Ancillary Anesthesia Drugs Flashcards
What’s important to consider for pre anesthesia?
Relieve anxiety, sedate, cause amenisa, dry secretions, reduce autonomic response, decrease gastric fluid volume, decrease gastric pH, antiemesis, reduce anesthetic requirement, induce, and prophylaxis of allergic rxn/Infxn.
What’s most important to consider regarding timing?
No best combination/drug. But, onset of action is important (when is the pt going to the OR). Differ b/w adults and kids.
What can be used for sedation?
Benzodiazepines and 1st gen. anti-histamines
What sedation effects do the benzo’s have?
Diazepam and Lorazepam have amnesic and calming effect, used night before to anxiolysis
What sedation effects do the 1st gen. histamines have?
Hydroxyzine, diphenhydramine and promethazine are useful for sedation, anxiolysis, bronchodilation, anti-emesis, and analgesia. These are anti cholinergic dry secretions too
What classes of drugs can be used for analgesia?
Opiates and NSAIDs
What ADEs are associated with opiates?
Morphine, Codeine, Fentanyl have ortho hypotension, constipation, N/V, respiratory depression and coma.
What ADEs are associated with NSAIDs?
Ketorolac and Ibuprofen can cause bleeding and fracture healing
What’s aspiration pneumonitis?
Reflux of gastric content into lung is a big problem in surgery
What can you give to neutralize the acid assoc. with aspiration pneumonitis?
H2 blockers: Cimetdine and
Ranitidine=prevent new acid, but you still have the old contents in there
What can you give to increase the pH to Tx aspiration pneumonitis?
Antacids like Bicitra and Polycitra
What will accelerate gastric emptying?
Metoclopromide (dopa blocker). Give 150mL of water which will cause emptying by stretch reflex.
What can you give for prophylaxis of allergic rxns?
Cimetidine and Diphenhydramine
What Rx are always given before surgery to prevent infection?
Cefazolin (staph/strep), cefotetan/cefoxitin (GI anaerobes) and vanc (MRSA).
What Rx could you give to prevent reflex bradycardia?
Atropine
What else can atropine be given for?
Amnesia and to sedate
What anticholinergic would you give to decrease secretions?
Glycopyrrolate
What anticholinergic has the greatest sedation/amnesia effect?
Scopolamine
What Rx’s do you give immediately before intubating?
First oxygenate the pt so you have more time. Then, Lidocaine, vecuronium, fentanyl
and atropine. After you give them that you push sedatives and succinylcholine.
Why do you give lidocaine before intubating?
For increasing ICP and bronchospasm
Why do you give vecuronium before intubating?
To decrease the ICP increase caused by succinylcholine
Why do you give fentanyl before intubating?
For increased ICP, CV dz and bleeding
Why do you give atropine before intubating?
To decrease bradycardia caused by succinylcholine
What problems are seen with post-‐anesthesia?
Big problems w/ N/V, can’t extubate, and CV problems like hyper/hypotension and arrhythmia’s
