Term
| What drug can cause bradycardia that is resistant to atropine. (3x drugs) How would you treat this refractory bradycardia |
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Definition
1. Amiodarone
2. 2nd dose of Sux
3. Lithium
Treat with EPI or pace the patient. |
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Term
| Which antidepressant can lower your seizure threshold? |
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Definition
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Term
| What antidepresants may actually precipitate hypotension? HOW/WHY? |
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Definition
| tricyclics work by blocking the reuptake of NE and serotonin. But they also block alpha receptors which are needed for vasoconstriction. Thereby causing hypotension at times. |
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Term
| What does lithium do to your heart's rhythm |
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Definition
1. T wave smoothing
2. V arryhtmias
3. sinus dysfunction with resistance to atropine. |
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Term
| Should lithium be D/C prior to surgery? |
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Definition
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Term
| when should the herb ephedra be d/c? How does it work on the body? |
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Definition
| It should be d/c 24 hours prior. It is a direct/indirect acting and depletes resevoirs of NE thereby making ephedrine intraop not as effective. |
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Term
| What are some concerns with garlic |
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Definition
1. hypotension
2. decrease platelet aggregation and increase fibrinolysis
d/c 7 days prior to surgery since it effects platelets!! |
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Term
| What does ginkgo do to body |
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Definition
| decrease platelet activity. D/C 72 hours prior. |
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Term
| What does ginseng do to body |
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Definition
1. inhibits platelet aggregation
2. lowers blood glucose |
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Term
| What does KAVA do to the body |
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Definition
|
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Term
| What does valerian do to the body |
|
Definition
| Sedation, can cause benzo withdrawal if held. Do no HOLD PREOP |
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Term
| Carbon dioxide has a ___ more affinity for hemoglobin than Oxygen |
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Definition
| CO has a 3x more affinity for Hb than O2. |
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Term
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Definition
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Term
| What are the proven benefits of cessation for smoking prior to surgery? |
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Definition
1. if you stop 12 hours prior you will have improved outcomes
2. if you stop 8 weeks out you will havae physiological changes to airway constriction and better ciliary function |
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Term
| What do you need to know about marijuana |
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Definition
| Half life depends if user chronic or not. 30 days typical. Broken down in liver to 20 metabolites, most of which are active. Highly fat soluble and stays in adipose tissue which accounts for its half life. Acute ingestion causes increase SNS, chronic and afterwards its acts more like a depressant on cardio. Smoke is irritating to resp tract. Consider a 4mg dose of dexamethasone prior to case to avoid edema or irritation, |
|
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Term
| what do you need to know about cocaine? |
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Definition
| Cocaine 1/2 life 1-1.5 hours. Broken down by liver and plasma esterases. Very lipid soluble. Works by blocking the presynaptic reuptake of NE, 5HT and Dopamine. As a result of this large increase in amines the heart and lungs suffer from vasoconstriction. Risks for MI, agitation, HTN, V arry, asthma, and pulmonary hemmorhage. thrombocytopenia, avoid indirects and give direct acting sympathomimetics. Avoid procedures for a least one week after last use of cocaine, expect all cocaine abusers to have underlying cardiac pathologies, |
|
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Term
| what is the pathogenesis of cocaine induced MI |
|
Definition
. As mentioned previously,
the pathogenesis of cocaine-related myocardial
ischemia is due to increased myocardium oxygen
demand, the result of the vasoconstriction of the coronary
arteries and/or because of enhanced platelet aggregation,
leading to thrombus formation |
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Term
| What are some considerations for PCP and LSD? |
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Definition
Both are in a class of hallucinogens. All are ingested orally and cause auditory, visual and tactile hallucinations with distortions of body
image, surroundings and reality, anxiety, panic attacks and a fear of ‘going crazy’They activate the sympathetic nervous system by causing hypertension and tachycardia, increase body
temperature and dilate pupils. The effects of acute
ingestion develop over 1–2 h and last for approximately 12 hOverdose with these medications can cause respiratory
depression, seizures, coma |
|
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Term
| treat PCP and LSD related agitation with what drugs |
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Definition
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Term
| PCP coma may present with |
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Definition
| PCP coma may present with nystagmus, muscle rigidity and increased deeptendon reflexes |
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Term
most important in
patients with a history of ??-related hyperthermia is the avoidance of volatile agents and succinylcholine. (Type of illicit drug) |
|
Definition
most important in
patients with a history of MDMA-related hyperthermia is the avoidance of volatile agents and succinylcholine |
|
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Term
| how do you calculate Ideal Body Weight for men and women |
|
Definition
Men: 105 lbs + 6 lbs for q inch over 60 in
Women: 100 lbs + 5 lbs for q in over 60 in |
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Term
| BMI equal to or greater > ___ is moribdly obese |
|
Definition
| 40 and greater morbidly obese |
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Term
|
Definition
TELANGIECTASIA
Telangiectasia are the permanent dilatation of superficial blood vessels in the skin and may occur as isolated phenomena or as part of a generalized disorder, such as ataxia telangiectasia. |
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Term
|
Definition
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Term
| How do you calculate BMI if I weight 150 lbs and my height is 64 inches? |
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Definition
| 25.7 BMI b/c BMI= {lbs / (Inches ^ 2)} x 703 |
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Term
| What is my BMI. I weight 70 KG and my height is 1.2 meters |
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Definition
| 70 kgs / (1.2 m x 1.2 m) = 48.6 BMI |
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Term
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Definition
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Term
| You can't have a light meal at least ___ hours prior to surgery |
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Definition
|
|
Term
| You can't have solid food at least ___ hours prior to surgery |
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Definition
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Term
| How many levels are part of the ASA guidelines score |
|
Definition
| 6 levels and ADD E if it involves an emergency |
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Term
| a person who has severe systemic disease with threat to life and functionally incapacitated would be an ASA? |
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Definition
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Term
| What do you need informed consent for? |
|
Definition
1. ETT
2. Mechanical ventilation
3. Invasive monitoring
4. Regional Anesthesia
5. blood
6. post op care |
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