EXAM #3 (10-6 → ) Flashcards
How many prescriptions in the 70’s vs. now
800 vs. >10,000
_____ of drugs is becoming a bigger responsibility for the technologist.
As your role increases your knowledge base needs to be broadened to include:
• Drug classification
• Drug action
• Drug interactions
• Drug reactions
• Principles and methods of administration
Preparation of drugs is becoming a bigger responsibility for the technologist.
As your role increases your knowledge base needs to be broadened to include:
• Drug classification
• Drug action
• Drug interactions
• Drug reactions
• Principles and methods of administration
What are drugs?
Substance used in medicine to aid in the diagnosis, treatment, or prevention of disease.
The science concerned with the origin,nature, effects and use of drugs is _____.
Drugs are = any chemical substance that produces a biologic response in a living system.
Substance used in medicine to aid in the diagnosis, treatment, or prevention of disease.
The science concerned with the origin,nature, effects and use of drugs is PHARMACOLOGY.
[Drug Nomenclature]
What is it?
Drugs are classified in many different ways:
• By name
• By action
• By method of legal purchase
It is classified system of names.
Drugs are classified in many different ways:
• By name
• By action
• By method of legal purchase
Chemical name:
• Identifies the actual _____ _____ _____
• Seldom of practical use to the technologist
Chemical name:
• Identifies the actual chemical structure complex
• Seldom of practical use to the technologist
Generic name:
• Name given when drug becomes commercially available
- Simpler name derived from more complex chemical name
- Easier to pronounce
- Never _____
Generic name:
• Name given when drug becomes commercially available
- Simpler name derived from more complex chemical name
- Easier to pronounce
- Never capitalized
Brand name:
• Name given to a drug manufactured by a specific company
- Usually short
- Easy to remember
- Always _____
Brand name:
• Name given to a drug manufactured by a specific company
- Usually short
- Easy to remember
- Always capitalized
What drug is cheaper? Generic or name brand?
Generic is cheaper
[Classification by Action]
Drugs that have similar chemical actions are grouped into categories called drug _____
According to _____ or _____
This is convenient but may not be totally reliable
One drug may have several different effects and is listed under more than one category
EXAMPLE:
_____ - drugs that relieve pain
_____ - drugs that fight inflammation
_____ - drugs used to treat high blood pressure
[Classification by Action]
Drugs that have similar chemical actions are grouped into categories called drug families
According to action or function
This is convenient but may not be totally reliable
One drug may have several different effects and is listed under more than one category
EXAMPLE:
Analgesics - drugs that relieve pain
Anti-inflammatories - drugs that fight inflammation
Antihypertensives - drugs used to treat high blood pressure
[Legal Classification ]
According to federal law drugs are classified as prescription or nonprescription
Prescription drugs need to be ordered by a legally authorized health practitioner.
The prescription is the document that specifies:
- _____
- _____
- _____
[Legal Classification ]
According to federal law drugs are classified as prescription or nonprescription
Prescription drugs need to be ordered by a legally authorized health practitioner.
The prescription is the document that specifies:
- Name of patient
- Name of drug
- Dosage regimen
Nonprescription drugs are better known as _____ _____ _____ drugs (OTC).
Can be obtained legally _____ a prescription.
Nonprescription drugs are better known as over- the - counter drugs (OTC).
Can be obtained legally without a prescription.
{*} No matter the legal classification, all medications administered to a patient must have an _____!
For example – even though Tylenol is an over the counter (OTC) medication, an _____ would be required!
No matter the legal classification, all medications administered to a patient must have an order!
For example – even though Tylenol is an over the counter (OTC) medication, an order would be required!
[Dose Form]
The type of preparation or the manner in which the chemical agent is transported into the human body
A drug may come in may different forms
The form may determine:
Speed of _____ of the therapeutic effect
Speed of the following from slowest to fastest? – patch – IV – injection – oral
[Dose Form]
The type of preparation or the manner in which the chemical agent is transported into the human body
A drug may come in may different forms
The form may determine:
Speed of onset of the therapeutic effect
SLOWEST TO FASTEST:
oral, patch, injection, IV
[Dose Forms]
Tablet -
Capsule -
Suppository -
Solution -
Suspension -
Transdermal patch -
[Dose Forms]
Tablet - compressed into a hard disc
Capsule - contained in a gelatin shell
Suppository - shaped for insertion into a body orifice - rectum, vagina, urethra
Solution - one or more drugs dissolved in a liquid carrier - administered orally or parenterally (any injection of the drug with a needle and syringe beneath the surface of the skin)
Suspension - one or more drugs in small particles are suspended in a liquid carrier - must be shaken thoroughly before administration
Transdermal patch - drug can be applied to the skin and is absorbed into the bloodstream
[Pharmacokinetics ]
What is it?
What are some factors that affect it?
When can contrast be added to a patient?
The study of how a drug is absorbed into the body, circulates within the body, is changed by the body, and leaves the body.
Many factors can affect these happenings:
Age, disease factors, sex, genetics, weight and route and time of administration.
Contrast can be added to a patient when their kidneys are in good working condition
[Drug effects on the body]
Undesirable effects: Side effects Toxic effects Allergic reactions Idiosyncratic reactions
Idiosyncratic = ?
[Drug effects on the body]
Undesirable effects: \_\_\_\_\_ effects \_\_\_\_\_ effects \_\_\_\_\_ reactions \_\_\_\_\_ reactions
Idiosyncratic = something we don’t want to happen that does anyway
[Drug effects on the body]
Side effects:
?
Toxic effects:
?
Allergic Reactions:
?
[Drug effects on the body]
Side effects:
Drug acting on tissues other than those intended - causes a response unrelated to the intended action
Toxic effects:
Adverse effects related to the dose of drug administered
Allergic Reactions:
Bodies immunological system is hypersensitive to the drug
[Drug effects on the body]
What are anaphylactic reactions
Delayed reactions usually _____ severe. May not become evident till _____ or _____ later.
[Drug effects on the body]
Immediate allergic reactions range from mild to severe (anaphylaxis) – carry epipens on person – can happen with contrast media (immediately)
Delayed reactions usually less severe. May not become evident till hours or days later.
[Conscious Sedation]
Used frequently in _____ to sedate for a lengthy, painful or difficult procedure
Most commonly used drugs are _____ (_____) and _____ (______)
_____ must be used with caution as can significantly _____ the respiratory system
Where does it happen most?
[Conscious Sedation]
Used frequently in radiology to sedate for a lengthy, painful or difficult procedure
Most commonly used drugs are Fentanyl (anesthetic) and Versed (antianxiety)
Fentanyl must be used with caution as can significantly depress the respiratory system
Happens most in IVR or SONO
[Levels of Sedation]
_____ - patient will respond normally to verbal commands
_____ (_____ _____) - depression of consciousness but patient will respond to verbal commands (_____ do this the most)
_____ - depression of consciousness in which the patient can not be easily aroused
_____ _____ - loss of consciousness
[Levels of Sedation]
Minimal - patient will respond normally to verbal commands
Moderate (conscious sedation) - depression of consciousness but patient will respond to verbal commands (Nurses do this the most)
Deep - depression of consciousness in which the patient can not be easily aroused
General anesthesia - loss of consciousness
{***} FIVE RIGHTS OF DRUG ADMINISTRATION
P D D T R
Right PATIENT
Right DRUG
Right DOSE
Right TIME
Right ROUTE
Most common routes of administration
- Oral (bust a nut in yo mouf)
- Sublingual (under tongue, immediately absorbed)
- Topical (cream + patches)
- Parenteral (IM, SC, IV)
Common Abbreviations
IM - IV - mg - ml - mm - po - prn - SC - Stat -
Only use abbreviations deemed acceptable by your facility
This list is usually available on the facilities Intranet
Common Abbreviations
IM - intramuscular IV - intravenous mg - Milligram ml - Milliliter mm - millimeter po - by mouth prn - as needed SC - Subcutaneous Stat - Immediately
Only use abbreviations deemed acceptable by your facility
This list is usually available on the facilities Intranet
[Medication Errors]
Errors associated with drug administration are among the most _____ legal problems in which radiologic technologists are involved.
If an error is made report to your _____ or _____
Follow the protocol of the facility for reporting drug _____ or drug _____ errors.
Example #1: X-ray a pt when they weren’t supposed to
Example #2: Oral/IV contrast media in error, needs to be reported to NY state
[Medication Errors]
Errors associated with drug administration are among the most common legal problems in which radiologic technologists are involved.
If an error is made report to your supervisor or physician
Follow the protocol of the facility for reporting drug charting or drug administration errors.
Example #1: X-ray a pt when they weren’t supposed to
Example #2: Oral/IV contrast media in error, needs to be reported to NY state
Can students inject contrast or do anything with contrast media for that matter?
NAH SON WE DON’T DO THAT
Normal level of BUN (blood urea nitrogen)
8-25 mg/dl
What is BUN (blood urea nitrogen)?
Indicator of _____ _____
Measure of _____ in _____ that comes the waste product _____
Values increase with _____ – infants have _____ values
What is BUN (blood urea nitrogen)?
Indicator of kidney function
Measure of nitrogen in blood that comes the waste product urea
Values increase with age – infants have lower values
Causes of high levels of BUN
Urinary tract obstruction
Kidney disease
Gastrointestinal bleed
Dehydration
Burns
Medication
High protein diets
Shock
Causes of low level BUN
Liver disorder
Over hydration
Malnutrition (not eating enough protein)
Normal value of Creatinine
0.6-1.5 mg/dl
What is Creatinine
Chemical waste product produced by muscle
Entirely filtered and eliminated from the blood by the kidneys
As men have higher muscle mass, levels are usually higher in men than women
Causes of high levels of Creatinine
Dehydration
Low blood volume
Medications
High protein diet
Kidney failure, infection
Causes of low levels in Creatinine
Conditions involving muscle
myasthenia gravis
Muscular dystrophy
Glomerular Filtration Rate (GFR)
Stage 1 = Kidney damage with normal or ↑GFR = GFR ?
Stage 2 = Kidney damage with mild ↓GFR = GFR ?
Stage 3 = Moderate ↓GFR = GFR ?
Stage 4 = Severe ↓GFR = GFR ?
Stage 5 = Kidney failure = GFR ?
Stage 1 = GFR >= 90
Stage 2 = GFR 60-89
Stage 3 = GFR 30-59
Stage 4 = GFR 15-29
Stage 5 = GFR < 15
Normal blood cell count for men
4.6-6.2 million/mm3
Normal blood cell count for women
4.2-5.9 million/mm3
Function of red blood cells?
carry oxygen
Function of white blood cells?
Also called leucocytes, cells of the immune system that are involved in protecting against infectious disease and foreign invaders
High causes of white blood cell count
infections
Low causes of white blood cell count
chemo, radiation, leukemia
Normal white blood cell count
4,300-10,800/mm3
Normal platelet count
150,000-350,000/mm3
[Platelets]
Cells produced by _____ _____ and released into blood stream
Function is to release _____ necessary to coagulate blood preventing excessive blood loss from an internal or external injury
_____ causes – cancer, infection, anemia, inflammatory diseases
_____ causes – bone marrow disease, radiation, chemo therapy
[Platelets]
Cells produced by _____ _____ and released into blood stream
Function is to release hormones necessary to coagulate blood preventing excessive blood loss from an internal or external injury
High causes – cancer, infection, anemia, inflammatory diseases
Low causes – bone marrow disease, radiation, chemo therapy
Normal Prothrombin - Protime time
Used to determine…?
10-12 seconds
Used to determine blood clotting tendency of blood in the measure of warfarin (Coumadin) dosing, liver damage and Vitamin K status
Normal thromboplastin time - PTT time
Used to determine…?
30-45 seconds
Determines the time it takes for blood to clot
Usually measured when blood thinner Heparin is used
