PHARMA-2 Flashcards by P A N E

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%

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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.

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equired to visualize areas of the
body when the organ or system of interest is too similar
to the surrounding area. When

Contrast agents

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When an anatomical area is
filled or outlined by a positive contrast agent, the organ
appears to be

radiopaque

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radiopaque appears

white or ligh

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radiolucent appears

black

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Negative contrast agents make the organ appear

darker

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what the
radiographer will be working with most frequently.

Radiopaque contrast media (ROCM)

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the most common type of contrast used
in imaging of the gastrointestinal system (GI).

Barium

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characteristics of barium

is a metal
does not dissolve
suspended
in solution.

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All positive contrast agents, except barium, used
in diagnostic imaging contain

iodine

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another type of contrast used for GI
imaging

Gastrografin

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iodine atomic number

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baium atomic number

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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

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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

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Most contrast agents are

water-based

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oil-based contrast
agent. These may be excreted from the body in ____

natural manner or may be removed at the end of the
procedure.

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Iodinated contrast agents are administered

OVIIa
oral, vaginal, intravenous, and intra-arterial routes

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contrast
agents are often administered in a large dose at one
time called a

bolus

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Most drugs used for treating illness
that are administered intravascularly are

isotonic.

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why most drugs administered intravascularly are isotonic

they have the same concentration of solute as other
body fluids

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Two commonly used iodinated substances

iothalamate and diatrizoate

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iothalamate and diatrizoate contains

meglumine and sodium salts or combination

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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:

1. Patients with a history of previous adverse reaction to contrast agents 2. Patients with asthmatic conditions 3. Patients with known cardiac conditions 4. Patients who are severely debilitated 5. Patients at high risk for contrast extravasation 6. 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

by mouth

intramuscular

intravenous

STAT

at once

verbal order

SC or SQ

subcutaneous

intradermal

bid

twice a day

gtt

drop

cubic centimeter

before meals

after meals

at bedtime

PRN

as necessary

every

every day

three times a day

tid

every 2 hours

q2hrs

milliliter

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

1. Slow the rate of the contrast infusion. 2. 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

1. Stop the infusion of contrast medium. 2. Place the patient in flat or Trendelenburg position. 3. Notify the radiologist. 4. 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

1. Stop the infusion. 2. Notify the radiologist and the radiology nurse. 3. Call for the emergency team if symptoms progress rapidly. 4. Remain with the patient and offer reassurance. 5. Prepare to administer oxygen and intravenous medications. 6. If the patient is in respiratory distress, place him in semi-Fowler’s position. 7. 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)