Surgical Tech Pharmacology

Adverse effect

An undesired, potentially harmful side effect of a drug

Agonist

A drug that binds to a receptor and stimulates the receptor's function

Amnesia

Loss of memory

Anesthesia

Without sensation

Antagonist

A drug that counteracts the action of another drug

Analgesia

Absence of pain

Antiarrhythmic

Drug given to correct cardiac dysrhythmia

Balanced anesthesia

Technique that uses a variety of drugs to achieve homeostasis, analgesia, amnesia, and muscle relaxation

Cathartic

Drug use to produce evacuation of the bowels; laxative

Contraindication

The reason a specific drug is not used

Controlled substance

Drug with potential for addiction and abuse

Emetic

Drug that induces vomiting

Expectorant

Drug that promotes expulsion of mucus from the lungs or trachea

Fasciculation

Muscular twitching or contraction following the administration of succinycholine chloride, a depolarizing neuromuscular blocker used in conjunction with general anesthesia

hypnotic

Drug used to induce sleep and in sensibility to pain

Indication

Reason for giving a specific drug

Intubation

Insertion of an endotracheal tube for the purpose of controlled respiration

Malignant hyperthermia

Hypermetabolic crisis triggered by some anesthetic agents and drugs in susceptible persons

Parenteral

Given by injection or a route other than the gastrointestinal tract

Pharmacodynamics

Study of drugs and their actions on living organisms

Pharmacokinetics

Entire process of the drug within the body

Pharmacokinetics processes

Absorption, distribution, metabolism, and excretion

Sedative

Drug used to allay (treat) anxiety or excitement or mental tension may be used to induce unconscious state; exerts a soothing or tranquilizing effect

Side effect

An expected but unintended effect of a drug

Toxicology

Study of poisons and the adverse effects of chemicals or drugs on the body

Tranquilizer

Drug used to allay anxiety without depressing the patient

Pharmacology

Study of drugs

Medication orders may be either

Standing or verbal

Purpose of drugs

Diagnose or investigate (contrast media and dyes)

Treat symptoms without curing disease (aspirin )

Cure disease (antibiotics)

Prevent illness (vaccines)

Drug Nonmenclature

1. Chemical Name (chemical formula) used frequently

2. Generic Name (non proprietary name that is often given by original developer) common name

3. Trace Name or brand name drug name (chosen by manufacturer for proprietary purposes) registered and capitalized

Sources of accurate drug information

1 US Pharmacopedia (USP) up to date carcinogens (FDA approved)

2 National Formulary (NF) AFI American Hospital Formulary (FDA approved) easier to read; every 5 yrs

3 Physician's Desk Reference (PDR) most common

Source of drugs

1. Plant products (digitalis)

2. Animal products (hormones)

3. Minerals (iron)

4. Laboratory synthesis (Demerol; antibiotics)

5. Biotechnology (Heptovax-hypatitis B vaccine

Routes of adminstrive

1. Oral (PO) enteral

2. Parenteral (IV, IM, SC, ID, and intrathecial

3. Topical, rectal, vagina, sublingual and buccal

4. Inhalation

Drug forms

1. Solids (tablet, powder, capsules, lozenges)

2. Semisolids ( suppositories, ointments, cream, gel and foams

3. Liquid most common in surgery

*solutions drug dissolved in Liquid, tincture, sryup, and elixir (sugar without alcohol

* suspension solid particles float in Liquid and must be shaken before use

*emulsion combination of 2 liquids the do not mixed.

Types of syringes

Standard, turberculin, insulin, tubex, and irrigating

Standard syringe

Plain tip or lure loc tip

Turberculin

1 cc for doses of less than 1 ml

Insulin

Calibrated in units up to 100 units (u)

Tubex

Metal or plastic device that holds a carpule of medication

Irrigating

Aseptic (bulb 120cc), ear, or toomey syringe

Six Rights

1. Right patient 2. Right drug 3. Right dose 4. Right route 5. Right time 6. Right label and documentation

As a scrub you need to verify what on a viral of medication and what else

Verify Name, Strength, Amount, and Expiration Date then label immediately

What does the scrub recites to the surgeon? And does what afterwards

The name, strength, and amount of the drug and needs to make note of the amount used.

Adrenergic drugs

Used to work with sympathetic nervous system to increase BP and dilate bronchioles; useful in shock and anaphylactic reactions; can be combined with local anesthetics

Adrenergic drug examples

Epinephrine (adrenalin), phenylephrine hydrochloride (Neo-Synephrine) - used in nasal and eye surgery

Antiarrhythmic drugs

Given by anesthesiologist to correct cardiac dysrhythmia

Antiarrhythmic drug examples

Lidocaine (Xylocaine), procainamide hydrochloride (Pronestyl)

Antibiotics/antibacterial drugs

Used to treat or prevent an infection (antibiotic prophylaxis)

Aminoglycosides

Broad spectrum antibiotics may be given IV or used in irrigate wounds when mixed with saline; most common

Aminoglycosides examples

Kanamycin (Kantrex), gentamicin (Garamycin)

Cephalosporins

Broad spectrum antibiotics, may be given IV or mixed with saline or lactated ringers solution for irrigation of wounds

Cephalosporins drug examples

Cefazolin (Ancef), cefotetan (Cefotan)

Penicillins

Antibiotic available in many natural and semisynthetic forms; example Ampicillin (Omnipen)

Syringes Summary

3 cc syringes are calibrated in tenths, TB syringes are calibrated in hundredths, 5 and 10 cc syringes are calibrated in full cc measures and read from top or front of ring

Tetracyclines

Broad spectrum antibiotic; example: Doxycycline (Vibramycin)

Heparin sodium

Interferes with clotting, given IV during vascular surgery, and effects can be reverse prior to closing; can be given in small doses pre/post operatively to prevent formation of blood clots; **reversal agent is procainamide sulfate

Anticoagulants

Used to prevent or delay the clotting of blood; example: Heparin sodium and warfin (Coumadin)

Warfarin (Coumadin)

Oral anticoagulant that interferes with synthesis of prothrombin in the liver, used to prevent clots, latent period of 24 hours and residual for several days; generally discontinued prior to surgery or treated with its antidote vitamin K (Mephyton, Aqua Mephyton)

Antihistamines

Used to prevent or counteract an allergic reaction example: Diphenhydramine (Benadryl)

Antihypertensive drugs

Used for rapid reduction of blood pressure example: Nitroprusside sodium (Nipride, Nitropress)

Bronchodilators

Used in treatment of both asthma and cheyne-stokes respiration to dilate bronchioles and enhance respiration; examples aminophylline and ephedrine sulfate

Cardiac glycosides

Used to increase cardiac output and give stronger, fuller beat, may result in slowing of the pulse; used to treat congestive heart failure and certain arrhythmias; example digitizing (Purodigin)

Cholinergic drugs

Used to work with parasympathetic nervous system and vagus nerve to speed up smooth muscle activity (promote intestinal motility and bladder motility) and to counteract nonpolarizing neuromuscular blockers; example prostigmine (Neostigmine)

Contrast Media

Outlines walls of hollow tubes or cavities; allows internal structures to be viewed on x-ray; are radiopaque; must contain iodine so patients history needs to be checked for allergies to iodine or shellfish

Coronary artery dilators

Used to dilate the coronary arteries to increase blood flow to the heart example nitroglycerin (may be administered sublingually or by a dermal patch)

Cycloplegic

Used to dilate the pupil by paralyzing the ciliary muscle examples: Cyclogyl and Mydriacyl

Diuretics

Used to increase urinary output and control edema and hypertension; use in neurosurgery and ophthalmic surgery examples furosemide and mannitol

Furosemide (Lasix)

Referred to as a loop diuretic because it acts at Henle's loop in the kidney tubule to increase renal excretion of fluid and electrolytes; both urinary output and potassium level should be monitored during use

Mannitol (Osmitrol)

Referred to as an osmotic diuretic because it raises osmotic pressure at the glomeruli level to increase urinary output; given during certain neurosurgical procedures to reduce intracranial pressure

Dyes

Used to enhance visualization of a structure or for marking skin incisions; examples methylene blue, indigo carmine, brilliant green, and gentian violet

Hemostatic agents (Coagulants)

Used to control bleeding in surgery; examples thrombin, bone wax, absorbable gelatin sponge (Gelfoam), oxidized cellulose (Oxycel, Surgicel), microfibrillar collagen (Avitene), absorbable collagen sponge, and protagonist sulfate

Thrombin

Topical powder may be mixed with a solution but NEVER injected (like cocaine); can be used with Gelfoam

Bone wax

Topical hemostatic agent made from beeswax used on bone surfaces; stops bone bleeding

Absorbable gelatin sponge (Gelfoam)

May be moistened with saline or thrombin solution and placed on bleeders

Oxidized Cellulose (Oxycel, Surgicel)

Applied dry and is absorbable; the gaze form may be cut into desired shape and size

Microfibrillar collagen (Avitene)

Absorbable and must be applied dry

Absorbable collagen sponge

Cut into desired shape and applied with pressure to the bleeding site; SHOULD NOT BE USED WITH METHYL METHACRYLATE

Protamine sulfate

Given IV to counteract the effects of heparin

Hormones

Used to replace loss or deficiencies; examples Insulin and Glucagon

Insulin

Used to promote utilization of glucose to treat diabetes

Glucagon

Used to antagonize insulin or treat hypoglycemia

Miotics

Used to constrict the pupil example acetylcholine chloride (Miochol)

Mydriatics

Used to dilate the pupil examples: Atropine, Cyclogyl, Mydriacyl, Neo-Synephrine and Tropicamide (cycloplegic and mydriatic)

Oxytocic drugs

Used to contract the uterus to induce or facilitate labor or given in larger doses following delivery to contract the uterus and control bleeding; examples: oxytocin (Pitocin) and methlergonovine (Methergine)-never used with labor it causes tetanic contractions and would cut off oxygen to fetus

Stains

Used to identify abnormal tissue usually iodine based examples: Schiller's test (uses Lugols solution) and Lugol's solution for identifying abnormal cervical cells prior to biopsy

Steroidal anti-inflammatory drugs

Used to decrease cerebral or ocular edema, prevent swelling; useful in arthroscopy, eye, head, and neck surgery; large doses of steroids preoperatively can interrupt the healing process.

Steroidal anti-inflammatory drug examples

Dexamethasone (Decadron), hydrocortisone (Solu-Cortef) and methylprednisolone (Solu-Medrol)

Vasodilator

Used to dilate peripheral blood vessels example: papaverine hydrochloride-also prevents vascular spasms

Vasopressor

Used to constrict blood vessels to raise blood pressure examples vasopressor (Pitressin) and norepinephrine (Levophed)

Viscoelastic agents

Thick jelly like substance injected into the eye to keep it expanded; examples Viscoat/Amvisc and Healon

alpha-chymotripsin (Chymar or Zolase)

An enzyme sometimes used during cataract extraction to dissolve zonules that hold the lens in place when performing intra-capsular lens extraction (ICCE)

Dantrolene sodium (Dantrium)

Skeletal muscle relaxant used in treatment of Malignant Hyperthermia

hyaluronidase (Wydase)

An enzyme added to a local anesthetic to enhance infiltration/spread

Rho GAM--Rh (D) immune globulin

Used to prevent isoimmunization in Rh-negative women exposed to Rh-positive blood; given after abortions, miscarriages, amniocentesis or delivery

Contrast Media examples

Omnipaque, Hypaque (diatrizoate

Electrolyte replacement

Calcium chloride or calcium gluconate, Magnesium sulfate, Potassium chloride, and sodium bicarbonate

Calcium chloride or calcium gluconate

given as a myocardinal stimulant or to enhance blood clotting in the patient with multiple blood transfusions. Calcium ions are essential in transmission of nerve impulses, muscle contractions, blood coagulation and cardiac function. (the preservative in stored blood destorys ionizable calcium (necessary in blood clotting)

Magnesium sulfate

used to prevent seizures in patients with eclampsia (toxemia of pregnancy); quites a contracting uterus

Potassium chloride

added to intravenous fluids in hypokalemic patients to correct cardiac dysrhythmias; also used as cardioplegic in open heart surgery (is an essential intracellular electrolyte for regulating neuromuscular excitability and muscle contractions)

Sodium bicarbonate

given to combat metabolic acidosis in a cardiac arrest patient (is the chief interstitial (btwn cells) electrolyte and essential in maintaining osmotic pressure)