Multimodal: Gabapentin

Question 1

Regarding Gabapentin’s preemptive analgesia, What 3 studies/ procedures is it used in?

Answer 1

• Spine surgeries
• Orthopedic procedures
• Major abdominal procedures.

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Question 1

What is the PO dose of preemptive Gabapentin?
When should we give it?

Answer 1

300-1200mg PO
1-2 hrs prior to OR

start slow then build up

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Question 2

For Preemptive Gabapentin, what patient population is it contraindicated for?

Answer 2

• MG and Myoclonus patients
• Reduce dose in elderly patients

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Question 3

What are Gabapentin’s side effects?

Answer 3

Think ↑GABA effects

• Somnolence
• fatigue
• ataxia
• vertigo
• GI disturbances: constipation
• abrupt withdrawal in seizure pts (when Gaba is used as an antiepiliptic) –> causing seizures
• wt gain

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Question 4

Is Gabapentin lipid soluble?
What percentage protein-binding occurs?
What’s it’s E 1/2 time?

Answer 4

• Yes, Lipid soluble
• 0% protein-bound
• Brief E 1/2 time – need redosing required

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Question 5

Does Gabapentin have any drug-drug interactions?

Answer 5

No drug interactions

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Question 6

What are indicated uses for gabapentin?

Answer 6

• Seizures
• Neuropathic pain
• Chronic pain syndromes.

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Question 7

What is the MOA of Gabapentin?

Answer 7

GABA analogue
(not act like GABA)

Binds voltage gated Ca++ channels:
enhances descending inhibition
inhibits excitatory neurotransmitter release

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