Non-Operating Room Anesthesia (NORA)

Question 1

What type of anesthetic is recommended for cerebral coiling?

Answer 1

GETA w/ arterial line and large bore IV.

Question 2

What is most important in prevention of radiation damage, shielding or distance?

Answer 2

Distance

Question 3

What drug(s) is/are direct thrombin inhibitors?

Answer 3

Dabigatran (Pradaxa)

Question 4

How do direct thrombin inhibitors work?

Answer 4

Antagonizes thrombin to prevent fibrinogen → fibrin

Question 5

What laboratory test will measure Pradaxa’s (Dabigatran) effects?

Answer 5

dTT

Question 6

What drug(s) is/are Factor Xa inhibitors?

Answer 6

• Rivaroxaban (Xarelto)
• Apixaban (Eliquis)
• Edoxaban (Savaysa)

Question 7

What is the MOA of Factor Xa inhibitors?

Answer 7

Prevents cleavage of prothrombin → thrombin

Question 8

What drugs can reverse the effects of coumadin?

Answer 8

Vitamin K
FFP

Question 9

What drugs reverse the effects of direct thrombin inhibitors and factor Xa inhibitors?

Answer 9

• Factor concentrates
• PCC

Question 10

What is the effect of CO₂ levels on cerebral blood flow?

Answer 10

Hypercapnia = Increased CBF