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Preop Med Mgmt > CNS medications > Flashcards

CNS medications Flashcards

1
Q

Central cholinesterase inhibitors
galantamine
rivastigmine
donepezil (Aricept)

A

SCh: Increased prolonged effect
NDMA: reduced effect
Neostigmine: decreased effect
Continue but flag to anesthesia

If DC: galantamine & rivastigmine (24h)
Donepezil 2-3 weeks (!)

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2
Q

TCA

A

continue
STOP > 7 days if increased risk of arrhythmia
High doses: Risk : QTc prolongation & arrhythmia

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3
Q

SSRI
citalopram, escitalopram
fluoxetine
sertraline

A

Continue
Risks: QTc prolongation (high-dose tx)
Bleeding from platelet inhibition

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4
Q

SNRI
venlafaxine
duloxetine

A

continue

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5
Q 
Monoamine oxidase inhibitors (MAO-I)
phenylzine (Nardil) antidepressant
isocarboxazid (Marplan)
tranylcypromine (Parnate)
moclobemide (Manerix)

selegeline (Eldepryl) anti-parkinsonian
razagiline (Azilect)

procarbazine (Matulane) antineoplastic
linezolid (Zyvox) antibacterial

A

FLAG anesthesia team
High risk of severe hypertensive crisis and serotonin syndrome
AVOID: ephedrine, meperidine, tramadol, and dextromethorphan.

STOP >14 days pre-op

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6
Q 
Other psych drugs:
Noradrenergic serotonin (NASSA): Mirtazepine (remeron)

Norepi & dopamine reuptake inhibitors: Bupropion (wellbutrin)

A

continue

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7
Q

CNS stimulants
Lisdexamfetamine (Vyvanse)
dextroamphetamine (Adderal)
methylphenidate (Concerta)

A

hold on AM of sx

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8
Q

Antipsychotics
haldol, chlopromazine
olanzepine, quetiapine, risperdone
aripiprazole (Abilify)

A

Continue

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9
Q

Anti-parkinson rx
Levodopa-carbidopa (Sinemet)
Dopamine agonist (bromocriptine, pramipexole)
benztropine (Cogentin)

A

Continue

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10
Q

Anticonvulsants

A

Continue

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11
Q

Lithium

A

Continue
Risks: hyperNa+, hypovolemia (diabetes insipidus)
Prolonged NMDA effect

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12
Q

Benzodiazepines

A

Continue

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13
Q

Fingolimod (Gilenya)

A

Rx Multiple sclerosis
Multiple drug interactions(!)
To be researched

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14
Q

natalizumab (Tysabri)

A

Rx MS biologic

time surgery to 1-2 weeks before next dose (2-3 weeks after last dose)

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Preop Med Mgmt (13 decks)

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