Ancillary Anesthetics Flashcards
What are some drugs used for sedation in a pre-surgical situation
Bezodiazepines (Diazepam and Lorezepam both have long duratins of action)
First Generation antihistamines (Hydroxyzine, Diphenhydramine, Promethazine)
Analgesia pre-surgery?
Opiates (Morphine, Codeine, Fentanyl)
NSAIDs (ketorolac and ibuprofen)
What are the adverse effects of opioids that make doctors leary of using them for pre-op analgesia
orthostatic hypotension, constipation, N/V, respiratory depression/coma
What is aspiration pneumonitis
can occur when pts inhale gastric contents during surgery
How do you treat or prevent aspiration pneumonitis
1) Neutralize the acid with H2 blockers (cimetidine and Ranitidine)
2) Antacids
3) Dopamine Blocker
4) Water- activates gastric stretch receptors and encourages natural emtying
What are the antacids that are commonly used to prevent aspiration pneumonitis
Bicitra and Polycitra
What is the problem with using H2 blockers to neutralize acid
They prevent new acid but they don’t get rid of the old
What is the dopamine blocker that can be used to prevent aspiration pneumonitis
metoclopramide
Prophylaxis of allergic rxn treated how?
Cimetidine and Diphenhydramine….antihistamines
Prophylaxis of infxn
Cefazolin (staph and strep). Cefotetan/cefoxitin (Gi anaerobes)
Prophylaxis of mrsa
vancomycin
Why give anticholinergics
- dry secretions
- prevent reflex bradycardia, sedate/amnesia
Atropine is an anticholinergic used to treat>
bradyc
Glycopyrrolate used to treat
secretions
Why Lidocaine prior to intubation
prevents rise in ICP and bronchospasm
