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Medication > Medications for Surgery Floor > Flashcards

Medications for Surgery Floor Flashcards

1
Q

risk of Tylenol 3s, Percocet, Oxycocet, Tramacet

A

sedation; nausea; constipation; tolerance

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2
Q

risk of amoxicillin, clavulin (amoxicillin-clavulanate), ampicillin

A

allergic reactions, diarrhea, antibiotic resistance

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3
Q

tramacet (acetaminophen-tramadol) clinical comments

A

Might be less constipating than Tylenol 3s and less euphoric than Percocet. Can rarely cause seizures in therapeutic doses.

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4
Q

amoxicillin clinical comments

A

use IV only; used w/ gentamicin for synergy

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5
Q

bisacodyl (dulcolax) benefit

A

treats constipation by stimulating gut motility

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6
Q

bisacodyl (dulcolax) risk

A

chronic use can lead to laxative dependence

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7
Q

bisacodyl (dulcolax) clinical comments

A

used for bowel routines in patients on opioids

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8
Q

Bupivacaine (macaine) benefit

A

relieves moderate to severe pain when used alone or with opioids; may be used topically prior to dressing changes to relieve pain

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9
Q

Bupivacaine risk

A

excessive numbing epidurally; stinging on topical application; allergic reactions

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10
Q

Bupivacaine (marcaine) clinical comments

A

may be used epidurally if patient develops excessive sedation; limited evidence of benefit in topical applications

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11
Q

cadacara

A

same as bisacodyl

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12
Q

cefazolin (ancel) benefit

A

cures many gram positive and gram negative infections (antibiotic)

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13
Q

cefazolin (ancel) risk

A

same as amoxicillin (so allergic reactions and diarrhea)

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14
Q

cefazolin clinical comments

A

may cross-react in patients allergic to penicillins (2-10%); used w/ gentamicin for synergy

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15
Q

cefotaxime benefit

A

cures many gram positive and gram negative infections

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16
Q

cefotaxime risks

A

same as amoxicillin (allergic & diarrhea)

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17
Q

cefotaxime clinical comments

A

alternative to ciprofloxacin

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18
Q

ciprofloxacin (cipro) benefits

A

cures some gram positive and many gram negative infections

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19
Q

ciprofloxacin risks

A

allergic; diarrhea, restless

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20
Q

ciprofloxacine clinical comments

A

can cause seizures in patients with history of seizures; IV and PO doses not equivalent in mg:mg

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21
Q

clindamycin benefit

A

cures some gram positive and many anaerobic infections

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22
Q

clindamycin risk

A

c.difficile diarrhea; less effective than metronidazole

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23
Q

clindamycin clinical comments

A

alternative to metronidazole

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24
Q

dimenhydrinate (gravel) benefit

A

treats N&V; especially associated w/ motion sickness

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25
Q

dimenhydrinate risk

A

sedation; limited anti-emetic effect

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26
Q

diphenoxylate-atropine (Lomotil) benefit

A

treats diarrhea by slowing passage of food through the gut

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27
Q

diphenoxylate-atropine (lomotil) risk

A

sedation; combine with atropine wot prevent abuse

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28
Q

diphenoxylate-atropine (lomotil) clinical comments

A

can be used in combination with other anti-diarrhea to reduce output but not if C.difficile positive

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29
Q

docusate (Colace) benefit

A

prevents & treats constipation (hard stools), especially associated with opioid use

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30
Q

domperidone benefit

A

facilitates stomach emptying and movement of food through the small bowel

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31
Q

domperidone clinical comments

A

not effective for lower GI motility problems; doesn’t readily cross BBB to the extent metoclopramide does, so causes less CNS effects (good for patients with Parkinsons

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32
Q

electrolyte lavage solution (PegLyte) benefit

A

evacuates contents of bowels prior to surgery via an osmotic effect

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33
Q

PegLyte risk

A

large volume of bad tasting solution

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34
Q

erythromycin benefit

A

same as domperidone via different mechanism; also treats gram positive and atypical bacterial infections

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35
Q

erythromycin risk

A

not effective for lower GI motility problems; important interactions with numerous medications

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36
Q

fluconazole benefit

A

treats many fungal infections

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37
Q

fluconazole clinical comments

A

oral and IV doses equivalent on a mg:mg basis

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38
Q

gentamicin benefit

A

same as ciprofloxacin

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39
Q

gentamicin risk

A

nephrotoxic; ototoxic; IV only; drug levels for prolonged (> 5 days) therapy

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40
Q

gentamicin clinical comments

A

drug level = 10-15 minutes before 3rd dose (trough) and 10-15 minutes after 3rd dose (peak)

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41
Q

hydrocortisone (solu-cortef) benefit

A

prevents adrenal crisis in patients on long term steroid therapy who require surgery

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42
Q

hydrocortisone (solu-cortef) risk

A

short-acting; hyperglycemia, delayed wound healing, infection

43
Q

hydromorphone (dilaudid) risk

A

sedation; pruritus; hallucinations

44
Q

hydromorphone clinical comments

A

hydromorph 1mg PO = morphine 5 mg PO

45
Q

hydromorphone CR clinical comments

A

may open capsules, but do not crush, to give down tubes

46
Q

Imipenem-cilastin (primaxin) benefit

A

same as amoxicillin-clavulonate

47
Q

Imipenem-cilastin (primaxin) clinical comments

A

can react with penicillins (10-50% risk); seizures at high doses

48
Q

ketorolac (toradol) risk

A

GI bleeding, nephrotoxicity, ASA cross-reaction can occur

49
Q

lansoprazole DR (Prevacid) benefits

A

prevents/treats symptoms of GERD

50
Q

lansoprazole DR (Prevacid) risks

A

diarrhea

51
Q

loperamide (Imodium) benefit

A

same as diphenoxylate-atropine (treats diarrhea)

52
Q

loperamide (Imodium) risk

A

less risk than diphenoxylate-atropine (Lomotil)

53
Q

loperamide (Imodium) clinical comments

A

often confused with diphenoxylate-atropine (lomotil); doesn’t readily cross the BBB; not to use if C.diff +

54
Q

lorazepam (ativan) benefits

A

prevents symptoms of alcohol withdrawal; also used to treat insomnia and relieve anxiety

55
Q

lorazepam risks

A

withdrawal; amnesia; sedation; habituation

56
Q

Meropenem (Merrem) benefit

A

same as imipenem-cilastin (antibiotic)

57
Q

Metoclopramide (maxeran) benefit

A

same as domperidone (facilitates stomach emptying )

58
Q

Metoclopramide (maxeran) clinical comments

A

avoid in patients with Parkinsonism and seizure disorders

59
Q

Metronidazole (Flagyl) benefit

A

treats many anaerobic infections

60
Q

Metronidazole (Flagyl) risk

A

metallic taste; allergic reactions

61
Q

Metronidazole (Flagyl) clinical comments

A

used Q12H for surgery patients but Q8H for C.diff; oral preferred but IV effective for C. diff

62
Q

Meperidine (demerol) benefit

A

same as hydromorph

63
Q

Meperidine (demerol) risk

A

short acting (Q3H dosing may be required); toxic metabolite

64
Q

Morphine (Satex) benefit

A

same as hydromorphine

65
Q

Morphine (Satex) risk

A

same as hydromorphone with a toxic metabolite

66
Q

Morphine clinical comments

A

gold standard opioid which others are compared against

67
Q

Morphine CR (MS Contin) benefit

A

same as hydromorphone

68
Q

Morphine CR (MS Contin) risk

A

same as morphine

69
Q

Morphine CR (MS Contin) clinical comments

A

equivalent to morphine ER but can not be given via tubes

70
Q

Morphine ER (M-Eslon) benefit

A

same as hydromorph

71
Q

Morphine ER (M-Eslon) risk

A

same as hydromoprhone

72
Q

Morphine ER (M-Eslon) clinical comments

A

capsules may be opened but not crushed to give via tubes

73
Q

Nystatin benefit

A

treats some fungal infections, primarily candida (thrush) of the oral cavity; also may be used around ostomy sites

74
Q

Nystatin risk

A

not absorbed orally so minimal toxicity; not effective against all fungi

75
Q

Nystatin clinical comments

A

should be given after meals to maximize contact time with mucosa

76
Q

Octreotide (Sandostatin) benefit

A

prevents complications (fistula, abscess formation) after pancreatic surgery; also decreases diarrhea from some kinds of GI tumours; also reduces ostomy output after GI surgery

77
Q

Octreotide (Sandostatin) risk

A

may be blunt GI mucosal adaptation if given early after major bowel resection; long term use may increase risk of gallstone formation; hyperglycemia

78
Q

Octreotide (Sandostatin) clinical comments

A

preferred route is SQ as IV has a shorter duration of action

79
Q

Octreotide LAR (Sandostatin LAR) benefit

A

used when longer-term therapy with octreotide is anticipated

80
Q

Octreotide LAR clinical comments

A

for IM use only - given once monthly (onset = 2 weeks); overlap recommended)

81
Q

Ondansetron (Zofran) benefit

A

prevents nausea and vomiting, especially postoperatively

82
Q

Ondansetron (zofran) risk

A

better for acute N&V (<48hrs) than delayed type N&V

83
Q

Pantaprazole (Pantoloc) benefit

A

same as lansoprazole; pantoprazole iv infusion used to treat upper GI bleeding

84
Q

Pantaprazole clinical comments

A

not indicated for patients already on ranitidine

85
Q

Prochlorperazine (stemetil) benefit

A

treats nausea/vomiting, especially associated with medication use

86
Q

Prochlorperazine (stemetil) risk

A

dystonic reactions (severe neck stiffness); extrapyramidal symptoms, especially if used with metoclopramide

87
Q

Prochlorperazine (stemetil) clinical comments

A

may be used with other anti-emetics (avoid metoclopramide) to control postoperative nausea and vomiting

88
Q

Ranitidine (Zantac) benefit

A

same as lansoprazole except less effective

89
Q

Ranitidine (zantac) risk

A

confusion in patients with renal impairment

90
Q

senna (senokot) benefit

A

same as bisacodyl (constipation)

91
Q

sodium phosphate (fleet) benefit

A

same as electrolyte lavage solution; also used as an enema for constipation/obstipation

92
Q

sodium phosphate (fleet) risk

A

two-dose oral bowel cleansing regimens associated with electrolyte abnormalities

93
Q

sodium phosphate (fleet) clinical comments

A

more electrolyte disturbances than with electrolyte lavage solution

94
Q

sulfamethoxazole-trimethoprim (septra) benefit

A

same as cefazolin (antibiotic)

95
Q

Sulfamethoxazole-trimethoprim (Septra) risk

A

nausea, allergic reactions, hyperkalemia

96
Q

Total Parenteral Nutrition (TPN) benefit

A

provides nutritional needs when the gut is being rested or is unavailable secondary to disease/surgery

97
Q

TPN risk

A

hyperglycemia, hyperlipidemia, electrolyte disturbances, liver toxicity, infections

98
Q

TPN clinical comments

A

slow initiation is recommended in malnourished patients “re-feeding syndrome”; taper on discontinuation; D10% may be used if TPN unavailable; avoid peripheral TPN

99
Q

warfarin (coumadin) benefit

A

treats clots by preventing their growth and forming thrombi

100
Q

warfarin (coumadin) risk

A

bleeding, hair loss, lab monitoring

101
Q

warfarin (coumadin) clinical comments

A

vitamin K reverses effect; may use vitamin K injection for oral doses; high doses (>5mg) of vitamin K can cause warfarin resistance

102
Q

zopiclone (imovane) benefit

A

insomnia

103
Q

zopiclone (imovane) risks

A

same as lorazepam

104
Q

zopiclone (imovane) clinical comments

A

alternative sedation if benzos ineffective

Medication (4 decks)

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