Midterm | Pharmacodynamics Flashcards
Study of how the effects of drugs are manifested
Pharmacodynamics
Pharmacodynamics types
- Primary effect
- Secondary effect
The reason why the drug is
administered
Primary effect
Side effect of the drug that
may or may not be desirable.
Secondary effect
Medication Effects
- Therapeutic Effect
- Side Effect
- Toxic Effect
- Idiosyncratic Effect
- Allergic Response
- Synergistic Effect
SIT SAT
Purpose of the medication
Therapeutic Effect
Usually, drug binds to receptor site on cells
Therapeutic Effect
Ex. Pain relief, BP control, reduced inflammation
Therapeutic Effect
Predictable action or effects of a drug other than the desired
Side Effect
Related to the chemical and therapeutic characteristics of the Medication
Side Effect
Ex. Nausea, headache, insomnia, dry mouth
Side Effect
Poisonous, potentially lethal
Toxic Effect
Inadequate excretion, impaired metabolism, overdose, or drug sensitivity
Toxic Effect
(DEMO)
Ex. Respiratory depression, kidney failure
Toxic Effect
Overreaction, underreaction,
unusual reaction
Idiosyncratic Effect
Unknown, unique to individuals
Idiosyncratic Effect
Ex.
Sedative causes anxiety
Appetite suppressant increases appetite
Mild stimulant causes extreme excitation
Idiosyncratic Effect
Characteristic response to an allergen
Allergic Response
Prior sensitization to an initial dose of the medication or one of its components
Allergic Response
Ex. Hives, asthma attack, bronchospasm
Allergic Response
Responses to combined drugs that differ from their individual effects
Synergistic Effect
Chemical or physiological drug interaction
Synergistic Effect
Ex. Combination of hypertension medication and diuretic drug causes weakness and fainting
Synergistic Effect
It affects the endothelial tissues (inner lining of the blood vessel).
Hypertonicity
If it affects the adventitia of the blood vessel, a scar may form in the tunica intima. This thrombus can also be an embolus
Formation of thrombus
Due to this lesion, endothelial dysfunction may occur affecting the function of a blood vessel
Endothelial lesion
CM can cause damage to the BBB
Blood brain barrier
RBC flow: Higher concentration, water will flow out and that can lead to (1) causing (2). The RBC can be deformed due to (3) in rigidity and cannot pass to the (4)
- crenation
- Hemolysis
- increase
- capillary bed
Vasodilation of the blood vessels can lead to generalized hypotension
Vascular effect
It can cause diuresis and dehydration leading to acute renal dysfunction
Renal effect
Other side effects of CM
Nausea, vomiting, fainting, and sneezing
SIDE EFFECTS OF CONTRAST MATERIAL
- Hypertonicity
- Formation of Thrombus
- Endothelial lesion
- Damage to the BBB
- RBC Flow
- Vascular effect
- Renal effect
- Nausea, vomiting, fainting, and sneezing
BETH RV RN
It is the (1) and (2) obligation of the radiographerto be knowledgeable about any drug that he administers
- legal
- ethical
Every detail of an incident, involving incorrect administration of drug must be included in the report. Items to include in the report are as follows:
- Dosage of drug administered
- Name of incorrect drug
- Why it was administered
- Patient’s reaction
- How the error was remedied
DNA RR
SPECIAL CONSIDERATION
Check for the patient’s (1), (2), (3) to calculate the dosage for many drugs. This information should be recorded accurately on the patient’s chart.
- age
- height
- weight
SPECIAL CONSIDERATION
The chart should also include all (1), especially results of (2) and (3) tests. This is to adjust the dosage of the drug if the body could not withstand the prescribed dosage of a certain drug
- current laboratory data
- renal
- liver function tests
SPECIAL CONSIDERATION
(1) and (2) should also be checked since it might alter the drug effect
- metabolic changes
- physiologic changes
SPECIAL CONSIDERATION
The radiographer should obtain a comprehensive (1) from the patient or his family, asking about past reactions to drugs, possible genetic traits that might affect drug response. This includes current use of (2), (3), (4), and (5)
- family history
- other prescription and OTC drugs
- illicit drugs
- herbal supplements
- vitamin supplements
SPECIAL CONSIDERATION
(1) can cause serious fatal drug interactions and can dramatically change many drugs’ effects
Multiple drug therapies
Administration of many drugs at the same time or the administration of excessive drugs, which is mainly observed in elderly patients who suffer from chronic diseases with concomitant pathologies.
Polypharmacy
Usually used for measuring patient weight when calculating dosage and is also used for measuring medications
Metric system
When medications are given in the imaging department, a physician (1), (2), and (3).
- selects the drug
- determines the route of administration
- prescribes the exact dosage
Orders may be (1) or (2) and sometimes be in the form of
(3).
- written
- verbal
- standing order
Consists of written directions for a specific medication or procedure, signed by a physician, and used only under the specific conditions stated in the order
Standing order
In preparation for medication administration, these are the steps:
- Verify (1) and check the (2). If you have questions about the dosage or the route of administration, check with the physician or the supervisor
- Verify (3) and check the (4)
- Check for (5) in the chart or obtain a/n (6) from the pt
- Remeber to perform (7) before preparing the medication
- pt identification
- order
- medication
- expiration date
- allergies
- allergy history form
- hand hygiene
This includes oral, rectal, and nasogastric route. It applies to medication in which administration is directly into the gastrointestinal tract via oral or rectal sites
Enteral route
Some lung conditions are treated with inhalation therapy. Liquid medications are vaporized, administered by an inhaler or nebulizer, and inhaled by the patient.
Medical inhalation
Refers to the application of medication to the surface of the skin. These medications are applied for a local effect.
Topical route
Used for a systemic effect. These medications are applied to the skin in a paste form or on a small adhesive disk that allow the medication to be absorbed through the skin and into the bloodstream.
Transdermal route
These medications are placed in the mouth; these are not considered oral or enteral routes. It can be absorbed into the blood through the oral mucosa and are immediately available without having to be digested and absorbed through the stomach or bowel
Sublingual and buccal route
Medications are injected directly into the body and bypass the GI tract.
Parenteral route
Parenteral route
Parenteral Equipment:
— (1): the (3) of a needle indicates the diameter of the (3) (opening in injection needle).
- hypodermic needles
- gauge
- bore
As the gauge number increases, the diameter of the bore —
decreases
Gauge number with the smallest bore and its purpose
30G; transdermal purposes
Gauge number with the largest bore and purpose
16G; spine (intrathecal), biopsy
Gauge size common for CM administration
Best: 20G
19-22G: Depends on CM solubility/ viscosity
Total Parental Nutrition (TPN) Administration
Nasogastric route
Nitroglycerine Administration
Sublingual route
A small hollow tube used for injecting or withdrawing liquids
Syringe
Types of Syringes
- Standard
- Insulin
- Tuberculin
Standard syringes come in what sizes?
3ml, 5ml, and 10ml
Designed specially for use with the ordered dose of insulin
Insulin syringe
Insulin syringes usually have caps that are colored —
orange
Narrow syringe, use to administer small or precise doses such as pediatric dosages.
Tuberculin syringe
Tuberculin syringe should be used for doses of — or less
0.5ml
Why should syringe bevels be pointed upwards?
Minimizes pain and skin trauma
(Sharp tip of the needle can pierce the skin first)
Parenteral injection between the layers of the skin. This method is used to test patient’s sensitivity to contrast media/ allergic reactions
Intradermal/ Intracutaneous
Site and gauge number for Intradermal/ Intracutaneous
Anterior surface of forearm (26G)
It instils medications into the fatty tissue layer beneath the skin.
Subcutaneous
Site and gauge number for subcutaneous
Upper arm, 45° angle (23-25G)
Syringe used for subcutaneous
=/< 2ml
Intramuscular site for adults
Deltoid muscle of the upper arm, the gluteal muscles in the hip area, or the vastus lateralis muscle of the lateral thigh.
Intramascular site for 5y/o
Vastus lateralis site is preferred because the gluteus muscle is still developing.
Intramascular syringe used & gauge size
22G; Syringe: >5mlL
Example of meds administered intramuscularly
Epipen
Pedia vaccine (fastest route of administration and less side effect)
Direct injection into a vein if immediate effect of a drug is desired.
Intravenous
Site for INtravenous
Basilic and cephalic vein
Involves percutaneous access to the artery by a needle, frequently followed by a catheter placement to permit injection at a specific anatomic site, and usually performed under surgical asepsis
Intra-arterial
Intra-arterial is specifically used in (1). (2) heal slowly compared to its counterpart, and there are less (3) and bigger (4)
- angiography
- arteries
- platelets
- vessels
It is used when a contrast medium is to be injected through a spinal needle directly into the subarachnoid space
Intrathecal / Intraspinal method
Intrathecal is when CM is injected directly into the subarachnoid space specifically what safest area?
Between L3 and L4 intervertebral space
Syringe angulation for deeper veins: (1)
Syringe angulation for superficial veins: (2)
- towards 90°
- at least 25°