Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Principles 2 > Exam 3 (PONV) > Flashcards

Exam 3 (PONV) Flashcards

1
Q
  • When does PONV peak & how long can it last?
A
  • Peaks at 6hrs &
  • Lasts 24-48hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • What are the general risk factors for PONV?
A
  • Female,
  • non-smoker
  • History of PONV
  • History of motion sickness.
  • Some anxiety &
  • delayed gastric emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  • What are PONV risk factors for adults?
A
  • Intraop opioids.
  • Volatiles
  • Longer anesthesia
  • Neostigmine
  • Nitrous oxide
  • Gastric distention
  • Mandatory PO fluids before D/C
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  • What are some high-risk surgeries causing PONV?
A
  • Laparoscopy
  • ENT surgeries
  • Neurosurgery
  • Laparotomy
  • Breast sx
  • strabismus sx
  • plastic Sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  • What are specific pediatric surgeries that increase PONV instances?
A
  • Adenotonsillectomy,
  • Strabismus,
  • Hernia repair,
  • Orchiopexy,
  • Penile Sx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  • What are strategies to reduce PONV?
A
  • Regional anesthesia,
  • Propofol,
  • hydration,
  • avoid NO2,
  • TIVA,
  • Minimize Neostigmine,
  • minimize motion & early ambulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  • Where is the emetic center located & what drugs act on it?
A
  • In the lateral reticular formation.
  • No drugs act on it directly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What locations send stimuli to the emetic center?

A
  • Pharynx,
  • GI tract
  • Mediastinum,
  • Higher brain centers,
  • Vestibular portion of CN8
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  • What are the PONV trigger zone receptors?
A
  • Dopamine,
  • serotonin,
  • 5-HT3,
  • Opioid,
  • histamine,
  • muscarinic,
  • Neurokinin-1,
  • cannabinoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  • Do benzos increase or decrease PONV?
A

Decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  • What induction drugs increase the risk for PONV?
A
  • Volatiles,
  • ketamine,
  • etomidate,
  • NO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  • What reversal drug increases PONV & what decreases?
A
  • Increase: Robinul, neostigmine
  • Decrease: atropine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  • At what Apfel score do we treat prophylactically?
A

At 2 risk factors (39%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  • What is the PONV algorithm for low risk?
A
  • Prophylaxis with 5-HT3 antagonist &
  • rescue w/ different class
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  • What is the PONV algorithm for moderate risk?
A
  • Prophylaxis w/ 5-HT3 & steroid (dexamethasone)
  • rescue w/ different class
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  • What is the PONV algorithm for high risk?
A
  • Prophylaxis w/ 5-HT3, steroid & propofol/TIVA
  • rescue w/ different class
17
Q
  • Activating the P6 spot results in?
A
  • Secretion of beta-endorphins.
  • Decreased acid secretion
18
Q
  • Which drugs are butyrophenones?
A
  • Haldol &
  • Droperidol (Enapsine)
19
Q
  • What is the Droperidol dose for PONV?
A

Less or equal to 0.625mg

20
Q
  • What are the side effects of Droperidol?
A
  • Hypotension &
  • Black box for Torsades
21
Q
  • What receptors does promethazine assert its effects?
A
  • Alpha adrenergic,
  • histamine,
  • muscarinic cholinergic receptors
22
Q
  • What is the black box warning for promethazine?
A
  • Tissue damage &
  • respiratory arrest in children < 2yrs
23
Q
  • What are the side effects of Zofran?
A
  • HA
  • constipation &
  • mild elevated liver enzymes
24
Q
  • Where does Zofran assert its effects?
A
  • On the vagal nerve &
  • CTZ (chemoreceptor trigger zone)
25
Q
  • What is the Scopolamine patch dose?
A

1.5mg

26
Q
  • What are the placement areas for scopolamine patches?
A
  • Thin area of skin & not in sun-exposed areas.
  • Upper chest/arm,
  • lower abd/hip
27
Q
  • What are the side effects of scopolamine?
A
  • Drowsiness
  • dry mouth
  • dizziness
28
Q
  • When should dexamethasone be given?
A

During or just after induction

29
Q
  • How does Reglan work?
A

Increases LES & GI motility

30
Q
  • What is the Reglan dose?
A

10 – 20 mg IVP

31
Q
  • How does Aprepitant work?
A

Antagonizes substance P in the emetic center

32
Q
  • What is the dose for Aprepitant?
A

40 – 125 mg

33
Q
  • When is Aprepitant most useful?
A
  • For active vomiting
  • Not as good as an anti-nausea
34
Q
  • When is Aprepitant given?
A

2 – 3 hrs prior to induction

35
Q
  • Where does propofol assert its effects?
A

Blocks serotonin release @ 5-HT3 receptors

36
Q
  • What is the subhypnotic/TIVA dose for propofol?
A

16.7 mcg/kg/min

37
Q
  • What is given in conjunction with propofol?
A

Glycopyrrolate (Robinul) for bradycardia

38
Q
  • What are some other choices to reduce PONV?
A
  • Pre-hydration 10 – 30 ml/kg
  • Carb loading
  • Aromatherapy
  • Ginger
  • Chewing gum
39
Q
  • What are the PONV risk factors for Peds?
A
  • Male = Females
  • Vomiting 2x that of adults
  • PONV increases with age

Principles 2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions