Anaesthesia Flashcards
What does corticosteroids and anaesthetics cause
fall in blood pressure
What drugs must you stop before surgery
- combined oral contraception
- hormone replacement therapy
- antidepressants: MAOI and TCA
- Lithium
- Potassium sparring drugs
- Anti-platelet / oral coagulants
- Diabetic drugs
When to stop combined oral contraception
4 weeks before major surgery and all lower body surgery due to prolonged immobilisation
When to stop Hormone replacement therapy
4 to 6 weeks before surgery and restart after mobilisation
When should you stop Antidepressants MAOIs
gradually withdraw before 2 weeks
What should you do if staying on TCA antidepressants during surgery
inform doctor as there is risk of:
- arrhythmias
- hypotension
When to stop lithium
24 hours before major surgery
- needs constant fluid and electrolyte balance to avoid toxicity
What to switch anticoagulants or anti-platelets to during surgery
Heparin
Examples of potassium sparing drugs
- ACE inhibitors
- ARBs
- Potassium sparring diuretics
Why stop ACE and ARB
can cause hypotension
Why stop potassium sparing diuretics
risk of hyperkalaemia
What to give before surgery instead of anti-diabetic drugs
switch patient to infused insulin regimen with glucose and potassium
Anaesthesia and Driving
warn patients about effects of sedatives
What drugs can extend their sedative effect 24 hours after taking
- IV Benzodiazpaines
- Short general anaesthetics
