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Patient Management 2 > Lecture 1- Pharmacology & Pharmaceutical Administration for the Radiographer > Flashcards

Lecture 1- Pharmacology & Pharmaceutical Administration for the Radiographer Flashcards

1
Q

Define Pharmacology:

A

The study of drugs actions and interactions.

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2
Q

Define what a drug is:

A

Chemical agent that produces a physiologic or biological effect in an organism.

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3
Q

What is the difference between drugs and medication?

A

Medications: are targeted in a positive way (causes a positive effect)
Drug: An umbrella term that includes medications

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4
Q

Is the radiographer licenced to administer drugs?

A

Yes, they are allowed to administer under medical directive and it must be documented.

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5
Q

Is the radiographer licenced to prescribe drugs?

A

No, only physicians can perscribe drugs.

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6
Q

What is a medical directive?

A

It is role specific (e.g., MRT), not person specific and users within the role must possess the necessary **knowledge, skill and judgment **before implementing the medical directive.

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7
Q

Under a medical directive, what are the types of orders?

A
  1. Standing
  2. STAT
  3. PRN
  4. Verbal
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8
Q

What is a standing order?

A

Written directions for specific medication or exam; part of policies and procedures

i.e. daily orders

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9
Q

What does a STAT order mean?

A

Drugs to be administered immediately

Will not often see this for drug orders.

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10
Q

What does a PRN order mean?

A

Drug administered as necessary

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11
Q

What is required for a verbal order?

A

-Given to person authorized to receive the order
-Should be documented and signed by that person (MRT)

i.e. Given an order over the phone if order is missing when patient arrives

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12
Q

Do alternitive medicines need to be documented in the drug history of a patient?

A

Yes, regardless of the type or use

Note how much the patient is taking

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13
Q

If a drug error is made by the radiographer, what must they do?

A

The incident must be completely documented - the radiographer must complete an **institutional incident report ** according to the policy of the employer.

-How many people involved

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14
Q

What is a Proprietary/Trade Name?

A

Assigned to a drug by the manufacturer (Brand name)

i.e. Gravel, tylenol

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15
Q

Define Generic Name in relation to the administration of drugs:

Who must learn generic names?

A
  1. Given to a drug before its official approval for use.
  2. Must be learned by all persons administering the drug

Ibprofin, acetominiphin

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16
Q

As a radiographer, what type of names should we be able to identify drugs by?

A

The radiographer must be able to identify certain drugs by their ** trade name and their generic name.**

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17
Q

What is Pharmacokinetics?

A

The study of how a drug is absorbed into the body, circulates within the body (distributed), is changed by the body (metabolized), and leaves the body (excreted).

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18
Q

Define Bioavailability:

A

The amount of drug that actually reaches the systemic circulation

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19
Q

Once a drug is taken into the body, when does it start to act?
a. Once it reaches the stomach
b. Once its absorbed and taken through the blood stream
c. Once the cells release pro-inflammatory or an anti-infmmatory response
d. Immedietly

A

b. Once its absorbed and taken through the blood stream

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20
Q

What plays an important part in drugs bioavailability.

A

The route of drug administration

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21
Q

What is the First Pass Effect?

A

Refers to partial metabolism of a drug before it reaches the systemic circulation.

(i.e. has to go through gut)

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22
Q

What types of routes of adminsitration avoid the first-pass effect by going directly into systemic circulation.

A

Drugs administered by sublingual, vaginal, IV, or parenteral route

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23
Q

What type of route of administration requires a larger dose and why?

A

Generally, much larger dose are required for drugs administered orally than those given by parenteral routes because they are susceptible to the first pass effect.

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24
Q

What is the absorption rate determined by?

A

Determined by how the drug is administered, the physicochemical properties of the drug and formulation.

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25
Q

In which state must drugs be in to be absorbed?

A

All drugs must be in liquid form to be absorbed

-Even oral medication in liquid form get absorbed faster than solid form

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26
Q

What phase do drugs that are administered in solid form have to go through prior to absorption by the body?

A

Drugs that are administered in solid form must go through a phase called the pharmaceutic phase before they can be absorbed.

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27
Q

What is the the pharmaceutic phase?

A

The solid form of the drugs must be broken down into tiny particles to be dissolved in fluids within the GI tract (small intestine).

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28
Q

Do drugs that are administered orally or parenterally in liquid go through the pharmaceutic phase?

A

No

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29
Q

Why do older patients (above 65) require a reduction in dose of medication?

A

Due to a decrease in distribution, metabolism and excretion.

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30
Q

Why do infants and children require a reduction in dose?

A

Because of a reduced capacity for metabolism and excretion.

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31
Q

What can delayed metabolism of a drug result in?

A
  1. accumulation of drug
  2. extended effect of drug
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32
Q

Geriatric considerations

If a patient has a decreased cardiac output, what happens to absorption and distribuation of a drug?

A

It decreases

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33
Q

Geriatric considerations

If a patient has a decreased blood flow, what happens to the absorption and distribuation of a drug?

A

It decreases

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34
Q

Geriatric considerations

What does a decrease in peristalsis cause in relation to gastric emptying?

A

Decreased gastric emptying

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35
Q

Geriatric considerations

If you have a decrease in gastrointenstinal enzyme production, what phase does it slow down in relation to drugs?

A

It slows the metabolism of drugs

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36
Q

Geriatric considerations

If you have a decrease in hepatic blood flow, what phase does it slow down in relation to drugs?

A

It decreases exretion of drugs

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37
Q

Geriatric considerations

If a paitent has a decreased function of kidneys, what phase does it slow down in relation to drugs?

A

Decreases the excretion of drugs

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38
Q

Geriatric considerations

If a patient has a decreased glomerular filteration rate, what phase does it slow down in relation to drugs?

A

It decreases the excretion of drugs

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39
Q

Geriatric considerations

What is the effect of increased pH?

A

Increased alkaline gastric secretions

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40
Q

What are the factors that affect pharmacokinetics?

A
  • Presence of disease in the liver or kidneys can influence the metabolism and excretions of the drug.
  • Drug interactions
  • Patient weight.
  • Sex
  • Ethnicity and Genetics
  • Nutritional status
  • Immune status
  • Time/interval of administration.
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41
Q

What are the areas of rapid distribution in the body in relation to drugs?

A

Heart, liver, kidneys, brain

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42
Q

What are the areas of slow distribution in the body in relation to drugs?

A

Muscle, skin, fat

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43
Q

What is Metabolism/Biotransformation?

A

The process of transforming of the drug into an inactive form (metabolite) that can be excreted by:
a. Kidneys
b. Lungs
c.Intestinal mucosa (feces)

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44
Q

What is the main organ for elimination of contrast?

A

Kidneys

45
Q

Define Half Life in relation to drugs in the body:

A

The time it takes for one half of the original amount of a drug in the body to be removed.
(It is a measure of the rate at which drugs are removed from the body.)

46
Q

What effects can adverse effects trigger?

A

Side effects, toxic effects and allergic effects.

47
Q

Define side effect:

A

An unintended effect

48
Q

Define toxic effect. What is it caused by?

A

Related to dose; pharmacological effect is amplified

49
Q

Read chapter 12 of Torres patient care.

A

Pharmacology & Pharmaceutical Administration for the Radiographer

50
Q

What can the presence of disease in the liver or kidneys influence in relation to drugs

A

Presence of disease in the liver or kidneys can influence the metabolism and excretions of the drug.

51
Q

What is an Allergic effect caused by?

A

Caused due to previous exposure to drug or compounds within drug

52
Q

What are the two types of allergic effects?

A
  1. Immediate
  2. Delayed
53
Q

Define and immediate allergic effect:

A

May range from mild (hives aka urticaria) to anaphylactic (respiratory collapse).

54
Q

Define delayed allergic effect:

A

May develop hours to days after drug administration; usually less severe intensity.

55
Q

If a medication causes adverse effects, how it it determined if it should be administered?

A

If the need (theraputic/diagnostic) outweighs the risk, it is prescribed by the physician with caution.

56
Q

Define drug tolerance:

A

Occurs when a drug received continually for a length of time creates a change in the intended response to that drug. Ussually needed in an increasingly larger doses to have a desired effect.

57
Q

What type of drugs are common with drug tolerance?

A

Narcotics and tranquilizers.

58
Q

Define Tachyphylaxis:

A

A rapidly diminishing response to successive doses of a drug, rendering it less effective

59
Q

The radiographer must adhere to the 5 “rights” of drug administration at all times:

List them:

A

The right patient
The right drug
The right amount/dose
The right route
The right time

60
Q

What are the drug classifications by action?

A

Analgesics (pain killers)
Anti-hypertensives
Anti-inflammatory

61
Q

What are the types of dosage forms?

A

Tablets, capsules, inhalants, suppositories, solutions, suspensions and transdermal patches.

62
Q

What is the most common oral dose form and easiest to adminster?

A

Tablet

63
Q

What is a tablet medication?

A

Powdered drug that has been compressed into a hard solid.

64
Q

When recording the drug administration, what things must be documented on the patient’s chart?

A
  • Drug name (WHAT)
  • Drug dose (HOW MUCH)
  • Route of administration (HOW)
  • Date and time (WHEN)
  • Signature of radiographer (WHO)
65
Q

What is the function of enteric-coated tablets?

A

They prevent gastric irritation or destruction of the drug by stomach acid.

66
Q

What is the function of polymer-coated tablets?

A

Tablets that allow for allow for sustained release

67
Q

What is a capsule medication?

A

Powdered or liquid drug contained within a gelatin shell

68
Q

What is the function of gelatin in capsule medication?

A
  1. Gelatin dissolved by stomach acid.
  2. Facilitates swallowing
  3. Works faster due to the fact that they get dissolved faster
69
Q

What is the function of Inhalant medication?

A

-Allows for high concentrations of a drug
-Deposited in the respiratory mucosa
-Produces bronchodilation by reducing inflammation.

70
Q

Give an example of local and systemic effect inhalent usage:

A

Local effect inhalents: Asthma or chronic obstructive pulmonary disease
Systeic effect inhalents: General anesthesia

71
Q

What two effects are inhalents used for?

A
  1. Local effect
  2. Systemic effect
72
Q

What two effects are suppositories used for?

A
  1. Local effect
  2. Systemic effect
73
Q

What is a suppository?

A

-Dose form shaped for the insertion into a body orifice (rectum, vagina or urethra).
-Once inserted, the suppository dissolves and releases the drug.

74
Q

What is the a solution medication?

A

Drugs are dissolved in a liquid carrier that are rapidly absorbed.

75
Q

How are solution medications administered?

A

May be administered parenterally or orally.

76
Q

Can suspension medication be administered intravenously?

A

NEVER administered intravenously (Most suspensions are administered orally)

77
Q

What are suspension medications?

A

Drugs in small particles are suspended in a liquid carrier.

(Barium)

78
Q

What is a transdermal patch?

A

Drug to be applied on the skin surface, where it is absorbed into the bloodstream gradually over time

79
Q

What are the most common Routes of Drug Administration?

A

enterally, parenterally and topically

80
Q

What does enteral administration mean?

A

Enterally: Through GI tract

81
Q

What does parenteral administration mean?

A

Parenterally: Anything other than GI

82
Q

How are entral drugs absorbed?

A

Drug is absorbed into the systemic circulation through the oral or gastric mucosa, the small intestine, or rectum.

83
Q

What are the entral routes of drug adminstration?

A
  1. Oral
  2. Sublingual
  3. Buccal
  4. Rectal
  5. Nasogastric/Naso-enteral
84
Q

What is the most efficient and cost-effective route of entral medication?

A

Oral (PO)

85
Q

When is an oral entral medication given?

A
  • Used if the drug will not be destroyed by gastric secretions
  • Used when slower absorption and longer duration of drug activity are required.
86
Q

Can sublingual medication be swallowed or chewed?

A

No

87
Q

What are the benefits of sublingual entral route medication?

A
  • Immediate onset
  • Avoid first-pass effect
88
Q

Give an example of a sublingual medication:

A

Nitroglycerin

89
Q

How should Buccal drugs be administered?

A
  1. Placed against the mucus membrane of the cheek till it dissolves.
  2. Not to be swallowed or chewed.
  3. Used for local effect.
90
Q

When would drugs be administered rectally?

A

Route may be chosen if patient is nauseated or unable to retain oral drugs.

91
Q

What are the Parenteral Routes of Drug Administration?

A
  1. Intramuscular
  2. Intradermal
  3. Subcutaneous
  4. Intravenous
  5. Intrathecal
  6. Intra-arterial
  7. Intra-articular
92
Q

When are IM drugs administered?

A

When prompt absorption is desired.

93
Q

When are intradermal drugs administered? How much is ussually given?

A

Used to test sensitivity to a drug or antigen. 0.5 mL or less is used.

TB

94
Q

What type of syringe is used for intadermal injections?

A

Tuberculin syringe (small syringe, fine needle) used.

95
Q

When are subcutaneuous injections administered?

A

Administration of post-op blood thinners, insulin, IVF drugs etc.

96
Q

Where are subcutaneous drugs adminstered?

A

-Injected under layer of skin but above muscle
-Usually into subcutaneous fat.
(Abdomen is a common site.)

97
Q

What route of parenteral administration provides most immediate effect of the drug?

A

Intravenous

98
Q

What is Intrathecal adminstration?

A

Into intrathecal space (into the spinal canal).

99
Q

What is Intra-arterial administration?

A

Into artery

100
Q

What is Intra-articular adminsitration?

A

Into joint (to see joint fluid leak).

101
Q

What angle should intramuscular drugs be inserted?

A

90 degrees

102
Q

What angle should subcutaneous drugs be inserted?

A

45 degrees

103
Q

What angle should intravenous drugs be inserted?

A

25 degrees

104
Q

What angle should intradermal drugs be inserted?

A

10-15 degrees

105
Q

What type of effects can topical drugs cause?

A

Can produce a local or systemic effect.

106
Q

What trimester is the greatest danger for drug-induced developmental defects?

A

First trimester

107
Q

Where do drugs diffuse during pregnancy?

A

Drugs diffuse across the placenta

108
Q

Is it safe to breastfeed after recieving contrast?

A

Yes, although sites may have a pump and dump policy for 48 hours

Patient Management 2 (11 decks)

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