Ch. 7 pharmacodynamics of radiopaque contrast media

Question 1

Define pharmacodynamics

Answer 1

study of the actions or outcome elicited by drugs when the site of action is reached.

Question 2

study of the actions or outcome elicited by drugs when the site of action is reached.

Answer 2

pharmacodynamics

can be :
Therapeutic
Diagnostic
Adverse

Question 3

Which drug can be therapeutic
Diagnostic and
adverse

Answer 3

Gastrografin

Question 4

Adverse effects of IV ROCM depend on:

Answer 4

1. Serum or tissue iodine concentration

2. Calcium chelating , anticoagulant & immune system stimulating abilites

Question 5

to show vascular lumen on x-ray serum iodine concentration must be ______ mg/ml

Answer 5

280-370 mg/ml

Question 6

Serum iodine concentration needs to be injected as a ____, at a _____ rate than blood flow

Answer 6

bolus

higher rate

Question 7

1 in ______ patients dies from adverse effects of ROCM

Answer 7

20-40,000

Question 8

ROCM has a ____ osmolar weight than bloodstream

Answer 8

higher

Question 9

After injection of ROCM _____ system dilutes it producing intravascular hypoosmolar state

Answer 9

Cardiovascular system

Question 10

What are the 2 receptors in the carotid arteries

Answer 10

1. Baroreceptors

2. Chemoreceptors

Question 11

vagus nerve is stimulated by ____

Answer 11

vascular hypertension

Question 12

Hyperosmolar ROCM injection into the carotid results in _____.

Answer 12

Intraarterial osmotic pressure changes

Question 13

Intravascular osmotic fluid shifts can cause ___

Answer 13

acute heart failure

Question 14

What are 3 signs and symptoms of acute heart failure caused by intravascular osmotic fluid

2. What is the treatment

Answer 14

1. Respiratory difficulty
2. Tachycardia/ bradycardia
3. Hyper or hypotension

1. Diruretics
2. Cardiac stimulators

Question 15

Chelate means ___?

Answer 15

to bind to

Question 16

ROCM can chelate ( bind to) ____ ions in cardiovascular system

2. What does this binding cause

Answer 16

calcium

1. cardiac arrest
2. Pulseless electrical activity (PEA)
3. Sudden death due to v-tac or v-fib

Question 17

What effect does high osmolality contrast have on the blood

Answer 17

causes blood to thin

results in bleeding or bruising

Question 18

Immediately life threatning , systemic hypersensitivity reaction

Answer 18

Anaphylaxis

= the allergic reaction

Question 19

Name 3 symptoms of anaphylaxis caused by mast cells

Answer 19

1. Nausea
2. Vomiting
3. Hives

Question 20

First time being exposed to an allergen is known as

Answer 20

Anaphylactoid reactions

Just as lethal as anaphylactoid

Question 21

Second or subsequent interaction with allergen

Answer 21

anaphylactic

Question 22

ROCM is responsible for _____ % for all acute of renal failure

Answer 22

10 %

Question 23

What are symptoms of Acute renal failure

Answer 23

1. Renal tubular toxicity
2. Renal ichemia
3. Toxic oxygen radicals

Question 24

If creatinine is high this indicates ____

Answer 24

renal failure

Question 25

List the 4 main drugs given in radiology after ROCM that prevent renal dysfunction

Answer 25

1. Half-normal saline 2. Fenoldopam 3. Acetyl cysteline 4. Sodium bicarbonate

Question 26

What is the most preventative measure that once can perform to prevent renal dysfunction

Answer 26

hydration *Use half-normal saline (.45%)

Question 27

Iodine in ROCM can cause the body to become untolerable to thyroid hormones. This is known as ____ List 2 signs

Answer 27

decompensated thyrotoxicosis 1. Fever 2. Tachycardia

Question 28

List general adverse reactions to ROCM

Answer 28

* metallic taste * Flushing * Feeling of warmth

Question 29

List adverse CNS effects that can occur due to ROCM

Answer 29

* Confusion * Anxiety * Nervousness

Question 30

Does ROCM cross the placental barrier?

Answer 30

Yes

Question 31

What are adverse reactions to galdolinium

Answer 31

1. Headache 2. Syncope 3. Chest pain