anesthetics

Question 1

which has higher allergy potential, esters or amides?

Answer 1

esters

Question 2

can benoxinate be used alone?

Answer 2

no (often mixed with fluorescein)

Question 3

is there cross sensitivity between amides and esters?

Answer 3

no

Question 4

T or F- there is cross reactivity between proparacaine and benoxinate

Answer 4

false! there is no cross reactivity between them

Question 5

1) ____ usually have one i and 2) ____ usually have 2 i’s

Answer 5

1) esters, 2) amides

Question 6

the most commonly used ester topical anesthetics in eye care are?

Answer 6

tetracaide, benoxinate, and proparacaine

Question 7

____ hydrozyses esters into ____, ____, and ____ products

Answer 7

pseudocholinesterase, PABA, MABA, BA

Question 8

which are the PABA esters?

Answer 8

tetracaine, benoxinate, benzocaine, procaine

Question 9

which are the MABA esters?

Answer 9

proparacaine

Question 10

BA ester?

Answer 10

cocaine

Question 11

is there cross reactivity between PABA and MABA products?

Answer 11

no

Question 12

amides are metabolized by what?

Answer 12

the liver, biliary canal, or kidneys

Question 13

which amide is saturable?

Answer 13

lidaocaine (can cause toxicity/seizures)

Question 14

which is the most commonly used topical AMIDE anesthetic

Answer 14

lidocaine

Question 15

which are longer acting with more systemic effects, esters or amides?

Answer 15

amides

Question 16

which amide has the least sting?

Answer 16

proparacaine

Question 17

which has the greatest corneal penetration?

Answer 17

tetracaine

Question 18

which has the least corneal penetration?

Answer 18

lidocaine

Question 19

which anesthetic is the best for corneal debridement?

Answer 19

tetracaine

Question 20

which amide used topically or injected for chalazions?

Answer 20

lidocaine

Question 21

which has more of a hypersensitive response, esters or amides?

Answer 21

esters

Question 22

lidocaine duration (time) on eye is ____ when used with epinephrine for vasoconstriction?

Answer 22

doubled

Question 23

intrinsic ____ will occur when anesthetic numbs nerve impulses responsible for vasoconstriction and decreases duration of action

Answer 23

vasodilation

Question 24

high ____ ______ of drug to albumin can account for longer duration of action

Answer 24

protein binding

Question 25

which anesthetic can transiently increase corneal thickness?

Answer 25

proparacaine

Question 26

6 adverse effects of anesthetics

Answer 26

epithelial desquamation, cornemal edema, conjunctival hyperemia, contact dermatitis, burning/stinging/lacrimation, delayed wound healing, seizures/CNS depression (rare)

Question 27

anesthetic combos: is their toxicity additive?

Answer 27

no

Question 28

toxicity is ____ related to dose in systemic effects

Answer 28

exponentially

Question 29

target of anesthetics is the ___ sodium channels

Answer 29

voltage gated(the anesthetic gets into nerve via lipophilic characters, binds to receptor and closes channel so impulse is not created)

Question 30

you use ____compresses to treat anesthetic issues

Answer 30

cold

Question 31

patients may cross-react to the ______ in injectables

Answer 31

preservatives

Question 32

common topical ester based anesthetics are pregnancy category __ but lidocaine topical is category __

Answer 32

C, B

Question 33

two non-anesthetic alternatives for "caine" allergies

Answer 33

antihistaminics (injectables and saline version) and saline (injectables)

Question 34

anesthetic abuse syndrome: the primary sign of ____ is a yellow/white stromal ring?

Answer 34

disciform stromal infiltrates

Question 35

anesthetic abuse syndrome: what causes loss of epithelium?

Answer 35

keratic precipitates

Question 36

anesthetic abuse syndrome: ____ causes cells and flare

Answer 36

anterior uveitis

Question 37

white blood cells and red blood cells settled in the anterior chamber are called _____ and ____ respectively? (effect of anesthetic abuse syndrome)

Answer 37

hypopyon, hyphema

Question 38

in anesthetic abuse syndrome, corneal epithelial defect can lead to _____ and _____?

Answer 38

stromal edema, descemet's folds

Question 39

______ and _____ are classic vasoconstrictors

Answer 39

phenylephrine, epinephrine

Question 40

a risk of vasoconstrictors?

Answer 40

local necrosis b/c blood supply cut off

Question 41

three ocular adverse effects of cocaine?

Answer 41

epithelial desquamation, mydriasis, lid retraction

Question 42

five systemic effects of cocaine?

Answer 42

myocardial infarction from vasoconstriction, convulsions, rapid palpitations, nausea, delirium

Question 43

4 drug interactions of cocaine

Answer 43

antihypertensives, MAOIs, tricyclic antidepressants, decongestants