PHARMA-2 Flashcards
Approximately___of all imaging examinations involve
the use of a form of contrast media to aid in the visualization
of a body part or body system.
30%
WHY IS CONTRAST MEDIA CONSIDERED AS DRUG
because they can be absorbed into the systemic circulation
and may produce a physiologic response on the
body.
equired to visualize areas of the
body when the organ or system of interest is too similar
to the surrounding area. When
Contrast agents
When an anatomical area is
filled or outlined by a positive contrast agent, the organ
appears to be
radiopaque
radiopaque appears
white or ligh
radiolucent appears
black
Negative contrast agents make the organ appear
darker
what the
radiographer will be working with most frequently.
Radiopaque contrast media (ROCM)
the most common type of contrast used
in imaging of the gastrointestinal system (GI).
Barium
characteristics of barium
is a metal
does not dissolve
suspended
in solution.
All positive contrast agents, except barium, used
in diagnostic imaging contain
iodine
another type of contrast used for GI
imaging
Gastrografin
iodine atomic number
53
baium atomic number
56
Iodinated contrast agents are used in the examination
of the
(ABGGPHVKUJS)
GI tract, kidneys, gallbladder, pancreas,
heart, brain, uterus, spinal column, arteries, veins, and
joints
Variables the physician considers when selecting a contrast
agent are the following:
AVIPPIO
1. Its ability to mix with body fluids
2. The viscosity
3. The ionic strength
4. Its persistence in the body
5. The osmolality
6. The iodine content
7. The potential for toxicity
Most contrast agents are
water-based
oil-based contrast
agent. These may be excreted from the body in ____
natural manner or may be removed at the end of the
procedure.
Iodinated contrast agents are administered
OVIIa
oral, vaginal, intravenous, and intra-arterial routes
contrast
agents are often administered in a large dose at one
time called a
bolus
Most drugs used for treating illness
that are administered intravascularly are
isotonic.
why most drugs administered intravascularly are isotonic
they have the same concentration of solute as other
body fluids
Two commonly used iodinated substances
iothalamate and diatrizoate
iothalamate and diatrizoate contains
meglumine and sodium salts or combination
less toxic but more viscous than sodium compounds.
Meglumine compounds
All
positive contrast media are made up of a
cation and anion
is either the sodium or the meglumine compound.
cation
basically the same in all media, with the exception
of one side chain, and this determines the remainder
of the makeup of the contrast agent.
anion
the ionic contrast media
consist of
positively charged cation and a negatively
charged anion.
For every
three iodine atoms in a contrast solution, there are____
two
particles for osmolality, one anion, and one cation.
It is the ___ in contrast agents that provides the
contrast (density difference) between the organ and the
surrounding tissues.
iodine
if the ____
was removed there was no diagnostic information lost
since the ____ did not contain any of the imageproducing
iodine.
cation
The lower osmolality factor
defines the group of contrasts known as
nonionic contrasts,
or low osmolar contrast media (LOCM).
the weight of the ion
osmolality
The osmolality of nonionic
contrast agents is closer to
human plasma
Patients of choice
for LOCM include the following:
- Patients with a history of previous adverse reaction
to contrast agents - Patients with asthmatic conditions
- Patients with known cardiac conditions
- Patients who are severely debilitated
- Patients at high risk for contrast extravasation
- Patients for whom the physician feels there is an
indication for its use
a reaction to the procedure itself rather than
to the contrast agent.
vasovagal response
The radiographer may assist in
reducing anxiety in the following ways:
AIEA
1. Assessment of the patient’s understanding of the
procedure
2. Informing the patient in detail concerning how the
examination will proceed
3. Explanation of the expected side effects and assurance
that these are not unusual
4. Allowing the patient to express feelings of anxiety
and obtaining patient feedback to ascertain his
complete understanding of the procedure
a____is
started to maintain hydration and to permit emergency
administration of medications if the situation requires
peripheral intravenous infusion
five rights of
drug administration at all times.
PRTDA
1. The right patient
2. The right drug
3. The right amount or dose
4. The right route
5. The right time
PO
by mouth
IM
intramuscular
IV
intravenous
STAT
at once
VO
verbal order
SC or SQ
subcutaneous
ID
intradermal
bid
twice a day
gtt
drop
cc
cubic centimeter
ac
before meals
pc
after meals
hs
at bedtime
PRN
as necessary
every
q
every day
qd
three times a day
tid
every 2 hours
q2hrs
milliliter
mL
The
written request for an examination using IV contrast
medium should include
the medical necessity for the
examination, the type of contrast to be used, and the
manner in which the procedure will be performed.M,
to mitigate the likelihood of an allergic-like reaction in high- risk patients.
Corticosteroid Premedication
that approximately _____of such adverse reactions are associated with direct release of histamine and other mediators from circulating basophils and eosinophils
90%
TRUE OR FALSE: IT IS UNSAFE FOR THE INFANT IF THE MOTHER IS RECEIVNG A CONTRAST MEDIA
FALSE
Contrast media for ultrasound is consist of
microbubbles or microsphere
3ultrasound contrast agents approved by FDA
1.Definity® (perflutren lipid microspheres)
2.Lumason® (sulfur hexafluoride lipid-type A microspheres; also known as SonoVue®)
3.Optison® (perflutren protein-type A)
disease, primarily involving the skin and subcutaneous tissues but also known to involve other organs, such as the lungs, esophagus, heart, and skeletal muscles.
NEPHROGENIC SYSTEMIC FIBROSIS
what should be the radiographer’s response to expected side effect
- Slow the rate of the contrast infusion.
- Observe the patient closely and offer reassurance.
Clinical Manifestations of Expected Side Effects
ANPHA
* A feeling of flushing or warmth
* Nausea and/or vomiting
* Headache
* Pain at the injection site
* Altered taste, may be metallic
Clinical Manifestations of a Vasovagal Reaction
PCRSBH
* Pallor
* Cold sweats
* Rapid pulse
* Syncope or complaint of feeling faint
* Bradycardia
* Hypotension
what should be the radiographer’s response to Clinical Manifestations of a Vasovagal Reaction
- Stop the infusion of contrast medium.
- Place the patient in flat or Trendelenburg position.
- Notify the radiologist.
- Remain with the patient and offer reassurance.
what should be the radiographer’s response to Clinical Manifestations of Mild Adverse Reaction
Stop the infusion and notify the radiologist or radiology
nurse.
2. Remain with the patient and offer reassurance.
CHAPTER 15: Pharmacology for the Radiographer 275
3. Prepare to assist in the administration of an antihistamine
or subcutaneous epinephrine.
what should be the radiographer’s response to Clinical Manifestations of a Moderate
Adverse Reaction
- Stop the infusion.
- Notify the radiologist and the radiology nurse.
- Call for the emergency team if symptoms progress
rapidly. - Remain with the patient and offer reassurance.
- Prepare to administer oxygen and intravenous
medications. - If the patient is in respiratory distress, place him in
semi-Fowler’s position. - Position patient who is vomiting in a position to
prevent aspiration.
what should be the radiographer’s response to Clinical Manifestations of a Severe
Anaphylactic Reaction
Radiographer’s Response
1. Call for emergency response team (Code Blue).
2. Notify the radiologist and radiology nurse.
3. Prepare to use AED (automated external defibrillator).
4. Prepare to administer oxygen and intravenous
medications.
Clinical Manifestations of a Moderate
Adverse Reaction
THDBP
* Tachycardia or bradycardia
* Hypertension or hypotension
* Dyspnea
* Bronchospasm or wheezing
* Patient complains of feeling of throat closing
(laryngeal edema)
