anaesthetics Flashcards
when do drugs have to be stopped before surgery ?
anti platelets 7 days before
warfarin 5 days before
ACEi and LMWH 1 day before
are the majority of cardiac drugs stopped before surgery
no
why do you stop ACEi
risk of AKI
stopping warfarin, who are high risk patients ?
AF
VTE in last 3 months
metallic heart valve
multiple heart valves
what does INR have to be below to proceed with surgery ?
1.5
if INR between 1.6 and 1.7
1mg vitamin K
if INR more than 1.8?
2mg vitamin K
general anaesthesia is a combination of ?
muscle relaxant and induction agent
2 induction agents (GABAa agonists)
profofol
thiopental
3 muscle relaxants
rocuronium
suxamethonium
vecuronium
what kind o drugs are the muscle relaxants?
nAch antagonists
how do you reverse muscle relaxants?
neoSTIGmine
what kind of drug is neostigmine?
acetyl choline esterase inhibitor
what does neostigmine do to levels of acetylcholine in synapse
it increases levels of Ach
drug that prevents psysiological response to trauma of intubation and incision
fentanyl
what is the benzo which is used to make patient drowsy before anaesthetic process?
midazolam
what do you give if bradycardia in GA?
IV atropine 500mcg
what two drugs can you give in hypotension (biel met)
ephedrine (alpha and beta agonist)
metaraminol (alpha 1 agonist)
which is more selective out of ephedrine and metaraminol
metaraminol
management of laryngospasm
extend neck
minor will resolve spontaneously
severe - suxamethasone
malignant hyperthermia. what is there usually history of?
family history problems with GA
management of malignant hyperthermia ?
IV dantrolene
mendelson syndrome?
aspiration of stomach acid into lungs
prevent mendelson syndrome?
ranitidine pre procedure
