked Do not combine two drugs in a syringe without pharmacist approval Ask patient to verify name and birthdate and any allergies

Question 57

# Patient Care What is Florida hospital's policy regarding administration of drugs under universal precautions?

Answer 57

That no one can take patient from room if administered IV narcotics like morphine or dilaudid within the past 30 minutes. Perform exam portable or wait 30 minutes.

Question 58

# Patient Care What are the guidelines for medication orders?

Answer 58

Only physicians, nurse practitioners, physician's assistants, and pharmacist may order or dispense drugs

Question 59

# Patient Care Medication errors are?

Answer 59

You are legally liable Medication is strictly controlled and locked up Error toward first reaction must be included in the patient's chart Incident reports are also required by the hospital, even if wrong dose, etc., almost occurred but did not, then do incident report as "a near miss"

Question 60

# Patient Care What are the three routes of drug administration?

Answer 60

Enteral Parenteral Topical

Question 61

# Patient Care What does enteral route mean?

Answer 61

Oral or by mouth, abbreviated PO: most efficient and cost-effective method; can be used only if not destroyed by gastric secretions

Question 62

# Patient Care What are the different ways to administer a drug through the enteral route?

Answer 62

Sublingual Buccal Rectal

Question 63

# Patient Care What are two things you must Do when giving a drug to a patient through the enteral route?

Answer 63

Never leave the drug by patient to take later | You must observe the patient taking the drug prior to your leaving

Question 64

# Patient Care Drug administration of the enteral route?

Answer 64

Do not crush enteric-coated tablets, they can become gastric irritant or have decreased effectiveness Sublingual drug - is placed under the time until dissolved Nothing to eat or drink until it dissolves cannot be swallowed or chewed Buccal route-place against inside cheek until it dissolves Administer rectally if patient is unable to retain oral drugs, difficult to get determine correct dosage as absorption is erratic

Question 65

# Patient Care How is topical route drugs administered?

Answer 65

Directly to skin, eyes, nose, throat | Administered respiratory mucosa via inhalation