Gastrointestinal/Hepatic Physiology


Anesthetic

Effect of decreased metabolism on duration of action

Propofol

No effect

Etomidate

No effect

Morphine

Prolonged

Succinylcholine

Prolonged

Fentanyl

No effect

Midazolam

Prolonged

Vecuronium

Prolonged

Rocuronium

Prolonged



Water-soluble drugs, such as rocuronium, will be distributed into a larger volume of distribution because of the volume-overloaded nature of many liver disease patients. This accounts for the need for a larger initial dose to obtain the desired clinical effect despite the prolonged duration of action.

Ester local anesthetics are metabolized by psuedocholinesterase and may have a prolonged duration of action. Amide local anesthetics are metabolized by the liver so they may also have a prolonged duration of action. With either class, care should be taken to avoid toxicity and large volume blocks probably should be approached with caution or avoided.





21.3 Questions and Answers



Questions (Choose the Most Appropriate Answer)




  1. 1.


    Bile helps emulsify what substance in the GI tract?


    1. A.


      Fat

       

    2. B.


      Protein

       

    3. C.


      Sugars

       

    4. D.


      Complex carbohydrates

       

     

  2. 2.


    Gastrin is secreted by which cells in the GI tract?


    1. A.


      K cells

       

    2. B.


      G cells

       

    3. C.


      S cells

       

    4. D.


      P cells

       

     

  3. 3.


    Thrombocytopenia occurs in liver disease as a result of which of the following?
Dec 18, 2017 | Posted by in Uncategorized | Comments Off on Gastrointestinal/Hepatic Physiology
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