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Radiology
Medications in Interventional Radiology
Built from Fundamentals of Diagnostic Radiology
What’s inside
9 sections · 85 slides
Overview
- Medications in interventional radiology
- Drug classes in the VIR toolkit
Moderate Sedation
Anxiolysis plus analgesia, with risk and airway assessment first
- What moderate sedation is
- Pre-sedation chart and history review
- ASA risk classification
- ASA classification scale
- Airway assessment with the Mallampati score
- Mallampati airway classification
- Two components of moderate sedation
- Benzodiazepines for anxiolysis
- Midazolam dosing and kinetics
- Benzodiazepine risks and alternatives
- Opioids for analgesia
- Fentanyl dosing and kinetics
- Recognising and reversing oversedation
- Oversedation response
- Moderate sedation medications and reversal agents
Antibiotics
Classifying each procedure to decide who needs prophylaxis
- Antibiotic prophylaxis in VIR
- Classifying procedures by contamination
- Procedure contamination classes
- When antibiotics are needed
- SIR guidance and lingering debate
- Prophylactic antibiotic choices
- Antibiotic prophylaxis by procedure
Vasodilators and Vasoconstrictors
Managing vessel spasm and controlling bleeding
- Why vasodilators are used
- Nitroglycerin mechanism and dosing
- How nitroglycerin relaxes vessels
- Verapamil
- Papaverine for special ischemia
- Vasopressin for bleeding
- Vasopressin cautions and kinetics
- Vasodilators and vasoconstrictors
Anticoagulants
Heparin, warfarin, and the newer direct oral agents
- Anticoagulants around VIR procedures
- Coagulation cascade and anticoagulant targets
- Bleeding-risk categories
- Procedure bleeding-risk categories
- Heparin basics
- Unfractionated heparin dosing
- Low-molecular-weight heparin
- Fondaparinux and heparin-induced thrombocytopenia
- Stopping heparin before procedures
- Heparin reversal and direct thrombin inhibitors
- Warfarin basics
- Warfarin challenges and reversal
- New direct oral anticoagulants (NOACs)
- NOAC agents
- NOAC monitoring and stopping
- NOAC reversal
- Warfarin versus NOACs
- Anticoagulants and reversal agents
Antiplatelets
Aspirin, thienopyridines, and glycoprotein IIb/IIIa inhibitors
- Why antiplatelets are used
- Platelet aggregation and antiplatelet targets
- Aspirin (cyclooxygenase inhibitor)
- Aspirin around procedures
- Thienopyridines (ADP receptor inhibitors)
- Clopidogrel timing debate
- Glycoprotein IIb/IIIa inhibitors
- Stopping and reversing antiplatelets
- Antiplatelet and reversal agents
Thrombolytics
Catheter-directed clot dissolution
- Catheter-directed thrombolysis
- History of thrombolytics
- Plasminogen activators (tPA)
- Alteplase
- Reteplase
- Tenecteplase
- Thrombolytic agents
Prothrombotics
Thrombin injection for arterial pseudoaneurysms
- Thrombin for pseudoaneurysms
- Thrombin cautions
- Prothrombotic agent
Adjunct Medications
Pain control, antiemetics, glucagon, and local anesthesia
- NSAIDs for pain
- Ketorolac cautions
- Ondansetron for nausea
- Diphenhydramine
- Glucagon
- Glucagon cautions
- Meperidine
- Lidocaine for local anesthesia
- Lidocaine cautions
- Adjunct medications
- Key takeaways
- Suggested readings
- Suggested readings
- Suggested readings
- Suggested readings
- Brant and Helms' Fundamentals of Diagnostic Radiology