1. Al H 116/Rad T 216 Adler/Carlton Ch 18 and 19 Pharmacology and Contrast Media

2. Drug Nomenclature Classification by: –Name –Action –Legal

3. Dosage Forms Tablet – MC oral dosage form Capsule Inhalation Suppository Solution Suspension Transdermal patch

4. Actions, Indications, and Precautions Analgesics – relieve pain –Opioid – narcotic –Non-opioid – tylenol Anesthetics – act on CNS to produce a loss of sensation –General –Local

5. Anti-anxiety – –Diazepam – valium Anti-arrhytmics Antiobiotics Anti-cholinergics- anti-spasmodics – reduce smooth muscle tone

6. 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

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

8. Vasoconstrictors – used to treat shock Vasodilators – treat angina

9. Routes of Administration Oral Sublingual Topical Parenteral – by injection –Intramuscular –Subcutaneous –Intravenous

10. Ampule – scored neck Vial – sealed rubber top

11. Purpose of Contrast Media Visualize anatomic detail Radiolucent – negative –Allows photons to easily pass thru Radiopaque – positive –Absorbs more photons

12. Positive Contrast Media Barium sulfate –Atomic number 56 –Used as a suspension Flocculation – fall out of suspension

13. 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

14. Osmolality Number of particles in solution per kilogram Most contrast reactions are related to osmolality

15. Non-ionic Contrast Media These DO NOT dissolve in solution Also they are more hydrophilic – soluble in water- ie they mix well together

16. 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

17. Renal effects –Can cause renal arterial constriction thereby decreasing blood flow to the kidneys

18. 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.

19. Scheduling on Contrast Exams Elderly or debilitated Diabetic Children Adults