Medical Pharmacology Chapter 12: Anxiolytics and Sedative-Hypnotics
Preoperative Medication: Sedative Hypnotics and Other Agents and Issues
Parietal cells H+ ion secretion depends on a H+,K+-ATPase pump, promoting H+ K+ exchange.
H+, K+-ATPase located in apical membrane and tubulovesicular apparatus of parietal cells.
Luminal surface of the membrane enzyme: exposed to gastric luminal acid.
Intravenous dosage is 40 mg administered 30 minutes prior to induction.
The oral dose range is between 40 and 80 mg administered between 2 and 4 hours before the procedure.
Mechanism of action: Omeprazole (Prilosec) and lansoprazole (Prevacid) bind "irreversibly" to the proton pump.
This action result in an extended duration of action, since new protein must be synthesized to reestablish proton secretion function.
Duration of action: The effect on gastric pH may be as long as 24 hours with variable effects on gastric volume (omeprazole (Prilosec)).
1Preoperative Medication in Basis of Anesthesia, 4th Edition, Stoelting, R.K. and Miller, R., p 119- 130, 2000)
Hobbs, W.R, Rall, T.W., and Verdoorn, T.A., Hypnotics and Sedatives; Ethanol In, Goodman and Gillman's The Pharmacologial Basis of Therapeutics,(Hardman, J.G, Limbird, L.E, Molinoff, P.B., Ruddon, R.W, and Gilman, A.G.,eds) TheMcGraw-Hill Companies, Inc., 1996, pp. 364-367.
3Sno E. White The Preoperative Visit and Premedication in Clinical Anesthesia Practice pp. 576-583 (Robert Kirby & Nikolaus Gravenstein, eds) W.B. Saunders Co., Philadelphia, 1994
4John R. Moyers and Carla M. Vincent Preoperative Medication in Clinical Anethesia, 4th edition (Paul G. Barash, Bruce. F. Cullen, Robert K. Stoelting, eds) Lippincott Williams & Wilkins, Philadelphia, PA, pp 551-565, 2001
5Michael Ross and Susan Dufel "Torticollis" emedicine, http://www.emedicine.com/emerg/topic597.htm