7 Surgery Workshop Flashcards
With opiate prescribe
Docusate and antiemetic
Frequency of DVT is … In general surgery
25-33% and 45-70% in total hip replacements
Cardiac drugs
Give all except ACEi at2 antagonists and diuretics
beta blockers help suppress tachy and BP increase from surgery
Aspirin
Safe to continue unless high post op bleed risk.
If for primary prevention stop 7 days before.
Eplilepsy and Parkinsons drugs
Give
Asthma drugs
Give
Medication to reduce gastric acid
Give (reduces risk of aspiration)
Thyroid meds
Give
Steroids
Give
Immunosuppressants and Cancer drugs
Give
Tranquillisers and antidepressants
Give ((except maoi which should stop 2 weeks before)
Analgesics
Give
Antipsychotics
Omit unless otherwise instructed as may potentiate arrhythmias and hypotension
Oral hypogylcemic
Omit on morning of surgery
Clopidogrel
Stop 7 days pre op. But if post coronary stent or ACS ideally delay surgery until safe to stop clop (3-12 months)
Dipyridamole
Stop 24 before surgery
Lithium
Omit 24 hours pre-op as can cause electrolyte inbalance
ACHE for dementia
Galantamine and rivastigmine - Stop 24 hours pre op as they prolong the action of muscle relaxants
Donepazil - don’t stop as its half life is too long
Orc /HRT
Stop 4 weeks prior , if not possible use stockings and LMWH prophylaxis
Diuretics and ace I
Discuss - as the can drop BP in surgery but local practice differs
Hyponatremia post surgery can lead to
Cognative impairment
Post surgery consider 5
Monitor renal func (and u and e) Fluid replacement Nutritional requirement Pain control Med review
Why is fluid replacement required3
Significant fluid loss (bleeding, burns patients)
Noble to take fluids
Resuscitation - going into shock from trauma
Signs of dehydration
Headache Dry lips and skin Confusion Decreased urine output Thirst Constipation Capillary refill time Skin turgidity