MultiModal (Exam 2)

Question 1

Gabapentin (Neurontin): MOA

Answer 1

-Binds VG Ca++ channels

-Inhibits glutamate release in the dorsal horn of the spinal cord

Question 2

Gabapentin (Neurontin): Doses

Answer 2

300 - 1200 mg prior to OR

Question 3

Gabapentin (Neurontin): Side Effects

Answer 3

Can exacerbate MG & myoclonus

Question 4

Dexamethasone (Decadron): MOA

Answer 4

-Inhibits phosolipase & cytokines

-Stabilizes membrane

Question 5

Dexamethasone (Decadron): Doses

Answer 5

8-10 mg

Question 6

Dexamethasone (Decadron): Side Effects

Answer 6

Can elicit a vomit reflex if given Rapid IVP; Perineal burning/Itching

Question 7

Celecoxib (Celebrex): MOA

Answer 7

-1st COX-2 specific Inhibitor

-Decreases PG synthesis (inducible)

Question 8

Celecoxib (Celebrex): Doses

Answer 8

200 - 400 mg PO QD.
Peak 3 hours

Question 9

Acetaminophen (Ofirmev): MOA

Answer 9

Decreases prostaglandin metabolites

Question 10

Acetaminophen (Ofirmev): Doses

Answer 10

-1 Gm IV/PO
-Onset: 30 - 60 mins IVOnset: 1-3 hours
-PO Max: 3 Gm (24 hrs)
-Duration: 6 - 8 hours

Question 11

Acetaminophen (Ofirmev): Misc.

Answer 11

Can have hepatic effects; toxic > 3 Gm/Day

Question 12

Ketorolac (Toradol): MOA

Answer 12

-Inhibits COX-1/COX-2

-Decreases PG synthesis

Question 13

Ketorolac (Toradol): Doses

Answer 13

-30 or 60 mg IM Q6 hours

-Elderly: 1/2 dose

-Peak: 45 to 60 mins IV

Question 14

Ketorolac (Toradol): Side Effects

Answer 14

-Can be extremely renal toxic
-1/2 doses in elderly & renal pts

Question 15

Ketorolac (Toradol): Misc.

Answer 15

Use with caution in:
-Renal patients
-Bleeding
-CAD/CABG
-Pregnancy
-Potential allergies

Question 16

Ibuprofen (Caldolor, Neoprofen): MOA

Answer 16

Inhibits COX-1/COX-2

Question 17

Ibuprofen (Caldolor, Neoprofen): Dose

Answer 17

-200 - 800 mg IV

-Max: 3200 mg (24 hrs)

Question 18

Ibuprofen (Caldolor, Neoprofen): Side Effect

Answer 18

Allergies to NSAIDs; bleeding, CABG, ulcers

Question 19

Lidocaine: MOA

Answer 19

Amide - Local Anesthetic

Question 20

Lidocaine: Doses

Answer 20

• 1 - 2 mg/kg IV Q 2 - 4 mins
• Gtt: 1 - 2 mg/kg/hr
• Terminated 12 - 72 hours

Question 21

Magnesium: MOA

Answer 21

NMDA receptor non-competitve antagonist

Question 22

Magnesium: Doses

Answer 22

• Pre-op: 50 mg IV
• Intra-op (gtt): 8 mg/kg/hr

Question 23

Magnesium: Side Effects

Answer 23

Contraindicated in Myasthenia Gravis (MG) and Renal Failure

Question 24

Magnesium: Misc.

Answer 24

SIGNIFICIANTLY DECREASES FENTANYL REQUIRMENTS