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Pharmacology > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

Define antibiotic resistance.

A

is the ability of somestrains of pathogenic microbes to prevent or withstand the activity of antimicrobial agents

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2
Q

why antibiotic resistance is a major cause of concern.

A

Microbes mutate rapidly and develop resistance mechanisms much faster than scientists can develop new agents.

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3
Q

examples of misuse of antibiotics.

A

Taking an antibiotic for a viral infection
Not taking antibiotic regularly as prescribed
Not taking entire dose, saving the rest for “next time”
Only the weaker bacteria were killed, the stronger bacteria survived; next time the bacteria may have become resistant to that antibiotic

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4
Q

Radiopaque contrast media (ROCM)

A

This agent is injected into the body when performing a radiation diagnostic tests. They contain a substance that do not allow x-ray to pass through, making the anatomical structures in the body visible.
Used in surgery to check for stones or tumors

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5
Q

Dyes

A

A solution that contain substances that colors or marks tissues for identification.
Used to enhance direct observation of a structure.

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6
Q

Staining agents

A

They are a type of solutions that reacts differently with abnormal cells so that we can visually identify them.

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7
Q

List contrast media (generic and brand name)

A

HYPAQUE (Diatrizoate Sodium)
OMNIPAQUE (Iohexol)
ISOVUE (Iopamidol)
VISIPAQUE (Iodixanol)

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8
Q

List dyes (generic and brand name [if applicable])

A

Methylene Blue
Isosulfan Blue (Lymphazurin 1%)
INDIGO CARMINE (indigotindisulfonate sodium)
Gentian Violet

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9
Q

List staining agents (generic and brand name [if applicable])

A

Lugol Solution

Acetic Acid

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10
Q

Diuretic

A

Agent administered to reduce body fluids by preventing reabsorption of sodium and water by the kidneys.

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11
Q

Diuresis

A

Agents that increases the amount of urine made by the kidney and passed from the body .

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12
Q

List the most common diuretics (generic and brand name) administered intraoperatively

A

Furosemide (Lasix)

Mannitol (Osmitrol)

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13
Q

category of various antibiotics

A 
Aminoglycosides
Cephalosporins
Penicillins
Macrolides
Fluoroquinolones
Tetracyclines
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14
Q

Aminoglycosides

A

entamicin (Garamycin)
tobramycin (Nebcin, Tobrex ophth)
kanamycin (generic only)

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15
Q

Cephalosporins

A

cefazolin (Ancef)
cefotetan (Cefotan)
ceftriaxone (Rocephin)
cefepime (Maxipime)

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16
Q

Penicillins

A

amoxicillin (Amoxil, Polymox)

piperacillin-tazobactam (Zosyn)

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17
Q

Macrolides

A

azithromycin (Zithromax)

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18
Q

Fluoroquinolones

A 
ciprofloxacin (Cipro)
ofloxacin (Floxin)
morfloxacin (Noroxin)
levofloxacin (Levaquin)
besifloxacin (Besivance)
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19
Q

Tetracyclines

A

tetracycline (generic only, this one is easy!)

tigecycline (Tygacil)

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20
Q

What is the purpose of oxytocin

A

Stimulate uterine contractions

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21
Q

What is the purpose of epinephrine

A

1:100,000 causes vasoconstriction which prevents the agent from being absorbed as rapidly so it stays in the site of action longer
used to prolong the action of local anesthetic
1:1000 is intended for topical use ONLY
used to provide hemostasis in the middle ear

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22
Q

What is the purpose of glucocorticoids (in general)

A

Anti-inflammatory

Used to reduce postoperative swelling

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23
Q

what is the surgical use of oxytocin

A

Intrauterine injection at surgical site for Cesarean section

Contracts uterine muscle for hemostasis

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24
Q

what is the surgical use of epinephrine

A

Used to prolong the anesthetic agent’s action
NOT for use with local anesthesia for procedures on areas of limited vascular supply (fingers, toes or tip of nose or on the surface of the penis)
epinephrine (Adrenalin) 1:1000 is mainly used to provide topical hemostasis in middle ear

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25
Q

State safety practices regarding the use of epinephrine from the sterile field.

A

We must understand the purpose of each strength of epinephrine and administration route
1:100,000 – injectable with local anesthetic; prolong effect
1:200,000 – injectable with local anesthetic; prolong effect
1:1000 – topical; middle ear hemostasis
Call out drug name and strength when handing to surgeon
Identify, accept, label, pass, say
Drug name and strength must be on all labels; syringes and intermediate containers
Do NOT put topical medications in syringes
When in doubt: STOP!!!! Verify!!

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26
Q

anticoagulant

A

Agent that inhibits or prevents blood clotting 

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27
Q

hemostatic

A

Topical coagulant used to promote clotting on bleeding surfaces

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28
Q

thrombolytic

A

Agent that helps speed the breakdown of blood clots

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29
Q

List two systemic coagulants

A

Calcium salts
Vitamin K
Anti-hemophilic factor VIII

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30
Q

List one parenteral anticoagulant

A

Heparin

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31
Q

List two oral anticoagulants

A 
warfarin sodium (Coumadin)
aspirin (acetylsalicylic acid; ASA)
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32
Q

List two thrombolytics

A

alteplase (Activase)

tenecteplase (TNKase)

33
Q

Identify the category of various agents that affect coagulation.

A 
Hemostatics
Systemic coagulants
Parenteral anticoagulant
Oral anticoagulantse
Thrombolytics
34
Q

constrict

A

To make an opening smaller; to narrow a structure/opening

35
Q

dilate

A

To make an opening larger; to expand a structure/opening

36
Q

miotic

A

Agent that causes constriction of pupil

37
Q

mydriatic

A

Agent that causes dilation of the pupil

38
Q

What is the purpose and example of irrigating solutions

A

Moisten cornea and cleanse the surgical site

39
Q

What is the purpose and examples of lubricants

A

Protect eyes when patient is under general anesthesia in any surgical specialty; not specific to ophthalmology!

40
Q

What is the purpose and examples of viscoelastics

A

Keep anterior chamber of eye expanded

Prevent injury to tissue; protect cornea

41
Q

What is the purpose and examples of miotics

A

Constrict pupil when performing iridectomy

Constrict pupil PRN during cataract with IOL if lens is being pushed out from ↑ intraocular pressure

42
Q

What is the purpose and examples of mydriatics

A

Dilate pupil to provide a more open surgical access

43
Q

What is the purpose and examples of antibiotics

A

Prevent or treat infections

44
Q

What is the purpose and examples of anesthetics

A

Block pain impulses

45
Q

What is the purpose and examples of enzymes (found under anesthetics)

A

Enzymes used in ophthalmic surgery are used to speed diffusion of an anesthetic agent through tissues in regional (retrobulbar, peribulbar) anesthesia

46
Q

What is the purpose and examples of anti-inflammatories

A

Reduce swelling d/t intraoperative trauma

47
Q

Identify category of ophthalmic agents.

A 
irrigating solutions
Lubricants
viscoelastics
miotics
mydriatics
antibiotics
anesthetics
enzymes (found under anesthetics)
anti-inflammatories
48
Q

Hemoglobin (Hgb)

A

a protein found in red blood cells that is responsible for carrying oxygen and carbon dioxide (CO2) between the lungs and the cells.

49
Q

Hematocrit (Hct)

A

Proportion of total blood volume that is composed of red blood cells. Measure of the oxygen-carrying capacity of the blood.
Highly important in surgery

50
Q

RBC

A

Red Blood Cells (erythrocyte) carries oxygen from the lungs to the cells of the body.

51
Q

WBC

A

White Blood Cells (leukocyte) provides protection against foreign microbes in a process known as phagocytosis. These cells also produce antibodies.

52
Q

List available options for blood replacement.

A

Use of donor blood (homologous donation)
Have the patient donate his or her own blood before the surgery (autologous donation)
Have the patient’s own blood collected and use it during the surgery (auto-transfusion)

53
Q

Outline the process of intraoperative autotransfusion.

A

Patient’s blood is collected as it is lost
Use special double-lumen suction tubing with Yankauer tip; second lumen is for heparin drip
Goes to cell-saver for processing, which filters out RBC’s
Returned to patient in 500 mL bag of collected RBC’s

54
Q

List fluids used as irrigation solutions in surgery.

A 
Sodium Chloride 0.9% (NS)
Sterile water
Physiosol
Glycine 1.5% 
Urologic Solution
55
Q

What is the purpose of Furosemide (Lasix)

A

Reduce intracranial pressure during craniotomy

Reduce brain swelling due to existing trauma or tissue handling

56
Q

What is the purpose of Mannitol (Osmitrol)

A

Reduce intraocular pressure
Protect kidneys during procedures on the aorta
Increase volume of fluids going through kidneys
Used to reduce intracranial pressure
Part of it is used to treatment for malignant hyperthermia

57
Q

What is the surgical use of glucocorticoids

A

used to prevent donated organs from being rejected and reduce inflations
For example, in knee arthroscopy or shoulder arthroscopy this agent is injected to reduces swelling d/t trauma. In cataract extraction this agent is administered to reduce swelling d/t surgical tissue trauma

58
Q

List four hemostatics

A 
Helistat or Helitene
Surgicel gauze or Surgicel Nu-knit
Thrombin
Bone Wax helps stops bone bleeding
QuickClot
59
Q

State the purpose of coagulants

A

are used to promote and accelerate the clotting process.

60
Q

State the purpose of hemostatics

A

Topical coagulant that Promotes clotting on bleeding surfaces

61
Q

State the purpose of systemic coagulants

A

Replace deficiencies in natural clotting mechanism

62
Q

State the purpose of anticoagulants

A

Agent that inhibits or prevents blood clotting

63
Q

State the purpose of parenteral anticoagulants

A

Prevent (inhibit) blood clots from forming

64
Q

State the purpose of oral anticoagulants

A

Prevent (inhibit) blood clots from forming

65
Q

State the purpose of thrombolytics

A

Assist the body to break down existing clots

66
Q

State safety considerations for heparin dosing from the sterile field.

A

VERIFY units of heparin, not just volume
Read labels very carefully!
Label meds immediately and completely!
Do NOT just write “heparin” on your label
Make sure strength is on the label and on the intermediate container label
Say the name and strength of the heparin you have when passing it!

67
Q

State average adult circulating volume of blood

A

4-6 L

68
Q

State average adult Hemoglobin

A

12-18 g/100 mL

69
Q

State average adult hematocrit

A

35-52%

70
Q

State the purpose HYPAQUE (Diatrizoate Sodium)

A

is meant to be used for retrograde urography (RU), a diagnostic procedure used to visualize abnormalities in the urinary system. Surgical applications would include stone extraction, cystoscopy (a procedure that visualize the lining of the bladder), etc.

71
Q

State the purpose OMNIPAQUE (Iohexol)

A

it can be used to visualize the spinal cord and nerve roots. On the other hand, if this agent is injected into the blood vessels it will make them opaque, making it possible to visualize blockages and other abnormalities in the vascular system. In surgery, we can use this agent to confirm the removal of the blockage or to confirm the position of the stent during an endograft procedure.

72
Q

State the purpose ISOVUE (Iopamidol)

A

is used for cerebral angiography (a diagnostic test that help doctors visualize blockages or other abnormalities in the blood vessels of your head and neck), peripheral arteriography (a diagnostic test that help doctors visualize narrowed or blocked areas in one or more of the arteries that supply blood to your legs), venography, urography, arthrography, etc.

73
Q

State the purpose VISIPAQUE (Iodixanol)

A

is the only type of contrast media that has the same osmolality as blood. Can be used to visualize blockages and other abnormalities in the vascular system. This agent can be used when performing a cardiography, peripheral, visceral and cerebral arteriography, etc.

74
Q

State the purpose Methylene Blue

A

Is used when performing a surgery on the urinary bladder, uterus, or the fallopian tubes. This substance is normally mix with a saline in order to have that deep blue solution. They administer the blue solution into the bladder to determine whether or not there is a tear or a leak in the bladder during a surgery
This solution is also used to mark or outline the anatomy and positions of tissues in the body.

75
Q

State the purpose Isosulfan Blue (Lymphazurin 1%)

A

Is used to test how well the lymphatic system is working in certain parts of the body. This substance is commonly used in surgery to diagnosed primary or secondary lymphedema on the extremities. In other words, they are used to perform Sentinel node biopsy.

76
Q

State the purpose INDIGO CARMINE (indigotindisulfonate sodium)

A

is used to diagnose the bladder and kidney function. This solution dyes the urine blue which indicates a possibility of leaks or damage to the ureter or the bladder. If this solution dyes the urine bluish-green it may indicate kidney problems.

77
Q

State the purpose Gentian Violet

A

is commonly used to mark incisions lines during surgeries. They are provided on your back table as commercial marking pens.

78
Q

State the purpose Lugol solution

A

is used to perform Schiller test (a type of test to diagnose cervical cancer). Not only that, this substance is also used to treat overly active thyroid gland cause by radiation therapy.

79
Q

State the purpose Acetic Acid (aka. Vinegar)

A

Is used so that the abnormal cells whiter appear whiter than normal cells. When laser is used to excise dysplasia this agent is administered.

Pharmacology (4 decks)

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