Pre-Operative Antacids Flashcards
What is the normal dosage of Na⁺ Citrate (Bicitra)
15 - 30 mls
How does Bicitra work?
Non-particulate neutralization of gastric pH
What is the downside of Bicitra?
- ↑ Na⁺
- ↑ gastric volume
- ↑ gastric pH
What are the H2 antagonists used in the operating room?
- Famotidine
- Ranitidine
- Cimetidine
What is the most potent H2 antagonist?
Famotidine
What is the dose of Famotidine?
20 mg IV
What is a major downside to famotidine usage?
Inhibition of phosphate absorption → hypophosphatemia
What is the major downside to cimetidine use?
CYP450 inhibition
Consider warfarin, phenytoin, TCA’s, etc..
What is the dose of cimetidine?
150 - 300 mg IV
What is the dose of Ranitidine?
50mg/20mls over 2 min
What effects do PPI’s have on anticoagulants?
- Inhibited warfarin metabolism = ↑ INR
- Inhibition of Plavix = ↓ PLT function
What is the IV dose of pantoprazole?
40 mg / 100 mls over 2 min
What is the IV dose of omeprazole?
40 mg / 100mls over 30 min
What is the PO dose of omeprazole?
40 mg → 3 hours prior to surgery