Drugs for OR

Question 1

T: Ancef G: cefazolin

Answer 1

A: Bactericidal. S/D: 500mg-1g q6-8 hr for 24 hr s/p surgery. S/E: pain, phlebitis, stevens-johnsons syndrom, N/V, diarrheam, rash pseudomembranous colitits. N/I: Observer for anaphylaxis, monitor bowel function, assess for rash. R: Preoperative prophylazis

Question 2

T: ativan G: Lorazepam

Answer 2

A: depresesses the CNS via potentiating GABA.S/D: 44mcg/kg (do not exceed 2 mg) IV. S/E: dizziness, drowsiness, lethargy, forgetfulness. N/I: Do not exceed 2mg /min, R: decrases preoperative anxiety and procvides amenesia

Question 3

T: Atr-Pen G: Atropine

Answer 3

A:Inhibits achetylcholine at postganglionci sites in smooth muscle. S/D:0.4 mg-0.6mg 30-60 min pre-op. S/E: drowsiness, blurred vision, tachcardia, urinary hesitancy.N/I: monitor v/s, ECG, I&O, assess bowel sounds. R: Given IM peroperiatlively to reduce oral & respiratory secretions.

Question 4

T: Benadryl G: Diphenhydramine

Answer 4

A: andgionizes the effects of histamine, CNS depressant & anticholinergic properties. S/D: 25-50 mg q 4-6hr do not exceed 300mg/day. S/E: drowsiness, anorexia, dry mouth. N/I: assess for urticaria, airway patentcy, R: Relief of allergic symptoms caused by histamine.

Question 5

T: Rocephin G: Cefotaximine

Answer 5

A: Bacterialcidal S/D: 1g 30-90 min before incision. S/E: pain, phlebitis, stevens-johnsons syndrom, N/V, diarrheam, rash pseudomembranous colitits. N/I: Observer for anaphylaxis, monitor bowel function, assess for rash. R: Preoperative prophylaxis

Question 6

T: Ceftin G: cefuroxime

Answer 6

A: Bacterialcidal S/D: 1.5 g IV 30-60 min before incision. S/E: pain, phlebitis, stevens-johnsons syndrom, N/V, diarrheam, rash pseudomembranous colitits. N/I: Observer for anaphylaxis, monitor bowel function, assess for rash. R: Preoperative prophylazis

Question 7

T: Demerol G: meperidine

Answer 7

A: binds to opiate receptors in the CNS. Alters preception and respones to painful stimuli, while producing generalized CNS dpression.S/D: 50-100mg IM or SQ 30-90 prior to anesthesia. S/E: confusion, sedation, hypotension, consitpaiton, N/V, seizure, respiratory depression. N/I:Monirot V/S, LOC changes, bowel changes. R: Preoperative sedation

Question 8

T: Dilaudid G: Hydromorphone

Answer 8

A: binds to opiate receptors in the CNS. Alters preception and respones to painful stimuli, while producing generalized CNS dpression. S/D: Dose depends on pain and drug tolerance. Start with 1.5mg q3-4 hr. S/E: confusion, sedation, hypotension, consitpaiton, N/V, seizure, respiratory depression. N/I:Monirot V/S, LOC changes, bowel changes. R: Preoperative sedation

Question 9

T: Cardizem G: Diltiazem

Answer 9

A: Inhibits transoport of Ca into mycarial and vascural smoothe muscle cells. S/D: 0.25 mg/kg q15 min with 0.35mg/kg S/E: peripheral edema, arrhythmias, HF, stevens-johnson syndrome. N/I:Montior V/S, record ECG, monirot I&O, assess for rash R: Treat arrhythmias like SVT, A-fib, also treats HTN.

Question 10

T: Dobutex G: Dobutamine

Answer 10

A: stimulates beta 1 aderenrgic receptors with relatively minor effect on the heart or peripherial blood vessesls. S/D: 2.5 -15mg/kg/min tirated to respones (up to 40mcg/kg/min) S/E: hypertension, increased HR, PVCs, SOB. N/I: Monitro V/S, palpate peripheral pules. R: Short term management of heart failure caused by surgical procedures.

Question 11

T: Inropin G: dopamine

Answer 11

A: Depends on the dose- low produces renal vasodialation, large stimulates beta 1 adernergic receptors, producing cardiac stimuation and reneal vasodialaion.S/D: Beta effects 5-15 mcg/kg/min. S/E: arrhythmias, hypotesion (low dose) dyspnea, irrtation at IV site. N/I: Monitor V/S, I&O, for extravassaiton d/t necrotic effects. R: Increases cardiac output, increases BP and improves renal blood flow. R

Question 12

T: Sublimaze G: fentanyl

Answer 12

A: binds to opiate receptor sites in the CNS, altering the response to & preception of pain. Produces CNS depression.S/D: 50-100 mcg/ kg (up to 150 mcg/kg) S/E: apnea, larygeospasm, bradicardia, hypotension. N/I: monior v/s esp EtCO2. R: preoperative & postoperative analgesia. Supplement to regional/ local analgesia.

Question 13

T: Flagyl G: metronidzole

Answer 13

A: Bactericidal. S/D: 15mg/kg 1 hr before surgery, then 7.5mg/kg 6-12 hr later. S/E: dizziness, HA, aseptic meningitis, encephalpathy, abdominal pain, anorexia, nausea, steven johnsons syndrome, seizues. N/I: Assess for infection, rash. Montior I& O and neurological status. R: perioperative prohylactic agent in colorectal surgery.

Question 14

T: Cidomycin G: gentamicin

Answer 14

A: bactericidal.S/D: 1-2 m/kg q8 hr (up to 6mg/kg/day in 3 doses) S/E: ataxiam, otoxicity, nephrotoxicity, sinusitis. N/I: monitor kiney function, monitor 8th crainal nerve function. R: Preventin of infective endocarditis

Question 15

T: Hepalean G:Heparin

Answer 15

A: inhibits effectof antithrombin on factor Xa. S/D: 10,000 units followed by 5000-10000 units q4-6 hr. S/E: bleeding, heparin induced thrombocytopenia. N/I: Assess for signs of hemorrhage, thrombosis. Monitor labs Parital thromboplastin time (PTT) R: prophylaxis to prevent thromboembolic.

Question 16

T: Inapsine G: droperidol

Answer 16

A: alters the action of dopamine in the CNS.S/D: 2.5mg initally with 1.25mg for the second dose S/E: extrapyramidal rxns, seizure, changes in mental status, arrhythmias, hpotensin, tachycardia. N/I: Assess for N/V & bowel sounds, assess for extrapyramidal rxns. Monitor V/S R: used to decrease postoperative N/V

Question 17

T: Lasix G: forsmide

Answer 17

A: inhibits the reabsorpion of Na & Cl from the loop of Henle and distal renal tubule. S/D: 20-80mg /day as a single dose q 6-8 hy with 20-40 mg. S/E: hearing loss, dehydration, hypoCa, Cl, K, Mg, Na, volemia. Metabolic alkalosis. N/I: do not push faster than 20mg over 2 min, monitor I&O, assess hearing. R: Edema d/t CHF, HTN or hepatic impairment.

Question 18

T: Levofloxacin G: Levaquin

Answer 18

A: Inhibit bacterial DNA sythesis. S/D:250-750 mg q24h S/E: ICP, seizures, dizziness, HA, insomnia,N/V Torsades, pseudomembranous colitis. N/I: Assess rash, allergic rxn, GI functnion. R: prophylaxis

Question 19

T: Lopressor G: metoprolol

Answer 19

A: blocks stimulation of beta-1 adrenergic receptors.S/D: 5 mg q2min for 3 doses. S/E: fatigue, weakenss, bradycardia, HF,pulmonary edema, erectile dysfuntion. N/I: Monitor v/s, ECG, 12-lead, asses for chest pain. R: decrease BP/ treat MI

Question 20

T: Astramorph G: Morphine

Answer 20

A: binds to opiate receptors in the CNS. Alters preception and respones to painful stimuli, while producing generalized CNS dpression.S/D: 5mg/day do not exceed 10mg/day for epidural. S/E: confusion, sedation, hypotension, consitpaiton, N/V, seizure, respiratory depression. N/I:Monirot V/S, LOC changes, bowel changes. R: Epidural

Question 21

T: Narcan G: nalxon

Answer 21

A :Reverses respiratory depression, sedation and hypotension effects of opioid overdose by occupying opiate receptor sites. S/D: 0.4mg/ml IV Titrate for return of respiratory and BP, want to avoid acute withdrawal symptoms. S/E: Acute withdrawals symptoms, N/V, tachycardia, hypertension. N/I: Titrate dose for return of respiratory drive and increased BP. Monitor for improvement in EtCO2, RR and increased BP. Use caution pt may be combative. Manage airway. R: in the event the pt goes into respriatory arrest from opoids.

Question 22

T: Nitro time G: nitroglyceren

Answer 22

A:increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. S/D: 5- 20mcg/min Max 200mcg/min. S/E: dizziness, HA, hypotension, tachycardia. N/I: monitor v/s, ECG, chest pain. R: Chest pain develops during surgery/ to dialiate the coronary arteries during surgery.

Question 23

T: nitorpress G: nitroprusside

Answer 23

A: produces periphiral vasodialation. S/D: 0.3mcg/kg/ min up to 10mcg/kg/ min S/E: dizziness, HA, abd pain, N/V. N/I: monitor v/s, serum metheoglobin concentration. R: Hypertensiv crises, cardiogenic shock.

Question 24

T: percocet G: oxycodone/ acetiminophen

Answer 24

A: Opiod agonist and nonopiod, salicylate analgesic. S/D: 2.5/325 mg- 10/650 mg. S/E: dizziness/ lightheadness, drowsiness/ sedation, N/V consitpaion. N/I: make sure the pt does not exceed the daily dose of acetaminphine 4mg/day. R: reduce pain/ analgesia

Question 25

T/ G: potassium Cl

Answer 25

A: electrolyte S/D: 20-25 mEq/LS/E: Arrhythmias, bleeding, diarrhea, dyspepsia, hyperkalemia, N/V, rash. Need to use in caution in CV disease and impaired renal fxn. N/I: assess for hyperkalemia and monitor ECG for changes. Assess and monitor for decreased urine output. R: to prevent hypokalemia during surgery.

Question 26

T: reglan G: metoclopramide

Answer 26

A: stimulates motility of the upper GI tract. S/D: 10mg at end surgery repeat q 6-8hr prn. S/E: drowsiness, extrapyramidal rxn, restlessness, neuroleptic maligant sydrome. N/I: Assess bowel funtion, extrapyramidal rxn and tardive dyskinesia and neruoleptic maligant syndrome R: postopeartive antiemetic.

Question 27

T: Claforan G: Cefotaximine

Answer 27

A: Bacterialcidal S/D: 1g 30-90 min before incision. S/E: pain, phlebitis, stevens-johnsons syndrom, N/V, diarrheam, rash pseudomembranous colitits. N/I: Observer for anaphylaxis, monitor bowel function, assess for rash. R: Preoperative prophylaxis

Question 28

T: romazicon G: flumazenil

Answer 28

A: antagonizes CNS depressent effects of benzodiazepine. S/D: 0.2 mg in 1min intervals do not exceed 3mg/hr. S/E: seizure, dizziness, N/V . N/I: assess LOC and respirartory status. R: reversal of benzodiazepine effects.

Question 29

T: Daptacel, G: tetans toxoid.

Answer 29

A:stimulates an immune respones by introducing antibodies. S/D: 0.5ml IM per dose. S/E: redness, tenderness, fever, malaise, myalgia, urticaria, hypotension. N/I: inguire about last tetanus shot. R: preoperative prophylaxic for clostridium tetani.

Question 30

T: Toradol G: ketorolact

Answer 30

A: Inhibits prostaglandin synthesis, producing peripherally mediated analgesia. S/D: 20mg followed with 10mg q4-5 hrs do not exceed 40mg/day. S/E: drowsiness, stroke, MI, GI bleeding, anaphylaxis. N/I: do not use preoperative d/t short duration. Pts with astham, ASA allergy and nasal polyps are increased risk for HTN. Assess for rash, pain and V/S R: short-term pain management during surgery.

Question 31

T: Tylenol G: Acetaminophen

Answer 31

A: Inhibits the synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS. S/D: 325mg q4 hr, do not exceed 4g/day S/E: Hepatic failure, hepatotoxicity (overdose), renal failure (high dose/chronic use), neutropenia, pancytopenia, leucopenia, rash, urticaria. N/I: monior for rash and I&O. R: pain managment.

Question 32

T: tylenol #3, G: codine/ acetaminophen.

Answer 32

A: Opiod agonist and nonopiod, salicylate analgesic. S/D: 15mg/ 300mg-60mg/ 300 mg. S/E: dizziness/ lightheadness, drowsiness/ sedation, N/V consitpaion. N/I: make sure the pt does not exceed the daily dose of acetaminphine 4mg/day. R: reduce pain/ analgesia

Question 33

T: valium G: diazepam

Answer 33

A: depresesses the CNS via potentiating GABA. S/D: 2-10 mg q 3-4 hr prn. S/E: dizziness, drowsiness, lethargy, forgetfulness. N/I: asses mental status, use in conjuction with theraputeic treatments. Monitor v/s. R: decrases preoperative anxiety and procvides amenesia.

Question 34

T: vancocin G: vancomycin

Answer 34

A: bactericidal S/D: 500mg q6hr or 1 g q12 hr (up to 4 g/day) S/E: neuprotoxicity, phelbitis, anaphlaxis, ototoxicity. N/I: assess for allergic rxn, assess injection site. R: endocarditis prohpylaxis in pt allergic to PCN.

Question 35

T: Calan G: verapamil.

Answer 35

A: Inhibits the transport Ca into myocaridal & vascular smooth muscle cells, resulting in inhibition of excitation-conctraction coupling and subsequent contraction. Decreases SA & AV condution and prolongs AV node period in conduction tissue. S/D: S/E: arrhythmias, CHF. N/I: monitor V/S, ECG, pulmonary edema. R: management of SVT adn rapid ventriclar rates.

Question 36

T: Versed G: midazolam

Answer 36

A: CNS depressant, prodcues anterograde amesia, then sedation. S/D: 0.07-0.08mg/kg 1 hr before surgery. S/E: Larynogspams, respiratory derpession/ apnea, drowsniess/ confusion/ amnesia, hypotension. N/I: Monitor V/S, assess for amesic effects, monitor respiatory function. R: relaxes muscles and sedates pts during anestheia.

Question 37

T: vicodin G: hydrocodone/ acetaminophen

Answer 37

A: Opiod agonist and nonopiod, salicylate analgesic. S/D: 2.5- 10mg q 3-6 hrs . S/E: dizziness/ lightheadness, drowsiness/ sedation, N/V consitpaion. N/I: make sure the pt does not exceed the daily dose of acetaminphine 4mg/day. R: reduce pain/ analgesia

Question 38

T: Vistaril G: hydroxyzine

Answer 38

A: acts as a CNS depressant at the subcorical level of the CNS. Has anticholinergic, antihistamie and antimemtiv propeties. S/D: anitaxiety 25-100mg q4/ day not to exceed 600mg/day. S/E: drowsiness, dry mouth, pain at IM site. N/I: monitor V/S proivide oral care, assess LOC. R: drys up secretions prior to surgery and helps relax pt.

Question 39

T: Zofran G: Ondansetron

Answer 39

A: blocks serotonin receptors in vagus nerve terminals and in small intestine that trigger the vomiting reflex. S/D: 4mg MR 1 in 10 min. S/E: GI symptoms, espically diarrhea, HA. N/I: Monitor bowel funtion/ sounds. Asses nausea/ voming. R: helps reduce nausea assoicated with anestheia.

Question 40

T: Zosyn G: piperacillin/tazobactram

Answer 40

A: Bacterialcidal S/D: 3.375g IV q6hr for infections. S/E: diarrhea, rashes, pain, phlebitis at IV site. N/I: assess IV prior to administraion, assess for rash and signs of infection. R: prophylaxis