Chapter 13Chapter 13

Preoperative MedicationsPreoperative Medications

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Objective 1Objective 1

Define terminology related to preoperative Define terminology related to preoperative medications.medications. AmnesticAmnestic

• An agent that produces memory impairmentAn agent that produces memory impairment AnalgesiaAnalgesia

• Absence of a normal sense of painAbsence of a normal sense of pain AnterogradeAnterograde

• From a point forward, as in memory impairment from the time From a point forward, as in memory impairment from the time an amnestic agent is administeredan amnestic agent is administered

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Objective 1. TermsObjective 1. Terms

AnesthesiologistAnesthesiologist Physician who specializes in anesthesia delivery and the Physician who specializes in anesthesia delivery and the

maintenance of the patient’s physiologic condition during maintenance of the patient’s physiologic condition during surgery.surgery.

AnesthetistAnesthetist A person (in the US, usually a CRNA) who specializes in A person (in the US, usually a CRNA) who specializes in

anesthesia delivery and the maintenance of the patient’s anesthesia delivery and the maintenance of the patient’s physiologic condition during surgery.physiologic condition during surgery.

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Objective 1. TermsObjective 1. Terms

AnticholinergicAnticholinergic An agent that blocks parasympathetic nerve An agent that blocks parasympathetic nerve

impulses; a vagolytic; parasympatholytic agentimpulses; a vagolytic; parasympatholytic agent AntisialagogueAntisialagogue

An agent that reduces oral secretions (saliva)An agent that reduces oral secretions (saliva)

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Objective 1. TermsObjective 1. Terms

AnxiolysisAnxiolysis Process of relieving anxietyProcess of relieving anxiety

AspirationAspiration Inspiration of foreign material into the airwayInspiration of foreign material into the airway

BenzodiazepineBenzodiazepine Chemical classification of agents used as Chemical classification of agents used as

sedativessedatives

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Objective 1. TermsObjective 1. Terms

CRNACRNA Certified Registered Nurse AnesthetistCertified Registered Nurse Anesthetist

HematocritHematocrit Measure of the volume of red blood cells in whole bloodMeasure of the volume of red blood cells in whole blood

HemoglobinHemoglobin A protein in red blood cells that is responsible for gas A protein in red blood cells that is responsible for gas

exchange; a measure of the amount of that proteinexchange; a measure of the amount of that protein

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Objective 1. TermsObjective 1. Terms

Mcg/kgMcg/kg Ratio representation of the amount of medication Ratio representation of the amount of medication

administered in micrograms per kilogram of patient body administered in micrograms per kilogram of patient body weightweight

Mg/kgMg/kg Ratio representation of the amount of medication Ratio representation of the amount of medication

administered in milligrams per kilogram of patient body administered in milligrams per kilogram of patient body weightweight

NPO NPO - - Nothing by mouthNothing by mouth

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Objective 1. TermsObjective 1. Terms

OpioidOpioid An agent containing opium or any of its derivativesAn agent containing opium or any of its derivatives

SedativeSedative An agent used to produce a calm, relaxed stateAn agent used to produce a calm, relaxed state

VagolysisVagolysis Blocking the effects of the vagus nerveBlocking the effects of the vagus nerve

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Objective 2Objective 2

Identify the purpose of preoperative patient Identify the purpose of preoperative patient evaluationevaluationGather information to determine:Gather information to determine:

•Anesthesia method/planAnesthesia method/plan

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Objective 3Objective 3

List sources of patient information used for List sources of patient information used for preoperative evaluation.preoperative evaluation.

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Objective 3Objective 3

Medical records/chartMedical records/chart Patient interviewPatient interview Physical examPhysical exam Test resultsTest results

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Objective 4Objective 4

List the components of a preoperative List the components of a preoperative evaluation.evaluation.

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Objective 4Objective 4

Patient questionnairePatient questionnaire

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Objective 4Objective 4

Patient interviewPatient interview

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Objective 4Objective 4

Pre-anesthesia evaluation formPre-anesthesia evaluation form

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Objective 4Objective 4

Physical examPhysical exam• All body systemsAll body systems

• Airway assessmentAirway assessment

Additional tests PRNAdditional tests PRN• EKG, H&H, chest x-ray etcEKG, H&H, chest x-ray etc

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Objective 5Objective 5

Identify classification of preoperative Identify classification of preoperative medications.medications. List classificationsList classifications Select in a multiple choice formatSelect in a multiple choice format

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Objective 5Objective 5

List classificationsList classifications SedativesSedatives AnalgesicsAnalgesics AnticholinergicsAnticholinergics Gastric agentsGastric agents

• Antacids, antiemeticsAntacids, antiemetics

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Objective 6Objective 6

Identify the purpose of each group of Identify the purpose of each group of preoperative medications.preoperative medications.

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Objective 6. Purpose:Objective 6. Purpose:

SedativesSedatives Relieve anxiety (anxiolysis)Relieve anxiety (anxiolysis)

AnalgesicsAnalgesics Relieve painRelieve pain

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Objective 6 Purpose:Objective 6 Purpose:

AnticholinergicsAnticholinergics Block vagus nerveBlock vagus nerve

VagolysisVagolysis secretionssecretions heart rateheart rate

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Objective 6. Purpose:Objective 6. Purpose:

Gastric drugsGastric drugs AntacidsAntacids

acid productionacid production AntiemeticsAntiemetics

nausea/vomitingnausea/vomiting

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Objective 7Objective 7

State examples of medications in each State examples of medications in each classification.classification.

Make drug cards with drug names, Make drug cards with drug names, category and purpose.category and purpose.

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Objective 7Objective 7

SedativesSedatives ValiumValium AtivanAtivan VersedVersed

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Objective 7Objective 7

AnalgesicsAnalgesics MorphineMorphine FentanylFentanyl MeperidineMeperidine

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Objective 7Objective 7

AnticholinergicsAnticholinergics AtropineAtropine ScopolomineScopolomine GlycopyrrolateGlycopyrrolate

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Objective 7Objective 7

Gastric agents/antacidsGastric agents/antacids Sodium citrateSodium citrate ZantacZantac PepcidPepcid TagametTagamet

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Objective 7Objective 7

Gastric agents/antiemeticsGastric agents/antiemetics ZofranZofran

• With dexamethasone PRNWith dexamethasone PRN ReglanReglan