multimodal analgesics

Question 1

Gabapentin dose

Answer 1

300-1200mg PO 1-2hr OR

Question 2

Gabapentin is contraindicated in ______

Answer 2

MG

Question 3

Gabapentin SE

Answer 3

Somnolence​

Fatigue​

Ataxia​

Vertigo​

GI disturbances: constipation​

Abrupt withdrawal in seizure pts: seizures​

Weight gain

Question 4

Effects of NSAIDs

Answer 4

Question 5

Which COX is ubiquitous?

Answer 5

COX1

Question 6

NSAIDS are used for what 3 things

Answer 6

analgesia, antiinflammation and antipyretic

Question 7

nonspecific NSAIDs are

Answer 7

Ibuprofen, naproxen, aspirin, acetaminophen, ketorolac​

Question 8

Specific COX 2 NSAIDs are

Answer 8

Celecoxib (Celebrex), rofecoxib (Vioxx), valdecoxib (Bextra), parecoxib (Dynastat)​

Question 9

COX ____ produces increase risk of bleeding

Answer 9

1

Question 10

Celebrex dose

Answer 10

200-400mg
peak 3hr
COX 2

Question 11

Ofirmev dose
Peak (PO;IV)
Dose

Answer 11

1000 mg IV Q4-6H; max 3000-4000 mg QD
peak 1-3hr PO
peak 30-60min IV
Duration: 6-8hr

Question 12

Ofirmev does not have any ____ properties

Answer 12

antiinflammation

Question 13

Ketorolac MOA

Answer 13

inhibits PG synthesis by inhibiting COX1 and COX2

Question 14

Ketorolac dose
peak

Answer 14

15-30mg q6h (1/2 dose in elderly)
Max 60-120mg QD
Peak: 45-60min

Question 15

With what disease will you not give ketorolac?

Answer 15

renal impairment because this drug can cause further renal impairment

Question 16

ketorolac has no effect on ___ tract and _____

Answer 16

biliary; ventilation

Question 17

Ibuprofen inhibits ____ and ____

Answer 17

COX 1 and 2

Question 18

Ibuprofen dose
Max dose
Peak
Excretion

Answer 18

Dose: 200-800mg over 30min Q6hr
max 3200mg/day
Peak: 1-2 hr
Excretion: urine and bile

Question 19

Lidocaine Doses
Bolus and Drip

Answer 19

1 to 2 mg/kg IV (initial bolus) over 2 - 4 min.​

1 to 2 mg/kg/hour (drip)​

terminated 12 - 72 hours​

Question 20

Dose dependent effects of lidocaine

Answer 20

Question 21

Mag attaches to what receptor?

Answer 21

NMDA antagonist

Question 22

magnesium has limited passage across the ___

Answer 22

BBB

Question 23

Mag dose in preop and intraop

Answer 23

50mg/kg IV preop, then …​

8 mg/kg/hr intraoperatively​

Question 24

corticosteroids increase the effectiveness of __ and ____

Answer 24

zofran and droperidol

Question 25

Dose of decadron

Answer 25

4-8mg

Question 26

decadron can prolong the life of a _______

Answer 26

block

Question 27

Where does precedex work at in the brain

Answer 27

mainly in the pontine locus coeruleus
a lot of alpha 2 receptors here

Question 28

precedex is an ___ agonist to the alpha 2 receptor

Answer 28

full

Question 29

what is the antagonist to precedex

Answer 29

atipamezole

Question 30

What are the uses of precedex

Answer 30

Conscious Sedation​

Calmness, easily rousable, spontaneous ventilation, amnesia is not assured​, may need to combine with versed

Postop/ICU​

GETA​

Tracheal intubation​

Decreased perioperative requirements of inhaled anesthetics & opioids​

TIVA​

Depression of ventilation

Question 31

Precedex E1/2

Answer 31

2-3hr

Question 32

List the doses of precedex for:
TIVA
Sedation
IV regional
Neuraxial: spinal and epidural

Answer 32