IV Drug Administration

Question 1

Reasons for IV administration

Answer 1

• 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 2

Five rights of medicine administration

Answer 2

RIGHT patient

RIGHT medicine

RIGHT route

Right dose

RIGHT time

Question 3

Disadvantages of IV administration

Answer 3

• Increased cost and time to administer medicine
• Requires trained staff to administer
• Rapid onset of action
• Volume of fluid needed to dilute medicine
• Can cause discomfort/pain to the patient
• Infection risk

Question 4

What are the types of intravascular devices (IVDs)

Answer 4

• peripheral venous catheter
• Central venous catheters
  
  • Peripherally inserted CVCs
  • Skin-tunnelled CVCs (Hickman and Broviac lines)
  • Arterial catheters

Question 5

What are the requirements for a continuous infusion?

Answer 5

• stable drugs
• short half-life
• time dependent effects
• needs dedicated IV site
• No fluctuation in flow rate

Question 6

What are the requirements for intermittent infusion?

Answer 6

• Unstable drugs
• Long half-life
• Concentration dependent effect
• Less compatibility

Question 7

What are the requirements for a bolus injection

Answer 7

• Rapid response required
• Incompatibilties
• Unstable drugs

Question 8

Complications of IV drug administration

Answer 8

• Fear, phobia, pain
• infection/sepsis
• thrombophlebitis
• Extravastion (leakage)/infiltration
• Emboli
• Anaphylaxis/hypersensitivty
• Overdose

Question 9

What is red man syndrome?

Answer 9

Hypersensitivty reaction due to histamine release

Question 10

What are the symptoms of red man syndrome?

Answer 10

• Erythematous rash of face, neck and upper torso
• Diffuse burning, itching, generalised discomfort

Question 11

What occurs in rare cases of red man syndrome?

Answer 11

hypotension, angioedema, chest pain, dyspnoea

Question 12

What is vancomycin used for?

Answer 12

Treatment of MRSA

Question 13

What is the incidence of red man syndrome reduced by?

Answer 13

• Allowing infusion rate
• more dilute drug solution

Question 14

Stability of medicines in solution is determined by?

Answer 14

• Light
• Temperature
• Concentration
• pH

Question 15

What is bioavilability?

Answer 15

• Fraction of unchanged drug that reaches the systemic circulation

Question 16

What is the bioavalibility when and IV injection is given?

Answer 16

100%

Question 17

What is zero order removal?

Answer 17

A set amount of drug is removed from the body per unit time

Question 18

What is first order removal?

Answer 18

High concentration = high removal rate

Question 19

Draw a graph indicating the concentration of drug in the body if it was infused at a constant rate and no drug was removed

Answer 19

Question 20

How are drugs eliminiated from the body?

Answer 20

Via the kidneys

Question 21

What is first order kinetics?

Answer 21

the amount of drug eliminated per unit time is related to the concentration of the drug in the plasma

Question 22

Explain plasma drug concentration during IV infusion

Answer 22

Plasma concentration increases during infusion until rate of inout equals rate of output “steady state”

Question 23

Define clearance (CL)

Answer 23

the volume of blood or plasma cleared of drug in a unit time

Question 24

How is CL altered in first order kinetics?

Answer 24

Stays constant

Question 25

What is C_ss?

Answer 25

Steady state plasma concentration

Question 26

The C_ss reached depends on?

Answer 26

Rate administed

_______________

Volume of plasma cleared of drug per unit time

Question 27

What does C_ss depend on?

Answer 27

Rate of the drug in, and the rate of clearance from the plasma

elimination half life (t_1/2)

Question 28

What does t_1/2 depend on?

Answer 28

Volume of distribution and inversely on the clearance of drug from the body