Essence of Anesthesia Practice

Androstenedione

Uses Testosterone replacement therapy Treatment of hypogonadal men Age-related sarcopenia HIV-related muscle wasting Increase in bone mineral density Prevention of age-related frailty and falls Perioperative Risks Coagulopathy Polycythemia You’re Reading a Preview Become a Clinical Tree membership for Full access…

Warfarin (Coumadin)

Uses Management of thromboembolic disorders: For prophylaxis, Rx, and prevention of recurrence of thromboembolic events including DVT, pulm embolism, thrombosis of grafts. Prevention of arterial emboli associated with prosthetic heart valves, nonvalvular AFib, acute MI. Prevention of MI, stroke, and…

Vitamin B 12 (Cyanocobalamin)

Indications Incidence of deficiency in USA varies with age: 5% of those <55 y, 10% of those 55–64 y, 10–15% of those 65–74 y, and 24% of those 74–80 y old. Some 75% of those >64 y with vitamin B…

Valproate

Uses Most widely prescribed antiepileptic drug worldwide. Used in treatment of epilepsy, acute mania, bipolar disease, impulse-control disorders, migraine headaches, and neuropathic pain. Perioperative Risks Hemorrhage Platelet dysfunction Coagulopathy Hyperammonemic encephalopathy Seizures with subtherapeutic plasma concentration Worry About Decreased factor…

Trimethaphan

Acknowledgment The author would like to acknowledge Dr. Tor Sandven’s contribution to this chapter in the previous edition. Uses Production of controlled hypotension during surgery to reduce bleeding into the surgical field Rapid reduction of BP in the treatment of…

Tranexamic Acid

Uses To prevent bleeding due to fibrinolysis after surgery or trauma (cardiac surgery with and without cardiopulmonary bypass; liver transplantation; orthopedic surgery including spine; GU surgery; peripartum hemorrhage). Bleeding can be diagnosed clinically or via lab tests (prolonged thrombin time,…

Tissue Plasminogen Activator

Uses Clinical indications for thrombolysis in treatment of pulmonary embolism, acute ischemic stroke, acute MI, and occluded central venous access devices. MI: Administration as soon as possible from symptom onset Stroke: Administration within 3 h from onset of symptoms Rapid…

Thyroid Supplements

Uses More than 3 million chronic users in USA. T 4 prescribed for pts with chronic hypothyroidism. T 3 used in myxedema coma. T 3 successfully used as rescue therapy for cardiogenic shock after CPB. T 3 favorably administered to…

Thiazolidinediones

Acknowledgment The authors would like to acknowledge the contributions of Drs. Ponnusamy Saravanan and Subramanian Sathiskumar to this chapter in the previous edition. Uses Oral insulin sensitizing agents for the treatment of type 2 DM. Their use in recent years…

Tetracyclines

Uses Administered PO (most common), IV (fewer side effects), IM (rare, painful), topically (eyes only). Original broad-spectrum antibiotic with activity against gram-positive and gram-negative bacteria; species of Chlamydia, Rickettsia, and Mycoplasma (in adults); some protozoa. One of few agents active…