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Al H 116/Rad T 216. Adler/Carlton Ch 20 and 21 Pharmacology and Contrast Media. Drug Nomenclature. Classification by: Name Action Legal. Dosage Forms. Tablet – MC oral dosage form Capsule Inhalation Suppository Solution Suspension Transdermal patch.
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Al H 116/Rad T 216 Adler/Carlton Ch 20 and 21 Pharmacology and Contrast Media
Drug Nomenclature • Classification by: • Name • Action • Legal
Dosage Forms • Tablet – MC oral dosage form • Capsule • Inhalation • Suppository • Solution • Suspension • Transdermal patch
Actions, Indications, and Precautions • Analgesics – relieve pain • Opioid – narcotic • Non-opioid – tylenol • Anesthetics – act on CNS to produce a loss of sensation • General • Local
Anti-anxiety – • Diazepam – valium • Anti-arrhytmics • Antiobiotics • Anti-cholinergics- anti-spasmodics – reduce smooth muscle tone
Anti-coagulants • Antimetics – prevent and treat nausea • Diuretics – increase urine production • Emetics – induce nausea nad vomiting • Sedatives – depress the CNS – chloral hydrate • Thrombolytics – dissolve clots tPA
Antihistamines – treat allergic reactions • Sedating – diphenhyramine(benadryl) • Non- sedating – loratadine(Claritin) • Antihyperlipidemis – control blood fat • Antihypertensives • Anti-inflammatory – NSAID • Antiplatelets – prevent coagulation • Vasoconstrictors – used to treat shock • Vasodilators – treat angina
Routes of Administration • Oral • Sublingual • Topical • Parenteral – by injection • Intramuscular • Subcutaneous • Intravenous
Ampule – scored neck • Vial – sealed rubber top
Purpose of Contrast Media • Visualize anatomic detail • Radiolucent – negative • Allows photons to easily pass thru • Radiopaque – positive • Absorbs more photons
Positive Contrast Media • Barium sulfate • Atomic number 56 • Used as a suspension • Flocculation – fall out of suspension
Water-soluble Iodine Contrast Media • Ionic • Atomic number 53 • Ionic because the solution dissolves in water • Anion – negative charge • Diatrizoate • Metrizoate • Iothalamate • Cation – positive charge • Sodium • Methylglucamine - megulmine
Osmolality • Number of particles in solution per kilogram • Most contrast reactions are related to osmolality
Non-ionic Contrast Media • These DO NOT dissolve in solution • Also they are more hydrophilic – soluble in water- ie they mix well together
General Effects of Contrast Media • Osmotic effects • Ionic media dissociate in water they create more particles and displace more water. Consequently, water moves from the cells into the blood. • Allergic – like effects • May be caused by the release of histamine • Pre-medication may help
Renal effects • Can cause renal arterial constriction thereby decreasing blood flow to the kidneys
Drug Interactions and Considerations • Beta blockers • Reduce cardiac output, reduce dilatation of smooth muscle, and block epinephrine. Increased risk of anaphylactoid reactions • Calcium channel blockers • Reduce hypertension. Risk of heart block and decreased blood pressure • Metformin • Diabetics. Cease drug adminstration 48 hours before and after injection. Causes lactic acidosis.
Scheduling on Contrast Exams • Elderly or debilitated • Diabetic • Children • Adults