What is the study of medications and their actions, including drug origins, properties, and uses
Pharmacology
What is defined as a substance used for the diagnosis, treatment, cure, mitigation, or prevention (prophylaxis) of disease or a condition
Drug
Who has approved and standardized for safety, dosage accuracy, and effectiveness after undergoing several phases of formal independent testing.
FDA
What refers to an agent that stimulates or prolongs the response of a drug or a physiologic action
agonist
What is lack of recall
amnesia
What is an immediate hypersensitivity reaction to a foreign protein or other specific substance
anaphylaxis
What is an absence of sensation
anesthesia
What refers to an agent used to block the action of another drug or physiological action without producing any effect of its own
antagonist
What refers to an agent used to block parasympathetic effects such as salivation and bradycardia
antimuscarinic/anticholingergic
What is the pulse taken at the apex of the heart
apical pulse
What is drawing in or out by suction
aspiration
What is the making of drugs in the laboratory using genetic engineering; also referred to as recombinant DNA technology
biotechnology
What is the name for a reason why a specific procedure or drug may be undesirable or improper in a particular situation
contraindication
What is an ultrasonic device used to identify and assess vascular status of peripheral arteries and veins by magnifying the sound of the blood moving through the vessel
Doppler
What is the nonproprietary name for a drug that is often a shortened version of the chemical name and may include a reference to the intended use
generic
What is the reactions in the body that act and counteract to maintain the body in a normal physiological state
homeostasis
What is the altered state of consciousness that may be achieved by suggestion of another, an individual’s own concentration, or with the use of a substance
hypnosis
What is a reason to perform a specific procedure or prescribe a certain drug
indication
What is the second phase of general anesthesia, in which the patient is given induction drugs and intubated
induction
What is the name for within a joint
intra-articular
What is a sudden involuntary contraction of the larynx capable of causing partial or total occlusion of the larynx
laryngospasm
What is the acronym for
Nothing by mouth; Latin acronym for nil per os
NPO
What is taken into the body or administered in a manner other than through the digestive tract, as by intravenous or intramuscular injection.
parenteral
What is the interaction of drug molecules with target cells, resulting in biochemical and physiological actions
pharmacodynamics
What is the name for behind the eyeball or pons
retrobulbar
What agent produces a soothing or quieting effect but does not cause the person to sleep
sedative
What (as pertaining to anesthesia) is an agent that is applied to the surface of the skin or anatomical structure (such as the eye) to produce a loss of feeling or sensation in the area of application; blocks the nerve conduction of superficial nerves
topical
What is a group of liquids that easily evaporate and, when inhaled, produce general anesthesia through interaction with the CNS
volatile agents
What is the drug source:
morphine sulfate
digitalis
Plants
At one time, the majority of drugs originated from plants; a number of plant-based medications still in use today
What is the drug source:
heparin sodium
thrombin
Animals
Nonsynthetic hormones are derived from animal sources, including human sources; drugs obtained from cows are referred to as bovine and those from pigs as porcine
What is the drug source:
calcium
iron
magnesium
zinc
Minerals
Derived from the earth, minerals, and mineral salts
What is the drug source:
meperidine sulfate (Demerol)
aminoglycoside
antibiotics
Laboratory synthesis
The majority of drugs used today are manufactured in the laboratory
What is the drug source:
A process known as genetic engineering hepatitis B vaccine
Biotechnology (laboratory)or recombinant DNA technology
What are drugs that are manufactured totally from laboratory chemicals
Synthetic drugs
What are drugs that are natural substances that are chemically altered
Semi-synthetic drugs
What involves the study of the interaction of drug molecules with the target cells of living tissue
Pharmacodynamics
What is the drug source:
What technology artificially introduces foreign DNA into the DNA of a specific organism; the two types of DNA combine and the new DNA and its specific protein are replicated in the daughter cells of the organism
Recombinant DNA
What is the study of the movement of drugs through the body, involving absorption, distribution, biotransformation, and excretion
Pharmacokinetics
What may be intentional (beneficial) or undesirable (detrimental)
Types of drug interactions
What can occur when two substances are prescribed concurrently, causing a modification of the action of one or both drugs.
Drug interactions
One causes an action, and one blocks the action of the causing the opposite action of the first.
Agonists vs Antagonists
What occurs when a drug enhances the effect of another substance. by binding to a specific receptor site in the body, producing an alteration in biological function
Agonists
What are two examples of agonists
Synergists and additives are
What agent acts in combination to produce a stronger or more powerful effect than would be demonstrated if each agent was administered individually, the action of one agent increases the action of the other agent when delivered together
Synergistic Agents
The use of midazolam (a sedative) and fentanyl (a narcotic analgesic) permits the use of lower concentrations of volatile gases during the administration of general inhalation anesthesia is an example of what?
Example of synergistic agent
Medication ........ alter some aspect of the action of the original agent.
Additive Agents
The addition of epinephrine to the local anesthetic lidocaine to prolong the anesthetic action is an example of what?
An example of an additive
What binds to the agonist’s receptor site, preventing the agonist from binding there and causing its desired effect. This results in an absence of the agonist’s action, referred to as agonist reversal.
Antagonists
This interaction is demonstrated when flumazinil Mazicon®) is given to reverse the sedative effects of midazolam HCl (Versed®)is an example of what?
An example of an antagonist
What action of a a medication describes the application or situation for which the medication is used and the timing of the effects commonly associated with a given medication and dosage.
Therapeutic action
What is listing of the medical conditions that the medication is known to treat. The dosage, and delivery form may vary according to the patient’s medical condition, weight, and age
Indication
What are a list of circumstances or medical conditions under which the medication should not be used
contraindications
What is the period of time required for the effects of the medication to begin to be demonstrated in the patient
Onset
What is the period of time when the maximum effect(s) of the medication are demonstrated in the patient.
Peak Effect
What is the overall period of time when the effects of a medication are demonstrated in the patient.
Duration
The concentration or dose of a medication used to produce the desired result without producing harmful effects is referred to as the medications ....
Therapeutic effect
An expected, undesirable, but tolerable effect of a medication. These can include symptoms such as dry mouth, constipation, diarrhea, dizziness or drowsiness is referred to as the medications ....
Side effect
An undesirable and potentially harmful effect of a medication that can lead to organ damage or failure is referred to as the medications ....
.
Adverse effect
An undesirable and unacceptable effect of a medication. The effect can include the promotion of growth of cancerous tumors (carcinogens) or the development of birth defects (teratogens)is referred to as the medications ....
Toxic effect
A reduction in the effect of a medication results in an increase in dosage in order to achieve the desired effect is referred to as the medications ....
Tolerance
A physical or psychological dependency on the effect of a medication is referred to as the medications ....
Addiction
What is the term used to describe the metabolic processing of a drug within the body
Pharmacokinetics
What does the processes of pharmacokinetics involve
absorption, distribution, biotransformation, and excretion.
1. Absorption occurs at site of administration
2. Drug transferred from higher to lower concentration until both sides of cell membrane is equal
Absorption via passive transport
Requires no energy
What is required for a limited number of drugs. An energy source in the form of a cation, such as sodium, is required to carry the substance from an area of lower concentration to one of higher concentration.
Active Transport
What can be added to a drug preparation to slow absorption.
The vasoconstrictor epinephrine
What is distributed to the target cells for action, to the liver for biotransformation, and to the liver or kidneys for elimination
Distribution of medication
pharmacokinetics
What is also affected or limited by plasma protein binding, tissue binding, and certain barriers established by the body
Placental barrier and the blood–brain barrier.
What are the steps involved in Pharmacokinetics
Absorption
Distribution
Metabolism
Excreetion
What action of a drug most often occurs in the liver, but other tissues, including the intestinal mucosa, lungs, kidneys, and blood plasma, may be involved
Biotransformation or metabolism
pharmacokinetics
Several medications are converted to an active substance by the liver, but the main function of the liver in drug metabolism is to break down the drug molecules in preparation for excretion.
Biotransformation or metabolism
pharmacokinetics
What is the main function of the liver in drug metabolism
It is to break down the drug molecules in preparation for excretion
pharmacokinetics
What are the products of metabolic breakdown called
Metabolites
(They are smaller, inactive substances)
pharmacokinetics
The effect of medication in the body continues until it is biotransformed and/or excreted. The kidneys are primarily responsible for the filtration of medications from the blood and elimination of medications and metabolites as part of urine formation and excretion. Some medications and metabolites may be eliminated fecally, via sweat or saliva, or exhaled.
Excretion
pharmacokinetics
Some medications are eliminated in breast milk, which may affect the breastfed baby
Excretion
pharmacokinetics
Placed between the layers of the skin
Intradermal
Parenteral: Other than through the gastrointestinal tract; by injection
Subcutaneous (SC or SQ)
Placed into the adipose (fat) tissue layer under the skin
Parenteral: Other than through the gastrointestinal tract; by injection
Oral (PO, meaning per os or by mouth)
Placed in the mouth and swallowed
Enteral: Through the gastrointestinal tract
Rectal
Placed into the rectum
Enteral: Through the gastrointestinal tract
Intramuscular (IM)
Placed within a muscle
Parenteral: Other than through the gastrointestinal tract; by injection
Intravenous (IV)
Placed directly into a vein
Parenteral: Other than through the gastrointestinal tract; by injection
Intra-articular
Placed within a joint
Parenteral: Other than through the gastrointestinal tract; by injection
Intrathecal
Placed into the subarachnoid space
Parenteral: Other than through the gastrointestinal tract; by injection
Intracardiac
Placed into the heart
Parenteral: Other than through the gastrointestinal tract; by injection
Buccal
Placed between the cheek and the teeth/gums until it is dissolved and/or absorbed
Topical: Applied to the skin or mucous membrane to provide a localized or systemic effect
Sublingual
Placed under the tongue until it is dissolved and/or absorbed
Topical: Applied to the skin or mucous membrane to provide a localized or systemic effect
Instillation
Placed in a hollow or cavity, such as the conjunctival fold or bladder
Topical: Applied to the skin or mucous membrane to provide a localized or systemic effect
Inhalation
Directly administered to the respiratory tract, usually as a gas or aerosol
Topical: Applied to the skin or mucous membrane to provide a localized or systemic effect
Which Drug Publication:
Contains information on single drugs and the formulas for drug mixtures; includes drug testing and purity information; lists drugs using generic names; lists medications no longer included in the USP
National Formulary
Which Drug Publication:
Contains information on medications used in current medical practice; lists drugs using generic names; includes the medication source, properties, category/classification, dosage range, and therapeutic dosages
Pharmacopeia of the United States (USP)
Which Drug Publication:
Presents medical information arranged in therapeutic or pharmacological classes according to generic name
American Hospital Formulary Service Index
Which Drug Publication:
Is not an official pharmacological listing, but commonly used by physicians for referencing medications for prescription; medications are listed alphabetically by manufacturer using their brand names
Physician’s Desk Reference (PDR)
Which Drug Publication:
Contains The National Patient Safety Goals include policies on “Look-alike/sound-alike medications” and the “Official Do Not Use” abbreviation list
The Joint Commission National Patient Safety Goals
Oxygen and nitrous oxide are included in this Forms of Drug Preparation category
Gas
Forms of Drug Preparation
(Category)
What is this drug preparation called
Drug (solute) is dissolved in a liquid (solvent)
Liquid - Solution
Forms of Drug Preparation
This category has a solution and suspension preparation
Liquid
Forms of Drug Preparation
What is this drug preparation called
Solution prepared with water
Aqueous - Liquid
Forms of Drug Preparation
What is this drug preparation called
Sweetened aqueous solution
Syrup - Liquid
Forms of Drug Preparation
What is this drug preparation called
Solution prepared with alcohol
Tincture - Liquid
Forms of Drug Preparation
What is this drug preparation called
Sweetened alcohol solution
Elixir - Liquid
Form of Drug Preparation
What is this drug preparation called
Powder —even though it may be in the powdered state, contained within a capsule, or compressed into tablet form—some powders must have liquid added (called reconstitution) prior to use—troches or lozenges also fall into this category
Solid
Forms of Drug Preparation
What is a combination of two liquids that cannot mix—droplets of one liquid are dispersed (suspended) throughout the other
Emulsion
What is this drug preparation called
Creams, foams, gels, lotions, ointments, and suppositories
Semisolid
Forms of Drug Preparation
What are those drugs with a high potential to cause psychological and/or physical dependence and abuse
Controlled substances
Controlled Substances - Which Class?
Includes substances for which there is a high abuse potential and no current approved medical use
Schedule Or Class I
heroin, marijuana, LSD, other hallucinogens, and certain opiates and opium derivatives
Controlled Substances - Which Class?
Includes substances that have a high abuse potential and a high ability to produce physical and/or psychological dependence and for which there is a current approved or acceptable medical use
Schedule Or Class II
morphine sulfate, oxycodone, hydromor-phone, meperidine, codeine, anabolic steroids
Controlled Substances - Which Class?
Includes substances for which there is less potential for abuse than drugs in Schedule II and for which there is a current approved medical use
Schedule Or Class III
hydrocodone, codeine, and others in combination with other drugs
Controlled Substances - Which Class?
Includes drugs for which there is a relatively low abuse potential and for which there is a current approved medical use
Schedule Or Class IV
benzodiazepines (Valium, Ativan)
Controlled Substances - Which Class?
Drugs in this category consist mainly of preparations containing limited amounts of certain narcotic drugs for use to treat coughing and diarrhea, drugs may be bought without a prescription by an individual at least 18 years of age.
Schedule Or Class V
cough syrups with codeine; diphenoxylate (Lomotil)
What medication information does the surgical technologist need in the surgical setting
names, classifications, actions, indications, uses in the surgical setting, and dosages for use in the surgical setting.
What is the name assigned to a medication and copyrighted by the manufacturer for marketing. There may be slight differences in the chemical preparation used by each manufacturer, making the preparation under each trade name slightly different
Trade, brand, or proprietary name
The trade name is prominently displayed on the medication label.
What is the nonproprietary name for a drug. It is often a shortened version of the chemical name. It may be produced by several manufacturers
Generic name
The generic name is prominently displayed on the medication label.
What is the precise chemical composition and molecular structure of the medication, often complex and difficult to use.
Chemical name
Chemical name is not included on the medication label, but is included in the package insert
The theory of drug–receptor interaction states that the active substance in the drug has an affinity for a specific chemical constituent of a cell. The interaction occurs on a molecular level with a specific receptor on the cell surface or within the cell to produce the pharmacological response.
Theory on ways that a drug produces its effect
The theory of drug–enzyme interaction states that a drug may combine with a specific enzyme to inhibit the action of the enzyme or alter the cellular response to the enzyme
Theory on ways that a drug produces its effect
The theory of nonspecific drug interaction, is related to a drug that does not act by either of the two previously described methods and is considered nonspecific in its interaction.
Theory on ways that a drug produces its effect
What is commonly expressed in a ratio of medication concentration per kilograms of patient body weight (mg/kg).
A medication dosage
What is the ratio of solute to solvent, the two components of a solution (medication)
The concentration
What % of sodium chloride is typically needed to reconstitute powder to solvent for injection
commonly 0.9% sodium chloride
The dose or dosage is documented in the patient’s record as part of the ........ of medication administration.
“sixth right”
What is the term for the medication’s use in the surgical setting
The application
What in concentrations of less than 1:100,000, can be injected as a vasoconstrictor, but in concentrations of 1:1,000, it should only be used topically to prevent serious patient complications, including death.
Epinephrine
In order to calculate medication dosages on the sterile field, the surgical technologist needs to understand two basic concepts:
Concentration and cumulative dose
In order to calculate concentration, you need to convert the solution into units of medications per one unit of fluid; in other words, solute to solvent. This is accomplished using the following formula:
A : B = C : D
If the label reads 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
When diluting a medication by adding more solvent to the solute, the concentration changes. For example, when 1 milliliter of heparin sodium 10,000 units per mL is added to 1,000 milliliters of normal saline for injection, the concentration of this medication is 10,000 units per 1,000 mL and needs to be converted using the previous formula
10,000 : 1,000 = X : 1 (multiply the means by extremes)
10,000 = 1,000X
Reduce the fraction by dividing both sides by “1,000”
10 = X or 10 units per mL
1 meter = 100 centimeters
1 meter = 1,000 millimeters
1 meter = 1,000 millimeters
1 millimeter = 1,000 microns
Length
Metric Conversion
1 millimeter = 1,000 microns
1 gram = 1,000 milligrams
1 gram = 1,000 milligrams
1 milligram = 1,000 micrograms
Weight
Metric Conversion
1 milligram = 1,000 micrograms
1 liter = 1,000 milliliters
Volume
Metric Conversion
What system do Pharmacists sometimes use.
This system is based on the weight of a grain of wheat. In this system, 12 ounces (rather than the more commonly known 16 ounces) equals one pound. The units of measure are the minim for volume and the grain for weight
Apothecary system
Volume
•Minim = m
•Dram = dr
•Drop = gtt
•Ounce = oz
•Pint = pt
Apothecary system Volume
•1 meter = approximately 1 yard or 36.37 inches
•2.54 centimeters = 1 inch
Length
Measurement Equivalents
Apothecary system Volume
Volume
•1 milliliter = 1 cubic centimeter
•1 fluid ounce = 30 milliliters
•1 gallon = 4 liters or 4000 milliliters
•1 quart = 1,000 milliliters or 1 liter
•1 pint = 500 milliliters
Volume
Measurement Equivalents
Apothecary system Volume
Weight
•1 kilogram = 2.2 pounds
•30grams = 1 ounce
•60 milligrams = 1 grain
Weight
Measurement Equivalents
Apothecary system Volume
•The “right” patient
•The “right” drug
•The “right” dose
•The “right” route of administration
•The “right” time and frequency
•The “right” documentation, including labeling
The Six “Rights” of Medication Administration
What are glass containers that require the top to be broken off to access the contents
Extra caution must be used when handling glass ampules to ensure that glass does not contaminate the medication upon opening the ampule
Ampule
Medication Identification
What are plastic or glass container that have a rubber stopper at the top that is held in place with a metal retaining ring—may contain liquid, powder, or compressed powder
Vial:Medication Identification
All drugs must be labeled by the manufacturer and the label must contain the following information
•Drug name (trade and generic)
•Manufacturer
•Strength
•Amount
•Expiration date
•Route of administration
•Lot number
•Handling/storage precautions and warnings
•Instructions for reconstitution (if applicable)
•Controlled substances classification (if applicable)
Drug labels by the manufacturer Must contain...
Parts of a needle
Circulator cleans the stopper at the top of the vial using an alcohol wipe and holds the vial at an angle while the surgical technologist inserts a hypodermic needle attached to the syringe through the stopper and withdraws the medication.
Medications from a vial may be transferred by one of four methods
Circulator inserts a sterile medication vial transfer device (a long straw-like device with a spiked end) into the vial stopper and pours the medication into a container on the back table.
Medications from a vial may be transferred by one of four methods
Circulator medication into a syringe using the hypodermic needle, and ejects the mediation into the container on the back table.
Medications from a vial may be transferred by one of four methods
•Circulator removes the metal retaining ring and rubber stopper and pours the medication into the container on the back table.
Medications from a vial may be transferred by one of four methods
Circulator removes the top of the ampule, draws the medication into a syringe using the hypodermic needle, and ejects the medication into the container on the back table.
Medications from an ampule may be transferred using one of two methods:
Circulator removes the top of the ampule and holds it at a slight angle while the surgical technologist withdraws the medication into a syringe via hypodermic needle
Medications from an ampule may be transferred using one of two methods
What methods are squeezed by the circulator onto a towel, into a small cup or directly onto a sterile dressing material on the back table.
Medications from a tube
Surgical-technologist-crafted labels using a sterile marking pen and a blank sterile label. If blank labels are not available, what may be used
a sterile skin closure tape (Steri-Strip™) is a possible alternative
LABEL MAKESHIFTS
What is ratio of solute to solvent
Concentration
What is the overall amount of medication delivered to the patient
Dose
What can also be expressed as a decimal by moving the decimal point two places to the left of the written number to indicate hundredths
%. Percentages
75% = 0.75 or 75/100
Examples of percentage calculations
•15 is what percentage of 30?
15/30 = 0.50 or 50%
•What is 20% of 80?
Change the 20% to a decimal and multiply by 80:
20% = 0.20 × 80 = 16
What temperature reference points are frequently referenced in the OR
1. Boiling point of water, 212°F or 100°C 2. Freezing point of water, 32°F or 0°C
3. Normal body temperature, 98.6°F or 37°C
The conversion formulas for converting between Fahrenheit and Celsius scales are
(°F − 32) 5/9 = °C
(°C × 9/5) + 32 = °F
What are the three classifications of drugs that are associated with surgical interventions of the female reproductive tract
Oxytocics, vasopressin, and immunoglobin
What drugs are used to induce labor and control uterine hemorrhage associated with pregnancy and childbirth.
Oxytocic drugs
What drug is used to induce or continue labor, contract the uterus following vaginal or cesarean birth, and as an adjunct in the treatment of incomplete or spontaneous abortion, planned abortion, and to control uterine bleeding following an abortion
Oxytocin (Pitocin, Syntocinon)
What is the second medication used in gynecologic surgery involving the cervix. It is injected around the cervix during a vaginal hysterectomy, cervical conization, or into a uterine fibroid during myomectomy to reduce intraoperative bleeding.
Vasopressin (Pitressin)
What immunoglobin, is administered to Rh-negative women who are pregnant to prevent sensitization of the maternal immune system when pregnant with an Rh-positive fetus
RhoGam
Maternal Rh antibodies can cross the placenta during subsequent pregnancies, where the antibodies destroy fetal circulating red blood cells.
What are the routine pharmacological supplies used in orthopedic surgery
Antibiotics, hemostatic agents, and steroids
What drugs are mixed with irrigation solutions or injected into the bags of solution used during irrigation and/or pulsed lavage of the surgical wound.
Polymixin, bacitracin, and cephalosporin antibiotics
What agents are used in orthopedic surgery include absorbable gelatin sponge (Gelfoam), microfibrillary collagen (Avitene), thrombin (Thrombinar), and bone wax
Hemostatic agents
“Chemical Methods of Hemostasis”
What drugs are used for their anti-inflammatory action. Dexamethasone (Decadron), a short-acting corticosteroid; dexamethasone long-acting (Decadron LA); or betamethasone (Celestone),
Steroids
What drug is a long-acting corticosteroid, may be administered to reduce inflammation in a joint area caused by trauma
Betamethasone (Celestone)
What intravascular irrigation is commonly used during cardiac and peripheral vascular procedures,
Heparinized saline
Dilute and concentrated heparin solutions may be required, and must be labeled accordingly
Additional medications used during vascular procedures include
contrast media for ........
arteriography (Xray)
Additional medications used during vascular procedures include:
opical papaverine HCl (Papaverine) for .......
dilating blood vessels
Additional medications used during vascular procedures include:
lidocaine HCl for .........
local anesthesia
Additional medications used during vascular procedures include:
oxidized cellulose (Oxicel, Surgicel) for ........
hemostasis
Drugs and solutions used during neurosurgical procedures include:
antibiotics in warm saline for .........
irrigation
neurosurgical procedures
Drugs and solutions used during neurosurgical procedures include: heparinized saline solution for ..........
intravascular irrigation
neurosurgical procedures
Drugs and solutions used during neurosurgical procedures include:
contrast media for .........
cerebral arteriography
neurosurgical procedures
Drugs and solutions used during neurosurgical procedures include: topical papaverine HCl (Papaverine) for ............ during procedures involving cerebral vasculature
dilating blood vessels
neurosurgical procedures
Drugs and solutions used during neurosurgical procedures include:
polifeprosan 20 with carmustine implants (Gliadel Wafers) for ........
topical placement onto the post-resection tumor bed for the treatment of glioblastoma multiforme
neurosurgical procedures
Drugs and solutions used during Ophthalmic Surgery:
What agents cause the iris to contract, resulting in dilation of the pupil referred to as mydriasis
Mydriatics and cyclopleoic
Ophthalmic procedures
Drugs and solutions used during Ophthalmic Surgery:
The commonly used mydriatic agent is called .....
phenylephrine HCl (Neo-Syne.hrine).
Ophthalmic procedures
Drugs and solutions used during Ophthalmic Surgery:
The commonly used cycloplegic agents include
Tropicamide (Mydriacyl), cyclopentolate (Cyclogyl), and atropine sulfate (Atropisol)
Ophthalmic procedures
What agents act on the iris, resulting in iris relaxation and, therefore, pupil constriction.
Miotic
Ophthalmic procedures
Drugs and solutions used during Ophthalmic Surgery:
Miotic agents include ........
Pilocarpine HCl (Pilocar, Isopto Carpine) and carbachol (Miostat).
Ophthalmic procedures
What drugs also facilitate the drainage of aqueous humor through the trabecular meshwork of the canal of Schlemm, thus decreasing intraocular pressure (IOP), making them useful for the treatment of increased IOP due to glaucoma
Miotic drugs
Ophthalmic procedures
What ophthalmic agents are used to expand the anterior chamber and prevent injury to the corneal endothelium and surrounding tissues during cataract extraction
Viscoelastic/viscosurgical (can also be used to replace vitreous humor)
Ophthalmic procedures
Drugs and solutions used during Ophthalmic Surgery:
What are commonly used viscoelastic agents.
Chondroitin sulfate-sodium hyaluronate (Viscoat) and sodium hyaluronate (Healon, Amvisc)
Ophthalmic procedures
Drugs and solutions used during Ophthalmic Surgery:
What are the most commonly used topical anesthetics in ophthalmic surgery
Tetracaine (Pontocaine) and proparacaine (Ophthaine
Ophthalmic procedures
In ophthalmic procedures which anesthesia may be necessary for some procedures to block both sensory and motor nerve function
Retrobulbar
Ophthalmic procedures
Which anesthesia is accomplished by injecting the area around the optic nerve with a combination of lidocaine HCl and bupivacaine, both without epinephrine
Retrobulbar anesthesia
What irrigation fluid is used during ophthalmic surgery to keep the cornea from drying out
Balanced salt solution
What is a sterile mix of beeswax, the body recognizes as a foreign body, and can reject or react to
Bone wax
What is used in thoracic surgery when the sternum is split, in neurosurgical procedures when a craniotomy is performed, and for orthopedic and otorhinolaryngologic (ENT) procedures
Bone wax
What sponge is placed over an area of bleeding, and fibrin is deposited initiating clot formation. It may also be soaked in epinephrine to enhance vasoconstriction
Absorbable Gelatin Sponge
Absorbable Gelatin Sponge is absorbed by the body in how many days
30 days
What collagen is soluble, and as hemostasis occurs, it is absorbed and eliminated from the body. It should be kept dry to avoid it becoming sticky
Microfibrillar Collagen (Avitene)
What products are available in the form of pads (Nu-Knit, Fibrillar, and SNoW) or fabric (Surgicel—Original). Blood clots rapidly form in the presence of these products. Absorbed and eliminated from body
Oxidized Cellulose
What is often used to control cervical or nasal bleeding. It is applied either in stick form as a caustic pencil or in solutions of 0.01% to 10% silver nitrate.
Silver Nitrate
What is a potent vasoconstrictor and is often combined with local anesthetic agents or with Gelfoam to aid in local hemostasis. It is absorbed rapidly by the body but provides good localized hemostasis.
Epinephrine
What is an enzyme that results from the activation of prothrombin, it is of bovine (cow) and never injected. It should be discarded if not used in several hours
Thrombin
Estimated Blood Loss
Calculated by a wet/dry formula, sponges used, suction canisters etc
EBL
All components of blood—not commonly used. Used to treat trauma-induced hemorrhage
Whole blood
What is from 1 unit of whole blood after most of plasma is removed. Used to restore oxygen-carrying capacity
Packed red blood cells (PRBCs)
What is the fluid component of blood containing clotting factors removed from 1 unit of whole blood Restores clotting factors; usually 1 unit of FFP is given for every 4 units of PRBCs
Fresh-frozen plasma (FFP)
What are removed from 1 unit of whole blood. Used to enhance blood clotting ability when the count is low—less commonly used
Platelets
Unused blood should be stored in a refrigerator at a temperature between
1° and 6°F (33.8−42.8°C)
What involves the use of the patient’s own blood that has been processed for reinfusion
Autotransfusion
What is blood collected in for use in auto-transfusion
Autologous blood retrieval system (Cell Saver®)