Lecture 4 Flashcards
Which neurotransmitter can lead to chronic pain?
Glutamate
Your patient has a fentanyl patch on and has not taken their 60 of oxycontin yet this morning. What should you do?
Leave the patch on
Get them 60 of oxycontin preop
What element is responsible for “plugging” the NMDA receptor?
Magnesium plug
A systemic effect of exogenous steroid administration is_
depression
Medication used to treat chronic pain should be continued throughout the perioperative period?
true
How soon can steroids can enhance opioid receptors?
one week
An epileptic receives phenytoin for seizures, what drug is metabolized more rapidly due to the phenytoin?
Methadone
If you receive exogenous steroid via epidural injection, how long can your HPA be out of whack?
up to five weeks
Which neurotransmitter is associated with “wind up”?
glutamate
What class blocks the alpha 2 delta subunit in treating neuropathic pain?
Pregabalin/lyrica
Neurontin/gabapentin
second gen anticonvulsants
Intraoperative opioid needs may be increased 30-100% because of receptor __ regulation and/or tolerance
down
Should you consider using narcan or buprenorphine or some butorphanol on your opioid dependent patient?
No, because opioid anatagonists or agonist/antagonists could precipitate withdrawl in those patients.
Is regional anesthesia a good choice for the chronic opioid patient?
absolutely
If your chronic opioid patient gets a PCA, then you should probably implement a __ rate
basal
Good idea to abruptly stop opioids or selective serotonin and norepinephrine reuptake inhibitors in the patient taking them on a chronic basis?
no way
