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The study of the effect or outcome elicited by drugs when they reach the site of action:
pharmacodynamics
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The three pharmacodynamic effects of drugs are:
therapeutic, diagnostic, adverse
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Diagnostic effects of intravascular ROCM are a function of the:
iodine contained within them
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Serum iodine concentration for x-ray must be within the range of:
280-370 mg/ml
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ROCM must contain ____ proportion of iodine and injected at a rate ___ than blood flow.
large; greater
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For CT or angiography, serum iodine concentration musts be in the range of ____-____ and injected at a rate ___ than blood flow:
2-8 mg/ml; slower
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One out of every ___-___ patietns receiving ROCM dies from adverse effects.
20,000-40,000
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Adverse effects of ROCM depend on:
serum or tissue iodine concentration, osmolality, calcium chelation, anti-coagulation, and immune system stimulating abilites
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ROCM increases osmotic pressure; termed:
hyperosmolar
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Heart rhythm disturbance characterized by electrical impulses without cardiac contraction:
PEA; pulseless electrical activity
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Calcium chelation caused by ROCM may result in:
PEA, cardiac arrest and sudden death
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Aticoagulation effects may be caused by ____ ROCM:
high-osmolality
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Immediately life-threatening systemic hypersensitivity reaction:
Anaphylaxis
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Anaphylaxis is generally referred to as a type 1 hypersensitivity reaction, which requires a:
first time reaction in the patient's history
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Reaction that mimics the anaphylactic reaction, but no prior exposure to ROCM is necessary to 'sensitize" the mast cell:
anaphylactoid
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ROCM are responsible for approximately 10% of all:
acute renal failure (ARF)
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Urine output of less than 400 ml/day:
Oliguric ARF
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A condition in which the body becomes unable to tolerate thyroid hormones:
decompensated thyrotoxicosis
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Iodine from ROCM may cause the thyroid to produce amounts of thyroid hormone that exceed the body's tolerance level in patients with decompensated thyrotoxicosis:
Thyroid Storm
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ROCM may cause sickling of RBCs or ARF in patients with:
sickle cell anemia/multiple myeloma
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Adverse CNS effects of ROCM:
nervousness, anxiety, confusion, tremors, agitation, seizures.
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An expected outcome of injected contrast media is a ____ while an unexpected outcome is a ___.
side effect/reaction
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Common side effects of ROCM:
metallic taste and temorary hot flash
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Why should ROCM not be used in pregnant patients?
Because it crosses the placental barrier
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Signs and sypmtoms of _____ include fever, tachycardia, diaphoresis, agitation, nervousness, and emotional instability.
Thyroid Storm
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What are used to improve delivery of ROCM to small arteries that may be inaccessible otherwise?
Vasodilators
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5 rights of drug administration:
Right: patient, drug, amount, time and route
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Common routes of administration:
Oral, Sublingual, Topical, Rectal and Parenteral
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Most common method of drug administration:
Oral
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Why is oral administration the most perferred route?
Safest, most econoical and convenient
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Most drugs undergo absorption in the:
small intestine
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When a drug is given orally rather than parenterally, the effects are generally:
slower and less efficient
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A major advantage of the oral route is that it allows for the easiest:
retrieval of a drug in overdose situations
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Drugs administered vie the sublingual route will gain access to the general circulation without traversing the _____ or being affected by gastric and intestinal ____.
liver; enzymes
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Drug administration route used when the oral method is unsuitable:
rectal route
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The four most common methods by which drugs are administered parenterally:
intradermal, subcutaneous, intramuscular, intravenous
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Most hazardous route by which to give a drug:
Parenteral
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Direct injection into a vein is warranted when:
immediate effects of a drug are desired
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Most common intravenous injection sites:
Basilic/cephalic veins on back of hand, basilic vein on forearm/elbow, cephaic vein on forearm/elbow, medial cubital vein (most common)
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Drug/blood leakage into the tissues surrounding a vein is termed:
extravasation
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If extravasation occurs:
remove needle immediately, apply pressure, and warm moist cloth to site
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Contraindications to Barium Sulfate:
pre-surgical patients, perforated alimentary canal, large intestine obstruction
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Contraindications to water soluble contrast media:
young/dehydrated patients or sensitive to iodine
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If two incompatible drugs must be administered to a patient:
saline flashing is advisable to avoid drug-drug interaction
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The difference between conscious sedation and general anesthesia is the:
dose
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Medications in the radiology department used for conscious sedation include:
barbituate, benzodiazepine, and opiate analgesic
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The highest survival rate of cardiac arrest occurs in patients who receive CPR within __ minutes and who are additionally provided medications within __ minutes.
4/8
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The most valuable, potentially life-saving therapeutic agent available to cardiac arrest victims:
epinephrine
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Two groups of microorganisms:
helpful (normal microbial flora) and harmful (pathogens)
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Microorganisms capable of causing disease are:
microorganisms
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Any place where pathogens can trhive in sufficient numbers to pose a threat:
reservoir of infection
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Any route through which blood or fluids leave the body:
portal of exit
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Suceptible hosts include:
patients with reduced natural resistance or prone to nosocomial infections
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The route by which microorganisms gain access to the host:
portal of entry
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Transmission of disease, 6 routes:
direct contact, fomite, vector, vehicle, airborne contamination, droplet contamination
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A nonliving material such as a bed linen that may transmit microorganisms:
fomite
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An organism that can harbor and transmit disease:
vector
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Droplets <5 microns:
airborn contamination
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Droplets of >5 microns:
droplet contamination
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Three defense mechanisms:
Natural resistance, acquired immunity, passive immunity
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The destruction of pathogens by using chemical materials:
disinfection
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Free of living microorganisms, the process of destroying all microorganisms:
sterilization
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