DRUGS, MEDICATION,

ANESTHETICS

&

SURGERY

Surgeries & Anesthetics

It is very important to discuss your NAION situation with surgeons and anesthesiologists and be sure they understand the importance of maintaining normal blood pressure, oxygen level, head placement, what medications may conflict with those you are taking and post-op monitoring for a secondary NAION event.

As per Claude AI

If you’ve experienced Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION), there are several important considerations to keep in mind when undergoing surgery and anesthesia:

  1. Inform your medical team: Make sure your surgeon and anesthesiologist are aware of your NAION history. This information is crucial for them to make appropriate decisions regarding your care.
  1. Blood pressure management: NAION is associated with sudden drops in blood pressure. Your anesthesiologist should carefully monitor and manage your blood pressure during surgery to avoid further optic nerve damage.
  1. Positioning during surgery: Certain surgical positions, especially those that involve the head being lower than the heart, may increase the risk of optic nerve complications. Discuss optimal positioning with your surgical team.
  1. Oxygen levels: Ensuring adequate oxygenation during surgery is important to protect the optic nerve.
  1. Medication considerations: Some medications used during anesthesia may affect blood flow. Your anesthesiologist should choose medications that minimize risk to the optic nerve.
  1. Fluid management: Proper fluid balance is important to maintain adequate blood flow to the optic nerve.
  1. Post-operative care: Close monitoring of vision and optic nerve function after surgery is crucial.
  1. Risk of second eye involvement: If your NAION affected only one eye, there may be a risk of involvement in the other eye. Discuss this with your doctors.
  1. Preoperative testing: Additional tests like visual field exams or optical coherence tomography (OCT) might be recommended before surgery.
  1. Alternatives to general anesthesia: In some cases, local or regional anesthesia might be preferable to minimize risks.

It’s important to have a thorough discussion with your healthcare providers about these considerations. They can tailor their approach based on your specific situation and the type of surgery you’re undergoing.

 

Drugs and Medications

Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) can be influenced by certain medications and drugs. Here are some that may be associated with or interfere with NAION. The following list is for reference only. As always, consult with your health care advisor for more information:

Medications and Drugs

  1. Phosphodiesterase type 5 inhibitors (PDE5 inhibitors):
  • Sildenafil (Viagra)
  • Tadalafil (Cialis)
  • Vardenafil (Levitra)

 

  1. Antihypertensives:

Some blood pressure medications may contribute to vascular changes.

 

Examples include:

1. Diuretics

  • Hydrochlorothiazide
  • Furosemide
  • Spironolactone

2. ACE Inhibitors

  •  Lisinopril
  • Enalapril
  • Ramipri

      

Angiotensin II Receptor        

Blockers (ARBs)

  • Losartan
  • Valsartan
  • Olmesartan

 

4. Calcium Channel Blockers

  • Amlodipine
  • Diltiazem
  • Verapamil

5. Beta-Blockers

  • Metoprolol
  • Atenolol
  • Carvedilol

6. Alpha-Blockers

  • Doxazosin
  • Prazosin
  • Terazosin

7. Central Alpha Agonists

Clonidine

Guanfacine

8. Vasodilators

  • Hydralazine
  • Minoxidil

Always consult a healthcare professional for personalized information and recommendations.

Antidepressants:

Certain SSRIs and other classes might have vascular effects.

Here are some common selective serotonin reuptake inhibitors (SSRIs) used as antidepressants:

Common SSRIs

Fluoxetine (Prozac)

Sertraline (Zoloft)

Citalopram (Celexa)

Escitalopram (Lexapro)

Paroxetine (Paxil)

Always consult a healthcare professional for advice on medications and their use.

 

Systemic corticosteroids:

Long-term use may affect blood flow.

Here are some common systemic corticosteroids:

Common Systemic Corticosteroids

  • Prednisone
  • Hydrocortisone
  • Methylprednisolone (Medrol)
  • Dexamethasone
  • Triamcinolone

These drugs are often used to reduce inflammation and suppress the immune response. Always consult a healthcare professional for guidance on their use.

 

Chemotherapeutic agents:

Some cancer drugs can have vascular side effects.

Recreational drugs:

Cocaine and methamphetamine use can lead to vascular issues.

Risk Factors

Systemic conditions: Diabetes, hypertension, and hyperlipidemia can exacerbate the risk.

Sleep apnea: Associated with increased risk of NAION.

Important Note

If you suspect NAION or are concerned about medication interactions, consult a healthcare provider for personalized advice and management.