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Pharmacology 2 > Anesthetics and Gout > Flashcards

Anesthetics and Gout Flashcards

1
Q

What is a local anesthetic?

A

An agent that interrupts pain impulses in a specific region of the body without a loss of patient consciousness. Renders a specific portion of the body insensitive to pain
Normally completely reversible

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2
Q

What drugs are local anesthetics?

A

Na channel blockers

Lidocaine, novocaine, cocaine

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3
Q

What is the difference between an anesthetic and an analgesic?

A

Anesthetics block Na channels, thus blocking ALL nerve transmission
Analgesics only inhibit pain

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4
Q

What are anesthetics often given with?

A

Opioids to increase effectiveness and epinephrine to prolong the effect (inhibits blood flow)

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5
Q

How is surface anesthesia accomplished?

A

By application of a local anesthetic to the skin or mucous membranes

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6
Q

What is surface anesthesia used for?

A

To relieve itching, burning and surface pain (minor sunburn)

Prior to injection

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7
Q

How does a nerve block work?

A

A local anesthetic is injected around a nerve that leads to the operative site (any nerve that is not spinal)
More concentrated forms of anesthesia are used

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8
Q

What is spinal anesthesia (epidural)?

A

Local anesthetic is injected into the subarachnoid space of the spinal cord
Blocks everything in the lower body

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9
Q

What are the effects of anesthetic?

A

First autonomic activity is lost, then pain and other sensory function. Motor is last to be lost. Peripheral is lost first
When wearing off, reverse is restored (motor first)

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10
Q

What is infiltration anesthesia used for?

A

Minor surgical and dental procedures

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11
Q

What is infiltration anesthesia?

A

Injection of the anesthetic solution intradermally, subcutaneously or submucosally across the path of nerves supply the target area
May be given in circular pattern around operative area

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12
Q

What is nerve block anesthesia used for?

A

Surgical, dental and diagnostic procedures

Therapeutic management of pain

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13
Q

Do side effects usually occur with anesthetics?

A

No as they are only used locally

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14
Q

How would side effects occur with anesthetics?

A

Inadvertent intravascular injection
Excessive dose or rate of injection
Slow metabolic breakdown
Injection into a highly vascular tissue (into the blood is bad)

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15
Q

What is gout?

A

Accumulation of uric acid crystals in joints causing acute joint inflammation (gouty arthritis)

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16
Q

What is gout associated with?

A

Ingestion of red meat, cheese and wine (large intake of purines)
“Rich man’s disease”

17
Q

Who is gout most common in?

A

Asians

18
Q

Why does the uric acid build up in the joints?

A

Because there is a high concentration of uric acid all throughout the body, the different pH found in the joints will cause the uric acid to come out of solution as crystals

19
Q

What is the important enzyme in uric acid production?

A

Xanthine oxidase

Converts hypoxanthine to xanthine and that to uric acid

20
Q

What is colchicine?

A

A weak anti inflammatory agent that is not analgesic or antipyretic

21
Q

How does colchicine work?

A

Impairs PMN motility and chemotaxis and thus inflammatory response
No effect on plasma or urinary uric acid

22
Q

What could we also use colchicine for?

A

Low dose continuous prophylactic therapy

23
Q

What are some symptoms of colchicine toxicity?

A

Nausea, vomiting, diarrhea, abdominal cramping, may cause death

24
Q

What is allopurinol?

A

A xanthine oxidase inhibitor that reduces urate formation but leaves hypoxanthine sitting (risk of hypoxanthine stones)
Active metabolite

25
Q

What should allopurinol be cautioned in?

A

Fluid intake and acute attack of gout

26
Q

What is allopurinol used for?

A

Prophylaxis when acute gouty attacks happen frequently

27
Q

Which NSAID is the drug of choice for gout?

A

Indomethacin

28
Q

What may be the genetic predisposition for gout?

A

Reabsorbing too much uric acid

29
Q

What makes indomethacin good for gout?

A

Less toxic than cochicine with long term use
Not uricosuric
Afford symptomatic relief

30
Q

What are the side effects of indomethacin?

A

GI side effects

31
Q

What does probenecid do?

A

Stops the reabsorption of uric acid (uricosuric)
Half-life dose dependent
Highly protein bound

32
Q

What are the downsides of probenecid?

A

Inhibits the excretion of other acidic drugs

Caution with renal urate stones (fluid intake)

Pharmacology 2 (23 decks)

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