IV Drug Administration Flashcards
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
Five rights of medicine administration
RIGHT patient
RIGHT medicine
RIGHT route
Right dose
RIGHT time
Disadvantages of IV administration
- 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
What are the types of intravascular devices (IVDs)
- peripheral venous catheter
- Central venous catheters
- Peripherally inserted CVCs
- Skin-tunnelled CVCs (Hickman and Broviac lines)
- Arterial catheters
What are the requirements for a continuous infusion?
- stable drugs
- short half-life
- time dependent effects
- needs dedicated IV site
- No fluctuation in flow rate
What are the requirements for intermittent infusion?
- Unstable drugs
- Long half-life
- Concentration dependent effect
- Less compatibility
What are the requirements for a bolus injection
- Rapid response required
- Incompatibilties
- Unstable drugs
Complications of IV drug administration
- Fear, phobia, pain
- infection/sepsis
- thrombophlebitis
- Extravastion (leakage)/infiltration
- Emboli
- Anaphylaxis/hypersensitivty
- Overdose
What is red man syndrome?
Hypersensitivty reaction due to histamine release
What are the symptoms of red man syndrome?
- Erythematous rash of face, neck and upper torso
- Diffuse burning, itching, generalised discomfort
What occurs in rare cases of red man syndrome?
hypotension, angioedema, chest pain, dyspnoea
What is vancomycin used for?
Treatment of MRSA
What is the incidence of red man syndrome reduced by?
- Allowing infusion rate
- more dilute drug solution
Stability of medicines in solution is determined by?
- Light
- Temperature
- Concentration
- pH
What is bioavilability?
- Fraction of unchanged drug that reaches the systemic circulation
What is the bioavalibility when and IV injection is given?
100%
What is zero order removal?
A set amount of drug is removed from the body per unit time
What is first order removal?
High concentration = high removal rate
Draw a graph indicating the concentration of drug in the body if it was infused at a constant rate and no drug was removed
How are drugs eliminiated from the body?
Via the kidneys
What is first order kinetics?
the amount of drug eliminated per unit time is related to the concentration of the drug in the plasma
Explain plasma drug concentration during IV infusion
Plasma concentration increases during infusion until rate of inout equals rate of output “steady state”
Define clearance (CL)
the volume of blood or plasma cleared of drug in a unit time
How is CL altered in first order kinetics?
Stays constant
