Drug Classifications by Name:
Chemical Name
Generic Name
Trade (brand) Name
What network allows for the research of a drug by both its generic and brand name, as well as side effects, accepted uses, contraindications, and doses?
The Physician’s Desk Reference (PDR)
Drug Classification by Action is:
Not always reliable or exclusive due to drugs having multiple effects on the body
Drug Classification the Law:
Prescription
Non-Prescription (over-the-counter)
Dietary Supplements (not FDA regulated)
The form of a drug’s dose determines:
speed/onset of the therapeutic effect
Dose Forms:
Tablets
Capsule
Inhalant
Suppository
Solution
Suspension
Transdermal Patch
Tablets are:
the most common oral dose form
What is the difference between Tablets and capsules?
Capsules are able to be broken open and have their contents dumped out (liquid, powder) whereas tablets cannot. Tablets also typically have a delay whereas capsules dissolve in the stomach
Suspensions must be:
shaken
Suspensions can never be:
administered through IV
The effect of solutions are:
rapid
Transdermal patches have a:
gradual absorption
Analgesics Examples
Opioids (morphine, OxyContin), non-opioids (Tylenol)
Types of Anesthetics:
General (loss of consciousness)
Local (block nerve conduction to a specific area)
Anesthetics Examples:
Lidocaine, Diprivan
Anti-Anxiety Agents Examples:
Benzodiazepines- Valium, Ativan, Versed
Antiarrhythmics Examples:
Digoxin
Anticholinergics Examples:
Ditropan, Detrol (overactive bladder), Atropine (prevention of bradycardia)
Anticoagulants Examples:
Heparin, Coumadin
What additional precaution should be taken when dealing with an IR patient on an anticoagulant?
They must be monitored to prevent massive hemorrhages
Anticonvulsants Examples:
Dilatin, Klonopin
Can anticonvulsants treat the cause of a seizure?
No
Antiemetics Examples:
Zophran, Compazine
When are antiemetics most effective:
Before the onset of symptoms
Antihistamine Examples:
Benadryl
What kinds of symptoms can antihistamine treat?
Acute or chronic
What situation can antihistamines be used for in radiology?
When administering contrast to someone who has known reactions to contrast
Antihypertensives Examples:
Zenstril (heart failure), Norvasc (angina pectoris)
Antipsychotics Examples:
Haldol, Zyprexa
What is especially important to remember when guiding/maneuvering a patient who is on antipsychotic medication?
They could experience orthostatic hypotension much easier/faster than a patient who is not on antipsychotic medication
Antiulcer Agents Examples:
Zantac, Pepcid, Prevacid, Prilosec (reduces acid production), Reglan (increases peristalsis and gastric emptying)
Bronchodilators Examples:
Albuterol (fast acting), Spiriva (long acting)
Diuretics Examples:
Lasix (congestive heart failure associated edema, used in conjunction with an antihypertensive)
Sedatives and Hypnotics Examples:
Ambien, Choral Hydrate (children)
Stimulants Examples:
Dobutamine, Dopamine (hypotension and shock), Epinephrine
Thrombolytics Examples:
Alteplase (tPA) (acute MI and stroke) (side effect: bleeding)
In what instances are blood thinners especially important to be aware of when interacting with a patient?
Whenever blood is drawn from the patient or the patient’s skin is otherwise broken. Blood will not clot as fast as with a patient not on blood thinners
Vasoconstrictors Examples:
Norepinephrine (shock treatment) (can cause necrosis if it infiltrates)
4 Basic Factors of the Movement of Drugs:
Absorption
Distribution
Metabolism
Excretion
What types of people may respond differently to drugs?
Older Patients (65+)
Response Factors:
Idiosyncratic Reactions
Side Effects
Allergies
Of the response factors, which can be the most unpredictable and life-threatening?
Idiosyncratic Reactions
Levels of Sedation:
Minimal (responds to verbal commands)
Moderate/Conscious (slowly responds to purposeful commands)
Deep (not easily aroused)
General (responds to no stimuli)
IM
Intramuscular
IV
Intravenous
mL
milliliter
mM
millimeter
PO
by mouth
Prn
as needed
SQ
Subcutaneous
STAT
Immediately
Patients rights:
Right drug
Right amount
Right Patient
Right time
Right route
The right drug:
Check label and name carefully, never use unlabeled, always check expiration date
The right amount:
Measure carefully and accurately, select right size and type of syringe
The right patient:
Check armband, ask patient to state their name
The right time:
Practitioner determines the time it should be administered
The right route:
Physician determines the route that should be used
Necessary Charting Information:
name
dose
route
date/time
What should you do if an error in charting or an adverse effect occurs?
Document the details of the incident thoroughly
Most common legal problem amongst technologists:
Errors in drug administration
When making a written error in a patient chart:
cross out with 1 solid line
write initials and time, as well as a correction next to it
use blue/black ink only
A patient’s chart is considered:
a legal document
Syringe parts:
Plunger
Barrel
Tip
Needle parts:
Bevel
Cannula/shaft
Hub
Needles vary according to:
gauge and length
After use of a needle and syringe:
both the needle and syringe must be discarded (sharps and biohazard containers)
Enteral Routes:
Oral
Sublingual
Buccal
Rectal
Parenteral Routes:
Intradermal
Intramuscular
Subcutaneous
Intravenous
Bolus
Drip Infusion
Radiopaque areas on an x ray will appear:
white, bright
Radiolucent areas of an x ray will appear:
dark
Types of Radiolucent (negative) contrast media
air, gas producing tablets, crystals
Complications from using air as a contrast media:
emboli
Does a high or low atomic number indicate if a contrast medium will be radiopaque?
high
What is a contraindication for the use of barium sulfate?
perforation in the GI tract
When using barium sulfate to study the small intestine, what is added in addition to the contrast media? (also has a laxative effect)
methylcellulose
If perforation of the GI tract prevents use of barium sulfate, what is used instead
water soluble iodine contrast
Adverse reactions to barium sulfate:
obstructions from residual barium
perforation from the catheter
vaginal rupture
increased risk of aspiration (if patient is sedated)
Areas of the body that we use barium for:
Esophagus
Stomach
Small intestine
Large intestine
Why does ionic iodine contrast media cause more adverse reactions?
It has a higher osmolality and therefore causes more extreme effects on the body as a result
Lower osmolality contrast media:
less adverse reactions
more expensive
hydrophilic (dissolves into water more easily)
Usage of iodinated contrast:
Brain
Thorax
Spine (nonionic only)
Urinary system
Heart
Viscosity of contrast media affects:
injectability (heating contrast media can help with this)
Osmotic effects of ionic contrast media:
The contrast can draw water from the cells of the body into the vascular system, which can cause blood vessels to dilate
Allergic reactions can be divided into:
mild (hives)
moderate
severe (anaphylaxis)
Renal effects of high osmolality contrast media:
Can cause dilation and then subsequent constriction of the renal arteries. Increased creatinine levels can indicate that contrast media-induced renal effects. GFR is the best indicator for kidney function.
If a patient experiences swelling and a burning sensation around the injection site when injecting contrast and the contrast has been warmed, what does this indicate?
infiltration of the contrast
Perforation can cause:
free air in the abdominal cavity
What is the atomic number of water-soluble Iodine contrast?
53
What is the atomic number of barium sulfate contrast medium
56
Why is visipaque such an ideal Iodine contrast media?
It’s nonionic and has the same osmolality as the human body, therefore causing minimal interactions with the body
What reactions are considered typical for injection of contrast media
feeling flushed or the urge/sensation of peeing oneself during the injection
What type of patient is especially important to obtain a thorough history of before injection of contrast?
Diabetics, especially non-insulin dependent diabetics
What two factors help determine if it is safe to inject a patient with contrast?
a creatinine lab test and using the results to obtain a GFR
What medication is a contraindication or at least must be discontinued before the injection of contrast in a diabetic person
Glucophage/Metaformin
What is the distribution of radiopharmaceuticals dependent on?
the route of administration
What are the types of radiation contamination sources?
External
Internal
Sources of radiation contamination:
the patient, floors, personnel, equipment, surfaces
When was contrast media first introduced?
1896 (contrast was toxic, such as bismuth subnitrate)
When was air first used in studies of children with hydrocephalus?
1918
When was the usage of nontoxic iodine contrast with water soluble carriers first used?
1930