12 Perioperative Pharmacology
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 12.1: Drug Regulations and Protocols
- 1. List the sources of drugs
- 2. Explain the different drug resources available
- 3. Discuss the importance of drug regulation
- 4. Understand how drugs are named and formulated
- 5. Correctly identify and interpret the components of a drug label
- 6. Discuss ways to prevent drug errors
- 7. List and use the seven rights of the medication process
- 8. Recognize the elements of a prescription and how drugs are ordered
- 9. Apply the correct protocol for receiving drugs on the sterile field
Lesson 12.2: Drug Delivery and Administration
- 10. Accurately convert values within and between measurement systems
- 11. List and describe the different drug delivery devices
- 12. Describe the role of the surgical technologist in handling drugs
- 13. List drug administration routes
Lesson 12.3: Drug Principles and Categories
- 14. Describe the principles of pharmacokinetics
- 15. Describe the principles of pharmacodynamics
- 16. Explain the different drug categories and give examples of drugs in each category
Classroom Preparation
Lesson 12.1: Drug Regulations and Protocols
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. List the sources of drugs
- 2. Explain the different drug resources available
- 3. Discuss the importance of drug regulation
- 4. Understand how drugs are named and formulated
- 5. Correctly identify and interpret the components of a drug label
- 6. Discuss ways to prevent drug errors
- 7. List and use the seven rights of the medication process
- 8. Recognize the elements of a prescription and how drugs are ordered
- 9. Apply the correct protocol for receiving drugs on the sterile field
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 12.1: Drug Regulations and Protocols
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Sources of Drugs ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Drug Information Resources ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Regulation of Drugs, Substances, and Devices Prescription and Over-the-Counter Drugs Herbal Remedies and Food Supplements Controlled Substances Pregnancy Categories ANSWER – Textbook • Review Question 1 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Drug Nomenclature Generic Name Trade (Proprietary) Name Chemical Name ANSWER – Textbook • Review Question 2 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Drug Labels • Drug Formats ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 6 | READ – Chapter Heading(s) • Section III: Preventing Drug Errors ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 7 | READ – Chapter Heading(s) • Section III: Preventing Drug Errors Drug Rights The Seven Rights ANSWER – Textbook • Review Question 6 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 8 | READ – Chapter Heading(s) • Section II: The Medication Process • Prescriptions and Drug Orders • Selection of Drugs • Section III: Preventing Drug Errors “Do Not Use” Abbreviations Look-Alike, Sound-Alike Drugs High-Alert Drugs ANSWER – Textbook • Review Question 5 • Case Studies 1, 2 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 9 | READ – Chapter Heading(s) • Drug Preparation and Transfer to the Surgical Field Guidelines for Drug Transfer ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 12.1: Drug Regulations and Protocols
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | DRUG SOURCES: SLIDE 4 | • Introduction • Sources of Drugs |
| 2 | DRUG RESOURCES: SLIDE 5 | • Drug Information Resources |
| 3 | DRUG REGULATION: SLIDES 6-7 | • Regulation of Drugs, Substances, and Devices Prescription and Over-the-Counter Drugs Herbal Remedies and Food Supplements Controlled Substances Pregnancy Categories |
| 4 | DRUG NAMES: SLIDE 8 | • Drug Nomenclature Generic Name Trade (Proprietary) Name Chemical Name |
| 5 | DRUG LABELS: SLIDE 9 | • Drug Labels • Drug Formats |
| 6 | DRUG ERRORS: SLIDE 10 | • Section III: Preventing Drug Errors |
| 7 | SEVEN “RIGHTS”: SLIDE 11 | • Section III: Preventing Drug Errors Drug Rights |
| 8 | DRUG ORDERS: SLIDES 12-14 | • Section II: The Medication Process • Prescriptions and Drug Orders • Selection of Drugs • Section III: Preventing Drug Errors “Do Not Use” Abbreviations Look-Alike, Sound-Alike Drugs High-Alert Drugs |
| 9 | DRUGS AND THE STERILE FIELD: SLIDES 15-16 | • Drug Preparation and Transfer to the Surgical Field Guidelines for Drug Transfer |
Learning Activities (choose one or more to equal 50 min)
| 1 | PRESENT (50 min) • In pairs, students will present a PowerPoint presentation on the sources of drugs, including all drug sources starting with the history. Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (20 min) • Discuss as a class the different drug resources available. Borrow the books from the library and show the students the content. • Appropriate Settings: Traditional classroom |
| 3 | DISCUSS (20 min) • Discuss as a class the importance of drug regulations. Explain why we have drug regulations and who oversees the regulations. Appropriate Settings: Traditional/online/flipped classroom |
| 4 | PRESENT (50 min) • In pairs, students will present a PowerPoint presentation on how drugs are named and formulated. Appropriate Settings: Traditional/online/flipped classroom |
| 5 | DISCUSS (30 min) • Ask students to bring drug labels to class and exchange them. Have them identify the following parts on the label they receive: o Drug trade name o Drug generic name o Purpose (if present on label) o Dose o Recommended dosage (if present on label) o Lot number o Expiration date o Manufacturer Have the students point out cases where the information is difficult to find or hard to interpret and suggest how it could be presented more clearly. Be sure to keep the drug labels that the students brought to use in the next class. Appropriate Settings: Traditional classroom |
| 6 | DISCUSS (30 min) • Have pairs of students quiz each other on surgical drugs using the flashcards they prepared for homework. Have one student in each pair name a medication and the other student name the drug category the medication is in. Correctly named cards are put to one side and counted when the first student is done responding. Have the members of each pair switch roles and repeat the exercise. Multiple rounds of this exercise can be played, with the winners of each pair being matched with other winners; these rounds can use more difficult questions such as asking a trade name and the generic name, asking a name and identifying the use or action, and so on. Appropriate Settings: Traditional classroom |
| 7 | DISCUSS (30 min) • Divide the class into seven groups and assign one “right” to each group. Have each group discuss the following questions and then present their answers to the rest of the class. o What does this right, or principle, mean? o What type of mistake would be a violation of this principle? What are some ways in which a violation of this principle might occur? (Example: a violation of “the right drug” could occur if two drugs have names that look or sound alike.) o What procedure should the surgical technologist follow to preserve this principle? What is the risk to the patient if this principle is violated? Appropriate Settings: Traditional/online/flipped classroom |
| 8 | INVITE (50 min) • Have a pharmacist as a guest speaker to discuss the dispensing of medications. Emphasis should be placed on the legal aspects of dispensing medications. Appropriate Settings: Traditional/online/flipped classroom |
| 9 | ROLE PLAY (50 min) • Divide the class into teams. Within each team, have one student play the surgeon, one play the circulator, and one play the scrubbed surgical technologist; others on the team will observe the role play until it is their turn. Using water and apple juice in small containers labeled to represent two different drugs, have the team practice transfer of drugs into the sterile field. Appropriate Settings: Traditional classroom |
Critical Thinking Question
Under what circumstances does a surgical technologist administer drugs to a patient?
Discussion Guidelines: A surgical technologist never administers drugs to a patient. Only licensed personnel may legally administer drugs. Surgical technologists can assist by getting the drugs ready for the surgeon or the circulator to administer.
What are the seven rights of medication administration in a surgical setting?
Discussion Guidelines: The seven rights are the right drug, the right dose, the right route, the right patient, the right time, and the right indication. The seventh right that refers only to the surgical field is the right label or documentation.
You are diluting a medication before surgery, and the resulting solution seems thicker than you remember it being in the past. You check your math, and the calculation seems to be correct, but you still feel that something isn’t quite right. What do you do?
Discussion Guidelines: Students might discuss the fact that although accurate drug dispensing relies on formal procedures and accurate calculations, there is an important place for one’s “gut feeling” and experience as an additional check. If something doesn’t seem right even after rechecking, the surgical technologist should ask someone else to independently review the prescription, the starting medication, and the final results. The surgical technologist might be mistaken in his or her recollection, but it is also possible that he or she has identified a real problem with the starting drug, the concentration requested, or the calculations.
Classroom Preparation
Lesson 12.2: Drug Delivery and Administration
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 10. Accurately convert values within and between measurement systems
- 11. List and describe the different drug delivery devices
- 12. Describe the role of the surgical technologist in handling drugs
- 13. List drug administration routes
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 12.2: Drug Delivery and Administration
STUDENT PREPARATION (1 hr)
| 10 | READ – Chapter Heading(s) • Unit Systems of Measurement Metric System Apothecary System International Unit Roman Numerals International Time ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 11 | READ – Chapter Heading(s) • Devices for Drug Preparation and Delivery Syringes Needles Dispensers, Tubing, and Pumps Drug Packaging ANSWER – Textbook • Review Question 7 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 12 | READ – Chapter Heading(s) • Preparing Drugs on the Sterile Field Labeling Measuring and Mixing Drugs on the Sterile Field Transferring a Drug to the Surgeon ANSWER – Textbook • Review Questions 8, 10 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 13 | READ – Chapter Heading(s) • Drug Administration Assessment Documentation ANSWER – Textbook • Review Questions 3, 4 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 12.2: Drug Delivery and Administration
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 10 | MEASUREMENT SYSTEMS: SLIDE 18 | • Unit Systems of Measurement Metric System Apothecary System International Unit Roman Numerals International Time |
| 11 | DRUG DELIVERY DEVICES: SLIDES 19-20 | • Devices for Drug Preparation and Delivery • Syringes • Needles • Dispensers, Tubing, and Pumps • Drug Packaging |
| 12 | ROLE OF THE SURGICAL TECHNOLOGIST: SLIDES 21-22 | • Preparing Drugs on the Sterile Field Labeling Measuring and Mixing Drugs on the Sterile Field Transferring a Drug to the Surgeon |
| 13 | ADMINISTRATION ROUTES: SLIDES 23-26 | • Drug Administration Assessment Documentation |
Learning Activities (choose one or more to equal 50 min)
| 10 | PRACTICE (30 min) • Have each student write out one drug calculation question and hand it in. Divide the class into small groups and pass out one question to each group. Give the groups a few minutes to work on the problems, and then ask a representative from each group to present its assigned question and answer. Ask the other groups whether they agree or disagree with the solution before going on to the next group. Appropriate Settings: Traditional/online/flipped classroom |
| 11 | DEMONSTRATE (30 min) • Demonstrate safe methods for use of syringes (e.g., how to use a syringe to withdraw medicine from a vial, how to pass a syringe to someone else). After demonstration, students look at sample syringes and practice safe handling of syringes under supervision of instructor. ROLE PLAY (30 min) • Identify each type of delivery device possible in the operating room. In pairs, have students identify the delivery device and practice loading the device. • Appropriate Settings: Traditional classroom |
| 12 | ROLE PLAY (30 min) • Divide the students into pairs, one student will be sterile and the other will be the “teacher.” Have the scrub student walk through the steps of the ST in handling drugs. “Teacher” will identify each error when it occurs. Swap roles. • Appropriate Settings: Traditional classroom |
| 13 | DISCUSS (30 min) • Discuss as a class the routes of drug administration. Include all possible routes and what type of drugs could be administered. • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
Why would surgical technologists take the time to become familiar with the drugs being used in surgery if they’re not involved in prescribing or administering them?
Discussion Guidelines: Students might discuss that although surgical technologists do not prescribe or administer medications, they directly participate in several critical aspects of drug handling, including receiving, labeling, mixing, and delivering them to the surgeon. Performance of all of these activities benefits from knowledge of the medications being handled. In addition, more knowledgeable surgical technologists are better able to identify mistakes, whether their own or someone else’s.
What should the scrubbed surgical technologist say when passing a drug to the surgeon in the sterile field?
Discussion Guidelines: The name of the drug and the strength of the drug. It should be repeated each time the drug is passed.
Classroom Preparation
Lesson 12.3: Drug Principles and Categories
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 14. Describe the principles of pharmacokinetics
- 15. Describe the principles of pharmacodynamics
- 16. Explain the different drug categories and give examples of drugs in each category
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 12.3: Drug Principles and Categories
STUDENT PREPARATION (1 hr)
| 14 | READ – Chapter Heading(s) • How Drugs Work Pharmacokinetics ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 15 | READ – Chapter Heading(s) • How Drugs Work Pharmacodynamics Therapeutic Window ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 16 | READ – Chapter Heading(s) • Section IV: Surgical Drugs • Local Anesthetics • Blood and Blood Derivatives • Types of Blood Products • Hemostatic Agents • Physiology of Coagulation • Active Hemostats • Mechanical Hemostat • Absorbable Gelatin • Oxidized Cellulose • Collagen Absorbable Hemostat • Bone Hemostat • Flowable Hemostats and Sealants • Anticoagulants and Thrombolytics • Heparins • Warfarin (Coumadin) • Thrombolytics • Central Nervous System Agents • Anesthetics • Neuromuscular Blocking Agents • Analgesics • Opiates • Non-Opiate Analgesics • Sedatives and Hypnotics • Dissociative Anesthesia • Barbiturates • Benzodiazepines • Contrast Media • Colored Dyes and Stains • Antiinfective Agents • Penicillin • Cephalosporins • Macrolides • Lincosamides, Vancomycin, and Ketolides • Tetracycline • Aminoglycosides • Quinolones • Sulfonamides • Antifungals • Antineoplastic Agents • Drugs that Affect the Autonomic Nervous System • Anticholinergics • Adrenergics • Fluid Balance and Electrolytes Crystalloids Colloids Irrigation Fluids |
| 16 | READ – Chapter Heading(s) – Continued • Cardiac Drugs • Diuretics • Gastrointestinal Drugs • Histamine-2 Receptor Antagonists and Proton-Pump Inhibitors • Antacids • Antiemetic Agents • Hormones and Synthetic Substitutes • Corticosteroids • Antidiabetic Drugs • Prostaglandins • Drugs Used in Obstetrics • Gonadal Steroids • Emergency Drugs ANSWER – Textbook • Review Question 9 ANSWER – Workbook • Chapter 12 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 12.3: Drug Principles and Categories
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 14 | PHARMACOKINETICS: SLIDES 28-29 | • How Drugs Work Pharmacokinetics |
| 15 | PHARMACODYNAMICS: SLIDE 28 & 30 | • How Drugs Work Pharmacodynamics Therapeutic Window |
| 16 | DRUG CATEGORIES: SLIDES 31-32 | • Section IV: Surgical Drugs • Local Anesthetics • Blood and Blood Derivatives • Types of Blood Products • Hemostatic Agents • Physiology of Coagulation • Active Hemostats • Mechanical Hemostat • Absorbable Gelatin • Oxidized Cellulose • Collagen Absorbable Hemostat • Bone Hemostat • Flowable Hemostats and Sealants • Anticoagulants and Thrombolytics • Heparins • Warfarin (Coumadin) • Thrombolytics • Central Nervous System Agents • Anesthetics • Neuromuscular Blocking Agents • Analgesics • Opiates • Non-Opiate Analgesics • Sedatives and Hypnotics • Dissociative Anesthesia • Barbiturates • Benzodiazepines • Contrast Media • Colored Dyes and Stains • Antiinfective Agents • Penicillin • Cephalosporins • Macrolides • Lincosamides, Vancomycin, and Ketolides • Tetracycline • Aminoglycosides • Quinolones • Sulfonamides • Antifungals • Antineoplastic Agents • Drugs that Affect the Autonomic Nervous System • Anticholinergics • Adrenergics • Fluid Balance and Electrolytes Crystalloids Colloids Irrigation Fluids |
| 16 | Continued | • Cardiac Drugs • Diuretics • Gastrointestinal Drugs • Histamine-2 Receptor Antagonists and Proton-Pump Inhibitors • Antacids • Antiemetic Agents • Hormones and Synthetic Substitutes • Corticosteroids • Antidiabetic Drugs • Prostaglandins • Drugs Used in Obstetrics • Gonadal Steroids • Emergency Drugs |
Learning Activities (choose one or more to equal 50 min)
| 14 | DISCUSS (30 min) • Divide the class into small groups. Give each group a box of toothpicks or M&M candies and have them count out 64 toothpicks or candies. Set a timer for 30 seconds; explain that 30 seconds is the “half-life” of a toothpick. When the timer goes off, have each group remove half the toothpicks. Continue the exercise, with groups removing half the remaining toothpicks after each 30-second period, until there is only one toothpick left in each pile. Have students note that the number of toothpicks decreases quickly but does not go to zero even after a number of “half-lives.” Appropriate Settings: Traditional classroom |
| 15 | DISCUSS (30 min) • As a class, analyze the principles of pharmacodynamics. Include critical thinking skills with each question. • Appropriate Settings: Traditional/online/flipped classroom |
| 16 | PRESENT (50 min) • Students will present the PowerPoint presentation or poster board on the different drug categories and give examples of drugs in each category. • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
How are intravenous drugs absorbed during the process of pharmacokinetics?
Discussion Guidelines: Discuss that intravenous drugs are injected directly into the bloodstream and therefore no absorption is necessary, whereas drugs injected intramuscularly or administered orally will need time to absorb.
Assessments
Chapter 12: Perioperative Pharmacology
ASSESSMENTS BY OBJECTIVE
| 1-16 | Workbook • Chapter 12 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 12 – Graded quizzes (Mastery Levels 1, 2, and 3) |
