Lewis 18-20 - Perioperative Care

Question 1

dantrolene

Answer 1

Used to manage muscle spasms associated with malignant hyperthermia.

Muscle relaxant

Tucker

Question 2

ondansetron

Answer 2

Used for nausea. Blocks the effects of serotonin on the vagus nerve and CTZ. May cause prolonged QT interval. Available IV and ODT.

5-HT3 (Serotonin) Receptor blocker

Question 3

dulaglutide (Trulicity), liraglutide (Victoza), semaglutide (Ozempic)

Answer 3

Antidiabetic medication - increases insulin release and decreases glucagon release; slows gastric emptying and increases satiety. May require up to 48-hour NPO status before surgery to decrease aspiration risk due to delayed gastric emptying.

GLP-1 (Glucagon-like peptide) Agonist

Question 4

warfarin, heparin, clopidogrel, ASA

Answer 4

Anticoagulants and antiplatelets. Check with the provider on when to stop administration prior to surgery to decrease bleeding risk.

Question 5

Insulin

Answer 5

Will typically continue to administer sliding scale insulin as needed even when NPO to maintain patient stability. Administer IV glucose solutions for hypoglycemia.

Question 6

phenytoin, divalproex, valproic acid, carbamazepine, levetiracetam

Answer 6

Typically get administered as scheduled to prevent the patient from having a seizure during surgery.

Antiseizure medications

Question 7

metoprolol, labetolol, etc.

Answer 7

Causes decrease in BP. May need to be held before surgery due to significant risk of hypotension during surgery from fluid loss and anesthesia.

Adrenergic (beta) blockers