Al H 116/Rad T 216

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Al H 116/Rad T 216

• Adler/Carlton Ch 18 and 19
• Pharmacology and Contrast Media

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Drug Nomenclature

• Classification by
• Name
• Action
• Legal

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Dosage Forms

• Tablet MC oral dosage form
• Capsule
• Inhalation
• Suppository
• Solution
• Suspension
• Transdermal patch

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Actions, Indications, and Precautions

• Analgesics relieve pain
• Opioid narcotic
• Non-opioid tylenol
• Anesthetics act on CNS to produce a loss of
  sensation
• General
• Local

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• Anti-anxiety
• Diazepam valium
• Anti-arrhytmics
• Antiobiotics
• Anti-cholinergics- anti-spasmodics reduce
  smooth muscle tone

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• 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

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• Antihistamines treat allergic reactions
• Sedating diphenhyramine(benadryl)
• Non- sedating loratadine(Claritin)
• Antihyperlipidemis control blood fat
• Antihypertensives
• Anti-inflammatory NSAID
• Antiplatelets pervent coasgulation

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• Vasoconstrictors used to treat shock
• Vasodilators treat angina

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Routes of Administration

• Oral
• Sublingual
• Topical
• Parenteral by injection
• Intramuscular
• Subcutaneous
• Intravenous

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• Ampule scored neck
• Vial sealed rubber top

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Purpose of Contrast Media

• Visualize anatomic detail
• Radiolucent negative
• Allows photons to easily pass thru
• Radiopaque positive
• Absorbs more photons

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Positive Contrast Media

• Barium sulfate
• Atomic number 56
• Used as a suspension
• Flocculation fall out of suspension

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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

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Osmolality

• Number of particles in solution per kilogram
• Most contrast reactions are related to osmolality

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Non-ionic Contrast Media

• These DO NOT dissolve in solution
• Also they are more hydrophilic soluble in
  water- ie they mix well together

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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

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• Renal effects
• Can cause renal arterial constriction thereby
  decreasing blood flow to the kidneys

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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.

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Scheduling on Contrast Exams

• Elderly or debilitated
• Diabetic
• Children
• Adults