Anesthetic Agents

Question 1

loss of pain w/ loss of consciousness

Answer 1

Anesthesia

Question 2

(paralysis of skeletal muscles)

Answer 2

Akinesia

Question 3

main side effects of Anesthesia

Answer 3

CNS depression

Question 4

anesthesia’s that can result to loss of consciousness:

Answer 4

• Systemic-acting Anesthesia
• General Anesthesia
• Intrathecal Injection
• SUBARACHNOID OR SPINAL anesthesia
• EPIDURAL anesthesia

Question 5

anesthesia that are strictly sedatives→ hypnosis-sleep

Answer 5

GENERAL anesthesia

Question 6

– uses amide anesthetics (L3-L4)

• used in abdominal surgery

Answer 6

SUBARACHNOID OR SPINAL anesthesia

Question 7

route of morphine (Narcotic analgesic)

Answer 7

EPIDURAL anesthesia

Question 8

– periocular anesthesia (subconjunctiva, sub Tenon), retrobulbar (anterior, posterior)

Answer 8

ocular injections anesthesia

Question 9

Topical Ocular anesthesia uses what group of anesthesia:

Answer 9

ESTER anesthesia (Proparacaine & Benoxinate)

Question 10

ocular injections uses what group of anesthesia:

Answer 10

AMIDE anesthesia (Lidocaine)

Question 11

• loss of pain w/o loss of consciousness, intact motor function (no akinesia)

Answer 11

Analgesia

Question 12

most common Narcotic Opioids analgesic:

Answer 12

Morphine

Question 13

4A’s effects of NSAIDs:

Answer 13

• Analgesic
• Antipyretic
• Anti-inflammatory
• Anti-platelets/thrombotic

Question 14

relieves pain:

Answer 14

Analgesic

Question 15

relieves fever

Answer 15

Antipyretic

Question 16

it is a non-NSAID that has analgesic and antipyretics without anti-inflammatory effect

Answer 16

Paracetamol / Acetaminophen

Question 17

most common used NSAIDs:

Answer 17

Aspirin

Mefenamic,

Naproxen,

Ibuprofen

Question 18

2 Mechanism of Action of Anesthetic Agents:

Answer 18

A. Specific receptor theory

B. Membrane expansion theory

Question 19

theory that Blocks nerve conduction by decreasing the permeability of nerve cell membrane to Na+ ions by blocking the openings of the Na+ channels thus interferes with the depolarization process.

Answer 19

Specific receptor theory

Question 20

theory in which In uncharged or unionized form, the anesthetic agent is absorbed at the cell membrane and becomes part of cell membrane structure at the Na+ channel which altering the channel configuration.

Answer 20

Membrane expansion theory

Question 21

Classifications of Anesthetic Agents based on:

Biochemical structure

Answer 21

Ester group

Amide group

Question 22

anesthetic group– topical destroy by esterase (tears)

Answer 22

Ester group

Question 23

anesthetic group - injection route

destroyed by the liver

Answer 23

Amide group

Question 24

Ester group anesthetics examples:

Answer 24

1. Procaine
2. Tetracaine
3. Benoxinate/Oxybuprocaine
4. Proparacaine
5. Benzocaine
6. Cocaine

Question 25

the only natural anesthesia, narcotic analgesic, 1st discovered

Answer 25

Cocaine

Question 26

2nd discovered, used for short procedure

Answer 26

Procaine

Question 27

3rd discovered Ester group anesthetic

Answer 27

Tetracaine

Question 28

most common Ester group Anesthetic:

Answer 28

Proparacaine

Question 29

Amide group anesthetics examples:

Answer 29

1. Lidocaine 2. Etidocaine 3. Mepivacaine 4. Bupivacaine 5. Prilocaine

Question 30

most common Amide group anesthetic:

Answer 30

Lidocaine

Question 31

Routes of administration of anesthetic agents:

Answer 31

I. Topical local ester anesthetic agents II. Injectable local amide anesthetic

Question 32

Indications of **ocular** Local Anesthetics:

Answer 32

1. Force duction test 2. ElectroRetinoGraphy (ERG) 3. Goldman applanation tonometry 4. Gonioscopy 5. Corneal epithelial debridement or Corneal scraping 6. Fundus-contact condensing lens examination 7. Foreign Body & Suture removal

Question 32

anesthesia used in Forced duction test:

Answer 32

cocaine or lidocaine

Question 33

anesthesia used in ElectroRetinoGraphy (ERG):

Answer 33

tetracaine

Question 34

anesthesia used in Goldman applanation tonometry:

Answer 34

proparacaine or benoxinate

Question 35

anesthesia used in Gonioscopy:

Answer 35

proparacaine or benoxinate

Question 36

anesthesia used in corneal epithelial debridement/**corneal scraping:**

Answer 36

cocaine or tetracaine

Question 37

anesthesia used in **fundus-contact** condensing lens examination

Answer 37

proparacaine

Question 38

anesthesia used in foreign body & suture removal

Answer 38

proparacaine

Question 39

Ocular side effects of topical anesthetics:

Answer 39

1. Mild stinging & burning sensation - most common 2. Conjunctival Vasodilation - red eyes 3. Shortening of TBUT 4. decrease reflex tearing 5. decrease blinking - DES 6. decrease epithelial mitosis & migration (delay corneal healing) 7. corneal edema - blurred vision 8. Punctuate epithelial keratitis 9. Epithelial desquamation 10. Allergy - at lids & conjunctiva

Question 40

Ocular side effects of topical anesthetics:

Answer 40

1. Mild stinging & burning sensation - most common 2. Conjunctival Vasodilation - red eyes 3. Shortening of TBUT 4. decrease reflex tearing 5. decrease blinking - DES 6. decrease epithelial mitosis & migration (delay corneal healing) 7. corneal edema - blurred vision 8. Punctuate epithelial keratitis 9. Epithelial desquamation 10. Allergy - at lids & conjunctiva

Question 41

Systemic side effects of local **injectable anesthetics**: CNS DEPRESSION - early excitatory effects

Answer 41

1. restlessness 2. anxiety 3. dizziness or vertigo 4. tinnitus (ringing at the ear) 5. miosis 6. tremors 7. convulsive seizures - most serious

Question 42

Systemic side effects of local **injectable anesthetics**: CNS DEPRESSION - depressive effects

Answer 42

1. drowsiness 2. sedation 3. unconsciousness 4. coma 5. respiratory failure (apnea)

Question 43

Systemic side effects of **local injectable anesthetics**: at Cardiovascular system

Answer 43

1. hypertension 2. bradycardia then tachycardia 3. decrease cardiac output 4. peripheral vasodilation 5. A-V heart block 6. circulatory collapse (shock) → cardiac arrest 7. methemoglobinemia → hypoxia