540 Exam 3 - Iv Administration

Front 1

Pros of IV admin

Back 1

-Immediate effect due to direct delivery into circulation (bolus dose)
-Desired blood levels (continuous infusion)
-Mode of dosing depends on pharmacokinetics, solubility, stability, and rate-dependent toxicity.
-Infusion can be halted if toxicity observed

Front 2

Cons of IV admin

Back 2

-No ability to recall if overdose occurs (oral route: induce vomiting)
-Relatively high cost
-Particulates and precipitation in blood
-May be associated with toxicity, due to high serum levels

Front 3

Extravasation

Back 3

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

Front 4

Compatibility issues

Back 4

Sequential: Flush line with saline between infusions
Concurrent: Do not run in same line unless there is compatibility data

Front 5

Continuous drip infusion

Back 5

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

Front 6

Intermittent infusion

Back 6

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

Front 7

Direct (bolus) injection

Back 7

Rapidly delivery of a small volume of undiluted drug to achieve an immediate effect (emergency) and achieve a therapeutic serum level quickly.

Front 8

Additive set infusion

Back 8

Using a volume-control device, it is used for the intermittent delivery of small amounts of IV solutions or diluted medications.

Front 9

Piggyback method

Back 9

Used when a drug cannot be mixed with the primary solution (use of Y tube).

Front 10

Containers

Back 10

Keep product stable, sterile, pyrogen-free, and pure.

Front 11

Glass types for containers

Back 11

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

Front 12

Type I Glass

Back 12

-Best for aqueous parenterals
-Borosilicate glass
-Resistance towards water (alkali release)

Front 13

Type II Glass

Back 13

-treated with sulfur dioxide
-must be buffered
-pH < 7 (single dose containers)

Front 14

Type III Glass

Back 14

-not treated with sulfur dioxide (sterile dry products)
-must be buffered
-pH < 7 (single dose containers)

Front 15

Type NP Glass

Back 15

General purpose soda-lime glass (non-parenteral)

Front 16

Basic structural unit of plastic

Back 16

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

Front 17

Pros of plastic

Back 17

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

Front 18

Cons of plastic

Back 18

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

Front 19

Simplest and safest method of IV chemotherapy delivery

Back 19

Peripheral venous administration

Front 20

Peripheral vein injection preferred drug characteristics (three)

Back 20

-drugs that do not irritate the veins -administration of isotonic solutions -patients who require only short-term IV therapy

Front 21

Usual site of peripheral venous access

Back 21

Dorsal forearm

Front 22

Type of administration set for short chemotherapy infusions (<60 min)

Back 22

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

Front 23

Catheter

Back 23

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

Front 24

Limitations of midline catheters (three)

Back 24

-Cannot be used to administer hyperosmotic solutions.
-Phlebitis occurs in about 10% of patients during the 1st week, often leading to catheter removal.
-No swimming!

Front 25

Midline catheter

Back 25

Catheters inserted into antecubital vein so that the tip ends in the proximal portion of the arm (14 to 19 cm long)

Front 26

Uses of central venous access device

Back 26

May be used for blood sampling as well as drug administration (commonly used for cancer chemotherapy and outpatient parenteral antimicrobial drug therapy for administration of drugs, antiemetics, parenteral nutrition, and analgesics)

Front 27

Central venous access device characteristics

Back 27

-Decrease the number of times that veins must be painfully repunctured since they can be reused for weeks to months
-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 28

Peripherally inserted central venous catheters

Back 28

Inserted into a forearm vein and advanced to the superior vena cava

Front 29

Non-tunneled central venous catheters

Back 29

-Placed by a physician into the superior vena cava through the subclavian or internal jugular vein

Front 30

Pros of non-tunneled central venous catheters

Back 30

-Frequency of phlebitis is very low
-Might be useful for patients who need a catheter for < 30 days

Front 31

Cons of non-tunneled central venous catheters

Back 31

Cost is much higher than peripheral venous catheters

Front 32

Tunneled central venous catheters

Back 32

The catheter is 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.
-Requires surgical insertion
-Used when therapy planned for more than 30 days.

Front 33

Implantable SC central catheters

Back 33

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

Front 34

Pros of implantable SC central catheters

Back 34

-Can be used for years for many different products
-Infection rates are low
-Not visible (patients prefer this)

Front 35

Central catheter issues

Back 35

-Venous thrombosis may develop any time a catheter is in place
-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 36

"Locking" a catheter

Back 36

Instilling a solution of heparin (100 units/ml) and saline in the catheter volume

Front 37

Complications of cathethers

Back 37

-Sterile phlebitis (inflammation of the vein) in 2-10% of patients
-Air embolism (100 ml of air can be fatal)
-Catheter can embolize if it is defective
-Infection