Patients who have had organ transplants should have Abx prophylaxis with cefalexin 1g, dicloxacillin 1g or azithromycin 500mg orally just before the procedure
F
1 hour before
if their physician has advised it
Vitamin E (alpha-tocopherol) is a potential anticoagulant.
T
The combination of non selective beta blockers (such as propranolol) and adrenaline may result in malignant hypertension, reflex bradycardia and even death
T
Selective beta blockers are ok
Patients with surgically repaired atrial or ventral septal defects are high-risk for developing bacterial endocarditis following a surgical procedure.
F
Low-risk
High-risk are pts with prosthetic valves, previous endocarditis, complex congenital heart disease, surgically constructed systemic-pulmonary shunts.
Alternatives to penicillins include macrolides
T
Appropriate antibiotics to prevent bacterial endocarditis in at risk patients are amoxicillin or if allergic, cefalexin, axithro or clindamicin
T 60min pre op Amox 2g Ceflex 2g Azithro 500mg Clinda 600mg - same for immmunosuppressed pts who have been advised they need prophylaxis
Heat electrocautery or bipolar coagulation should not be used in patients with implanted cardiac pacemakers.
F
These are advocated.
The risk of cardiac conditions has been stratified into high, moderate, low or negligible risks by the American Heart Association
T
Procedures involving infected or eroded skin are associated with significantly higher infection risk and warrant the use of prophylactic antibiotics.
T
Lidocaine and prilocaine are the preferred anesthetics for use during pregnancy
T
cat A in Aus
(B in USA but stil preferred)
Patients with hypertrophic cardiomyopathy and mitral valve prolapse with regurgitation are medium-risk for developing bacterial endocarditis following a surgical procedure.
T
High-risk categories include patients with prosthetic valves, a previous history of endocarditis, complex congenital cyanotic heart disease, and surgically constructed systemic–pulmonary shunts
Antiviral prophylaxis for laser resurfacing should begin within 48hrs preoperatively and continue until re-epithelialisation is complete, generally within 7-10 days.
T
Cephalospirin Abx can usually be given safely to penicillin allergic patients who do not have anyphylactic response to penicillin
T
Garlic, ginseng, ginger, ginkgo, St John’s wort and feverfew are all potential anticoagulants.
T
Electrocautery is the preferred method of haemostasis in patients with implanted deep-brain stimulators.
T
Consider delaying surgery in hypertensive patients with a systolic pressure of >170 mmHg and/or a diastolic pressure >100 mmHg
T
bleeding risk and stroke risk
send to GP for BP lowering
Lignocaine and prilocaine are the preferred anaesthetics for pregnancy.
T
Dabigaptran (Pradaxa) is a factor Xa inhibitor
F
direct thrombin inhibitor
Erythromycin estolate is safe to use during pregnancy.
F
Assoc with hepatotoxicity during pregnancy.
Fondaparinux and Rivaroxiban are factor 9 (IX) inhibitors
F factor 10a (Xa) inhibitors
Inactivation of the deep-brain stimulator has never been necessary as effective hemostasis can be achieved with electrocautery in dermatologic surgery
T
In pts with Hx of HSV undergoing facial resurfacing procedures antivral prophylaxis options include acyclovir 400 mg three times daily, valacyclovir 500 mg twice daily, and famciclovir 250 mg twice daily.
T
start 48 hrs before and continue until re-epithelialization 7-10 days after
There are no adverse effects associated with bupivacaine and mepivacaine use in pregnancy. .
F
Associated with increased risk of foetal bradycardia
Alcohol may result in an increased bleeding potential.
T
advise pts to avoid for 2 days prior to surgery and at least until day afterwards
Use of the hyfrecator is acceptable in pts with deep brain stimulators
F Use Electrocautery (hot wire)
Patients with implanted pacemakers and defibrillators and patients with physiologic heart murmurs are low-risk for development of bacterial endocarditis following surgery.
T
Intrapartum use of tetracycline may result in staining of foetal dental enamel.
T
Small volumes of adrenaline-containing anaesthetics cannot be given safely in patients with advanced heart disease.
F
can be
must be max conc 1:200,000