Pharmacology : An Important Aspect Of The Surgical Environment

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Pharmacology is an important aspect of the surgical environment. Many different medications are used for a variety of indications at the sterile field; as a surgical technologist you are responsible for verifying and properly labeling all medications included in the surgical procedure. The three medications this paper will focus on are topical thrombin, heparin, and Xylocaine® with epinephrine; all are commonly used during surgical procedures for very different reasons. Topical thrombin, also known under the brand name of Thrombin-JMI®, is bovine in origin (PDR, Thrombin). It is classified as a hemostatic agent (Snyder, 2017), which requires a doctor’s order and is placed in category C for pregnant women and should only be administered…show more content…
In surgery it is most often used in the dry, powder form and is dusted onto oozing surfaces as needed. For reconstituted thrombin, the recommended dosage is 1,000 to 2,000 International Units per milliliter (King, FDA, 2016). Vials come in total volumes of 5,000 units with a 5 mL diluent and 20,000 units with a 20 mL diluent (Medscape, thrombin). Thrombin is for topical use only (Snyder, 2017). This product should never be directly injected into the circulatory system, used in patients with antibodies to bovine thrombin or Factor V, have a history of hypersensitivity to thrombin or bovine products, or for severe arterial bleeding (PDR, Thrombin). Antibodies may develop in patients with repeated exposure to topical thrombin. Side effects include: bleeding, thrombosis, hypersensitivity, anemia, postoperative wound infection, hypotension, pyrexia, tachycardia, and thrombocytopenia (PDR, thrombin). Adverse effects, which may be life threatening, include anaphylaxis and extensive intravascular clotting if it enters large blood vessels (King, FDA 2016). At the opposite end of the spectrum from thrombin is heparin sodium. Heparin sodium; which is also known as Heparin Sodium Injection, USP, Fragmin®, Innohep®, and Lovenox®. Fragmin, Innohep, and Lovenox are low molecular weight heparin products (Snyder, 2017). Heparin sodium is classified as a glycosaminoglycan anticoagulant, which requires a doctor’s
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