NS: Pre-medication and peri-operative drugs Flashcards
What is Mendelson’s syndrome?
Regurgitation and aspiration of gastric contents (Mendelson’s syndrome) can be an important complication of general anaesthesia, particularly in obstetrics and during emergency surgery, and requires prophylaxis against acid aspiration. Prophylaxis is also needed in those with gastro-oesophageal reflux disease and in circumstances where gastric emptying may be delayed.
What can be used before surgery to increase the pH and reduce the volume of gastric fluid?
A H2 receptor antagonist
When should an oral H2 receptor antagonist be given before a planned procedure?
1-2 hours.
Antimuscarinic drugs are used (less commonly nowadays) as premedicants to do what?
Antimuscarinic drugs are used (less commonly nowadays) as premedicants to dry bronchial and salivary secretions which are increased by intubation, upper airway surgery, or some inhalational anaesthetics
Why are antimuscarinics used before or with neostigmine?
They are also used before or with neostigmine to prevent bradycardia, excessive salivation, and other muscarinic actions of neostigmine.
What do antimuscarinic drugs achieve when used with drugs such as propofol and suxamethonium?
They are also used before or with neostigmine to prevent bradycardia, excessive salivation, and other muscarinic actions of neostigmine. They also prevent bradycardia and hypotension associated with drugs such as propofol and suxamethonium chloride.
Atropine sulfate is now rarely used for premedication but still has an emergency role in the treatment of what?
Atropine sulfate is now rarely used for premedication but still has an emergency role in the treatment of vagotonic side-effects. Atropine sulfate may have a role in acute arrhythmias after myocardial infarction.
Hyoscine hydrobromide reduces secretions and also provides a degree of what? (3)
Hyoscine hydrobromide reduces secretions and also provides a degree of amnesia, sedation, and anti-emesis. Unlike atropine sulfate it may produce bradycardia rather than tachycardia.
Unlike atropine sulfate, hyoscine hydrobromide may cause what?
Hyoscine hydrobromide reduces secretions and also provides a degree of amnesia, sedation, and anti-emesis. Unlike atropine sulfate it may produce bradycardia rather than tachycardia.
Glycopyrronium reduces salivary secretions and when given intravenously it has what advantage over atropine?
Glycopyrronium bromide reduces salivary secretions. When given intravenously it produces less tachycardia than atropine sulfate. It is widely used with neostigmine for reversal of non-depolarising neuromuscular blocking drugs.
Glycopyrronium is widely used with what drug for the reversal of non-depolarising neuromuscular blocking drugs?
Glycopyrronium bromide reduces salivary secretions. When given intravenously it produces less tachycardia than atropine sulfate. It is widely used with neostigmine for reversal of non-depolarising neuromuscular blocking drugs.
What is used to antagonise the effects of benzodiazepines?
Flumazenil
What duration of action does diazepam have?
long-acting drug with active metabolites and a second period of drowsiness can occur several hours after its administration.
What duration of action does temazepam have?
Shorter than diazepam and a more rapid onset.
Dexmedetomidine is an alpha2-adrenergic agonist with sedative properties. It is licensed for what?
Sedation of patients receiving intensive care who need to remain responsive to verbal stimulation
