Unless you're among the particularly well-organized (I, sadly, am not), the medicine cabinet in your bathroom at home is on the cluttered side of clean - I nearly lost an eye recently when my exploratory dig to excavate Band-Aids instead knocked loose projectile tweezers from the top shelf. Even those of you who are so good at keeping your surgical facilities organized might find yourselves on a veritable treasure hunt when in need of a simple aspirin at home.

On the other hand, your facility's formulary is neat and well ordered - but that doesn't mean it holds any less potential for confusion. In fact, with the myriad choices on the market and in your medication storage area, you might actually wish that pulling the right antibiotic were as simple as unearthing dental floss from your medicine cabinet.

That's why the bulk of the 2005-06 Manager's Guide to Surgical Drugs is devoted to reviewing, drug by drug (and, in the case of pain pumps, device by device), your formulary options. With this simple reference, you'll be able to get a handle on drug classes, effects, indications and contraindications.

We consulted with anesthesia providers, pharmacists, doctors of pharmacy and nurse administrators to break down the major types of drugs and devices used in surgical practice:

• general, local and IV anesthetics (page 8)
• pain pumps (page 17)
• opioid pain medications (page 21)
• non-opioids (page 25)
• anti-emetics (page 28) and
• antibiotics for prophylaxis (page 43).

My simplistic answer to the can't-ever-find-what-I'm-looking-for problem is to carry a bottle of Excedrin Migraine in my purse; that way, the wonder pills and I are never far from one another when I'm final-proofing one of our issues.

Of course, facility-wide medication management needs to be far more comprehensive. Among other things, you have staff in-services to hold, governmental and accreditation agencies to deal with, and supply and cost barriers to overcome. Mary Grear, RPh, a pharmacy consultant in Las Vegas, gives you 14 ways to better supervise and utilize your formulary in "Making All the Right Moves" on page 39.

And to aid your efforts at preventing medication errors - numbers and types of which you can find on page 6 - we detail the sweeping, six-pronged effort undertaken by Metropolitan Hospital in Grand Rapids, Mich., in "Six Steps to Five-star Medication Safety" on page 34.

We hope you'll find this guide handy year-round. In the meantime, I'm going to tidy my medicine cabinet.