Patient Care ch 5

ASRT Scope of Practice

•Performing venipuncture as prescribed by a licensed practitioner.

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•Starting, maintaining and/or removing intravenous access as prescribed by a licensed practitioner.

•Identifying, preparing and/or administering medications as prescribed by a licensed practitioner.

ASRT Practice Standard

•Radiographers prepare, administer and document activities related to medications and radiation exposure in accordance with federal and state laws, regulations or lawful institutional policy.

•Standard 4 - Monitors the patient for reactions to medications.

Professional Liability

•The professional radiographer who administers drugs is expected to know the safe dosage, the safe route of administration, and the limitations of the drug to be administered. All potential hazards of any drug that is incorrectly or unsafely administered must also be known. If drug administration errors are made because of lack of knowledge, the person who administers the drug is legally liable.

Negligence

Court decisions against a health care provider may be centered on what another provider in your profession would have done under the same circumstance to determine if your actions were appropriate or inappropriate (negligent). Negligence of duty is malpractice

•Employer Prerogative:

•Free will of management to conduct its own affairs to achieve its purpose.

• However, the exercise of its management prerogative through policies, rules and regulations on work-related activities of the employees must always be fair and reasonable and the corresponding penalties, when prescribed, commensurate to the offense involved and to the degree of the infraction.

•Drug

Any substance that, when taken into a living organism, may modify one or more of its functions

•Pharmacology

Study of drugs and their origin, nature, properties, and effects on living organisms

Classifications

•Nomenclature

•Chemical group (Action)

•Method of Legal Purchase

•Mechanism and site of action

•Primary effect

Nomenclature

(classified system of names)

Chemical Name

N-acetyl-p-aminophenol, C8H9NO2

Generic Name

acetaminophen

Trade/Brand Name

Tylenol

Chemical Group

(Action or Function)

Chemical Group is Grouped into FAMILIES that have similar chemical actions

Family: Relieve Pain àanalgesics

Family: Treat high BP à antihypertensives

Family: fight inflammation à anti-inflammatories

Legal Purchase

Prescription vs. Non-prescription

Mechanism and site of action

A term used to describe how a drug or other substance produces an effect in the body

•Provides information about the safety of the drug

Primary Effect

•Desired therapeutic effect of the drug

•Therapeutic Index/Range

•Measures the safety of a drug

•The relation between dosage at which the intended effect of a drug is obtained and the amount that produces an unwanted effect

Analgesics

•Relieve pain without causing loss of consciousness

Two groups of Analgesicis

•Opioid (narcotic) 
•Nonopioid (non-narcotic)

•Nonopioid (non-narcotic)

•Treat mild to moderate pain

•acetaminophen (Tylenol)

•Opioid (narcotic)

•Treat moderate to severe pain

•Morphine; oxycodone (OxyContin)

•Side Effects: nausea, vomiting, constipation; can be very harsh to the GI system

•Overdose of opioid = naloxone (Narcan) parenterally or intranasally administered

Anesthetics

•Reversibly depress neuronal function, producing loss of ability to perceive pain and/or other sensations

Two types of anesthetics

General

Local

General

•Produce muscle relaxation and loss of consciousness

•Inhalation : sevoflurane (Ultane)

•IV : propofol (Diprovan)

Local

•Block nerve conduction from an area of the body to the central nervous system

•mepivacaine (Carbocaine); lidocaine (Xylocaine); procaine hydrochloride (Novocain)

Anesthetics Side effects

•irregular heartbeat, seizures, breathing issues, death

Antianxiety (Anxiolytics)

•Treatment of anxiety; Act on the Central Nervous System to calm/relax anxiousness

•Benzodiazepines

•used often as a pre-operative drug for procedures (anxiety), relieves muscle spasm, and seizures

•diazapam (Valium)

•lorazepam (Ativan)

•alprazolam (Xanax)

•midazolam (Versed)

Anticholinergics

•Reduce smooth muscle tone, motility of the GI tract, and secretions from respiratory tract and secretory glands

Two types of anticholinergics

•Oxybutynin (Ditropan XL) & tolterodine (Detrol LA)

•Atropine

•Atropine

used preoperatively to inhibit the secretions that can be stimulated by general anesthetics and to prevent bradycardia

•Oxybutynin (Ditropan XL) & tolterodine (Detrol LA)

•Use for the treatment of overactive bladder

Anticholinergics side effects

•Dry mouth

•Delirium (high doses)

Antiarrhythmics

•Treat (arrhythmias) variations from normal rhythm of the heartbeat

•Depends on type of arrhythmia

•Amiodarone (Cordarone) –used for ventricular arrhythmias

Antiarrhythmics side effects

Could cause adverse effects such as hypothyroidism and pulmonary fibrosis

Anticonvulsants (antiepileptic)

•Used to prevent or control the occurrence of seizures

•DO NOT treat the CAUSE of seizures

••Some types are available as oral or parenteral

•Not only treats seizures, but certain types can help with bipolar disease and fibromyalgia

Types of Anticonvulsants (antiepileptic)

divalproex (Depakote)

Phenytoin (Dilantin)

Anticonvulsants Side effects

Liver toxicity, thrombocytopenia, pancreatitis

Antidiabetic

•INSULIN

• only treatment used to treat Type 1 but also used for Type 2

•Type 2 medications: Micronase, Glucotrol, Amaryl, Glucophage (metformin), Actos, Januvia, Victoza, Invokana

Antidiabetic Complications

• hypoglycemic reactions

•Recommended to temporarily discontinue metformin before x-ray contrast used to prevent renal function issues

Anticoagulants

Inhibit clotting of the blood (increase coagulation time)

•Prevent/treat thromboembolic disorders

•Patients undergoing IR procedures receive anticoagulants

•IV: Heparin; enoxaparin (Lovenox)

•Oral: Warfarin (Coumadin)

Coagulants

•Control hemorrhage or speed up coagulation

•Oral and IV: Phytonadione (Mephyton)

Antidepressant

•Treatment of depression; panic disorder; OCD; and depressive state of bipolar disorder

•fluoxetine (Prozac)

•sertraline (Zoloft)

•paroxetine (Paxil)

•duloxetine (Cymbalta)

•bupropion (Wellbutrin)

Antidepressant treatment

•of 6-12 weeks for maximum effect

•Drug interactions can occur if receiving drugs in combination with

•antidepressants

Antidepressants side effects

•nausea, vomiting, diarrhea

Antiviral

•DOES NOT DESTROY their target pathogen; instead they inhibit its developments

Antiviral treats

•herpes simplex, chicken pox, shingles, flu, hepatitis, and infection from HIV 

Zovirax

available as oral, topical and parenteral forms

Antiviral side effects

Nausea, vomiting, diarrhea, and headache

Antiemetic

Prevent/treat nausea and vomiting

Antiemetic

•Most effective in prevention versus after the symptoms have started

•Oral and IV: prochlorperazine (Compazine); ondansetron (Zofran)

•Reduces motion sickness

metoclopramide (Reglan)

prochlorperazine (Compazine)

dimenhydrate (Dramamine)