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Operating Room Rx- Score an A+ on Your
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Version: Final
, Pseudocholinesterase disease - ✔✔patient doesn't produce enough and so metabolizing succ. can take days!
Patient wakes up paralyzed, very scary
Contraindications of succ - ✔✔Glaucoma
Elevated ICP
MH family hx
degenerative muscular diseases (elevates potassium too much)
What are the side effects of non-depolarizing agents? - ✔✔Think "rest and digest"
Bradycardia, increased GI peristalsis, bronchospasm, and increased oral secretions
What are the NDMR? - ✔✔Neotsigmime (mixed with glycopyrrolate/robinall)
Edrophonium and Elon plus (mixed with atropine)
Both are mixed with anticholinergic to prevent side effects
Reversal agent for MDMR? - ✔✔Sugammadex
What is a caffeine halothane test? - ✔✔Small amount of tissue is excised from pt and halothane is injected into
it.
When can we not give isoflurane? - ✔✔When a tourniquet is used. We use Sevoflurane in these pts instead.
When is Ethrane contraindicated? - ✔✔In patients with seizures! Lowers the seizure threshold, bad news bears
Desflurane - ✔✔Not commonly used with neuro procedures because it causes coughing
What is the only non-volatile inhaled gas? - ✔✔Nitrous Oxide.
We always give this when using a volatile gas because it has opioid properties with it.
What can nitrous oxide cause? - ✔✔Diffusion hypoxia. So these pts will come out of surgery on supplemental
oxygen
What chromosome does MH affect? - ✔✔Chromosome 19
What are triggering agents for MH? - ✔✔Succ and all volatile gases (desflurane, Ethrane, isoflurane, halothane,
and sevoflurane)
What are the early signs of MH? - ✔✔Trismus (locked jaw)
Increase in end tidal CO2
Increased HR and BP
Increase in muscle rigidity