JuniorDentist.com

Oral Care Tips by a Dentist

You are here: Home / Oral And Maxillofacial Surgery / Medications that interact with General Anesthesia

Medications that interact with General Anesthesia

April 13, 2020 by Dr. Varun Pandula Leave a Comment

General Anesthesia is an integral part of Oral and Maxillofacial Surgery, it consists of many components that might interact with medications taken for other health issues. General Anesthesia is administered in Dental treatments such as surgeries for Orofacial trauma Trauma such as Le-Fort fractures, Prosthetic surgeries such as Orthognathic surgery, Large Tumors (Ameloblastoma) or Cyst (Odontogenic Cysts) removals in the Mandible or Maxilla, Malignant lesions, etc. Proper history taking is a very important part of treatment planning, every problem either present or past should be revealed along with any medications which you are currently taking. Any history of allergies to any medication should also be mentioned, information regarding pregnancy should be revealed as GA agents can lead to spontaneous abortion in early pregnancy and complications in late pregnancy.

So it is very important for the patient to furnish any past medical history without hiding anything to avoid any complications during General Anesthesia.

Medications which interact with General Anesthesia:

ACE Inhibitors or Angiotensin-converting enzymes: Captopril and Enalapril

Being Vasodilators, these are used in high blood pressure (hypertension), congestive heart failure, kidney problems caused by diabetes, and given after an episode of a heart attack. They interact with General anesthetic agents by having a similar function thus leading to hypotension and rapid fall in Blood pressure.

Antibiotics: Aminoglycosides (Gentamycin, Neomycin, Amikacin) and polymixins (Polymixin B)

These interact with neuromuscular blocking drugs which prolong the length of blocks, Renal toxicity with long term therapy or in combination with other diuretics

Anticoagulants: Oral – warfarin, nicoumalone. Intravenous – heparin

Patients on anticoagulants have increased risk of hemorrhage during intubation, insertion of central lines, local or regional anesthesia, surgery, insertion of a nasogastric tube.

Anticonvulsants: barbiturates, phenytoin, carbamazepine

These induce hepatic enzymes which increase the requirement of doses of induction agents and opioids.

  • Benzodiazepines: It leads to addictive effects with other CNS depressants, a withdrawal syndrome may be precipitated in the case of flumazenil.

Beta-Blockers: Atenolol, metoprolol, oxyprenolol, propranolol, sotalol, etc.

Beta-blockers cause negative ionotropic effects which along with the vasodilation caused by GA agents lead to hypotension.  With the use of Beta-blockers, the pulse rate becomes a poor guide to blood loss on the operating table.

Diuretics: Thiazides and loop diuretics

  • Low Potassium or Hypokalemia lead to dysrhythmias and also lead to prolonged neuromuscular blockade can be caused due to use of Thiazides.
  • In the case of loop diuretics, it leads to Hyponatraemia (low Sodium content in the blood)
  • Use of Lithium along with General Anesthesia prolongs the effect of non-depolarizing neuromuscular-blocking drugs.

Calcium Antagonists: diltiazem, nefedipine, isoflurane, enflurane and halothane are non-specific calcium antagonists that may lead to hypotension. Verapamil leads to bradycardia along with decreased antrioventricular conduction. Digoxin leads to toxicity, predisposing to arrhythmias, potentiated by suxamethonium.

Tricyclic antidepressants: potentiated the effects of exogenous catecholamines causing arrhythmias, for example, adrenaline, when it is used as a vasoconstrictor in local anesthetics or to reduce bleeding.

Monoamine oxidase inhibitors (MAO): Isocarboxazid, phenelzine, tranylcypromine

Interactions are very uncommon but can lead to fatal interactions in combination with opioids such as pethidine and sympathomimetics. MAO’s should be stopped two weeks before surgery.

Steroids: Hypotension is seen during the induction of general anesthesia. For patients with long term treatment, supplementary doses are required. Adrenocorticol supression is seen in patients who have taken the medicine in the past 3 months.

These are some of the most commonly used medications on a daily basis for any underlying medical condition by patients which can have interactions with General Anesthesia agents.

Leave a Reply

Your email address will not be published. Required fields are marked *

Recent Posts

  • Gum infection can lead to Hearth Arrhythmia – Research by Hiroshima University
  • Classification of Fluorosis Stains on Teeth
  • Indian Orthodontic Society complain against at-home Aligner providers to DCI
  • Triple Antibiotic Paste Composition and use in Root Canal Treatment
  • Frequently asked Questions regarding Dental Braces and Water Sports

Search Juniordentist.com

Popular P Topics

  • Dry Socket Pictures | Pictures of Alveolar Osteitis
  • How many days does it take for Antibiotics to get rid of tooth infection or abscess
  • Protocol for Management and handling of Dental Hospital Waste - Color coding for waste disposal
  • Sequence of Extraction for Complete Maxillary and Mandibular teeth extraction
  • List of Papillae of Tongue – Location and Histology
  • Kennedy’s Classification of Edentulous Space and Applegate’s Rules
  • Differences between male skull and female skull
  • Types of Bevels and their Uses in Tooth or Cavity Preperation
  • Faulty Radiographs due to Faulty Processing Techniques
  • Arrested Caries - Causes, Color, Stages of Development and Treatment

Categories

Disclaimer

Juniordentist.com is intended for educational, informative and entertainment purposes only. It is not intended to replace your Dental Visit. Only a proper dental Checkup by a professional in person can help diagnose the problem you are suffering from and help give you the required treatment. You should always understand that a Patient to Doctor interaction is the only way to properly diagnose the problem and decide its cure.

Varun Pandula

Varun Pandula

A Dentist by profession but a tech enthusiast by heart, trying to learn and enjoy both the professions.

View Full Profile →

About Me

Hi I'm Varun, I'm currently a Dental Surgeon from India practicing from the past few years. I Started this Blog to help dental students as you can see from the name and also constantly try to keep updating information which can be useful for patients and Dental Practitioners as well. You can contact me here to for any Questions. Read More…

Recent Posts

  • Gum infection can lead to Hearth Arrhythmia – Research by Hiroshima University
  • Classification of Fluorosis Stains on Teeth
  • Indian Orthodontic Society complain against at-home Aligner providers to DCI
  • Triple Antibiotic Paste Composition and use in Root Canal Treatment
  • Frequently asked Questions regarding Dental Braces and Water Sports

Recent Comments

  • Dr. Varun Pandula on Arrested Caries – Causes, Color, Stages of Development and Treatment
  • Dr. Varun Pandula on Sequence of Extraction for Complete Maxillary and Mandibular teeth extraction
  • Dr. Varun Pandula on Enlargement of Lymph Nodes and their related Dental Conditions
  • Elizabeth on Enlargement of Lymph Nodes and their related Dental Conditions
  • Thasneem on Sequence of Extraction for Complete Maxillary and Mandibular teeth extraction