Chapter 7: Intravenous Medication Principles

Question 1

PICC

Answer 1

Peripherally Inserted Central Catheter

Question 2

What are the two types of venous catheters? What is the difference between them?

Answer 2

Central catheters and peripheral catheters. Central catheters means that the medication is placed in the “central compartment” of the body and peripheral means “away from the central” compartment like the arms and legs.

Question 3

Why do we use peripheral catheters?

Answer 3

This is because its a lot cheaper than central catheters. However, it does have its bad effects. This would be phlebitis, fluid extravasation, and thrombosis.

Question 4

What is a vesicant?

Answer 4

This is a drug that can cause severe tissue damage of the catheter is dislodged from outside of the vein (Extravasation).

Question 5

What are good examples of vesicants?

Answer 5

Epinephrine, Norepinephrine, vincristine, and vinblastine.

Question 6

Sources to look up information regarding IV medications

Answer 6

1. Trissel’s Handbook on Injectable Drugs
2. King’s guide to parenteral medications
3. Micromedex, Clinical Pharmacology, Lexicomp

Remember that the pharmacist (you) is the primary source of information for the patient.

Question 7

Chemical and Physical Stability of IV Drugs.

Answer 7

The chemical and physical stability of IV drugs is important. IV drugs can degrade through hydrolysis, oxidation, or decomposition. The IV drug can have bad interactions with the container, diluent, or other drugs.

Question 8

Drugs that interact badly with PVC of plastic bottles

Answer 8

Lorazepam Amiodarone Taxanes Tacrolimus Insulin Nitroglycerin

Question 9

Drugs that interact badly with diluents

Answer 9

Ampicillin Daptomycin Infliximab Ampicillin/Sulbactam Caspofungin Ertapenem Phenytoin

Question 10

What is Y-Site Administration?

Answer 10

This is when two IV bags are placed in a “Y” formation to be able to administer several IV medications together but in separate times. This is to reduce having to use central and peripheral lines.

Question 11

Additive Mixtures

Answer 11

This is when IV medications are mixed in together in the same plastic container for administration. Before doing this, a pharmacist must make sure that the medications are compatible with one another. A good example of medications that are not compatible would be Ceftriaxone and Calcium. This can cause precipitates.