IV drug administration Flashcards
What are the 5 rights of medicine administration?
- Right patient
- Right medicine
- Right route
- Right dose
- Right time
What are the reasons for IV administration?
- Medicine is not available in another form
- Cannot tolerate medication by another route
- Constant or high blood level of medicine is needed
- A rapid onset of effect is needed
- Some medications are more effective via IV
- Rarely, to ensure compliance
What are the disadvantages of IV administration?
- Increased time to administer the medicine
- Requires trained staff to administer
- Rapid onset of action (can be disadvantage e.g hypersensitivity)
- Volume of fluid needed to dilute the medicine
- Can cause discomfort/pain to the patient
- Health risks (e.g infection)
What are the different types of IV devices?
- Peripheral venous catheter
- Central venous catheter (positioned in IVC or SVC) (peripherally or skin-tunneled CVC)
- Arterial catheters
What are Hickman and Broviac lines examples of?
Skin-tunneled Central Venous Catheters
What are the different methods of administering IV medications?
- Continous infusion
- Bolus injection
- Intermittent infusion
When should drugs be administered via continous infusion?
- Stable drugs
- Short half-life
When should drugs be administered via a bolus injection?
- Rapid respnse is required
When should drugs be administered via intermittent infusion?
- Often for unstable drugs with long half-lives.
- If concentration dependent effects are needed
- If there are compatibility concerns
What are the complications of IV drug administrations?
- Fear/Phobia/ Pain
- Infection/Sepsis
- Thrombophlebitis
- Extravasation/Infiltration
- Emboli
- Anaphylaxis/Hypersensitivity
- Overdose
What is Vancomycin used to treat?
MRSA
What is red man syndrome?
A hypersensitivity reaction due to histamine release. Erythmatous rash of upper body.
How is the incidence of red man syndrome decreased?
- Slowing infusion rate
- More dilute drug solution
What are the complicactions of IV drug administration?
- Insufficient mixing
- Stability of medicines in solution (light, temperature, conc. amd pH)`
- Interaction of medicines with the syringe/bag
What is the definition of bioavailability?
The fraction of unchanged drug that reaches the systemic circulation (IV = 100%)
What would the time to plasma concentration graph look like if a drug was infused at a constant rate and none was removed?
A straight line
What order of kinetics do most drugs fall under?
First order kinetics (the higher the conc. the more drug being removed per unit of time)`
What is clearence defined as?
The volume of blood/plasma cleared of drug in a unit time (e.g 10ml/min). Clearence always stays at a constant volume.
What does the plasma steady state concentration depend on
(The rate of drug administered K0) / (Volume of plasma cleared of drug per unit time CL)
What does the time taken to reach plasma steady state concentration depend on?
Elimination half-life
What does the elimination half-life depend on?
- Volume of distribution (Vd)
- Inversely on the clearence (CL) of drug from the body
