LA Pharmacology

Question 1

What are the pharmacological properties of Lido/ligncaine?

Answer 1

Highly lipophillic therefore rapidly absorbed and short onset of action

Question 2

Which group does lidocaine/lignocaine belong too?

Answer 2

amid

Question 3

How is lidocaine/lignocaine metabolised?

Answer 3

Hepatic (95%)

Question 4

What is the elimination half life of lidocaine/lignocaine?

Answer 4

90-120 min

Question 5

What is the onset of action for lidocaine/lignocaine?

Answer 5

2-3 min

Question 6

What is the ‘duration of action for lidocaine/lignocaine in Pulp and Soft tissues?

Answer 6

Pulp: 60-90min

Soft tissue: 60-120min

Question 7

Which LA is most commonly used?

Answer 7

lidocaine/lignocaine

Question 8

What is the max dose for lidocaine/lignocaine?

Answer 8

7mg/kg/ absolute max for 2% lignocaine with 1:80 000 adrenaline

Question 9

What are the pharmacological properties of Prilocaine?

Answer 9

Slightly slower that lignocaine.

Less vasodilatory, distrubuted more rapidly,

Question 10

What group does Prilocaine belong too?

Answer 10

Amides

Question 11

How is Prilocaine metabolised?

Answer 11

By product of metabolism can exert effect on tisues in large doses

Question 12

What is the elimination half life of Prilocaine ?

Answer 12

Highest clearance of all amides.
Rapid metabolisim in the liver.
Additional clearance in lungs and kidneys.

Question 13

What is the duration of action in Prilocaine in Pulp and ST?

Answer 13

Pulp 40-90min

Soft tissues: 150-210 (with vasoconstrictor)

Question 14

Which LA is used when preparation with adrenaline is contraindicated?

Answer 14

Prilocaine (citanist)

Question 15

What is the max does for Prilocaine ?

Answer 15

9.0mg/kg, absolute max (600mg adult). 3% prilocaine HCI w fennypressin

Question 16

How is Articaine metabolised?

Answer 16

Articaine undergoes biotransformation in the blood plasma + liver

Question 17

What group does Articaine belong too?

Answer 17

Amide

Question 18

What is the elimination half life of Articaine ?

Answer 18

20min

Question 19

What is the onset of action for Articaine ?

Answer 19

2 min

Question 20

What is the duration of action for Articaine ? Pulp and tissue?

Answer 20

Pulp: 60-75

Tissue 180-360

Question 21

What category is Articaine ?

Answer 21

Category C drug

Question 22

What is the max dose for Articaine ?

Answer 22

7mg/kg absolute max (500mg adult).

Question 23

What are the indications for lignocaine?

Answer 23

Majority of dental LA

Question 24

What are medical contraindications for lido/lignocaine?

Answer 24

Adrenal tumors

Uncontrolled diabetes

Question 25

What are the indications for articaine?

Answer 25

Maxillary infiltrations

Question 26

What are the contraindications for articaine?

Answer 26

Avoid in preg. impaired renal function Elderly Children

Question 27

What is the indication for prilocaine?

Answer 27

When adrenaline is too be avoided

Question 28

What are the contraindications for prilocaine?

Answer 28

Coronary artery conditions. | Renal impairment

Question 29

What are the pharmacological properties of Mepivacaine?

Answer 29

Least vasodilatory of all amides. Similar to lignocaine, but short duration of action. Used when need vasoconstrictor free sol. Extremely low incidence of allergy

Question 30

What is the proprietary name of Mepivacaine?

Answer 30

Scandonest (gold).

Question 31

What is the metabolisim of Mepivacaine?

Answer 31

Hepatic

Question 32

What is the elimination half life of Mepivacaine?

Answer 32

114-192min

Question 33

What is the Onset of Action for Mepivacaine?

Answer 33

1.5-2min

Question 34

What is the duration of action for Mepivacaine; pulp and soft tissue?

Answer 34

Pulp: 20-40min | Soft tissue: 120-180

Question 35

What category is Mepivacaine?

Answer 35

Cat C.

Question 36

What are the pharmacological properties of Bupivacaine?

Answer 36

Long last and high protein binding. | Used at low concerntrations due to its cardiotoxic effects

Question 37

Would you use Bupivacaine as an OHT?

Answer 37

NO!

Question 38

Should you use articaine for IAN?

Answer 38

No

Question 39

What is the effect of vasoconstrictor?

Answer 39

Duration of action longer, keeping LA localised for longer

Question 40

What is the effect of vasodilator?

Answer 40

Increases perfussion, LA si caried away

Question 41

What precaution does 1. renal function and 2. liver disease require?

Answer 41

Dose reduction

Question 42

What precaution does cardiovascular disease require?

Answer 42

Adrenaline does reduction

Question 43

What precaution does Atypical pseudocholinesterase require?

Answer 43

Avoid articaine and esters

Question 44

What precaution does pregnancy require?

Answer 44

Avoid cat B3, C, D and X medications

Question 45

What do children general require?

Answer 45

Dose reduction?

Question 46

What do elderly generally requie?

Answer 46

Dose reduction?