Surgical Pharmacology and Anesthesia
Study of medications and their actions:
Regulates the safety, dosage accuracy and effectiveness of drugs:
U.S. Federal Drug Administration (FDA)
Describes metabolic processing of a drug within the body:
4 processes of pharmacokinetics:
Process that occurs at site of administration:
Hint: Process is passive transport . May involve active transport depending on drug.
Process affected by rate of absorption, systemic circulation and regional blood flow to a target organ or tissue:
Involves transport of medication within the body once it enters the circulatory system:
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.
Conversion of molecules from one form to another within an organism:
Processes by which a drug is eliminated from an organism:
Substances used for the diagnosis, treatment, cure, mitigation or prevention of a disease or condition:
5 drug sources:
- Laboratory synthesis
Study of interaction of drug molecules with target cells of living tissue:
Occurs when one drug alters the pharmacological effect of another drug:
4 types of drug interactions:
- inhibition or destruction of foreign organisms or malignant cells
- protection of cells from foreign agents
- supplementation or replacement of specific hormones/vitamins/enzymes
- increasing or decreasing speed of a physiologic function
Drugs that enhances the effect of another substance:
Opposite of agonists:
Hint: Produce stronger/more powerful effect when administered with another substance.
Drugs that alter some aspect of the action/effect of the original agent:
Reverse a medication’s effects:
Describes a situation in which a medication is used and the timing of effects:
Timing of medication administration depends on 3 things:
- Peak effect
4 factors that affect medication selection criteria of a given medication for a patient:
3 main theories explain how a drug produces its effects:
- Theory of drug-receptor interaction
- Theory of drug-enzyme interaction
- Nonspecific drug interaction
Amount of medication delivered to patient in order to achieve optimal therapeutic effect:
How drugs are categorized:
Hint: Includes principal action, organ/body system affected, physiological action produced and therapeutic action.
Ability of a medication to affect illness or disease by preventing, improving or treating conditions:
6 effects of medication:
- Therapeutic effect
- Side effect
- Adverse effect
- Toxic effect
- Addiction or dependence
Method used to deliver a medication into the body:
Route of administration
3 most common routes of administration:
Through gastrointestinal tract:
By injection; other than through the gastrointestinal tract:
Applied to the skin or mucous membrane to provide a localized or systemic effect:
Form of drug preparation determine:
A medication’s route of administration and its pharmacodynamics and pharmacokinetics.
7 forms of drug preparation:
Drug standards are:
A review and approval process set by the FDA.
5 drug publications that list approved drugs and formulas:
- National Formulary
- Pharmacopeia of the United States (USP)
- American Hospital Formulary Services Index
- Physician's Desk Reference (PDR)
- The Joint Commission National Patient Safety Goals
5 types of "drug nomenclature" (names assigned to drugs):
The name assigned to a medication and copyrighted by the manufacturer for marketing purposes, and may include a reference to the intended use:
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:
A widely known household name of a medication:
Nonproprietary name for a drug:
Hint: Often a shortened version of the chemical name.
Name referring to the precise chemical composition and molecular structure of a medication:
3 legal drug classifications:
- Controlled substances
- Prescription medications
- Over-the-Counter medications
Drugs with a high potential to cause psychological and/or physical dependency and abuse.
Medications that require a written order from a doctor.
Hint: Order must include the name, dose, quantity and timing of the medication.
Pharmacologic agents prepared in dosages that are safe to administer without the direction of a physician:
Over-the-counter medications (OTC)
Federal drug policy that regulates manufacture and distribution of controlled substances and categorizes them into 5 "schedules" or "classes:"
The Controlled Substances Act
Includes substances that have high abuse potential and no current approved medical use.
Hint: heroin, marijuana, LSD, other hallucinogens, certain opiates and opium derivatives.
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
Includes substances with less potential abuse than Class II, and for which there is current approved medical use.
Hint: hydrocodone, codeine
Includes drugs for which there is a relatively low abuse potential and for which there is current approved medical use.
Hint: benzodiazepines (Valium, Ativan)
Includes drugs containing limited amounts of narcotic drugs for treatment of coughs and diarrhea:
Hint: cough syrups with codeine, diphenoxylate (Lomotil)
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
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
May interact with traditional medications, produce negative side effects and include ingredients harmful to pregnant women, children and the elderly:
Alternative Medication Supplements
10 most commonly used alternative medication supplements:
- Fish Oil/Omega 3/DHA
- Glucosamine combined with chondroitin
- Flaxseed Oil
- Gingko biloba
- Vitamins E and C
- B-complex Vitamins
- Aloe Vera
Hint: patient request for post-operative analgesics
pro re nata
Latin for "as needed"
Routine order for medication to be given pre-operatively as a standard usage unless told otherwise:
Means "immediately or at once." Variation of Latin statim:
Any order given by the surgeon or anesthesia provider during a procedure:
Ratio of medication solute to solvent:
Overall amount of medication delivered to the patient:
Medication's use in the surgical setting:
Formula for calculating a medication's concentration:
A : B = C : D
(B and C are the means; A and D are the extremes)
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
Total amount of medication given to the patient:
Formula for calculating a medication's cumulative dose:
Solution delivered is multiplied by the amount of solute from the previous (concentration) ratio.
2 scales commonly used to measure temperature:
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
Normal body temperature:
- 98.6° F
- 37° C
Conversion formulas for converting between Fahrenheit and Celsius:
- (F° - 32) 5/9 = C°
- (°C x 9/5) + 32 = °F
Primary system of measurement used in the healthcare field:
Meter = m
Centimeter = cm
Millimeter = mm
Metric system abbreviations for length
Kilogram = kg
Gram = g
Milligram = mg
Microgram = mcg
Metric system abbreviations for weight
Kiloliter = kl
Liter = l
Cubic centimeter = cc
Milliliter = mL
Metric System abbreviations for volume
2 measurement systems rarely used in the medical field that are still important to know:
- Household measurement system
- Apothecary measurement system
Yard = yd
Foot = ft.
Inch = in.
Household system abbreviations for length
Teaspoon = tsp.
Tablespoon = Tbsp.
Ounce = oz.
Pint = pt
Quart = qt
Gallon = gal
Household system abbreviations for volume
Pound = lb.
Household system abbreviation for weight
System based on weight of a grain of wheat:
Minim = m
Dram = dr
Drop = gtt
Ounce = oz
Pint = pt
Apothecary system abbreviations for volume
Grain = gr
Pound = lb
Apothecary system abbreviations for weight
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
The Six "Rights" of Medication Administration:
- The "right" patient
- The "right" drug
- The "right" dose
- The "right" route of administration
- The "right" time and frequency
- The "right" documentation, including labeling
All medication must be labeled with this information:
- Drug name
- Expiration date
- Route of administration
- Lot number
- Handling/storage precautions
- Instructions for reconstitution (if applicable)
- Controlled substances classification (if applicable)
Glass container that requires the top to be broken off to access the contents:
Hint: Usually contains liquid medication.
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.
Disposable item already loaded with the substance to be injected:
Metal or plastic item that may contain medication in cream, gel or ointment forms:
4 methods of medication transfer for vial:
- ST uses hypodermic needle attached to syringe
- Circulator uses vial decanter
- Circulator ejects medication into container onto back table with hypodermic needle
- Circulator pours
2 methods of medication transfer for ampule:
- circulator ejects medication into container onto back table with hypodermic needle
- ST uses hypodermic needle attached to syringe
Method of medication transfer for tube:
- circulator squeezes onto towel or sterile dressing material
ST should label all medication on the field with: