test 3 part 4 Flashcards
T/F: the pathogenesis of ALS is debatable. Could be genetic, environmental, autoimmune and/or viral
true
what is the median time of survival of ALS after dx
3-5 years
T/F: 5-10% of cases of ALS have a familial component
true
ALS anesthesia implications
- preop testing guided by comorbidities
- Risk of dehydration and aspiration
- respiratory compromise
- End of life care, intubation, and reuscitation
what lab is typically evaluated in pts with ALS
creatine phosphokinase (CPK) due to chronic muscle wasting
what drug anesthetic induction drug should be avoided in pts with ALS
succ
if pt with ALS is coming in for surgical procedure, what should you advise them to bring with them?
NIPPV
in a pt with ALS you should be aware of autonomic dysfunction, which will have what clinical sx?
- resting tachycardia
- orthostatic hypotension
- elevated circulating levels of epi/norepi
what is the dose of phenytoin given for seizure d/o
400 mg/day
for a seizure d/o what is the therapeutic phenytoin level?
10-20 mcg/ml
what are the adverse effects/toxicity sx with phenytoin
ataxia
drowsiness
gum hyperplasia
macrocytic anemia
steven johnson syndrome
what is the dose of carbmazepine for seizure d/o
600 mg/day
for seizure d/o what is the therapeutic level of carbmazepine (tegretol)
4-8 mcg/ml
what are the adverse/toxicity sx for carbamazepine (tegretol)
- N/D
- rash
- Dizziness
- hyponatremia
- blood dyscrasias
- steven johnson syndrome
what is the dose of phenobarbital for seizure d/o
120 mg/day
for seizure d/o what is the therapeutic level of phenobarbitol
10-35 mcg/day
what is the dose of ethosuximide for seizure d/o
1000 mg/day
For seizure d/o what is the therapeutic level for ethosuximide (zarontin)
40-100 mcg/ml
what is the dosage of lamotrigine (lamictal) for seizure d/o
300-500 mg/day
what is the dosage for levetiracetam (keppra) for seizure d/o
2000 mg/day
for seizure d/o what are the adverse effects/toxicity sx of phenobarbitol (luminal)
drowsiness
nystagmus
rash
what are the adverse effects/toxic sx for Ethosuximide (zarontin) in the tx of seizure d/o
drowsiness
nausea
rash
bone marrow depression
what are the adverse/toxicity effects of lamotrigine (lamictal) in the tx of seizure d/o
dizziness
ataxia
blurred vision
stevens johnson syndrome
what are the adverse effects/toxicity sx of levetiracetam (keppra) in the tx of seizure d/o
somnolence
dizziness