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Oral Boards Study Guide > Local Anesthetics > Flashcards

Local Anesthetics Flashcards

1
Q

Lidocaine: Class

A

Amide

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2
Q

Lidocaine: Use

A

Topic Anesthesia
Local infiltration
Neuraxial Anesthesia

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3
Q

Lidocaine: Mechanism of Action

A

Reversibly block voltage-gated sodium channels in neurons

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4
Q

Lidocaine: Dose

A

Plain:
Max = 5 mg/kg or 350mg

With Epinephrine:
Max = 7mg/kg or 500mg

IV: 1-2 mg/kg

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5
Q

Lidocaine: Pharmacokinetics

A

Onset: Fast

Duration of Action: 90-120 minutes

Metabolism: In the liver via CYP1A2 and CYP3A4

Excretion: Kidneys

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6
Q

Lidocaine Absorption

A

Systemic absorption depends on vascularity of the area. More vascular = higher blood concentrations

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7
Q

Lidocaine : Contraindications/ Considerations

A

Newborns and elderly have prolonged 1/2 lives

Amide Local Anesthetic –> Metabolism in liver, risk for accumulation in liver failure

Propranolol and Cimetidine can inhibit hepatic blood flow and increase accumulation

Risk for LAST

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8
Q

Bupivacaine: Class

A

Amide

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9
Q

Bupivacaine : Use

A

Topic Anesthesia
Local infiltration
Neuraxial Anesthesia

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10
Q

Bupivacaine: Mechanism of Action

A

Reversibly block voltage-gated sodium channels in neurons

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11
Q

Bupivacaine: Dose

A

Plain:
2mg/kg or 175mg

With Epinephrine:
3mg/kg or 225mg

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12
Q

Bupivacaine: Pharmacokinetics

A

Onset: Slow
Duration of Action: Long 180-600 minutes
Metabolism: Hepatic via CYP 1A2 and CYP 3A4
Excretion: Kidneys

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13
Q

Bupivacaine: Absorption

A

Systemic absorption depends on vascularity of the area. More vascular = higher blood concentrations

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14
Q

Bupivacaine: Contraindications and Considerations

A

High affinity for myocardial sodium channels, very high risk for cardiac toxicity

Prolonged 1/2 in Newborns and Elderly

Amide Local Anesthetic –> Metabolism in liver, risk for accumulation in liver failure

Propranolol and Cimetidine can inhibit hepatic blood flow and increase accumulation

Risk for LAST

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15
Q

Chloroprocaine: Class

A

Ester

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16
Q

Chloroprocaine: Use

A

Topic Anesthesia
Local infiltration
Neuraxial Anesthesia

17
Q

Chloroprocaine: Mechanism of Action

A

Reversibly block voltage-gated sodium channels in neurons

18
Q

Chloroprocaine: Dose

A

Plain:
11mg/kg or 800mg

With Epinephrine:
14mg/kg or 1000mg

19
Q

Chloroprocaine: Pharmacokinetics

A

Onset: Fast
Duration of Action: 30-60 minutes
Metabolism: Rapid hydrolysis via plasma and tissue cholinesterases
Excretion: Kidney

20
Q

Chloroprocaine: Absorption

A

Systemic absorption depends on vascularity of the area. More vascular = higher blood concentrations

21
Q

Chloroprocaine: Contraindications and Considerations

A

Reduced potential for toxicity

High pKa but fast onset

Low Potency

Decreased hydrolysis with succinylcholine or neostigmine

Higher Risk for Allergy

Oral Boards Study Guide (15 decks)

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