Flashcards in Anesthetics Deck (47):
What is the MOA of local anesthetics?
Directly affects sensitive Na+ channels
What are two types of local anesthetics?
What are some amide local anesthetics?
*note the i in each*
What is an example of an ester local anesthetic?
What is the onset time of procaine and how long does it last?
What is the time of onset for bupivacaine and how long does it last?
What is the time of onset of lidocaine and how long does it last?
< 2 minutes
What does the aromatic ring structure do for local anesthetics?
Increased lipid solubility
What does the linkage structure do for local anesthetics?
Determines the type of metabolism
What kind of metabolism do amide local anesthetics have?
What kind of metabolism do ester local anesthetics have?
Plasma esterases metabolize
What do terminal amines do for local anesthetics?
Influence aqueous solubility
Why do you combine lidocaine with?
What is lidocaine with epinephrine and what are the advantages of it?
Prolongs duration of action
What is the max dosage of lidocaine 2%?
Total = 500 mg
What concentration of procaine has a shorter duration of action?
Which percentage of bupivacaine is most commonly used?
What local anesthetic is most widely used?
Is the efficacy comparable between all local anesthetics?
What is the "dosage" of 1% solution equivalent to?
What is the max dosage of lidocaine and its concentration?
50 mL of 1%
What is a patch used as local anesthetic?
Lidocaine patch 5% topical
How do you administer the lidocaine patch?
On 12 hours
Off 12 hours
Can you cut the lidocaine patch?
Yes -> different from other transdermal systems
What is the max amount of patches that can be used per day?
Are true allergies to local anesthetic common or rare?
Which type of local anesthetic MC has allergic reactions?
If allergic to 1 ester, can you take others?
No, allergic to 1 allergic to all
Switch to amide
What are systemic effects of local anesthesia?
Respiratory depression (death)
What anesthetic is commonly used in epidurals?
What is EMLA?
Eutectic mixture of local anesthetics
What do you combine for EMLAs?
What population doe you used EMLAs with?
What do we use EMLAs for?
Venous, arterial, finger, heel, and lumbar punctures
Removal of staples, sutures, and lines
What were the emergent toxicities of general anesthetic chloroform?
Long term liver damage
What was the emergent toxicity of general anesthetic methoxyflurane?
What was the problem with general anesthetic ether?
What is a problem with nitrous oxide (inhaled)?
Increased post-operative nausea and vomitting
What is a problem with halothane (inhaled)?
What is a problem with enflurane (inhaled)?
Hepato and renal toxicities
What is a problem with isoflurane (inhaled)?
(shunting of blood away from already ischemic myocardium)
What is a problem with desflurane (inhaled)?
What is an issue with sevoflurane (inhaled)?
When is elimination of an agent and emergence from anesthesia essentially guaranteed?
As long as breathing is satisfactory
What are some advantages of inhalational anesthesia?
Completely painless induction
No IV access
Most rapid delivery to blood stream
How are the rates of PONV in all generalized inhalation anesthesias?
They are all similar