Surgical Pharmacology and Anesthesia

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Part I: The Science of Pharmacology
updated 3 years ago by clarkm359
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1

Study of medications and their actions:

Pharmacology

2

Regulates the safety, dosage accuracy and effectiveness of drugs:

U.S. Federal Drug Administration (FDA)

3

Describes metabolic processing of a drug within the body:

Pharmacokinetics

4

4 processes of pharmacokinetics:

  1. Absorption
  2. Distribution
  3. Biotransformation
  4. Excretion
5

Process that occurs at site of administration:

Hint: Process is passive transport . May involve active transport depending on drug.

Absorption

6

Process affected by rate of absorption, systemic circulation and regional blood flow to a target organ or tissue:

Distribution

7

Involves transport of medication within the body once it enters the circulatory system:

Distribution

8

Process that refers to metabolism of a drug in the liver:

Hint: Other tissues, like intestinal mucosa, lungs, kidneys and blood plasma may be involved.

Biotransformation

9

Conversion of molecules from one form to another within an organism:

Biotransformation

10

Processes by which a drug is eliminated from an organism:

Excretion

11

Substances used for the diagnosis, treatment, cure, mitigation or prevention of a disease or condition:

Drugs

12

5 drug sources:

  1. Plants
  2. Animals
  3. Minerals
  4. Laboratory synthesis
  5. Biotechnology
13

Study of interaction of drug molecules with target cells of living tissue:

Pharmacodynamics

14

Occurs when one drug alters the pharmacological effect of another drug:

Drug interactions

15

4 types of drug interactions:

  1. inhibition or destruction of foreign organisms or malignant cells
  2. protection of cells from foreign agents
  3. supplementation or replacement of specific hormones/vitamins/enzymes
  4. increasing or decreasing speed of a physiologic function
16

Drugs that enhances the effect of another substance:

Agonists

17

Opposite of agonists:

Hint: Produce stronger/more powerful effect when administered with another substance.

Synergists

18

Drugs that alter some aspect of the action/effect of the original agent:

Additive Agents

19

Reverse a medication’s effects:

Antagonists

20

Describes a situation in which a medication is used and the timing of effects:

Therapeutic Action

21

Timing of medication administration depends on 3 things:

  1. Onset
  2. Peak effect
  3. Duration
22

4 factors that affect medication selection criteria of a given medication for a patient:

  1. Indication
  2. Contraindications
  3. Actions
  4. Dosage
23

3 main theories explain how a drug produces its effects:

  1. Theory of drug-receptor interaction
  2. Theory of drug-enzyme interaction
  3. Nonspecific drug interaction
24

Amount of medication delivered to patient in order to achieve optimal therapeutic effect:

Dosage

25

How drugs are categorized:

Hint: Includes principal action, organ/body system affected, physiological action produced and therapeutic action.

Classifications

26

Ability of a medication to affect illness or disease by preventing, improving or treating conditions:

Medication Effects

27

6 effects of medication:

  1. Therapeutic effect
  2. Side effect
  3. Adverse effect
  4. Toxic effect
  5. Tolerance
  6. Addiction or dependence
28

Method used to deliver a medication into the body:

Route of administration

29

3 most common routes of administration:

  1. Enteral
  2. Parenteral
  3. Topical
30

Through gastrointestinal tract:

Enteral

31

By injection; other than through the gastrointestinal tract:

Parenteral

32

Applied to the skin or mucous membrane to provide a localized or systemic effect:

Topical

33

Form of drug preparation determine:

A medication’s route of administration and its pharmacodynamics and pharmacokinetics.

34

7 forms of drug preparation:

  1. Gas
  2. Liquid
  3. Solution
  4. Suspension
  5. Emulsion
  6. Solid
  7. Semisolid
35

Drug standards are:

A review and approval process set by the FDA.

36

5 drug publications that list approved drugs and formulas:

  1. National Formulary
  2. Pharmacopeia of the United States (USP)
  3. American Hospital Formulary Services Index
  4. Physician's Desk Reference (PDR)
  5. The Joint Commission National Patient Safety Goals
37

5 types of "drug nomenclature" (names assigned to drugs):

  1. Trade
  2. Brand
  3. Proprietary
  4. Generic
  5. Chemical
38

The name assigned to a medication and copyrighted by the manufacturer for marketing purposes, and may include a reference to the intended use:

Proprietary

39

Capitalized name of a medication followed by the © symbol, indicating that the name/chemical formula used by a specific company have been registered with the federal government:

Trade

40

A widely known household name of a medication:

Hint: Tylenol

Brand

41

Nonproprietary name for a drug:

Hint: Often a shortened version of the chemical name.

Generic

42

Name referring to the precise chemical composition and molecular structure of a medication:

Chemical

43

3 legal drug classifications:

  1. Controlled substances
  2. Prescription medications
  3. Over-the-Counter medications
44

Drugs with a high potential to cause psychological and/or physical dependency and abuse.

Controlled substances

45

Medications that require a written order from a doctor.

Hint: Order must include the name, dose, quantity and timing of the medication.

Prescription medications

46

Pharmacologic agents prepared in dosages that are safe to administer without the direction of a physician:

Over-the-counter medications (OTC)

47

Federal drug policy that regulates manufacture and distribution of controlled substances and categorizes them into 5 "schedules" or "classes:"

The Controlled Substances Act

48

Includes substances that have high abuse potential and no current approved medical use.

Hint: heroin, marijuana, LSD, other hallucinogens, certain opiates and opium derivatives.

Class I

49

Includes substances that have high abuse potential and high ability to produce physical and/or psychological dependence, and no current approved medical use.

Hint: morphine sulfate, oxycodone, codeine, anabolic steroids

Class II

50

Includes substances with less potential abuse than Class II, and for which there is current approved medical use.

Hint: hydrocodone, codeine

Class III

51

Includes drugs for which there is a relatively low abuse potential and for which there is current approved medical use.

Hint: benzodiazepines (Valium, Ativan)

Class IV

52

Includes drugs containing limited amounts of narcotic drugs for treatment of coughs and diarrhea:

Hint: cough syrups with codeine, diphenoxylate (Lomotil)

Class V

53

Assessment of the risk of fetal injury due to medication used as directed by the mother during pregnancy (not including risks associated with post-pregnancy effects on breast milk or breast-fed infants):

Hint: Established by the FDA

FDA Pregnancy Drug Categories

54

Includes dietary supplements, nutritional supplements, herbal medicines, probiotics, vitamins, minerals and other natural products that have undergone limited studies to determine safety and effectiveness:

Alternative Medication Supplements

55

May interact with traditional medications, produce negative side effects and include ingredients harmful to pregnant women, children and the elderly:

Alternative Medication Supplements

56

10 most commonly used alternative medication supplements:

  1. Fish Oil/Omega 3/DHA
  2. Glucosamine combined with chondroitin
  3. Echinacea
  4. Flaxseed Oil
  5. Gingko biloba
  6. Ginseng
  7. Vitamins E and C
  8. Calcium
  9. B-complex Vitamins
  10. Aloe Vera
57

PRN:

Hint: patient request for post-operative analgesics

pro re nata

Latin for "as needed"

58

Routine order for medication to be given pre-operatively as a standard usage unless told otherwise:

Standing

59

Means "immediately or at once." Variation of Latin statim:

STAT

60

Any order given by the surgeon or anesthesia provider during a procedure:

Verbal

61

Ratio of medication solute to solvent:

Concentration

62

Overall amount of medication delivered to the patient:

Dose

63

Medication's use in the surgical setting:

Application

64

Formula for calculating a medication's concentration:

A : B = C : D

(B and C are the means; A and D are the extremes)

Example

Label says 500 milligrams per 5 milliliters:

  • 500 : 5 = x : 1 (multiply the means and extremes)
  • 500 = 5x
  • Reduce the fraction by dividing both sides by 5
  • 100 = x
65

Total amount of medication given to the patient:

Cumulative dose

66

Formula for calculating a medication's cumulative dose:

Solution delivered is multiplied by the amount of solute from the previous (concentration) ratio.

67

2 scales commonly used to measure temperature:

  1. Celsius
  2. Fahrenheit
68

Surgical patient's temperature is monitored preoperatively, intraoperatively and postoperatively for these reasons:

  • Preoperatively: if not normal, procedure may be delayed or canceled
  • Intraoperatively: hyperthermia and hypothermia affect hemostasis
  • Postoperatively: rise could indicate SSI
69

Normal body temperature:

  • 98.6° F
  • 37° C
70

Conversion formulas for converting between Fahrenheit and Celsius:

  • (F° - 32) 5/9 = C°
  • (°C x 9/5) + 32 = °F
71

Primary system of measurement used in the healthcare field:

Metric system

72

Meter = m

Centimeter = cm

Millimeter = mm

Metric system abbreviations for length

73

Kilogram = kg

Gram = g

Milligram = mg

Microgram = mcg

Metric system abbreviations for weight

74

Kiloliter = kl

Liter = l

Cubic centimeter = cc

Milliliter = mL

Metric System abbreviations for volume

75

2 measurement systems rarely used in the medical field that are still important to know:

  • Household measurement system
  • Apothecary measurement system
76

Yard = yd

Foot = ft.

Inch = in.

Household system abbreviations for length

77

Teaspoon = tsp.

Tablespoon = Tbsp.

Ounce = oz.

Pint = pt

Quart = qt

Gallon = gal

Household system abbreviations for volume

78

Pound = lb.

Household system abbreviation for weight

79

System based on weight of a grain of wheat:

Apothecary system

80

Minim = m

Dram = dr

Drop = gtt

Ounce = oz

Pint = pt

Apothecary system abbreviations for volume

81

Grain = gr

Pound = lb

Apothecary system abbreviations for weight

82

List of medical abbreviations that should NOT be used in order to reduce risk and prevent errors in patient care:

The Joint Commission - Official Do Not Use List

83

The Six "Rights" of Medication Administration:

  1. The "right" patient
  2. The "right" drug
  3. The "right" dose
  4. The "right" route of administration
  5. The "right" time and frequency
  6. The "right" documentation, including labeling
84

All medication must be labeled with this information:

  • Drug name
  • Strength
  • Amount
  • Expiration date
  • Route of administration
  • Lot number
  • Handling/storage precautions
  • Instructions for reconstitution (if applicable)
  • Controlled substances classification (if applicable)
85

Glass container that requires the top to be broken off to access the contents:

Hint: Usually contains liquid medication.

Ampule

86

Plastic or glass container that has a rubber stopper at the top that is held in place with a metal retaining ring:

Hint: Usually contains liquid, powder or compressed powder.

Vial

87

Disposable item already loaded with the substance to be injected:

Preloaded syringe

88

Metal or plastic item that may contain medication in cream, gel or ointment forms:

Tube

89

4 methods of medication transfer for vial:

  1. ST uses hypodermic needle attached to syringe
  2. Circulator uses vial decanter
  3. Circulator ejects medication into container onto back table with hypodermic needle
  4. Circulator pours
90

2 methods of medication transfer for ampule:

  1. circulator ejects medication into container onto back table with hypodermic needle
  2. ST uses hypodermic needle attached to syringe
91

Method of medication transfer for tube:

  1. circulator squeezes onto towel or sterile dressing material
92

ST should label all medication on the field with:

  • Name
  • Concentration