LAA

Question 1

Potency of an LAA is generally related to

Answer 1

Lipid solubility

Slower rate of absorption

Question 2

Clinical efficacy of LAA may be increased by adding

Answer 2

Epinephrine
Opioids
A2 Agonist

Question 3

Local anesthesia

Answer 3

Loss of sensation in a circumscribed area of the body

Question 4

MoA of LA

Answer 4

Inhibition of conduction in peripheral nerve

Depression of excitation in nerve ending

Question 5

Regional anesthesia

Answer 5

Loss of sensation over a portion of anatomy without loss of consciousness

Question 6

Three layers of nerve tissue layer in PNS

Answer 6

Endoneurium
Perineurium
Epineurium

Question 7

Purpose of nerve tissue layers in PNS

Answer 7

Protection and barrier for passive diffusion of LAA

Question 8

Means of regeneration of ion gradient in neuron membrane

Answer 8

Protein pumps
Cotransporters
Channels

Question 9

Permeability of cell membranes at rest and during depolarization

Answer 9

K+

Na+

Question 10

Membrane expansion theory

Answer 10

LA molecule diffuse to hydrophobic regions of membrane and create disturbance and prevent permeability to Na+

Question 11

Specific recptor theory

Answer 11

LAA acts by binding to specific receptors on channel

Question 12

Metabolism of amino esters

Answer 12

Plasma cholinesterase

Question 13

Metabolism of amino amides

Answer 13

Hepatic carboxylesterase

CP450

Question 14

pH of; 
Commercially prepared LA
LA after injection
Solutions without epinephrine
Solutions with epinephrine

Answer 14

5. 5 - 7
6. 4
7. 5
8. 5

Question 15

Effect of increasing pH of LA solutions

Answer 15

Speeds its onset
Increase clinical effectiveness
Make injections more comfortable

Unstable
Precipitates

Question 16

Effect of decreasing pH of LA solutions

Answer 16

Burning sensation

Slightly lower onset

Question 17

Highest pKa and cationic/ionization at 7.4 pH

Answer 17

Procaine

Bupivacaine

Question 18

Highest lipid solubility

Answer 18

Bupivacaine

Lidocaine

Question 19

Sequence of Clinical anesthesia

Answer 19

Sympathetic block (VasoDial) 
Loss of sensation
(Pain and Temp
Proprioception
Touch and Pressure
Motor function)

Question 20

Highest duration of action (PPB)

Answer 20

Bupivacaine (95%)

Lidocaine (64%)

Question 21

Benzoic acid esters

Answer 21

Benzocaine

Cocaine

Question 22

Amides

Answer 22

Lidocaine

Bupivacaine

Question 23

Quinololes

Answer 23

Centbucridine

Question 24

Effect of Epinephrine on LA activity

Answer 24

Prolonged action
Increased intensity of block
Decreased systemic absorption

Question 25

Effect of Opioid on LA activity

Answer 25

Synergistic activity | Prolong and intensify analgesia and anesthesia

Question 26

Exception to analgesic synergy of opioids

Answer 26

2-chloroprocaine (epidural)

Question 27

Factor that influence rate of Absorption

Answer 27

Tissue vascularity

Question 28

Areas with the greatest systemic absorption

Answer 28

Intercostal Caudal and epidural Brachial Femoral and Sciatic

Question 29

Potent agent at low concentration

Answer 29

Cause more vasoconstriction | Decrease rate of absorption

Question 30

LAA at high concentration

Answer 30

Predominant vasodilatory effect

Question 31

Effect of Renal disease on pharmacokinetics of LAA

Answer 31

Little effect

Question 32

Effect of Severe Liver disease on pharmacokinetics of LAA

Answer 32

Slow their clearance | Accumulation of drug

Question 33

Half life of Bupivacaine

Answer 33

3.5 hrs

Question 34

Half life of Lidocaine

Answer 34

1.6 hrs

Question 35

Use of Local anesthesia

Answer 35

Infiltration anesthesia Regional anesthesia Surface anesthesia

Question 36

Cause of toxicity of LAA

Answer 36

Rapid injection Rapid absorption from very vascular site (mucous membrane) Overdose

Question 37

Most cardiotoxic LAA

Answer 37

Bupivacaine

Question 38

High toxic dose of LIdocaine

Answer 38

Hypotension Bradycardia Hypoxia

Question 39

High toxic dose of Bupivacaine, Levobupivacaine, Ropivacaine

Answer 39

Ventricular dysrhythmias | Sudden CV collapse