Medications and Contrast

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55 Terms

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Chemical Name

  •  identifies the chemical of the drug 

  • Example: (RS)-2-4 

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Generic Name

  • name given to a drug when it becomes commercially available

  • Example: Ibuprofen, aspirin

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Trade (brand) name

  • name given by a drug a particular manufacturer 

  • Motrin, teneylo (have the same active agent)


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Drug families

  • drugs that have similar actions (beta blockers) 

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Legal classification

  • Prescription: require order from a MD 

  • Non-prescription: “over the counter” (so many people needed it)

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Dosage forms

  • Tablets: power shaped into a disk 

  • Suspensions: small particles suspended (not mixed )

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Route

  • Enteral: by GI tract 

  • Parenteral: route other than GI tract 

  • Topical: through skin 

  • Contrast Media: most important pharmaceutical in radiology

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Drug Administration Patient Rights

  • 1. Right Medication 

  • 2. Right Amount (most mistakes)

  • 3. Right Patient (most mistakes)

  • 4. Right Time (most mistakes ) 

  • 5. Right Route 

  • 6. Right Documentation & reaction 

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Legal Responsibility

  •  1. Record the name of medication (what was it) 

  •  2. Record the route taken (oral or rectal) 

  •  3. Record the amount of medication administered (dose) 

  •  4. Record the time of administration (period) 

  •  5. Record the patient reactions to the medication administered 

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Pharmacodynamics

  • what the drug does to the body 

  • How the the drug interact

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Pharmacokinetics

  •  what the body does to the drug 

  • How does it break down? Look at the liver!

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Pharmacogenetics

  • how genes affect drug response

  •  How do genetic variations affect metabolism and the effect of the drug? 

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Analgesic

  •  Control without losing consciousness 

  • Example: Narcotics (opioids) and non-carocotis 

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Anesthetic

  • Suppress nerve function, loss of pain and sensations 

  • Example: General anesthesia

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Antianxiety

  • Treat anxiety, calm and relax person 

  • Example: Ativan and Valium 

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Antiarrhythmics

  • Treat abnormal heart rhythms 

  • Example: Amiodarone 

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Antibiotics

  • Kill or inhibit growth of microorganism

  •  Penicillin and Ciprofloxcin 

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Anticholinergics

  • Reduce muscle tone and motility of GI tract and effect salivary glands and respiratory tract 

  •  Example: Diropan 

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Anticoagulants

  • Prevent clotting of the blood 

  • Ex: Heparin, Warfarin, and Eliquis

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Antidepressants

  • Treat depression 

  • Ex: Prozac, Zoloft, Cymbalta, Wellbutrin 

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Antidiabetics

  • Treatment of diabetes 

  • Ex: Type 1 Insulin/Type 2 Glucophage and Metformin 

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Antiemetics

  • Treat vomiting and neusa 

  • Ex: Zofran 

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Antihistamines

  •  Allergic reaction 

  • Benadryl, Claritin, Allegra

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Antihypertensive

  •  Treat high BP 

  • Ex: Lopressor and ACE inhibitors 

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  • Anti-inflammatory

  •  Treatment of inflammation 

  • NSAIDS (motrin) 

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Antiseptic

  • Reduce infection risk 

  • Hydrogen peroxide and alcohol

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Antiviral

  •  Inhibit development of viral agents

  • Ex: Zovirax

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Bronchodilators

  • : Treat asthma and CPD

  • Ex: Albuterol 

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Cathartic/laxative

  •  Speeds up bowel movements

  • Ex: GoLYTELY, Dulcolax, Magnesium Citrate 

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Antidiarrheal

  • Treatment of diarrhea 

  • Imodium

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Coagulants

  •  Speeds up blood clotting 

  • Ex: Mephyton 

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Corticosteroids

  •  Chronic inflammation 

  • Hydrocortisone 

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Diuretics

  •  Increase the amount of urine; used to treat emdema or CHF 

  • Lasix

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Hormones

  •  Various effects on endocrine system 

  • Estrogen, progesterone 

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Sedatives

  • Mild sedation/sleep 

  • Ex: Ambien

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Vasodilators

  • Dilates blood vessels

  •  Ex: Nitroglycerin  

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Vasoconstrictors

  • :Constrict blood vessels; increase blood pressure

  •  Ex: Norepinephrine

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Contrast media

Creates the ability to visualize anatomic structures that are not normally seen on a diagnostic image

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Health Professional Responsibility:   

  • Administered under MD 

  • Perform patient assessment and get a through history 

  • May need to complete informed consent 

  • Emphasize patient care, comfort, and education  

  • Recognize signs and symptoms of reaction and act appropriately

  • Continuously monitor patient 

  • Post-exam consideration for patient 

  • Remain calm, confident, and reassuring during producers 

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Contrast Media: 

  • Generally classified as negative (appear dark on the image or positive agents (appear bright on the image) 

  • Requires attention to indications and contraindications 

  • Some require a thorough patient history and warrants serious attention to patient reactions 

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Types of Contrast (Negative)

  • X-ray beam passes through to the image receptor 

  • Appear radiolucent (dark) 

  • Ex: Air, Co2

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Types of Contrast (positive)

  • X-ray beam is absorbed by contrast agent, does not reach the image receptor 

  • Appear radiopaque (light) 

  • Examples: Barium, iodinated Contrast

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Typical Contrast Media Choices

  • Barium Sulfate (atomic number 56) 

  • Air/gas (CO2) (average atomic number 8) 

  • Oil-based iodine (atomic number 53) contrast agents 

  • Water-soluble iodine ( atomic number 53) contrast agents 

  • Visualization of contrast media depends upon the atomic number and concentration of the atom of the element per volume of the contrast material 

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Barium Sulfate 

  • BaSO4 

  • Compound 

  • Colloidal suspension- does not dissolve in water 

  • Inert physiologic activity within human body 

  • Used in many GI studies 

  • Push fluid following barium studies 

  • Better with cold water

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Barium Studies of the GI tract 

  • Barium is contraindicated  in suspected cases of bowel perforations post abdominal surgery, or rarer cases of allergic reaction 

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Gastrografin

  • Water-soluble iodinated-based contrast media used as a substitute for barium in GI studies in the following instances:

  • Post surgery 

  • Bowel obstruction 

  • Suspected perforation

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Ionic

  • When injected into bloodstream will dissociate two ions 

  • High Osmolality

  • Increased risk of allergic reaction

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Non-ionic

  • When injected into bloodstream will remain as a single compound 

  • Low osmolality 

  • Dec risk of allergic reaction compared to ionic agents 

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Advantages of non-ionic contrast

  • Does not dissociate

  • Lower osmolality

  • More water soluble 

  • Less likely to cause a reaction in a patient 

  • Tolerated better by patients   

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Ionic and Non-ionic contrast Media Considerations

  • Patient history/condition 

  • Previous contrast media give 

  • Renal function

  • BUN 

  • Creatinine 

  • Cost 

  • Diabetic patient taking Metformin or glucophage or similar medications

  • Recant other imaging studied with iodinated based contrast media 

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Systemic Ionic and Non-Ionic Contrast Media Reactions

  • Generally occur within 1st mins

  • Unpredictable 

  • Mild reaction can worsen 

  • Reactions diff than side effects

  • Must look at patent always 

  • Types of reactions: mild, mordrate, and severe/anaphylaxis 

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 Ionic and Non-Ionic Contrast Media Typical Side Effects

  • Flushed feeling that goes away quickly 

  • Strange taste in mouth (metallic) 

  • Peeing pants

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Mild Reactions

  • Any symptoms: Document all reactions 

  • Anxiety: Reassure patient 

  • Nausea vomiting: Turn to side and provide emesis 

  •  Syncope (faniting): Be observant 

  • Itching mild urticaria: Infor nurse 

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Moderate Reactions

  • Moderate to severe urticaria (hives)

  • Laryngeal swelling (choking sensation) 

  • Angioedema (soft tissue swelling)

  • Moderate hypotension 

  • Moderate tachycardia

  • Moderate bradycardia 

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Severe Reactions

  • Hypotension 

  • Bradycardia 

  • No detectable pulse

  • Laryngeal swelling 

  • Loss of consciousness

  • Seruizers 

  • Cardiac arrhythmias 

  • Cardiac arrest 

  • Respiratory arrest

  • Call code