Ppt chapter018

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Ppt chapter018

  1. 1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Clinical Pharmacology Chapter 18- Anesthetic Drugs
  2. 2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Anesthesia and Types of Anesthesia • Induced by various drugs to bring about partial or complete loss of sensation • Types of anesthesia: – Local anesthesia – General anesthesia • Anesthesiologist – Trained physician to administer anesthesia
  3. 3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Local Anesthesia and Types • Local anesthesia: – Topical anesthesia: Application of the anesthesia to surface of skin, open area, mucous membrane – Local infiltration anesthesia: Injection of anesthesia into tissue •Dental procedures, suturing of small wounds, making an incision into a small area
  4. 4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Local Anesthesia and Types • Local anesthesia (cont’d): – Regional anesthesia: Injection of anesthesia around nerves to prevent sending pain signals •Spinal anesthesia: Injection of anesthesia into the subarachnoid space of the spinal cord •Conduction blocks: Injection of anesthesia into or near a nerve trunk
  5. 5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Preparing Patient for Local Anesthesia • Take patient’s allergy history • Prepare the area to be anesthetized: – Cleaning the area with antiseptic, shaving the area – Require fasting • May administer intravenous sedative
  6. 6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Administering Local Anesthesia • Mixed with epinephrine to cause local vasoconstriction • Epinephrine contraindicated when used on an extremity • Aware of when to and when not to use epinephrine
  7. 7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities when Caring for Patient Receiving Local Anesthesia • Applying dressing to the appropriate surgical area • Observe area for bleeding, oozing, other problems after administration
  8. 8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Preanesthetic Drugs • Given before administration of anesthesia • May consist of one drug or a combination of drugs
  9. 9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Preanesthetic Drugs: Uses • Used to decrease anxiety and apprehension immediately before surgery • Used to decrease secretions of the upper respiratory tract • Used to lessen the incidence of nausea and vomiting during the immediate postoperative recovery period
  10. 10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Selection of Preanesthetic Drugs • May consist one or more drug • Opioid or barbiturate may be given to relax the patient • Cholinergic blocking drug is given to dry secretions in the upper respiratory tract • Drug diazepam (valium) used for preoperative sedation
  11. 11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities • Describe or explain the preparations for surgery ordered by the physician • Describe or explain immediate postoperative care • Demonstrates, describes and explains postoperative patient activities • Emphasizes the importance of pain control using PCA pump
  12. 12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins General Anesthesia • The choice of anesthetic drug depends on: – General physical condition of the patient – Area, organ, system being operated on – Anticipated length of the surgical procedure
  13. 13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Drugs used for General Anesthesia • Barbiturates and similar agents: – Methohexital; etomidate; propofol • Benzodiazepines: Midazolam • Ketamine • Gases and volatile liquids: – Nitrous oxide; enflurane; halothane; isoflurane; methoxyflurane; desflurane; sevoflurane
  14. 14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Drugs used for General Anesthesia (cont’d) • Opioids – Analgesic fentanyl; droperidol; remifentanil; neuroleptic drug • Skeletal muscle relaxants – Tracrium; nimbex
  15. 15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Stages of General Anesthesia • Stage 1- analgesia • Stage 2- delirium • Stage 3- surgical analgesia • Stage 4- respiratory paralysis
  16. 16. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities • Preanesthesia – Performing the required tasks and procedures as prescribed – Checking the chart for any recent, abnormal laboratory tests – Placing a list of known or suspected drug allergies – Administering the preanesthetic drug
  17. 17. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities • Postanesthesia – Admitting the patient to the unit according to hospital procedure or policy – Positioning the patient to prevent aspiration of vomitus and secretions – Checking the airway for patency, assessing the respiratory status, and giving oxygen as needed
  18. 18. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities • Postanesthesia (cont’d) – Check blood pressure and pulse, IV lines, catheters, drainage tubes, surgical dressings, and casts – Review the patient’s surgical and anesthesia records – Monitor the blood pressure, pulse, and respiratory rate every 5 to 15 minutes until the patient is discharged from the area.
  19. 19. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities • Postanesthesia (cont’d) – Check the patient every 5 to 15 minutes for emergence from anesthesia. Suctioning is provided as needed – Exercise caution in administering opioids – Discharge the patient from the area to his or her room or other specified area
  20. 20. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins End of Presentation

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