GasGasGas - The FRCA Primary Exam Podcast VivaCast 12 - Anti Emetics, Propofol (again!) and Antimicrobial Prophylaxis in Surgery
Mar 14, 2025
Dive into the fascinating world of antiemetics as Tom reveals his favorite, Droperidol, alongside its rivals like Ondansetron. Explore the intricate pharmacokinetics of Propofol, tracing its journey from IV emulsion to brain effects, while discussing factors that influence its onset and effectiveness. Unpack the essentials of antimicrobial prophylaxis in surgery, including key antibiotic classes and their mechanisms. This engaging session blends exam prep with essential clinical insights, making complex topics accessible and entertaining.
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Choose Antiemetic By Receptor Target
- Use droperidol as a D2 antagonist antiemetic similar to prochlorperazine for vomiting control.
- Remember ondansetron targets 5-HT3 receptors while cyclizine acts on histamine-related vestibular pathways.
Dexamethasone's Broad Perioperative Role
- Dexamethasone has multiple perioperative roles beyond antiemesis, notably reducing inflammation and swelling.
- Use it for ENT, orthopaedics and to temporise raised intracranial pressure from tumours.
Anticipate Propofol Redistribution Effects
- Expect rapid onset then redistribution when you give a propofol bolus because it diffuses into well-perfused tissues then adipose reservoirs.
- Anticipate short initial duration but prolonged effect after long infusions due to fat storage and context-sensitive half-time.