The medicines and solutions used in the Operation unit

- Prepared by

Operation Room guide

- Isoptin

• Generic Name: Verapamil
• Drug Class: Calcium Channel Blocker
• Category: Cardiovascular Diseases

- Papaverine

• Drug Class: Vasodilator
• Category: Cardiovascular Diseases

- Fentanyl (Durogesic)

• Drug Class: Opioid Analgesic
• Category: Pain Management

Fentanyl is a potent opioid analgesic used for moderate to severe pain relief. It works by inhibiting pain receptors in the central nervous system. Prolonged or high-dose use may lead to dependence and tolerance.

Uses:

• Pain management
• Adjunctive anesthesia

Side Effects:

• Nausea
• Vomiting
• Constipation
• Dizziness
• Drowsiness
• Headache
• Fatigue
• Swelling in hands or feet

Contraindications:

• Hypersensitivity to fentanyl
• Elevated intracranial pressure
• Severe respiratory depression
• Paralytic ileus
• Severe liver or kidney failure
• Not recommended for prolonged use in pregnancy

- Propofol

• Drug Class: General Anesthetic
• Category: Anesthesia

Propofol is a general anesthetic used for induction and maintenance of anesthesia during surgery or painful medical procedures. It should only be administered by an anesthesiologist.

Contraindications:

• Hypersensitivity to propofol or any excipients
• Allergy to eggs, soy, or their derivatives
• Conditions where general anesthesia is contraindicated

Side Effects:

• Pain or burning at the injection site
• Hypotension
• Skin rash or itching
• Respiratory difficulty or apnea
• Involuntary movements

Available Forms:

• Injectable Emulsion: 10 mg/mL (available in 20 mL, 50 mL, and 100 mL vials)

.

- Ketamine

• Drug Class: General Anesthetic
• Category: Anesthesia

Ketamine is a general anesthetic that acts on the central nervous system, inducing a dissociative state. It is used for anesthesia induction and maintenance in surgeries and painful procedures.

Contraindications:

• Hypersensitivity to ketamine
• Conditions where increased blood pressure poses a risk

Side Effects:

• Post-anesthetic delirium
• Hallucinations or dream-like states
• Double vision
• Muscle twitching
• Dizziness, drowsiness
• Nausea, vomiting
• Insomnia

Available Forms:

• Injectable Solution:
• 10 mg/mL (20 mL)
• 50 mg/mL (10 mL)
• 100 mg/mL (5 or 10 mL)

.

- Norepinephrine (Noradrenaline)

• Drug Class: Cardiac Stimulant
• Category: Cardiovascular Diseases

Norepinephrine is a natural neurotransmitter that stimulates the body’s "fight or flight" response, increasing heart rate, blood pressure, and bronchodilation while constricting peripheral blood vessels. It is used in emergency situations to restore dangerously low blood pressure.

Contraindications:

• Hypersensitivity to the drug
• Temporary fluid deficiency until corrected
• Mesenteric or peripheral vascular thrombosis unless life-saving
• Not recommended with cyclopropane or halothane anesthesia
• Severe hypoxia or hypercapnia

Side Effects:

• Headache
• Bradycardia
• Hypertension
• Reduced blood flow to extremities (risk of gangrene)

Available Forms:

• Injectable Solution: 1 mg/mL

- Thiopental (Intraval)

• Drug Class: Barbiturate
• Category: Anesthesia

Thiopental is a barbiturate that suppresses sensory cortical activity, reducing motor activity, causing sedation, and acting as an anticonvulsant in high doses. It has potential for psychological and physical dependence.

Contraindications:

• Hypersensitivity to thiopental or barbiturates
• Severe cardiovascular disease
• Porphyria
• Severe bronchial asthma

Side Effects:

• Headache, dizziness, drowsiness
• Nausea, vomiting
• Loss of appetite
• Indigestion
• Skin rash

Available Forms:

• Injectable Powder (Sodium Salt): 250 mg, 400 mg, 500 mg, 1 g, 2.5 g, 5 g

- Nitroglycerin

• Drug Class: Nitrate (Vasodilator)
• Category: Cardiovascular Diseases

Nitroglycerin dilates blood vessels to increase oxygen delivery to the heart, reducing cardiac workload and oxygen demand. It is used for angina treatment.

Precautions:

• History of heart conditions (heart failure, stroke, hyperthyroidism)
• Anemia, dehydration, or low blood volume
• Alcohol consumption
• Elderly patients may require dose adjustments due to tolerance development

Side Effects:

• Dizziness
• Headache

- Halothane

• Drug Class: Inhaled General Anesthetic
• Category: Anesthesia

Halothane induces unconsciousness by depressing the central nervous system. It is often used with other anesthetics for a more effective result.

Contraindications:

• Not recommended for obstetric anesthesia due to postpartum bleeding risk (unless otherwise specified by a doctor)

Side Effects:

• Hypotension
• Nausea, vomiting
• Chills or shivering

- Aminophylline

• Drug Class: Bronchodilator
• Category: Respiratory Diseases

Aminophylline relaxes airway smooth muscles, reducing lung responsiveness to allergens, thereby improving airflow and breathing.

Contraindications:

• Hypersensitivity to aminophylline or its excipients

Side Effects:

• Heart palpitations
• Insomnia, headache, irritability
• Nausea, vomiting, diarrhea
• Muscle tremors
• Skin reactions

- Milrinone (Primacor)

• Drug Class: Cardiac Stimulant
• Category: Cardiovascular Diseases
• Pharmacological Family: Phosphodiesterase Inhibitor

Milrinone acts on cardiac muscle cells and certain blood vessels. It works by inhibiting the enzyme phosphodiesterase, which typically regulates ion flow into and out of muscle cells. By blocking this enzyme, the drug increases calcium influx into cardiac muscle cells, enhancing their contractility. Additionally, it dilates blood vessels, reducing the heart's workload.

Contraindications:

• Hypersensitivity to any of the drug’s components
• Concurrent use with inamrinone

Side Effects:

• Headache
• Dizziness
• Skin rash
• Hypotension
• Tremors (especially in the hands)
• Severe allergic reactions
• Breathing difficulties due to bronchial constriction
• Chest pain (angina)
• Irregular heart rhythms

Available Forms:

• Injectable Solution: 10 mg/10 mL

- Neostigmine

• Drug Class: Acetylcholinesterase Inhibitor
• Category: Neurological Disorders
• Pharmacological Family: Peripheral Nervous System Agent

Neostigmine inhibits the enzyme acetylcholinesterase, which breaks down acetylcholine (a neurotransmitter that regulates muscle movement). This leads to an increased and prolonged effect of acetylcholine, helping treat certain neuromuscular disorders.

Contraindications:

• Hypersensitivity to neostigmine, bromide, or any other component
• Gastrointestinal or urinary tract obstruction

Side Effects:

• Headache
• Drowsiness
• Nausea and vomiting
• Abdominal cramps
• Increased urination
• Cold sweats
• Tingling or warmth in extremities
• Mild skin rash

Available Forms:

• Injectable Solution: 0.5 mg/mL, 1 mg/mL
• Tablets: 15 mg

- Calcium

• Drug Class: Nutritional Supplement
• Category: Musculoskeletal and Joint Disorders

Calcium is a vital mineral essential for numerous bodily functions, particularly bone formation. It also helps regulate other minerals like phosphate, aiding their removal in individuals with kidney failure. Dairy products are a primary dietary source of calcium, and people with lactose intolerance are at a higher risk of deficiency.

Contraindications:

• Hypercalcemia (elevated blood calcium levels)
• Concurrent use with digoxin

Side Effects:

Seek emergency medical help if you experience an allergic reaction, including:

• Flushing
• Breathing difficulties
• Swelling of the face, lips, tongue, or throat

Less severe but possible side effects include:

• Nausea, vomiting, loss of appetite
• Constipation
• Dry mouth or excessive thirst
• Frequent urination

- Potassium Chloride

• Drug Class: Electrolyte Supplement
• Category: Nutritional Deficiencies

Potassium chloride is used as a supplement to correct potassium deficiency in the body.

Contraindications:

• Hypersensitivity to potassium chloride
• Hyperkalemia (elevated potassium levels)
• Solid oral potassium chloride formulations should not be used in patients with gastric motility disorders (e.g., diabetic gastroparesis, structural obstructions, or medication-induced motility issues)

Side Effects:

• Usually well-tolerated
• Most common gastrointestinal effects include:
• Nausea and vomiting
• Abdominal bloating
• Stomach pain
• Diarrhea

These symptoms result from gastrointestinal irritation and may be reduced by taking the supplement with meals or in smaller doses.

Available Forms:

• Tablets:
• 600 mg potassium chloride (equivalent to 8 mEq potassium)
• 750 mg potassium chloride (equivalent to 10 mEq potassium)
• Oral Liquid Solution: 40 mEq/15 mL
• Injectable Solution:
• 2 mEq/mL
• 10 mEq, 20 mEq, 30 mEq, 40 mEq, 60 mEq concentrations

- Isoflurane

• Drug Class: General Anesthetic (Inhaled)
• Category: Anesthesia
• Pharmacological Family: Halogenated Anesthetics

Isoflurane is a general anesthetic administered via inhalation. It works by depressing the central nervous system, inducing unconsciousness for surgical procedures. Typically, it is combined with other anesthetics for enhanced effect. Only a specialized anesthesiologist should administer this drug.

Contraindications:

• Hypersensitivity to isoflurane or other halogenated anesthetics
• Patients with a genetic predisposition to malignant hyperthermia

Side Effects:

• Nausea and vomiting
• Chills or shivering
• Hypotension

Available Forms:

• Liquid anesthetic in amber-colored bottles: 100 mL or 250 mL

- Epinephrine (Adrenaline)

• Drug Class: Bronchodilator
• Category: Respiratory Diseases

Epinephrine directly affects both alpha- and beta-adrenergic receptors in nerve cells, increasing heart rate and contraction strength, enhancing blood flow to muscles and skeletal tissues, and relaxing smooth muscles in the airways. It plays a crucial role in treating severe allergic reactions and can be life-saving in cases of anaphylaxis. It is also used during cardiac arrest.

Contraindications:

There are no absolute contraindications for epinephrine in life-threatening situations. However, caution is advised in cases of:

• Hypersensitivity to epinephrine or any excipients
• Cardiac arrhythmias
• Angle-closure glaucoma (when used as eye drops)

Side Effects:

• Central Nervous System: Anxiety, nervousness, headache, dizziness, weakness
• Gastrointestinal: Nausea, vomiting
• Cardiovascular System:
• ECG changes
• Arrhythmias
• Palpitations
• Increased risk of myocardial infarction in coronary artery disease patients
• Potential for fatal ventricular arrhythmias, especially in those with heart disease
• Repeated injections may cause tissue necrosis due to vasoconstriction at the injection site.

Available Forms:

• Injectable Solution:
• 1 mg/mL (1:1000)
• 0.1 mg/mL (1:10,000)
• Inhalation Solution:

- Ranitidine

• Drug Class: H2 Receptor Antagonist
• Category: Gastrointestinal Disorders

Ranitidine inhibits histamine H2 receptors, reducing stomach acid production.

Uses:

• Duodenal ulcer
• Gastric ulcer
• Gastroesophageal reflux disease (GERD)
• Hypersecretory conditions (e.g., Zollinger-Ellison syndrome)
• Erosive esophagitis
• Relief from heartburn and indigestion

Contraindications:

• Hypersensitivity to ranitidine or any component

Side Effects:

• Generally rare
• Headache

Available Forms:

• Tablets: 25 mg, 75 mg, 150 mg, 300 mg
• Effervescent Tablets: 150 mg
• Injectable Solution: 1 mg/mL, 25 mg/mL
• Oral Syrup: 15 mg/mL

- Furosemide (Lasix)

• Drug Class: Loop Diuretic
• Category: Hypertension

Furosemide inhibits the reabsorption of sodium and chloride in the ascending loop of Henle, promoting water, chloride, sodium, magnesium, and calcium excretion.

Contraindications:

• Hypersensitivity to furosemide or sulfonylureas
• Anuria (complete lack of urine output)
• Severe hyponatremia or electrolyte imbalance
• Hepatic coma (until improvement)

Side Effects:

• Electrolyte imbalances (low sodium, low potassium)
• Dehydration
• Gout
• Dizziness, headache, blurred vision
• Hypotension
• Nausea, constipation
• Hearing loss (especially with IV/IM administration)

Available Forms:

• Injectable Solution: 10 mg/mL
• Oral Solution: 40 mg/5 mL, 10 mg/mL
• Tablets: 20 mg, 40 mg, 80 mg

- Amiodarone (Cordarone)

• Drug Class: Antiarrhythmic
• Category: Cardiovascular Diseases

Amiodarone is a non-competitive inhibitor of alpha- and beta-adrenergic receptors. It is used to treat life-threatening arrhythmias, such as ventricular tachycardia and ventricular fibrillation.

Contraindications:

• Hypersensitivity to amiodarone or any excipients
• Severe sinus node dysfunction
• Second- or third-degree AV block (without a pacemaker)
• Cardiogenic shock
• Bradycardia (unless a pacemaker is used)

Side Effects:

• Dizziness, fatigue
• Nausea, vomiting, stomach pain
• Constipation, loss of appetite
• Insomnia
• Weakness, tingling sensation
• Skin redness

Available Forms:

• Injectable Solution: 50 mg/mL

- Dopamine

• Drug Class: Cardiac Stimulant
• Category: Cardiovascular Diseases

Dopamine stimulates beta-1 adrenergic receptors in the heart, increasing contraction strength. At higher doses, it also acts on alpha receptors, promoting vasoconstriction.

Contraindications:

• Pheochromocytoma (adrenal tumor)
• Uncontrolled ventricular fibrillation
• Hypersensitivity to dopamine

Side Effects:

• Tachycardia
• Headache
• Nausea, vomiting

Available Forms:

• Injectable Solution:
• 200 mg/5 mL
• 50 mg/5 mL
• 40 mg/5 mL

- Dobutamine

• Drug Class: Cardiac Stimulant
• Category: Cardiovascular Diseases

Dobutamine selectively stimulates beta-1 adrenergic receptors, increasing heart contraction strength without significantly raising heart rate or blood pressure.

Contraindications:

• Hypersensitivity to dobutamine or any component

Side Effects:

• Headache
• Rash
• Chest pain (angina)
• Nausea
• Irregular heartbeat
• Phlebitis (vein inflammation)
• Hypokalemia
• Fever
• Palpitations
• Shortness of breath

Available Forms:

• Injectable Solution: 12.5 mg/mL

- Protamine

• Drug Class: Heparin Antagonist
• Category: Cardiovascular Diseases

Protamine neutralizes heparin's anticoagulant effects by forming a protamine-heparin complex.

Contraindications:

• Hypersensitivity to protamine

Side Effects:

• Cardiovascular: Hypotension, bradycardia, circulatory collapse
• Nervous System: Fatigue
• Gastrointestinal: Nausea, vomiting
• Respiratory: Shortness of breath, pulmonary edema, acute pulmonary hypertension
• Skin Reactions: Flushing, back pain, hypersensitivity

Available Forms:

• Injectable Solution: 10 mg/mL

- Heparin

• Drug Class: Anticoagulant
• Category: Cardiovascular Diseases

Heparin prevents blood clot formation by inhibiting thrombin in the coagulation process. It is used to treat and prevent abnormal blood clots.

Contraindications:

• Severe thrombocytopenia
• Previous heparin-induced thrombocytopenia
• Active bleeding (except disseminated intravascular coagulation - DIC)
• Patients at high bleeding risk (e.g., hemophilia, peptic ulcers, severe hypertension)
• Bacterial endocarditis
• Recent brain, spinal, or eye surgery
• Severe liver disease

Side Effects:

• Bleeding
• Hyperkalemia
• Thrombocytopenia
• Injection site irritation

Available Forms:

• Injectable Solution:
• 1,000–40,000 units/mL

- Solutions used in the operating unit

• Saline Solution: Used for fluid depletion and postoperative recovery.
• Dextrose 5% Solution: Treats acute circulatory collapse and diabetic coma (administered with insulin).
• Dextrose 10% Solution: Used for acute circulatory collapse and diabetic coma (administered with insulin).
• Dextrose 25% Solution: Administered post-concussion and for hypoglycemic coma due to low blood sugar.
• Ringer's Solution: Used for fluid replacement in dehydration.
• Sodium Bicarbonate: Treats metabolic acidosis (e.g., cardiac and respiratory arrest).
• Potassium Chloride: Used to correct potassium deficiency.
• Whole Blood (Red Blood Cells - Platelets - Plasma - Coagulation Factors): Used for hypovolemic shock, bleeding, and coagulation disorders.
• Plasma: Administered in cases of burns and protein deficiency.
• Vamin: Contains amino acids and proteins, used for severe protein deficiency, coma, and major surgeries (especially in prolonged fasting).
• Intralipid: A fatty acid-based solution required by the body, used in total coma and cholesterol deficiency.