Local anesthetics Flashcards

1
Q

Cocaine; benzocaine; procaine; tetracaine; chlorprocaine

A
  • Ester anesthetic: binds reversibly to the intracellular portion of the voltage-gated sodium channel and inactivates it, and so blocks transmission of nociceptive nerve impulses
  • Local anesthesia
  • Side effects: Local: transient neurologic symptoms (basically, really bad pain), neuronal injury. Systemic (more common with long-acting local anesthetics): circumoral numbness, dizziness, tinnitis, blurred vision, CNS excitation (restlessness, agitation, seizures), followed by CNS depression (respiratory arrest, unconsciousness); hypotension; cardic toxicity with higher doses.
  • Methemoglobinemia with benzocaine, allergic rxns
  • Used less frequently than amides
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2
Q

Lidocaine; mepivacaine; bupivacaine; ropivacaine

note the two i’s in each name

A
  • Amide anesthetic: binds reversibly to the intracellular portion of the voltage-gated sodium channel and inactivates it, and so blocks transmission of nociceptive nerve impulses
  • Local anesthesia
  • Side effects: Local: transient neurologic symptoms (basically, really bad pain), neuronal injury. Systemic (more common with long-acting local anesthetics): circumoral numbness, dizziness, tinnitis, blurred vision, CNS excitation (restlessness, agitation, seizures), followed by CNS depression (respiratory arrest, unconsciousness); hypotension; cardic toxicity with higher doses.
  • Bupivicaine has highest cardiac toxicity potential; ropivicaine less potent than others (so larger therapeutic index)
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