IV drug administration

Question 1

What are the 5 rights of medicine administration?

Answer 1

• Right patient
• Right medicine
• Right route
• Right dose
• Right time

Question 2

What are the reasons for IV administration?

Answer 2

• 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

Question 3

What are the disadvantages of IV administration?

Answer 3

• 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)

Question 4

What are the different types of IV devices?

Answer 4

• Peripheral venous catheter
• Central venous catheter (positioned in IVC or SVC) (peripherally or skin-tunneled CVC)
• Arterial catheters

Question 5

What are Hickman and Broviac lines examples of?

Answer 5

Skin-tunneled Central Venous Catheters

Question 6

What are the different methods of administering IV medications?

Answer 6

• Continous infusion
• Bolus injection
• Intermittent infusion

Question 7

When should drugs be administered via continous infusion?

Answer 7

• Stable drugs

- Short half-life

Question 8

When should drugs be administered via a bolus injection?

Answer 8

• Rapid respnse is required

Question 9

When should drugs be administered via intermittent infusion?

Answer 9

• Often for unstable drugs with long half-lives.
• If concentration dependent effects are needed
• If there are compatibility concerns

Question 10

What are the complications of IV drug administrations?

Answer 10

• Fear/Phobia/ Pain
• Infection/Sepsis
• Thrombophlebitis
• Extravasation/Infiltration
• Emboli
• Anaphylaxis/Hypersensitivity
• Overdose

Question 11

What is Vancomycin used to treat?

Answer 11

MRSA

Question 12

What is red man syndrome?

Answer 12

A hypersensitivity reaction due to histamine release. Erythmatous rash of upper body.

Question 13

How is the incidence of red man syndrome decreased?

Answer 13

• Slowing infusion rate

- More dilute drug solution

Question 14

What are the complicactions of IV drug administration?

Answer 14

• Insufficient mixing
• Stability of medicines in solution (light, temperature, conc. amd pH)`
• Interaction of medicines with the syringe/bag

Question 15

What is the definition of bioavailability?

Answer 15

The fraction of unchanged drug that reaches the systemic circulation (IV = 100%)

Question 16

What would the time to plasma concentration graph look like if a drug was infused at a constant rate and none was removed?

Answer 16

A straight line

Question 17

What order of kinetics do most drugs fall under?

Answer 17

First order kinetics (the higher the conc. the more drug being removed per unit of time)`

Question 18

What is clearence defined as?

Answer 18

The volume of blood/plasma cleared of drug in a unit time (e.g 10ml/min). Clearence always stays at a constant volume.

Question 19

What does the plasma steady state concentration depend on

Answer 19

(The rate of drug administered K0) / (Volume of plasma cleared of drug per unit time CL)

Question 20

What does the time taken to reach plasma steady state concentration depend on?

Answer 20

Elimination half-life

Question 21

What does the elimination half-life depend on?

Answer 21

• Volume of distribution (Vd)

- Inversely on the clearence (CL) of drug from the body