Exam 2; Local Anesthetics and Spasmolytics Flashcards Preview

AU14 Pharmacology > Exam 2; Local Anesthetics and Spasmolytics > Flashcards

Flashcards in Exam 2; Local Anesthetics and Spasmolytics Deck (52):
1

This is any agent that can reversibly block the electrical activity of excitable tissues

local anesthetic

2

What are the two actions of local anesthetics

decrease neuronal conduction
block impulse conduction in the heart

3

How are local anesthetics used as painkillers

temporary analgesia without loss of consciousness

4

All local anesthetics have what two ends

automatic (lipophilic)
amino (hydrophilic)

5

This part of the local anesthetic can get though the neuronal membrane

lipophilic

6

This part of the local anesthetic is inside the membrane or cell, this end gets ionized

amino

7

Local anesthetics in the non-ionized form get through the neuronal membrane and once inside, what occurs

the hydrophilic side is ionized and binds to a specific site on the sodium channel of the excitable membrane/tissue; blocking the Na channel

8

What are the three events of local anesthetics blocking the Na channels

decreases neuronal conduction
decreases repolarization rate
increases refractory period

9

What will increase effect of the local anesthetic

Na channels are open; neurons not fire more rapidly
will have open channels more often and affected more

10

Which size of neurons are generally more susceptible to local anesthetics

smaller neurons
pain more susceptible than motor neurons

11

Which type of myelination of neurons is more susceptible to local anesthetics

myelinated neurons

12

Which speed of firing is more susceptible to local anesthetics

faster the firing rate the more susceptible

13

What is the sensitivity ranking regarding, warm, cold, pain, motor, and touch/pressure

pain > cold > warm > touch/pressure > motor

14

What is the major distinction between local anesthetics

their duration of action

15

This type in linkage has a relatively short duration

ester linkage

16

The ester is metabolized by what

plasma cholinesterase

17

What is the half like of ester linked LAs

minutes

18

This type of linkage is fairly long

amide linkage

19

The amide is metabolized by what

in the liver by CYP450

20

What is the half life of amide linked LAs

hours

21

Local anesthetics are weak bases or acids

bases

22

In an acidic environment, the local anesthetic will be what

more ionized

23

In infected tissues which tend to be more acidic, what happens to the local anesthetic

the molecules don't readily enter the cell and LA activity is decreased

24

Repeated use of an epidural anesthetic can do what

lower pH and cause tachyphalaxis

25

These are used with local anesthetics to increase duration of action (except for cocaine)

vasoconstrictors (like Epi.)

26

What are the three topical routes of administration of a LA

skin
mucosa
eye

27

What are the three routes of administration of injection of LA

infiltration
direct nerve block
spinal or epidural

28

Regardless of route of administration, all local anesthetics can be what

systemically absorbed

29

Which linkage of LA is more likely to cause an allergic reaction

esters

30

This ester LA inhibits the re-uptake of NE in the CNS

cocaine

31

What is cocaine used for

ophthalmic; nasal surgery

32

This is an ester LA with low solubility so a long duration of action and is used topically

benzoxaine

33

This ester LA has a short half-life and is not used topically because it doesn't readily pass through the mucous membranes

procaine

34

These are ester LAs that are used in the eye

benoxinate and proparacaine

35

These is an amino amide LA used IV for cardiac arrthymia and produces a lupus like syndrome in slow acetylators

procainamide

36

This is the most common amino amide LA and is used IV for arrthymias

lidocaine

37

What are some CNS side effects of lidocaine

tremors
slurred speech
drowsiness

38

What is it that distinguishes the amino amide LAs

all the names contain "two i's" and "-caine"
articaine
mevpicane

39

What are the six CNS side effects of local anesthetics

disorientation
drowsiness
slurred speech
tongue numbness
tinnitus (ringing in the ears)
burred vision

40

What is the side effect on the cardiovascular system of LAs

alter the heart rhythm

41

What are the two specific side effects of cocaine

vasoconstrictor
CNS effects

42

This is an irreversible sodium channel blocker that can cause muscle weakness, respiratory paralysis, and death

tetrodotoxi

43

This is an irreversible sodium channel blocker that can cause muscle weakness, respiratory paralysis, and death; from the red tide

saxitoxin

44

This is excessive muscle contraction; muscle hypertonia

spasticity

45

What results in spasticity

neuronal damage; injury, stroke, MS, CP, ALS

46

What is the treatment for spasticity

either alter the innervating neurons or act directly on muscle

47

This is a GABA agonist that increases the activity of inhibitory neurons; treatment for spasticity

baclofen

48

This is a minor tranquilizer and muscle relaxant that increases GABA activity; treatment for spasticity

diazepam and other benzodiazepines

49

This is an α2 agonist; inhibiting motor neurons; treatment for spasticity

tizanidine

50

This is a treatment for spasticity; neuronal effects

botulinum toxin

51

This acts directly on muscle cells and inhibits the stimulus induced release of Ca from the muscle SR; decreasing availability of Ca for muscle; treatment for spasticity

dantrolene

52

What are two side effects of dantrolene

muscle weakness
hepatitis