Local Anesthetics

Question 1

Identify:

Esters

Answer 1

TetracaIne
ProcaIne
BenzocaIne

Esters have only one I in their names

Question 2

Identify:

Amide

Answer 2

Bupivacaine
Ropivacaine
Lidocaine

Amides have 2 I’s in their names

Question 3

Local anesthetic with the shortest half life

Answer 3

Procaine 1-2mins

Question 4

Local anesthetic with the longest half life

Answer 4

Ropivacaine 4.2 hrs

Question 5

Why should you not inject lidocaine into an abscess

Answer 5

Abscess is acidic; if below pKa = charged form will predominate, drug will be ineffective

Question 6

All local anesthetics are vasodilators except:

Answer 6

Cocaine

Question 7

Most important toxic effect of local anesthetics

Answer 7

CNS: Seizures
Cardiotoxicity: Arrhythmia

Question 8

MOA of Cocaine

Answer 8

blocks catecholamine reuptake, intrinsic sympathomimetic activity

Question 9

Blocks Na channel
Drug of extravasation complications from venipuncture, inadvertent intraarterial injections
SE: Antibody formtion
Shortest half life among local anesthetics

Drug, Class

Answer 9

Procaine, Local anesthetic (ester)

Novocaine

Question 10

Blocks Na channel
Drug of Topical anesthesia
SE: Skin irritation, antibody formation, CNS and Cardiac effects
Shortest half life among local anesthetics

Drug, Class

Answer 10

Benzocaine, Local anesthetic (ester)

Butamben

Question 11

Blocks Na channel, intrinsic sympathomimetic activity. Vasoconstriction
Drug for Topical anesthesia (very effective)
SE: Antibody formation, abuse liability, severe HPN, cerebral hemorrhage, cardiac arrhythmia, MI

Drug, Class

Answer 11

Cocaine, Local anesthetic (ester)

Drug of abuse

Question 12

Blocks Na channel
Drug for spinal anesthesia, Epidural anesthesia, topical ophthalmic anesthesia
SE: Antibody formation, CNS and Heart effects

Drug, Class

Answer 12

Tetracaine, Local anesthetic (ester)

Question 13

Blocks Na channel
Drug for arrhytmia
SE: Seizures, CNS and Heart effects
Shortest half life among local anesthetics

Drug, Class

Answer 13

Lidocaine, Local anesthetic (amide)

Question 14

Toxic Dose of Lidocaine

Answer 14

5mg/kg

Question 15

Solution Concentration? How many mg in ml

Answer 15

10mg/mL

Question 16

Blocks Na channel
Drug for Dental Anesthesia
SE: Methemoglobinemia (Fe in 3+)

Drug, Class

Answer 16

Prilocaine, Local Anesthetic (amide)

Question 17

Blocks Na channels
Drugs for Epidural anesthesia, intrathecal anesthesia
SE: Severe cardiovascular toxicity, HPN, arrhythmia
Use with caution in pregnant

Answer 17

Bupivacaine, Local Anesthetic (amide)

Question 18

Blockade of Na channels slows
Drug for Epidural anesthesia
SE: Cardiotoxicity

Answer 18

Ropivacaine

Question 19

Longest half-life among local anesthetics

Answer 19

Ropivacaine