Pre- Medication Pharmacology

Question 1

What is an appropriate anxiolytic pre-op?

Answer 1

Temazepam is given orally at 10-20mg 1-2h pre-op
No sign effect on CV. Resp depression in high doses
Liver met, renal exc

Question 2

Goal of GORD management pre-op?

Answer 2

Reduces gastric volume
Increase gastric pH
Antacid limited value as short acting and only increase pH

Question 3

What is a PPI?

Answer 3

Proton pump inhibitor

Works on H+ pumps in gastric parietal cells

Question 4

Side effect of NSAIDs?

Answer 4

Gastric irritation
Asthma
Renal
Platelet function only when at effective concentrations

Question 5

Mechanism of action of NSAIDs?

Answer 5

Inhibit cyclo-oxygenase
Reduce prostaglandin production, therefore protective effect on stomach and kidneys lost.
Reduces thromboxane A2 and prostacyclin.
Inhibited inflammatory response
COX2 assoc thrombo- embolic effects

Question 6

How long are neuroaxial blocks prohibited after LMWH?

Answer 6

10hrs

Read guideline on AAGBI

Question 7

Thromboprophylaxis

Answer 7

Read risk guidelines

Question 8

Short acting hypoglycaemic agents

Answer 8

Gliclazide

Repaglinide