1. Chapter 13 Preoperative Medications Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc.

2. Objective 1  Define terminology related to preoperative medications.  Amnestic An agent that produces memory impairment An agent that produces memory impairment  Analgesia Absence of a normal sense of pain Absence of a normal sense of pain  Anterograde From a point forward, as in memory impairment from the time an amnestic agent is administered From a point forward, as in memory impairment from the time an amnestic agent is administered

3. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Terms  Anesthesiologist  Physician who specializes in anesthesia delivery and the maintenance of the patient’s physiologic condition during surgery.  Anesthetist  A person (in the US, usually a CRNA) who specializes in anesthesia delivery and the maintenance of the patient’s physiologic condition during surgery.

4. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Terms  Anticholinergic  An agent that blocks parasympathetic nerve impulses; a vagolytic; parasympatholytic agent  Antisialagogue  An agent that reduces oral secretions (saliva)

5. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Terms  Anxiolysis  Process of relieving anxiety  Aspiration  Inspiration of foreign material into the airway  Benzodiazepine  Chemical classification of agents used as sedatives

6. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Terms  CRNA  Certified Registered Nurse Anesthetist  Hematocrit  Measure of the volume of red blood cells in whole blood  Hemoglobin  A protein in red blood cells that is responsible for gas exchange; a measure of the amount of that protein

7. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Terms  Mcg/kg  Ratio representation of the amount of medication administered in micrograms per kilogram of patient body weight  Mg/kg  Ratio representation of the amount of medication administered in milligrams per kilogram of patient body weight  NPO - Nothing by mouth

8. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 1. Terms  Opioid  An agent containing opium or any of its derivatives  Sedative  An agent used to produce a calm, relaxed state  Vagolysis  Blocking the effects of the vagus nerve

9. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 2 Identify the purpose of preoperative patient evaluation  Gather information to determine: Anesthesia method/plan Anesthesia method/plan

10. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3 List sources of patient information used for preoperative evaluation.

11. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 3  Medical records/chart  Patient interview  Physical exam  Test results

12. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4 List the components of a preoperative evaluation.

13. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4  Patient questionnaire

14. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc.

16. Objective 4  Patient interview

17. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 4  Pre-anesthesia evaluation form

18. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc.

20. Objective 4  Physical exam All body systems All body systems Airway assessment Airway assessment  Additional tests PRN EKG, H&H, chest x-ray etc EKG, H&H, chest x-ray etc

21. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5  Identify classification of preoperative medications.  List classifications  Select in a multiple choice format

22. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 5  List classifications  Sedatives  Analgesics  Anticholinergics  Gastric agents Antacids, antiemetics Antacids, antiemetics

23. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 6  Identify the purpose of each group of preoperative medications.

24. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 6. Purpose:  Sedatives  Relieve anxiety (anxiolysis)  Analgesics  Relieve pain

25. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 6 Purpose:  Anticholinergics  Block vagus nerve  Vagolysis   secretions   heart rate

26. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 6. Purpose: Gastric drugs  Antacids   acid production  Antiemetics   nausea/vomiting

27. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7  State examples of medications in each classification.  Make drug cards with drug names, category and purpose.

28. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7  Sedatives  Valium  Ativan  Versed

29. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7  Analgesics  Morphine  Fentanyl  Meperidine

30. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7  Anticholinergics  Atropine  Scopolomine  Glycopyrrolate

31. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7  Gastric agents/antacids  Sodium citrate  Zantac  Pepcid  Tagamet

32. Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc. Objective 7  Gastric agents/antiemetics  Zofran With dexamethasone PRN With dexamethasone PRN  Reglan