DRUG

INTERACTIONS
SIX RIGHTS
OF DRUG
◦While the radiographer
Maynever have to mix two drugs into the
SAFETY
same syringe, he/she must remember to consult a drug compatibility
chart before doing so, should the need ever arise.
◦This situation may occur with an intravenous injection of contrast
medium through a butterfly needle rather than hanging. IV
. solution
◦ If this occurs, the radiographer must flush the butterfly line with
saline before injecting any other drug, even another contrast medium.
◦ Many drugs combined with another drug, can become inactivated or form a toxic
compound.
◦ At times, when two drugs are combined, they increase the effect of each drug given
alone.
◦ An example of this is a dose of heparin when given with alcohol increases bleeding.
◦ This can equate to one plus one equals two and is called an additive reaction
◦ A synergistic drug reaction may occur when two drugs interact to equal an effect
greater than the sum of their separate dosage.
◦ Some drugs are antagonistic to other drugs or interfere with the action of another drug.
◦ Drugs may also be affected by food if given orally.
◦ Directions for drug administration list whether the drug should be taken on an empty
stomach or taken with food. These directions must be taken seriously as some drugs may
be absorbed into the bloodstream more quickly with food and others may need to be
taken on an empty stomach to enhance absorption.
ADVERSE DRUG REACTION
◦ When a drug produces an effect that is more severe or life-threatening.
◦ Any person who participates in drug administration must be aware of the potential harm
that may result from drugs. They may produce many unintended effects. When a drug
produces an effect that is mild, common, unintended and non-toxic this is said to be as a
side effect.
◦ Some adverse reactions occur almost immediately after the drug is administered and
some take weeks or months of administration before an untoward reaction is produced.
◦ A toxic reaction is an unwanted effect that is an extension of the therapeutic effect.
◦ A toxic reaction does not include an allergic reaction or anaphylactic shock, which is classified as an
adverse reaction.
◦ A drug that is given in the prescribed amount is therapeutic but may become toxic when
given in an increased amount; this is considered as overdose.
DRUG IDIOSYNCRASY
◦ An unexpected or exacerbated effect from a drug
◦ For example, a drug given to produce sleep instead produces a hyperactive
reaction.
◦ Thecause of this reaction is not clear, but it may be due to a genetic deficiency
that creates an inability to tolerate certain chemicals.
Drug tolerance
◦occurs when a drug received continually for a length of time creates a
change in the response to that drug.
◦Usually, the drug is needed in increasingly larger doses to create the
desired effect
.
◦Drug tolerance is a sign of drug dependence and the drugs that are
related to this problem are narcotics and tranquilizers.
◦Tachyphylaxis
is a rapid development of tolerance to. a drug
1. Theright patient

◦Ask the name of the patient and check his or her

ID band before giving any medication. Even if
you know the patient’s name, make sure to verify
it carefully.
2. The right drug

◦Check and verify the medication. Beware of look

-alike and
sound-alike medication names.
◦Misreadingmedications’ name is a common mistake.
◦These look-alike medications may also sound -alike and can
lead to errors associated with verbal prescriptions.
3. Theright amount of dose
◦ Most of the time, this can be achieved just by double checking the label to see
what dose needs to be given.
◦ However
, a liquid medication can be a bit trickier because the person giving it
must measure the dose.
◦ Measuring
the dose using an oral syringe and not a household teaspoon is
recommended.
◦ If the medication does not come with a dosing cup or a syringe, be sure to ask
the pharmacist for one.
4. Theright route
◦ While it may seem unimaginable, we are often called about medications being
administered via an unintended route.
◦ For example, eardrops administered as eye drops, or swallowing medication
intended to be used with an inhaler.
◦ Besure to double
-check the label to ensure that the right medication is being
administered via the right route
.
◦ While the labelling on drops can sometimes be confusing, remember
otic” that “
refers to the ears while “ophthalmic” refers to the eyes.
5. The right time
◦ Be aware of dosing frequency – Although most medications are taken once a day,
some are prescribed to be taken two or three or even four times a day.
◦ Use a schedule or medication log – The more doses a drug requires throughout the
day, the more likely the person may forget to administer a dose. To avoid this from
happening, create a schedule as a visual and/or electronic reminder to administer the
next dose.
◦ Set an alarm – Set a cell phone alarm or other reminder to help you remember when
doses are due.
◦ Communicate clearly – Many dosing mistakes, especially double dosing, happens from
communication mishaps. Keep a physical schedule handy that both guardians and other
allied health care providers can access and be sure to check off when a medication was
administered.
6. TheRightDocumentation

◦Ensure that you are properly documenting the medication,

including the time, dosage, and route so that you have proof
of what you gave to the patient in case there’s a bad reaction.
PRECAUTIONS IN
DRUG
ADMINISTRAION
 Other precautions that must be taken before
administration of any drug are as follows:

1. Read all labels carefully before drawing up or pouring a drug. Check the name,
strength and dosage of the drug.
2. If a drug contains a sediment or appears to be cloudy, do not use until the pharmacist
approves the drug.
3. Check the expiration date of the drug on the label. If that date has passed, do not use.
4. Do not use drugs from unmarked or poorly marked containers. Discard them.
5. Measure exact amounts of every drug used. If medication is left over, do not replace
it in the container; discard it according the institutional policy.
6. Drugs must be stored in accordance with the manufacturer’s specifications. No drug should
be stored in an area where temperature and humidity vary greatly and or extreme. Low room
temperature is advised.

7. If a medication is a liquid to be poured, pour away from the label.

8. Do not combine two drugs in a syringe without verifying their compatibility with the
pharmacist. If in doubt, do not combine.

9. Before selecting a medication, check the label of the container three times; before taking it
from storage, before pouring it or drawing it up and after it has been prepared for
administration.

10. When approaching a patient who is to receive a drug, ask the patient to state his or her name.
Do not accept the fact that a patient answers to what is thought to be the correct name. An
anxious patient may respond incorrectly. Read the name label on the patient’s wrist.

11. After identifying the patient, explain to him or her about the drug and how it will be given.
12. A drug history of allergies must be taken before any drug is administered.
13. The radiographer must not administer a drug that she or he has not prepared.
14. Report and document any drug that the patient refuses to take.
15. Documentany drug administered immediately according to department
procedure.
16. Do not leave a patient unattended who may be having a drug reaction.
17. Apatient who has received a sedative, hypotonic, antianxiety or narcotic
analgesic drug must not be allowed to drive himself or
home.
herself
18. A child who has received a medication and is sleeping may not leave the
department until fully awake.
19. Patientsshould be observed for 1 hour before leaving the department alone
after receiving any drug.
 SPECIAL
CONSIDERATIONS
IN DRUG
ADMINISTRAION
 Age group Physiologic Changes Precautions

Pregna Many drugs cross the placental barrier. Drug effects depend on fetal age and can result in harm to the fetus. Drugs
nt during
women pregnancy
must be
avoided or
administer
ed only to
women
who
absolutely
require
treatment.
If in
doubt,
inform
patient’s
physician
of
possible
pregnancy
before
administer
ing any
drug.
Infants Only
persons
educated
in drug
administra
tion to
infants
must
Lack well-developed muscle mass; lack the administer
protective mechanisms of older children and medicatio
adults. Skin is thin and permeable; stomachs ns to
lacks mucous barrier; temperature control is them.
poor; they become dehydratedeasilyand have
immature liver and kidneys that cannot
manage foreign chemicals.
Breastf May have all drugs in maternal circulation transferred to colostrum and breast milk. Mothers
eed who are
Infants breastfeed
ing may
be advised
by the
physician
to cease
breastfeed
ing for a
prescribed
time if
they are to
receive
radioisoto
pes or
radiation.
All other
drug
therapies
must be
evaluated
as they
may harm
the
infants. A
detailed
history
must be
taken and
no drugs
should be
administer
ed without
establishi
ng that
they will
not harm
the infant.
 SYSTEMS OF DRUG MEASUREMENT
◦ The metric system of measurement has been adopted in most countries of the world as the official
standard; however, its use is recommended but not required in the United States.

◦ It is used most medical settings in this country, but the apothecary system of measurement are also used.
This means that anyone who administers drugs must understand and be able to use the two systems
interchangeable. Household measurements are not commonly used in medical facilities and only those
most commonly used will be mentioned

◦ The radiographer who plans to administer drugs must learn to convert from metric o apothecary
measurement depending upon how the physician’s order is written.

◦ The metric unit of measure is the Liter (L), which contains 1,000 milliliters (mL) or the approximate
cubic metric equivalent of 1,000 cubic centimeters (cc). The unit of weight is the gram (g). Kilograms
(kg), milligrams (mg) and micrograms (ug) are used in health care. The kilogram is 1,000 g or in
nonmetric terms, 2.2 lb.