Anesthetics and Gout Flashcards Preview

Pharmacology 2 > Anesthetics and Gout > Flashcards

Flashcards in Anesthetics and Gout Deck (32):
1

What is a local anesthetic?

An agent that interrupts pain impulses in a specific region of the body without a loss of patient consciousness. Renders a specific portion of the body insensitive to pain
Normally completely reversible

2

What drugs are local anesthetics?

Na channel blockers
Lidocaine, novocaine, cocaine

3

What is the difference between an anesthetic and an analgesic?

Anesthetics block Na channels, thus blocking ALL nerve transmission
Analgesics only inhibit pain

4

What are anesthetics often given with?

Opioids to increase effectiveness and epinephrine to prolong the effect (inhibits blood flow)

5

How is surface anesthesia accomplished?

By application of a local anesthetic to the skin or mucous membranes

6

What is surface anesthesia used for?

To relieve itching, burning and surface pain (minor sunburn)
Prior to injection

7

How does a nerve block work?

A local anesthetic is injected around a nerve that leads to the operative site (any nerve that is not spinal)
More concentrated forms of anesthesia are used

8

What is spinal anesthesia (epidural)?

Local anesthetic is injected into the subarachnoid space of the spinal cord
Blocks everything in the lower body

9

What are the effects of anesthetic?

First autonomic activity is lost, then pain and other sensory function. Motor is last to be lost. Peripheral is lost first
When wearing off, reverse is restored (motor first)

10

What is infiltration anesthesia used for?

Minor surgical and dental procedures

11

What is infiltration anesthesia?

Injection of the anesthetic solution intradermally, subcutaneously or submucosally across the path of nerves supply the target area
May be given in circular pattern around operative area

12

What is nerve block anesthesia used for?

Surgical, dental and diagnostic procedures
Therapeutic management of pain

13

Do side effects usually occur with anesthetics?

No as they are only used locally

14

How would side effects occur with anesthetics?

Inadvertent intravascular injection
Excessive dose or rate of injection
Slow metabolic breakdown
Injection into a highly vascular tissue (into the blood is bad)

15

What is gout?

Accumulation of uric acid crystals in joints causing acute joint inflammation (gouty arthritis)

16

What is gout associated with?

Ingestion of red meat, cheese and wine (large intake of purines)
"Rich man's disease"

17

Who is gout most common in?

Asians

18

Why does the uric acid build up in the joints?

Because there is a high concentration of uric acid all throughout the body, the different pH found in the joints will cause the uric acid to come out of solution as crystals

19

What is the important enzyme in uric acid production?

Xanthine oxidase
Converts hypoxanthine to xanthine and that to uric acid

20

What is colchicine?

A weak anti inflammatory agent that is not analgesic or antipyretic

21

How does colchicine work?

Impairs PMN motility and chemotaxis and thus inflammatory response
No effect on plasma or urinary uric acid

22

What could we also use colchicine for?

Low dose continuous prophylactic therapy

23

What are some symptoms of colchicine toxicity?

Nausea, vomiting, diarrhea, abdominal cramping, may cause death

24

What is allopurinol?

A xanthine oxidase inhibitor that reduces urate formation but leaves hypoxanthine sitting (risk of hypoxanthine stones)
Active metabolite

25

What should allopurinol be cautioned in?

Fluid intake and acute attack of gout

26

What is allopurinol used for?

Prophylaxis when acute gouty attacks happen frequently

27

Which NSAID is the drug of choice for gout?

Indomethacin

28

What may be the genetic predisposition for gout?

Reabsorbing too much uric acid

29

What makes indomethacin good for gout?

Less toxic than cochicine with long term use
Not uricosuric
Afford symptomatic relief

30

What are the side effects of indomethacin?

GI side effects

31

What does probenecid do?

Stops the reabsorption of uric acid (uricosuric)
Half-life dose dependent
Highly protein bound

32

What are the downsides of probenecid?

Inhibits the excretion of other acidic drugs
Caution with renal urate stones (fluid intake)