Anaesthetics

Question 1

chemical structure of local anesthetics = lipophilic synthetic aromatic or heterocyclic residue, with intermediate ester/amide linkage and weakly basic tertiary amine terminal.

Answer 1

true

Question 2

myelination enhances anesthetic sensitivity, independent of diameter

Answer 2

true

Question 3

T/F: small diameter nerves tend to be MORE sensitive than large diameter nerves.

Answer 3

true

Question 4

anesthetic targets:

pain > cold > warmth > touch > deep pressure > motor.

Answer 4

true

Question 5

_______ was the first local anesthetic isolated in 1860 and was a popular pre-op topical ocular anesthetic.

Answer 5

cocaine!

Question 6

Procaine and lidocaine were the first _______ derivatives of cocaine.

Answer 6

synthetic derivatives

Question 7

Tetracaine, benoxinate, proparacaine, and lidocaine are the most commonly used topical anesthetics in eye care.

Answer 7

true

Question 8

Tetracaine, Procaine, lidocaine, and bupivicaine are the most widely used anesthetics on the market today.

Answer 8

true

Question 9

esters have one “i” while amides have two “i”

Answer 9

true

Question 10

When used as a topical anesthetic, ______ does NOT have any visible effect on the corneal epithelium, unlike most others.

Answer 10

lidocaine (amide)

Question 11

proparacaine and tetracaine have the same indications, while benzocaine is for OTC oral, dental and cough; cocaine is for otolaryngology.

Answer 11

true

Question 12

which ester anesthetic has the LEAST sting?

a. tetracaine
b. benzocaine
c. benoxinate
d. proparacaine

Answer 12

proparacaine

Question 13

which amide anesthetic is used for chalazion surgery?

a. lidocaine
b. mepivicaine
c. etidocaine
d. prilocaine

Answer 13

lidocaine (3.5% topical gel)

Question 14

which two amide anesthetics can be used for obstetrics?

a. bupivicaine & etidocaine
b. bupivicaine & prilocaine
c. ropivacaine & bupivicaine
d. ropivacaine & prilocaine

Answer 14

bupivicaine & ropivacaine

BR

Question 15

T/F: Etidocaine is an amide anesthetic used for ONLY LA (local anesthesia).

Answer 15

True

Question 16

injectable anesthetics are used for subconjunctival cases (uveitis, cystoid macular edema, several corneal ulcer), facial nerve block, and retrobulbar block.

Answer 16

true

Question 17

which two anesthetics have the longest durations? and why?

Answer 17

etidocaine and bupivicaine.

(5-10 hours, 4-12 hours) because they have high protein binding.

Question 18

lidocaine duration is doubled when used with epinephrine for vasoCONSTRICTION.

Answer 18

true.

Question 19

which anesthetic has the following adverse effects?

excitement, convulsions, rapid palpitations, nausea, delirium, desquamation, mydriasis and lid retraction.

Answer 19

cocaine

Question 20

which of the following are ocular adverse effects of anesthetics?

a. desquamation
b. corneal edema
c. conjunctival hyperemia
d. allergic conjunctivitis
e. all of the above

Answer 20

all of the above!

Question 21

how do anesthetics adversely effect the cardiovascular system?

a. increase excitability, increase cardiac conduction, causing hypertension.
b. decrease excitability, decrease cardiac conduction, causing hypotension and cardiac collapse.

Answer 21

b. it decreases the heart’s ability to function.

Question 22

Potency of anesthetics is ______ related to lipid solubility, while toxicity is _______ related to dose. (ie. double dose is 4x more toxic)

a. inversely, exponentially
b. directly, inversely
c. directly, exponentially

Answer 22

directly , exponentially.

Question 23

what is the FIRST SIGN of (topical) anesthetic abuse syndrome??

Answer 23

yellow-white stromal ring at active site.

Question 24

1% benadryl and saline are the injectable non-aesthetic alternatives

Answer 24

true

Question 25

EMLA eutectic mixture (lidocaine/prilocaine), iontophoresis (lidocaine sponge) and lidoderm patch are the topical non-anesthetic alternative.

Answer 25

true