LA Flashcards
(100 cards)
1
Q
_______ to the tissues and produce no secondary local reaction
A
non-irritating
2
Q
LA have a ______ of _______, ________ and be of ______ duration
A
LOW DEGREE of SYSTEMIC TOXICITY, RAPID ONSET and be of SUFFICIENT duration .
3
Q
have a _____ _____ properties to be effective as a topical anesthesia
A
sufficient penetrating
4
Q
LA must be ____ in solution and under go biotransformation readily within the body
A
stable
5
Q
TRUE OR FALSE
LA is capable of being sterilized by heat with deterioration
A
FALSE, without deterioration
6
Q
what is PABA means
A
para-aminobenzoicacid esters
7
Q
what are the benzioc esters
A
cocaine and benzocaine
8
Q
an ester group that is used in dentistry as topical anesthesia
A
benzocaine
9
Q
A PABA group which in spray form and use when the patient need to undergo in general anesthesia
A
tetracaine (pontocaine)
10
Q
ESTER OR AMIDE and its brand name
procaine
A
ester, novocaine
11
Q
ESTER OR AMIDE and its brand name
2-chloroprocaine
A
ester, nesacaine
12
Q
ESTER OR AMIDE and its brand name
propoxycaine
A
ester, ravocaine
13
Q
ESTER OR AMIDE and its brand name
tetracaine
A
ester, pontocaine
14
Q
ESTER OR AMIDE and its brand name
articaine
A
amide, primacaine
15
Q
ESTER OR AMIDE, and its brand name
prilocaine
A
amide, citanest
16
Q
ESTER OR AMIDE and its brand name
mepivacaine
A
amide, carbocaine
17
Q
ESTER OR AMIDE and its brand name’
lidocaine
A
amide, xylocaine
18
Q
ESTER OR AMIDE and its brand name
etidocaine
A
amide, duranest
19
Q
ESTER OR AMIDE and its brand name
bupivacaine
A
amide, marcaine or sensorcaine
20
Q
an ester group used in eye surgery
A
cocaine
21
Q
an amide group that is known for paresthesia
A
articaine
22
Q
what year did cocaine made
A
1884
23
Q
what year did procaine made
A
1905
24
Q
year of lidocaine made
A
1948
25
year of mepivacaine made
1956
26
year of prilocaine made
1960
27
year of bupivacaine made
1963
28
year of etidocaine made
1971
29
year of articaine made
1975
30
compare lidocaine and procaine
lidocaine has more than procaine
rapid onset of action
more profound anesthesia
longer durationand greater potency
31
charateristics of pure LA
weekly basic
poorly soluble in water
unstable when exposed to air
32
what acid addd to pure LA to be stable, acidic and soluble
hydrochloric acid
33
pH level of LA w/o epinephrine
5.5 or 6.5
34
pH level of LA w/ epi
3.3-4.4
35
what characteristics of LA with epi when deposit
burning sensation on injection
slightly slower onset of action
and mor post injection soreness
36
it is added to LA to make injection more comfortable
sodium bicarbonate or CO2
37
low concentration of H+ ( high pH)
free base
38
high concentration of H+ (low pH)
cation
39
what are the 2 factors involve in the nerve membrane
diffusion through nerve sheath (free base) and binding of the receptor sites (cation)
40
pH level of normal tissue
7.4 pH
41
pH level of inflamed tissue
5-6 pH
42
how many % did cation have if the tissue is inflamed
99%
43
why LA is not effective when the tissue is inflamed
because the pH level, it is acidic
44
LA is effectively stops the nerve impulse propagation
minimal blocking concentration
45
how many successive nodes of ranvier o blocked the nerve conduction to be stop
3
46
proportional to the diameter of the nerve and spans 3 nodes that must be blocked by LA
critical blocking length
47
it is longer in thicker muscle fibers and less smaller in pain fibers
internodal distance
48
a single nerve cell
nerve fiber
49
covers each nerve fiber
endoneurium
50
bundle of 100-500 nerve fibers
fasciculi
51
it covers the fasciculi
perineurium
52
innermost layer of perineurium
perilemma
53
it supports fasciculi and carrying nutrient vessels
epineurium
54
outer layer of epineurium
epineural sheath
55
what fiber anesthesize first and it covers the?
mantle fiber and it covers the proximal structures
56
what fiber anesthesize next and it covers the?
Core fiber and it covers the distal structures
57
in diffusion, greater the initial concentration of LA, the __________ and the _______
faster the diffusion of molecules and more rapid the onset of action
58
in blocking process, what are the factors that decrease the LA concentration outside the nerve
some of the drug is absorbed by non neural tissues
some is diluted by interstitial fluid
some is removed by capillaries and lympatics from injection site
some ester types are hydrolyzed
59
measure from time of deposition to profound anesthesia or to complete the conduction blockage
induction time or onset
60
factors of induction time
concentration of the drug
pH of local anesthetic solution
rate of diffusion
anatomical barries of the nerve
61
what are the factors affecting the LA action
pka
lipid solubility
protein binding
non nervous tissue diffusibility
vasodilator activity
62
what is the action affected of pka and its description
onset, low pka has more rapid onset
63
what action affected on lipid solubility and its descrip
potency, higher the lipid solubility, more potency
64
what action affected in protein binding and its descrip
Duration, higher the protein binding, longer the time of duration
65
action affected in vasodilator activity and its descrip
potency and duration, the higher the vasodilator property, higher the bloodflow and it decreases the potency and duration
66
what LA is not use that has high pka and longer time of onset
procaine
67
what LA has highest lipid solubility
Etidocaine
68
what LA has higher protein binding
bupivacaine
69
signs of recovery from anesthesia
follow the diffusion pattern, reversed order
concentration gradient is reversed
mantle fiber lose LA first than core fibers
70
what is the meaning of intraneural concentration exceeding the extraneural concentration?
anesthetic molecules diffuse out of the nerve
71
effects of plain LA
more blood flow
more absorption of LA in blood circulation
high chance of toxicity
shorter the duration of action
more bleeding
72
what are the effects of LA with vc
decreased the blood flow
decreased the absorption of LA
decreased the chance of toxicity
longer duration of action
less bleeding
73
causes of vasodilator
increased rate of absorption into the blood
decreased the duration of pain control
increased the ansthetic blood level and potential for over dose
74
it prevents the oxidation of the vasopessor by oxygen that can cause allergy and asthma attacks
sodium bisulfite
75
in derma that topical anesthesia used on intact skin
EMLA or eutectic mixture of LA
76
seen on the vial and possess bacteriostatic, fungistatic and antioxidant properties
methylparaben
77
what LA used on hypothyrodism patient
plain LA
78
least vasodilate type of LA
mepivacaine
79
what nerve has high risk of paresthesia
inferior alveolar nerve and lingual nerve
80
contraindication in the prilocaine
methemoglobinemia and anemia
81
to prolong the shelf life in a vial
methylparaben
82
What is the alternative LA if the patient is allergic to sodium bisulfate
plain LA
2% lidocaine in vial
3% mepivacaine and 4% prilocaine in dental cartridge
83
in the concentration of VC there is effect of its duration?
none, all concentration has longer duration
84
in the concentration of the vc, there is an effect in the bleeding?
yes, more concentrated less bleeding
85
why articaine is not used in blocking technique?
increased risk of nerve paresthesia in inferior alveolar and lingual nerve block that suggest a possible greater neurotoxicity
86
what can happen if the balance between the rate of absorption into the bloodstream and the rate of removal from the blood is not balance to metabolized?
possible of toxicity
87
ester is metabolized and excrete in?
metabolized in plasma and excrete in kidney
88
what are the contraindication of ester
plasma cholinesterase deficiency
renal impairment
89
how the amide metabolized and excrete?
metabolized in the liver and excrete in the kidney
90
what are the contraindication of amides
liver dysfunction
renal impairment
91
how to manage the patient if it is contraindicated and has allergic reaction but has no alternative?
the LA can be administered but in less dosage
92
the dosage of the LA is varies and depends the effectivity on what?
vascularity of the tissues
individual tolerance
techniques of anesthesia
93
according to american heart association the vasoconstrictor in LA is not contraindicated as long as?
preliminary aspiration is practiced
the agent is injected slowly
smallest effective dose is administered
94
why is bupivacaine is not used in pediatric patient?
greater risk of paresthesia
prolonged duration of action
potential self mutilation
95
what are the 5 selections of LA nd VC ?
duration of the procedure
need for post operative pain control'
physical condition of the patient
desire to produce hemostasis
whethe there is any contraindication exist
96
weighing the risk of using it to its potential benefit and if an acceptable alternative is not available
relative contraindication
97
under no circumstance should the drug be administered to the patient
absolute contraindication
98
how the duration of plain prilocaine is used?
when the technique is by infiltration , the duration is short
when the technique is by nerve block, the duration is intermediate
99
General order of loss of nerve function
Pain
Temperature
Touch and pressure
Propioception
Skeleton muscle tone
100
Clinical advantage of articaine
Duration of its anesthetic effect
Superior diffusion in bony tissue
