540 - Drug Delivery Systems - Exam Iii - Iv Administration

Front 1

List Three Advantages of IV Administration

Back 1

1) Rapid onset of action due to direct delivery into circulation (bolus dose), 2) Precise control of desired blood levels (continuous infusion), & 3) Infusion can be halted if toxicity is observed.

Front 2

On what four factors does the mode of IV dosing depend?

Back 2

Mode of dosing depends on 1) pharmacokinetics, 2) solubility, 3) stability, and 4) rate-dependent toxicity.

Front 3

List Four Disadvantages of IV Administration

Back 3

1) No ability to recall if overdose occurs (oral route: induce vomiting), 2) Relatively high cost, 3) Risk of particulates or precipitates in blood, & 4) May be associated with toxicity, due to high serum levels.

Front 4

What is Extravasation?

Back 4

The leakage of drug, especially anticancer drugs, into surrounding soft tissue, causing local tissue damage and pain (needle dislodges from vein).

Front 5

By what procedure are compatibility issues in sequential IV dosing redressed?

Back 5

Compatibility issues in sequential IV dosing are redressed by flushing the IV line with saline between infusions.

Front 6

By what procedure are concurrent IV dosing compatibility issues redressed?

Back 6

Compatibility issues in concurrent IV dosing are redressed by utilizing separate IV lines, unless compatibility data indicated it is safe to do otherwise.

Front 7

Describe Intermittent Infusion

Back 7

The administration of drug at specific intervals, e.g. every 4 hours.

Front 8

Describe a Continuous Drip Infusion

Back 8

A slow, primary-line infusion to maintain a therapeutic drug level or to provide fluid and electrolyte replacement (IV fluids).

Front 9

Describe a Direct (Bolus) injection

Back 9

A rapid delivery of a small volume of undiluted drug to achieve an immediate effect (useful in an emergency) and / or to quickly achieve a therapeutic serum level.

Front 10

Describe an Additive Set Infusion

Back 10

It utilizes a volume-control device for the intermittent delivery of small amounts of IV solutions or diluted medications.

Front 11

Describe the Piggyback Method

Back 11

The use of a Y tube when simply diluting a drug in the primary solution is not ideal.

Front 12

Aside from merely holding the product, what other functions do containers ideally serve?

Back 12

They keep the product stable, sterile, pyrogen-free, and pure.

Front 13

What are the four Glass Types for Containers?

Back 13

Types I, II, III, and NP (clarity)

Front 14

List Three Features of Type I Glass

Back 14

1) Best for aqueous parenterals, 2) Made from borosilicate glass, 3) Resistance towards water (alkali release).

Front 15

List Three Features of Type II Glass

Back 15

1) They are treated with sulfur dioxide, 2) They must be buffered, 3) pH < 7 (single dose containers)

Front 16

List Three Features of Type III Glass

Back 16

1) They are not treated with sulfur dioxide (sterile dry products), 2) They must be buffered, 3) pH < 7 (single dose containers)

Front 17

What is Type NP Glass?

Back 17

General purpose, soda-lime glass (non-parenteral)

Front 18

What is the basic structure of plastics?

Back 18

Linear, high molecular weight polymer, e.g. saturated hydrocarbon, sometimes with a halide, such as chloride in polyvinyl chloride.

Front 19

Describe the permeability of plastics with respect to chemical molecules and gases

Back 19

Most plastics selectively permit passage of chemical molecules and most are permeable to gases.

Front 20

What are two limitations or disadvantages of plastics?

Back 20

1) Since they melt at elevated temperatures, only a few can be subjected to autoclaving & 2) Many plastics contain additives, plasticizers (bisphenol-A), antioxidants, and / or antistatic agents, which may leech into a product.

Front 21

What is the simplest and safest method of IV chemotherapy delivery?

Back 21

Peripheral Venous Administration

Front 22

List Three Ideal Features for Peripheral Vein Injections

Back 22

1) Drugs that do not irritate the veins, 2) Administration of isotonic solutions, & 3) Patients who require only short-term IV therapy.

Front 23

What is the usual site of peripheral venous access?

Back 23

The dorsal portion of the forearm

Front 24

What type of administration set is used for short chemotherapy infusions (<60 min)?

Back 24

Stainless steel scalp vein needles (called wing-tipped butterfly needles)

Front 25

What is a catheter and what are two things an ideal catheter does?

Back 25

A catheter is a plastic tube passed through the body for evacuating or injecting fluids. An ideal catheter inhibits formation of a thrombus and resists the adherence of microbes.

Front 26

What are three limitations associated with midline catheters?

Back 26

1) Cannot be used to administer hyperosmotic solutions, 2) About 10% of patients develop phlebitis during the 1st week, often requiring catheter removal, & 3) No swimming!

Front 27

Where are midline peripheral intravenous catheters inserted?

Back 27

Into an antecubital vein, so that the tip ends in the proximal portion of the arm (14 to 19 cm long)

Front 28

What are common uses of a Central Venous Access Device?

Back 28

They are commonly used for cancer chemotherapy and for outpatient parenteral antimicrobial drug therapy, as well as for the administration of drugs, antiemetics, parenteral nutrition, and analgesics. They may be used for blood sampling as well as drug administration.

Front 29

What advantage do central venous access devices offer for repeated dosing?

Back 29

Since they can be reused for weeks to months, they decrease the number of times that veins must be painfully repunctured.

Front 30

What advantage does the placement of the catheter tip provide in central venous access?

Back 30

Since the tip of the catheter is placed at the superior vena cava, it is safe to administer hypertonic solutions (including parenteral nutrition solutions), vesicants, and irritants without substantial risk of phlebitis and extravasation.

Front 31

Describe access through Peripherally Inserted Central Venous Catheters

Back 31

They are inserted into a forearm vein and advanced to the superior vena cava

Front 32

Describe access through Non-Tunneled Central Venous Catheters

Back 32

They are placed by a physician into the superior vena cava through the subclavian or internal jugular vein

Front 33

What are Two Advantages of Non-Tunneled Central Venous Catheters?

Back 33

1) The frequency of phlebitis is very low & 2) They might be useful for patients who need a catheter for < 30 days.

Front 34

How does the cost of non-tunneled central venous catheters compare with that of peripheral venous catheters?

Back 34

The cost is much higher than that of peripheral venous catheters.

Front 35

What is a Tunneled Central Venous Catheters and under what circumstances might they be useful?

Back 35

The catheter is surgically tunneled, subcutaneously, for a short distance (usually across the chest) to a provide a barrier between the skin exit site and the vascular entrance site. They may be useful when a patient needs a catheter for more than 30 days.

Front 36

Describe Implantable SC Central Catheters

Back 36

Access port is SC, and it is entirely under the skin (2000 needle entries)

Front 37

List Three Advantages of Implantable SC Central Catheters?

Back 37

1) They can be used for years for many different products, 2) They have low infection rates, & 3) They are not visible (patients prefer this).

Front 38

Describe two problems associated with Central Catheters

Back 38

1) A venous thrombosis may develop any time a catheter is in place & 2) The catheter or port lumen may also become occluded when a clot forms within the lumen or at the catheter tip when a drug or electrolyte solution precipitates within the lumen.

Front 39

Describe the process referred to as "Locking" a catheter

Back 39

Filling the catheter lumen with a saline solution containing a low level of heparin (100 units/ml) between uses.

Front 40

Describe Four Complications associated with Cathethers

Back 40

1) Sterile phlebitis (inflammation of the vein) in 2 to 10% of patients, 2) Air embolism (100 ml of air can be fatal), 3) Catheter can embolize if it is severed during placement or if it is defective, & 4) Infection