Pre-op 1/21 Flashcards
Test 1 (50 cards)
What is the most common NMB allergy?
Rocuronium
What would be a way that you can tell that a patient is having an allergic reaction while under anesthesia?
Cant ventilate them
What are factors that increase your risk of latex allergy?
Multiple Sx
-occupation: healthcare workers; food handlers
-food allergies: mangoes; kiwi; avocado; passion fruit; banana; chestnut
-spina bifida
What adverse effects can local anesthetics cause?
Increased HR dt epi
Which local anesthetics have a lower risk of allergic reactions? Why?
Amides have a lower risk for allergic reactions than esters
Esters have a perservative para-aminobenzoic (PABA)
Amides: Lidocaine, Bupivcaine,
Esters: Procaine, chloroprocaine,
What allergies have cross activity with NMB?
Morphine
Neostigmine
What BP medication do we need to d/c at least 24 hrs prior to Sx? Why?
ACE inhibitors
Makes BP hard to manage
What consideration should we have for all contraceptives?
High risk pt for postop venous thrombosis should DC four weeks prior to Sx
If patient is already taking a opioid, what considerations should i have?
I can give opioid that works on different opioid receptors
What consideration should we have with patient taking aspirin prior to surgery?
Cont if significant CVS disease/event
if not, d/c 10-14 days prior to surgery
What consideration should we have with Cox-2 inhibitors?
They can affect bone healing, can DC prior to surgery
what consideration should we have with MAOIs medication’s?
Avoid meperidine and indirect acting vasopressors (ephedrine)
What consideration should we have with P2Y12 inhibitors? (Antiplatelets)
Do not d/c with stent for Sx until 6 months of dual therapy
What are the d/c time frames for P2Y12 inhibitors? (Antiplatelets)
Clopidogrel/ticagrelor: 5-7 days
-Prasugrel: 7-10 days
-Ticlopidine: 10 days
When should topical & diuretics medications be d/c? What is the exception?
The day of Sx
Continue Thiazide diuretics
Sildenafil is ______ and should be d/c ____ before Sx
viagra
24
What are all the medications you d/c before Sx?
ASA
P2Y inhibitors (clopidogrel)
Topicals
Diuretics (not thiazides)
Sildenafil
NSAIDS
Warfarin
Postmenopausal Hormone Replacement Therapy (HRT)
Non-insulin anti-diabetic medication’s
When do we d/c NSAIDs before Sx?
48 hours
When do we d/c warfarin before Sx?
5 days
When do we d/c Post menopausal HRT before Sx?
4 weeks
When do we d/c non-insulin anti-diabetic medication before Sx?
Day of Sx
When do we d/c SGLT inhibitors before Sx?
24 hours
What is the protocol for insulin the day of Sx for type 1 vs type 2?
Type 1: 1/3 or normal dose of long acting insulin in the morning
Type 2: none or up to 1/2 of normal dose of long acting insulin in the morning
What are the periop corticosteroid doses?
50 mg IV before incision
25 mgs q8h for 24 hours
Theres more but this should be all im worried about
