1.4 - Vasoconstrictors Flashcards Preview

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Flashcards in 1.4 - Vasoconstrictors Deck (9)
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1
Q
  1. Do vasoconstrictors increase or decrease duration of action of LA? Do they increase or decrease bleeding?

Do they increase or decrease risk of LA toxicity?

A
  1. Vasoconstrictors increase duration of LA by decreasing blood flow and decreasing overall bleeding
  2. Decrease risk of LA toxicity
2
Q
  1. What is the benchmark vasoconstrictor in dental LA?

What is the second vasoconstrictor?

A
  1. Epinephrine

2. Levonordefrin (NeoCobefrin)

3
Q
  1. What is the only LA in the US that contains levonordefrin?
A

2% Mepivacaine HCl with levonordefrin (1:20,000)

4
Q
  1. What are some epinephrine beta1 effects on cardiac tissue?
    - Heart rate, contraction force, stroke volume, cardiac output?
A

Increases everything (increase HR, contraction force, SV, cardiac output)

5
Q
  1. What are some epinephrine beta2 effects on cardiac tissue?
    - Constrict or dilate Coronary arteries?
    - Vasoconstrict or vasodilate vessels to skeletal muscle?
A
  1. Dilate coronary arteries

2. Vasodilate vessels to skeletal muscles

6
Q
  1. What metabolic effects does epi have?
    - Oxygen consumption levels
    - Stimulates or reduces glycogen levels
    - Blood sugar levels
A
  1. Increases oxygen consumption
  2. Stimulates glycogenolysis
  3. Increase blood sugar levels
7
Q
  1. What is the maximum safe dosage of epinephrine to a healthy patient in mg?

How about to a patient with CV disease?

A
  1. 0.2 mg epi (11 cartridges of 1:100,000)

2. 0.04 mg epi (2 cartridges of 1:100,000)

8
Q
  1. What dilution of epinephrine is the dilution of choice in at risk individuals?
    (1: 50,000, 1:100,000 or 1:200,000)
A

1:100,000

9
Q
  1. If patient may have a drug interaction with epinephrine, levonordefrin may be used (found in Mepivacaine 2% w/ levonordefrin 1:20,000).

What percent is levonordefrin as potent as epinephrine? In general, is levonordefrin as effective as epi?

A

Levonordefrin is 15% as potent

Much less effective at hemostasis and airway dilation, no stimulation of cns, and much less metabolic effects