5-Medicine Flashcards
What are the reasons for post-op fever?
Wind (12-24hr): atelectasis Water (~24 hr): UTI Walk (~48 hr): DVT/PE Wound (~72 hrs): post-op infection Wonder drug (anytime): drug fever
What part of the brain regulates the body’s temperature?
hypothalamus
What is malignant hyperthermia? name the s/s.
side effect of general anesthesia- tachycardia, hypertension, hyperthermia, muscle rigidity, acid-base and electrolyte abnormalities
What is the treatment for malignant hyperthermia?
Dantrolene. (for muscle relaxation
2.5mg/kg IV then 1mg/kg IV rapid push q6h until sx subside or until max dose of 10mg/kg
if a risk of malignant hyperthermia is suspected, what preop test may be performed?
CPK- elevated in 79% of patients with malignant hyperthermia
what is the moa of local anesthetics?
block VG-Na+ channels and conduction of AP along sensory nerves
what is the toxic dose of lidocaine (Xylocaine)? plain and with epi?
plain- 300mg
w/ epi- 500mg
what is the toxic dose of bupivicaine (marcaine)?
plain- 175mg
w/ epi- 225 mg
how do you convert percentage of solution to mg/mL?
move decimal point of percentage one place to right
e.g. 1% solution has 10mg/mL
What are the side effects of lidocaine and bupivicaine associated with systemic exposure?
CNS- initial excitation (dizziness, blurred vision, tremor, seizures) followed by depression (resp. depression, LOC)
CV- hypotension, bradycardia, arrhythmias, cardiac arrest
what can be given to help reverse local anesthetic-induced CV collapse?
IV fat emulsion (intralipid)
how are amides like lidocaine and bupivicaine metabolized?
liver (p450s)
how are esters like Novocain metabolized?
plasma pseudocholinesterase
what is the only local anesthetic with vasoconstriction?
cocaine
is there a risk with intra-articular injections of bupivicaine?
studies have shown chondrocyte death following prolonged exposure to bupivicaine
