Pharmacology Quiz: Surgical Technologist Exam

Antibiotics may be administered oral, intramuscularly, intravenously, or topically, depending on the agent

Estrogens are also used for palliative treatment of advanced androgen-dependant prostate cancer

In a patient under general anesthesia, vomiting may be a life-threating situation; inability to clear the airway may result in aspiration of gastric contents into the lungs. Due to its acidic nature, the gastric contents can severely damage delicate lung tissue

Heparin is the primary anticoagulant used intraoperatively. Heparin is administered intravenously 3 minutes prior to placement of an arterial occluding clamp. Heparin is frequently used from the sterile back table during peripheral vascular procedures and is used as a topical arterial irrigant. Carotid endartectomy, peripheral vascular procedures, femerol-popliteal bypass/fem-pop bypass, open heart procedures. Anticoagulants are drugs that prevent or interfere with blood coagulation. Anticoagulants are administered in the medical setting to prevent venous thrombosis, pulmonary embolism, acute coronary occlusions after myocardial infarction (MI), and strokes caused by an embolus or cerebral blood clot. Anticoagulants do not dissolve existing clots; rather they prevent new clots from forming. Anticoagulants are used in surgery to prevent clot formation as a response to trauma or manipulation of blood vessels

Epinephrine is often used in combination with local anesthetics to prolong anesthesia. Epinephrine causes local vasoconstriction; epinephrine (adrenalin)

Common intraoperative miotics include, Acetylcholine chloride and Carbachol (IsoptoCarbachol)

Narcotics are often given during maintenance of general anesthesia because of their analgesic effects

Diprivan

Succinylcholine (Anectine) is the only depolarizing muscle relaxant in used today.

The metric system is the most commonly used standard of weights and measures.

Today drugs are derived from plants, animals, and minerals, as well as drugs developed in the chemistry and molecular biology laboratory.

Federal regulation of drugs was initially intended to protect consumers from harmful, impure, or unsafe drugs in the early 1900-‘s. The FDA is responsible for monitoring drug development, manufacturing, and marketing. New drugs must be thoroughly tested prior to approval for release by the FDA.

VRE: Vancomycin-resistant enterococci; strains of the Streptococcus family of bacteria (normally found in the digestive tract) that are unresponsive to the antibiotic vanco

The trade name, also referred to as the brand name, is the name selected by the pharmaceutical manufacturer and used to market the drug. By law, the manufacturer has exclusive rights to market a new drug for 17 years. After these exclusive rights have expired, other companies may produce equivalent drugs under different trade manes

*There are two most frequently used pharmacology resources:
The PDR is divided into six color-coded sections
1. A list of drug manufacturers
2. An index of brand and generic drug names
3. a list of drugs by prescribing category
4. A photographic identification section
5. A product information section
6. A section on diagnostic agents
¬ * The USP/NF is the official drug list recognized by the United States government

Right Drug: Drugs that are routinely needed on the sterile field during a procedure should be clearly specified on the surgeon’s preference card by the surgical staff. The scrub person always states the name and strength of the drug aloud as he or she hands it to the surgeon, thus serving a confirmation that the medication is correct. All empty medication vials and bottles should be kept in the room during the procedure as evidence that the proper medication has been delivered to the field
¬ Right Dose: How much of the drug is required and what concentration?
¬ Right Route: How will the drug be administered?
¬ Right Patient: Who will receive the drug?
¬ Right Time: When will the drug be administered?

MRSA: Methicillin-resistant Staphylococcus aureus; a strain of staph bacteria that is unresponsive to the antibiotic methicillin

Some bacteria have developed resistance to some leading antibiotics, making treatment protocols difficult to treat

bactericidal: Bacteria-killing; destructive to bacteria
bacteriostatic: Bacterial-stopping; inhibiting the growth of bacteria

Diuretics are agents administered to reduce the amount of fluid accumulating in patients with renal , hepatic, or cardiac dysfunction, as well as to relieve excessive intracranial or intraocular pressure.

The endocrine system works with the nervous system to relay messages to maintain homeostasis.
Regulation of internal chemical balance and volume
Response to environmental changes, including stress, trauma, and temperature changes, etc.
Growth and development
Reproduction

Testosterone may also be used to treat some types of advanced breast cancer in females. The androgen danazol (Danocrine) is used to treat diseases in females such as endometriosis and fibrocystic disease of the breast

The evaluation is used to confirm the patient’s surgical disease and to assess concurrent medical conditions, Talk with anesthesia, get pre-op meds, sign consent A preoperative assessment is made by the anesthesia team to determine both the appropriate anesthetic method and the preoperative medications needed. The evaluation is used to confirm the patient’s surgical disease and to assess concurrent medical conditions. It also lists any medications the patient may be taking, as well as allergies and physical status. Special emphasis is placed on diseases of the cardiovascular and respiratory systems and diabetes

MAC is local anesthesia with Monitored Anesthesia Care; the patient is awake but heavily sedated Local is a locally anesthetized area and the patent is conscious, awake, and aware of his/her surroundings

MAC is local anesthesia with Monitored Anesthesia Care the patient is awake but heavily sedated. The patent is not conscious, awake, and aware of his/her surroundings

local (with or without MAC)
regional blockade
general

Blood must be typed and cross-matched in order to administer compatible donor blood. The blood type is determined by proteins called antigens present on the surface of RBCs. Blood type is inherited. The major groupings of concern in surgery are ABO and Rh. Patients may be type A, B, AB, or O. Type A blood contains the A antigen, type b has the B antigen, type AB contains both, and type O blood has neither. Rh –positive blood contains the Rh antigen and Rh-negative blood has no Rh antigen present. Each person also has the corresponding antibody present in his or her plasma. If a type A blood is administered to a type B patient, the recipient’s antibodies will attack the donor RBCs, causing potentially fatal transfusion reactions

Heparin is the primary anticoagulant used intraoperatively. Heparin is administered intravenously 3 minutes prior to placement of an arterial occluding clamp. Heparin is frequently used from the sterile back table during peripheral vascular procedures and is used as a topical arterial irrigant. Carotid endartectomy, peripheral vascular procedures, femerol-popliteal bypass/fem-pop bypass, open heart procedures. Anticoagulants are drugs that prevent or interfere with blood coagulation. Anticoagulants are administered in the medical setting to prevent venous thrombosis, pulmonary embolism, acute coronary occlusions after myocardial infarction (MI), and strokes caused by an embolus or cerebral blood clot. Anticoagulants do not dissolve existing clots; rather they prevent new clots from forming. Anticoagulants are used in surgery to prevent clot formation as a response to trauma or manipulation of blood vessels

Diuretics are agents administered to reduce the amount of fluid accumulating in patients with renal , hepatic, or cardiac dysfunction, as well as to relieve excessive intracranial or intraocular pressure. Excess fluid is removed through excretion of urine

The most common diuretics administered during surgery are mannitol (Osmitrol) and furosemide (Lasix).

Gastric drugs are a subclass of drugs that affect the digestive system. In surgery, gastric drugs are administered preoperatively to reduce used to neutralize or reduce production of gastric acid and to reduce the potential for gastric reflux, vomiting, and aspiration

The gastric drugs used in surgical patients include antacids such as sodium citrate, cimetidine, and ranitidine, as well as antiemetics such as droperidol, metoclopramide, and ondansetron

antacids are drugs used to neutralize gastric acid or block production of gastric acid

Common antacids used preoperatively include sodium citrate (Bicitra) and histamine (H2) receptor antagonists (blockers)

Antiemetics are agents administered to prevent nausea and vomiting. Some agents are given preoperatively to minimize the possibility of regurgitation and aspiration of gastric contents while under general anesthesia

Common antiemetics agents include droperidol (Inapsine), metochlopramide (Reglan), and ondansetron hydrochloride (zofran). Antiemetics that may be used postoperatively include benzquinamide (Emete-con), diphenidol (Vontrol), and prochlorperazine (Compazine).

Oxytocin stimulates the uterine contractions necessary for normal labor and delivery

Cesarean section (C-section), vaginal delivery/birth

Epinephrine may also be used topically for hemostasis in middle ear procedures utilizing tiny pledglets of Gelfoam dipped in concentrated epinephrine

Most significant to the ST are the glucocorticoids, which are used to reduce or inhibit the inflammatory response after surgical procedures such as shoulder arthroscopy or cataract extraction

Hip, Knee replacement surgery (Joint replacement surgery), shoulder, knee arthroscopy

Pitressin is vasopressin, which contains antidiuretic hormone (ADH) and oxytocin in a ration of 20:1. It is used subcutaneously or intramuscularly to stabilize fluid balance in patients with diabetes insipidus.

It is used subcutaneously or intramuscularly to stabilize fluid balance in patients with diabetes insipidus.

Agents that enhance clot formation and reduce bleeding

Absorbable gelatin – Gelfoam, Gelfoam powder, Gelfoam sponge
Microfibrullar collagen hemostat – Avitene, Instat MCH
Oxidized cellulose – Oxycel, Surgicel, Surgicel Nuknit
Absorbable collagen sponge – Collastat, Helistat, Hemopad, Instat, Superstat
Thrombin – Thrombogen
Bone Wax
Chemical hemostatics – Tannic acid, Silver nitrate

Miotics are drugs that constrict the pupil by stimulating the sphincter muscle of the iris. Occasionally, miotics are used to maintain the position of an implanted lens after cataract extraction

Both mydriatics and cycloplegics are paralytic agents used to dilate the pupil prior to opthalmoscopy. These agents paralyze the sphincter muscle of the iris. Cycloplegics also may inhibit the patient from seeing near objects clearly

Ophthalmic antibiotic ointments include gentamycin, neomycin, and tobramycin. Other common ophthalmic antibiotics include bacitracin ointment and erythromycin ointment

Long term management of increased intraocular pressure may be accomplished with several different types of agents including diuretics.

When local or regional block is administered, the patient will remain conscious, yet will be pain-free

Excision or biopsy of small soft tissue masses such as lipomas, moles, or lesions. Finger lacerations toenail excisions, limited work on digits, otorhinolaryngeal procedures, minor facial procedures in plastic surgery, septoplasty/nasal procedures, cystoscopy