A drug that binds to a receptor and stimulates its function is said to be a(n) __________ drug?
Agonist
Which of the following is not used for the classification of drugs?
Source of origin
An anticoagulant drug is classified by its?
Therapeutic action
Prescriptions must include all of the following information except?
Patients social security numnber
An order for a drug to be given as needed is called a _________ order.
PRN
Which one of the following abbreviations indicated that a drug is to be given orally?
PO
How is a medication administered by any route except the mouth?
Parenterally
The time between the administration of a drug and the first appearance of its effects is called?
onset
An expected but unintended effect of a drug is termed a(n)_________ effect.
Side
Malignant hyperthermia is a(n) _________________ effect to certain drugs.
Idiosyncratic
Which drug form is used the least in the surgical department?
Solid
When a drug travels from the site of administration into the bloodstream, it is called?
Absorption
Drugs are chemically altered via a process called metabolism in the?
Liver
Most drugs are excreted and eliminated by the
Kidney's
A drug that enhances the effect of another drug is called a(n)
synergist
Which of the following types of drug binds to receptor site proteins and then inhibits a response?
Antagonist
How is antibiotic irrigation applied during surgery?
Topical
Many antibiotics used in surgery come in ___________ form and must be reconstituted.
Powder
Which Federal action sets the standards for quality and requires proper medication labeling for preparations containing morphine?
Pure Food and Drug Act
Drugs that are listed with a C-1 are considered to
have a high-abuse potential with no medical use
Which government agency was established to enforce the Controlled Substance Act?
The Drug Enforcement Agency (DEA)
Nonprescription medications are also known as which one of the following?
Over the counter medications (OTC)
All of the following are disadvantages to pharmacogenetics except
Its use to target specific diseases
Who assigns a brand name to a new medication?
Maufacturer
A medication's generic name is
never capitalized on the label
The full quantity contained in a medication bottle is its
Total volume
The organization that internationally regulates medications is
The World Health Organization
How does a surgical tech know if he or she can handle and administer medications in his or her state?
By researching that state's policy online
Which drug law established classifications, known as schedules, of medications that had potential for abuse?
Controlled Substances ACT
Which of the following is an advantage of pharmacogenomics?
Complexity of the genetic research
How should an outdated multiuse vial of a local anesthetic be handled?
By returning it to the pharmacy
Seven o'clock in the morning, military time, would be written as:
0700
The equivalent fraction to 3/4 is
75/100
In the number 123.45678, which digit is in the ten thousands place?
7
What is the decimal form of the fraction 1/8
0.125
1 gram of an antibiotic is equal to __________ mL of fluid.
1
Which member of the surgical team must document the medications that are used at the surgical field?
Circulator
When changing shifts, the incoming surgical tech notices one of the medications on the sterile field is not accurately labeled. What should he or she do?
Discard the medication and ask the circulator for a new dose.
The five rights of medication administration include all of the following EXCEPT
right physician
Which statement does not apply to the required steps for proper medication identification?
show the label to the surgeon
Improper or inadequate labeling of medication may be considered
Negligence
Which of the following steps does not apply once a medication error has occured?
An incident report is not required
A 30-gauge hypodermic needle is larger in diameter than an 18-gauge needle.
False
Before medications are delivered into the sterile field , they must be identified by
Scrub and CN
All of the following must be read aloud when identifying a drug except
Manufacturer
The most common type of syringe used in surgery is the
Luer-loc
When recapping a needle you should
Use the one-handed method
Who is responsible for passing a medication to the surgeon form administration during the surgical procedure?
Scrubbed surgical tech
Which of these is not on of the "five rights" but is crucial in medication administration?
Right documentation
Which one of the following hypodermic needles has the smaller lumen?
27-gauge
Which of the following is not a form of absorbable gelatin?
Thrombogen
Which is not a topical hemostatic?
Calcium salts
Which one of the following causes a chemical burn to stop capillary bleeding?
Silver nitrate
Which group of drugs is given intravenously to dissolve existing blood clots?
Thrombolytics
Which one of the following is a systemic anticoagulant?
Heparin
Thrombolytic medications are used to treat all of the following except
hemorrhage
All of the following are topical hemostatics except
Vitamin K
Which one of the following agents is a thrombolytic?
Streptokinase
Which one of the following agents is a chemical hemostatic?
Silver nitrate
If a venous clot breaks off and travels to the heart, it is called a(n)
embolus
The anterior cavity of the eye is filled with
Aqueous humour
What prep solution is acceptable for eyes, including the eyelids, brows, and cheeks?
Betadine Opthalmic
BSS is an example of which ophthalmic drug category?
Irrigating solution
Which one of the following is not a viscoelastic agent?
Miochol
Drugs that constrict the pupil by stimulating the iris muscle are called
Miotics
Which one of the following is commonly used as a topical ophthalmic anesthetic agent?
Tetracaine or proparacaine
Which one of the following drugs is a Diuretic?
Osmitrol
Which one of the following, if administered preoperatively, will necessitate the placements of an indwelling urinary catheter?
Osmitrol
When Miochol-E is used , how long does miosis last?
10 mins
Major electrolytes found in body fluids are sodium, chloride, calcium and
Potassium
Food and fluids restrictions preoperatively can result in the surgical patient needing
IV fluids
The volume of erythrocytes in a given volume of blood is called which one of the following?
Hematocrit
Another name for donor blood is which one of the following?
Homologous
Which IV solution increases insulin requirements for the patient with diabetes?
Dextrose
One of the most common IV solutions used in the surgical setting is which one of the following?
0.9% sodium chloride
All drugs in this class act on bacteria by inhibiting a penicillin-binding protein that makes cross-links during formation of bacterial cell walls
Beta-Lactams
Used as prophylaxis in a variety of surgical procedures, and several of these agents are specifically recommended as part of the SCIP measures.
Cephalosporins
Wide spectrum, last line of defense against a number of MDR bacteria.
Carbapenems
First of the true antibiotic and available in several natural and semisynthetic
Penicillins
Totally synthetic form of antibiotic originally isolated from Chromobacterium violaceium
Aztreonam
Interfere with protein synthesis by binding to bacterial ribosomes and create small holes in bacterial cell membrane causing leakage.
Amingoglycosides
Category of synthetic antibiotics that inhibit DNA gyrase, a protein necessary for bacterial replication.
Fluoroquinolones
Which of the following would NOT gather information from the patient, to determine the optimal anesthetic plan
Surgeon
Given to relieve anxiety, which is common in surgical patients.
Sedatives
Pertaining to amnesia
amnestic
Most common sedatives preoperatively are:
Benzodiazepines
Benzodiazepines and are highly bound to plasma proteins
diazepam(valium), lorazepam(Ativan), and midazolam(Versed)
Pain relief, literally without pain
Analgesics
Morphine
Astramorph or Duramorph
Most common opioid used in surgery is and is administered intravenously to provide pre-op analgesia. Effects occur 1 to 3 mins and peaks at 5 to 20 mins
meperidine (Demerol)
Agents that block the action of the neurotransmitter acetylcholine, inhibiting the transmission of parasympathetic nerve impulses
Anticholinergics
Anticholinergics most frequently used preoperatively are:
atropine, scopolamine, and glycopyrrolate
Both of these can cross the blood brain barrier, so they can also cause sedation and amnesia
atropine and scopolamine
During induction of general anesthesia, the lower esophageal may relax to an extent and cause what
that a reflux of gastric contents may occur
Gastric contents can enter the lungs during induction this complication is called what? Body's inflammatory response to the presence of foreign substances in the lungs
Aspiration
What does NPO stand for
Nothing by mouth or nil per os
what agents are administered pre-op to reduce nausea and minimize the possibility of post-op nausea and vomiting (PONV)
antiemetics and gastrokinetics
Three main are used to prevent PONV
Gastrokinetics (metoclopramide), Neuroleptics( droperidol), and Serotonin antagonists (ondansetron)
The most common one to prevent PONV is
Ondansetron (Zofran)
How will patients heart rate and rhythm be assessed?
electrocardiography
Noninvasive measure of the O2 saturation of the blood
Pulse Oximetry
Measure of the force of blood against the vessel walls
Blood Pressure
How is BP measured?
inflatable cuff on arm that does not have IV cannula in place
May be assessed from any number of places like skin, axilla, bladder, esophagus and ear
Temperature
Measurement of CO2 exhaled by the patient
Capnometry
What is used to measure patients consciouness?
EEG
This is often placed on the ulnar nerve or a branch of facial nerve a train of four used to
nerve stimulator
Usually placed in the radial artery and connected to a transducer that records continues, immediate and highly accurate measurement of BP?
Arterial pressure monitoring catheter
Positioned in the superior vena cava and is used to assess the volume of blood returning to the heart
CVP line
To obtain measurements of central venous pressure PA pressure, pulmonary capillary wedge pressure, and cardiac output
PA catheter/ Swan-Ganz catheter
May be used to assess cardiac function
TEE
For a diagnostic or therapeutic procedure that includes all aspects of anesthesia care -before, during, and after the procedure?
MAC (monitored anesthesia care)
The parenteral administration of an anesthetic agent to nerve endings in the immediate surgical site
Local anesthesia
Specialized type of local infiltration requiring MAC and is widely used in liposuction
Tumescent
All of these may be used with Epinephrine EXCEPT;
Ropivacaine (Naropin)
The most common local anesthetic is
Lidocaine
Technique used to accomplish both sensory and motor block nerves or groups of nerves at specific locations
Regional anesthesia
Where are spinal anesthesia injected (intrathecal route)
Through the dura mater into the subarachnoid space and cerebrospinal fluid and no higher then L3 to L4
Injected into the space surrounding the dura mater
Epidural
Type of epidural block injected into the space via the sacral canal, and mainly used in urologic and lower extremity procedures
Caudal Block
May be used for procedures on distal arms and legs, the hand and fingers, and foot and toes
Peripheral Nerve block
One of the most common extremity blocks used on upper and lower extremities
Bier block
May be used on the hand, forearm, or elbow
Brachial plexus block
Injected behind the eye into the muscle cone to block branches of the oculomotor nerve
Retrobulbar Block
Literally defined as absence of sensation
Anesthesia
PATIENT AGE, COGNITIVE ABILITY, MENTAL OR EMOTIONAL STATE, AND PATIENT PREFERENCE
Patient factors
Remains unconscious, is pain free, retains no memory of event, is immobile, and maintains normal cardiovascular function
Several class of drugs are used to achieve general anesthesia
The only depolarizing muscle relaxant in use
Succinylcholine
Long acting opioid antagonist
Nalmefene
also used as a reversal agent
Naloxone (Narcan)
Defined as impaired breathing from constriction and inflammation of the bronchi and given 100% O2 ventilated manually or given Abuterol
Bronchospasm
Involuntary constriction of the vocal cords that may result in partial or complete closure. Succ may be administered
Laryngospasm
signs of MH
Increased end-tidal CO2PyrexiaTachycardiaTachypneaDiaphoresis
MH triggers
Sux and all inhaled anesthetics (except N2O). Presentation:- elevated ETCO2- Tachycardia- Tachypnea- hyperthermia
MH treatment
hyperventilatedantrolenesodium bicarbonatetemp managementdiureticsinsulin
Hemoglobin
protein resonsible for transport of O2 and CO2 between the lungs and the cells
Hemocratic
volume of erythrocytes in a given voulume of blood and is expressed as a percentage.
Which drug law established classifications, known as schedules, of medications that had potential for abuse?
Controlled Substance ACT
Used medically to help prevent rejection of donated organs
Glucocorticoids