Peri-operative drugs. Flashcards
What tests should we do before and during lisinopril treatment?
renal function and electrolytes.
What common drugs potentiate the activity of warfarin?
antibiotics
What common drugs inhibit warfarin activity?
OCP
barbituates
carbamezipine
What do beta2 adrenoreceptors do to glucagon?
Bets 2 adrenoreceptors normally stimulate glycogen breakdown and pancreatic release of glucagon, increasing plasma glucose.
What metabolic problem should we use beta blockers with caution in and why?
IDDM
because early signs of hypo e.g. tachycardia can be masked.
What side effects can NSAIDs cause in the perioperative period?
renal failure
increased bleeding.
How long should LMWH be stopped prior to surgery?
24 hours
How long should unfractioned heparin be stopped prior to surgery?
6 hours
When can heparin, warfarin and LMWH be commenced post op, if no bleeding?
warfarin same day (long onset)
hepatin - 12h
LMWH - 24h.
What antihypertensives can be given on the day of surgery?
most of them except ACE inhibitors.
How long should clopidogrel and aspirin be stopped before surgery?
Why?
7 days as irreversible platelet inhibitors, so need to wait out platelet life span.
When should NSAIDs be stopped prior to surgery?
24h
How should we dilute morphine?
1mg per 1ml solution.
What are the side effects of naloxone?
stops analgesia hypertension arrhythmias pulmonary oedema cardiac arrest following IV bolus
What is a standard PCA prescription?
1mg bolus, 5 min lockout.
