Pharmacology : An Important Aspect Of The Surgical Environment

Dosages of the drug vary from one extreme to another based upon the patients needs.

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

~ There were more than 20,000 uses of anesthetic agents by surgeons on both sides during the

Failure to thoroughly decontaminate the site can allow the naturally present microbiota of the patient’s skin to enter the bloodstream, causing an infection and possibly result with a disease. (Tortora, 2013) Additionally, test results can be falsely elevated or decreased if the site is not completely dry before needle insertion due to the body’s ability to metabolize alcohol into a form of sugar. (Garza, 2010) For example, test results for glucose levels would be falsely elevated if alcohol entered the bloodstream. Phlebotomists can also cause hemoconcentration by over palpitating the vein, excessive tourniquet application, and allowing the patients to overly pump their fist. (Morgan, 2005) These actions manipulate the vein’s chemistry and adversely affect the results of laboratory assays conducted. For instance, an increase of proteins, lipids, cholesterol, and Iron is evident of prolonged use of the tourniquet during blood collection. (Morgan, 2005) A Phlebotomist should always treat venipunctures safely and gently to ensure a quality

In cardiothoracic surgical patients, an incidence of as high as 16-46% has been reported8. This is related to a number of factors that can be encountered during surgery. Mechanical factors like manipulating the heart, pain and sympathetic stimulation can all induce POAF. It can also be related to systemic inflammatory processes, hypotension, hypoxia, anemia and metabolic alterations. These situations can all be expected during anaesthesia. Volatile agents used during anaesthesia may also have antifibrillatory action8.

The intravenous dosage in this case is 0.5 - 1 mg/kg IV (range: 0.5 - 2 mg/kg).

He was advised to continue with OxyContin 20mg every 12 hours #120, Percocet 10/25mg #180 as patient is having surgery on 09/03 for left foot debridement, and

First of all is necessary to analyze the differences in effectiveness of the products in treatments. The use of heparin has associated some general disadvantages like: • Unpredictable effects: it is difficult to use properly since its effectiveness depends on achieving a certain level of anticoagulation of the blood, too much might lead to uncontrolled bleeding and too little might not prevent a blood clot • • High risk of

Anticoagulant therapy will started according to facility protocol. This therapy will decrease the blood’s ability to clot, and help to prevent the formation of new clots. Anticoagulants used will be warfarin, heparin, or coumadin. In facility therapy will be initiated via IV push according to facility protocol, with continuous monitoring of patient condition.

1). In the Quaid’s case, “heparin and hep-lock medications […] were labeled similarly in appearance and blue text/color on the vials,” therefore; the nurse made a mistake by not double checking the medication prior to administration (Shapiro, 2010, p. 1). Due to the number of anticoagulant medication errors, “The Joint Commission has designated reducing harm from anticoagulant therapy as a National Patient Safety Goal” (Dunn, 2014, p.

The agents chosen by most hospitals are chlorhexidine gluconate (CHG) 2% and isopropyl alcohol (IPA). “The use of a 2% chlorhexidine-based preparation for cutaneous antisepsis is classified as a Category 1A recommendation—the highest level of recommendation the CDC bestows” (ChloraPrep FAQs, 2015). Alcohol is contraindicated in some instances “…including procedures in which the preparatory agent may pool or not dry, for example, procedures involving hai due to fire risk. Alcohol may also be contraindicated for procedures involving mucosa, cornea, or ear” (Anderson, et. al. 2014) Skin should be allowed to dry after the prepping of the skin. Chlorahexadine washes are encouraged the night before and the day of surgery.

A common use is for minor wounds, which are too small to mend by other standard surgical methods. One method to deal with bleeding is to use fibrin glue on the site of the wound. The glue contains both fibrinogen and thrombin and once applied to the site of the injury forms fibrin monomers and eventually a fibrin clot. Alternatively, administration of a hemostatic carrier with thrombin so topical treatment is not necessary if not desired. Medical professionals also use pure thrombin applied in a mist after dissolving it in a saline solution. This final method is typically only for wounds that cover a large

2.) Enoxaparin (Trade Name: Lovenox) 40 mg by subcutaneous injection, once every morning; used for the prevention of thrombosis formation (Deglin & Vallerand, 2007).

Occasionally a baby is born with this disorder and no family history of it. When this happens, it could be caused by a hidden gene, which is when several generations of female carry it, and it has not affected any male members of the family or a spontaneous mutation. With each pregnancy, a woman who is a carrier has a 25% possibility of having a son born with hemophilia. Since the father's X chromosome is what determines if the unborn child will be a girl, all of the daughters born of a man with hemophilia will be carriers. None of his sons, which is determined by the father through his Y chromosome, will have hemophilia. Individuals who suffer from mild hemophilia may choose to use a non-blood product known as Desmopressin acetate (DDAVP) to help treat the small bleeds and/or scrapes. For deep cuts or internal bleeding, the treatment called DDAVP may not be enough and therefore, may need a much more complex treatment. The clotting factor must be replenished so the affected person can form a clot to stop the bleeding. Plasma is one of the ‘human blood products’ than is used for factor replacement. Another factor replacement option is using the recombinant factor, which is produced in a laboratory.

2000mg/day. If doses >2000mg/day are required, give in 3 divided doses (not to exceed 2500mg/day)