LA 1 Flashcards

1
Q

What do you call LA in America?

A

Novocaine

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2
Q

What is analgesia?

A

Pain relief medication

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3
Q

What are the 3 structures compromising LA?

A
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4
Q

Why is the role of the aromatic ring in LA?

A

Lipid solubility potency

More soluble more potent

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5
Q

What is the role of the intermediate link in LA?

A

Determines biotransformation

We use amide now, less likely for patients to be allergic

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6
Q

Where are the amides linkagages metabolised?

A

In the liver

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7
Q

What does the LA block in the nerve?

A

Reversible blocks the sodium channel and blocking the depolarisation (action potential) and signals of pain

Blocking excitable membranes

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8
Q

Does LA act on all excitable membranes?

A

Yes

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9
Q

What creates a quicker onset time of LA?

A

The higher the tissue pH the quicker the onset time

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10
Q

LA goes in at neutral or charged form?

A

Neutral

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11
Q

When does LA become charged?

A

When it is propagated

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12
Q

What 2 organs are important in LA excretion?

A

Liver and kidneys

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13
Q

In what form does LA penetrate the lipid part of the neuron membrane?

A

Uncharged lipophilic form (fat soluble)

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14
Q

What is the concentration of LA in the UK?

A

2% preparation with 1:80,000 adrenaline

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15
Q

How do you calculate how much LA to give?

A

7mg/kg of body weight, up to 50pmg

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16
Q

What is the max LA you can give?

A

500 mg

17
Q

Compare mepivacaine and lidocaine?

A

Melivicaine doesn’t need a vasoconstrictor LA does

18
Q

What is a benefit of melivocaine?

A

Useful to ensure good blood supply

19
Q

What vasodilator can accompany prilocaine?

A

Felylressin in UK

20
Q

What is more toxic prilocaine or lidocaine?

A

Lidocaine remains in the plasma longer than prilocaine

21
Q

When would you use bupivacaine?

A

Long duration of numbness, for surgery or post-op

22
Q

What is the maximum recommended dose of articaine?

A

7mg/kg

(88mg is standard 2.2ml cart)

23
Q

Are LAs vasodilators or vasoconstrictors?

A

Vasodilators?

24
Q

Why is articaine good for patients with liver failure?

A

Ester group tagged on, so pseudocholonesterases are metabolised in the plasma, don’t rely on liver metabolism

25
Q

What is the duration of numbness for pulpal anaesthesia for articaine and lidocaine?

A

60 mins

26
Q

What has a shorter half life, lidocaine or articaine?

A

Articaine, top up more