Term
| many factors affect drug interactions including: |
|
Definition
drug solubility
drug compatibility |
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|
Term
| mixing of two drugs in a solution can cause an adverse interaction called? |
|
Definition
|
|
Term
| factors affecting drug solubility and compatability include: |
|
Definition
- drug concentration
-I.V. fluid or drug
- type of administration set
- preparation technique, duration of drug-drug or drug-solution contact
- PH value
-Temperature of the room and light |
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Term
| drugs can be ____________ when mixed in certain solutions but ___________ when mixed with others. |
|
Definition
|
|
Term
| mixing two incompatible drugs in solution in a particular order: |
|
Definition
| may be enough to avoid potentially adverse interaction |
|
|
Term
| what must be considered when compounding medications? |
|
Definition
| the PH of BOTH the solution and the drug |
|
|
Term
| drugs that are widely dissimilar in PH values are: |
|
Definition
| unlikely to be compatible in solution |
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|
Term
| dextrose solutions are slightly? |
|
Definition
acidic
with a PH of 4.5-5.5 |
|
|
Term
| several antiboitics on the market have an ________ PH |
|
Definition
acidic
- which is stable in dextrose- |
|
|
Term
| Alkaline antiboitics are ___________ when mixed with dextrose: |
|
Definition
unstable.
ex. carbenicillin |
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|
Term
|
Definition
|
|
Term
| dextrose ( PH 4.5-5.5) should be used as a base for: |
|
Definition
|
|
Term
| alkaline medication dilution should be used with: |
|
Definition
|
|
Term
| the prevent I.V drug incompatibilities, best practice is to flush the infusion device with ___________ _________ before and after medications are infused |
|
Definition
|
|
Term
| the attachment of one substance to the surface of another: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| disadvantages associated with adsorption: |
|
Definition
- pt recieves smaller amount of the drug than was intended
- amount of absorption is difficult to predict |
|
|
Term
| the amount of adsorption is difficult to predict and is affect by: |
|
Definition
- the drug concentration
-solution of the drug
-amount of surface contacted by the drug
- temperature changes |
|
|
Term
| an example of adsorption is the binding of insulin to : |
|
Definition
| plastic and glass containers |
|
|
Term
| during the initial part of the infusion: |
|
Definition
very little of the drug will reach the patient
until it saturates all potential adsorption sites (IV containers and tubing)
--> then more of the drug is delivered to the patient |
|
|
Term
| once all the adsorption sites in the IV container and tubing are full: |
|
Definition
| the patient will be delivered more of the medication |
|
|
Term
| to prevent drug adsorption losses: |
|
Definition
inject the drug as close to the IV insertion site as possible
* will promote better theraputic drug effects* |
|
|
Term
| polyvinyl chloride (PVC) in plastic flexible IV bags promotes: |
|
Definition
|
|
Term
Di(2- ethylhexyl) phthalate
[DEHP]: |
|
Definition
| is a plasticizer that is added to PVC that allows PVC to be flexible |
|
|
Term
| some drug formulations leach the plasticizer [DEHP} out of the plastic matrix and into: |
|
Definition
|
|
Term
| what is the solubility of DEHP? |
|
Definition
|
|
Term
| what products can extract the plasticizer from the pvc bags and tubing? |
|
Definition
|
|
Term
| DEHP is also leached from pvc bags by: |
|
Definition
organic solvents and
surfactants contained in some drugs
> which may result in DEHP induced toxicity |
|
|
Term
| when mixing medications into glass or plastic systems< refer to? |
|
Definition
| the maufacturer"s guidelines to prevent adsorption |
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|
Term
| p patient"s complaint of burning at the IV site from a presumably dilute drug is a warning that: |
|
Definition
| the concentration of the drug is too high and needs to be diluted further |
|
|
Term
| many hospitals allow only registered ___________ to prepare admixtures |
|
Definition
|
|
Term
| what can result from inadequate mixing of a drug into the infusion container? |
|
Definition
drug toxicity
subtheraputic infusion
erratic theraputic effects |
|
|
Term
| inadequate mixing can contribute to a : |
|
Definition
BOLUS of medication being delivered to the patient
(which may cause adverse effects) |
|
|
Term
factors that contribute to inadequate mixing include:
(5) |
|
Definition
- Length of time required to adequately mix drugs in flexible bags
- Addition of a drug to a hanging flexible bag
- Addititives injected at a slow rate into the primary bag (the turbulence of fast flow promotes mixing, esp. in glass containers)
- Inadqeuate movement of the additive from the injection port (e.g., the long, narrow sleeve-type additive ports on some flexible bags, as opposed to the button type, hinder effective mixing)
- Tendency of very dense drugs to settle at the bottom of the infusion container |
|
|
Term
| to adequately mix the medication with the solution, taking care to avoid foaming the solution, you do what? |
|
Definition
| gently invert the IV container |
|
|
Term
mixing:
when inversion is impossible, what do you do to prevent the drug from settling to the bottom of the container? |
|
Definition
| gently swirl or rotate the container |
|
|
Term
| when agitating an intermittent infusion set, clamp off the air vent; if the vent become wet: |
|
Definition
| the solution will not infuse properly after mixing |
|
|
Term
| vacuum devices can facilitate mixing in plastic flexible bags by creating a vacuum and drawing any drug left in the port into: |
|
Definition
|
|
Term
| add ____ drug(s) at a time to the primary IV solution |
|
Definition
|
|
Term
| add which types of drugs to the solutions first because of incompatibilities, such as precipitiates, require a certain concentration or amount of time to develop: |
|
Definition
the most concentrated &
the most soluable drugs
*mix well and then add the diluted bags* |
|
|
Term
| add which additives last to avoid masking possible precipitate cloudiness? |
|
Definition
|
|
Term
| always visually inspect containers after adding and mixing drugs; hold the container against a light of white surface and check for: |
|
Definition
particulate matter
obvious layering
foaming |
|
|
Term
| if you do not have a clear understanding of the compatibility or stability of the admixtures you are using, check : |
|
Definition
| the manufacturer's recommendation or consult a pharmacist |
|
|
Term
when mixing:
what are the signs of incompatibility? |
|
Definition
cloudiness
foam
layering
precipitate |
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