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159 - Regional Anesthesia and Conscious Sedation > Local Anesthetics > Flashcards

Local Anesthetics Flashcards

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1
Q

Main function of local anesthetics

A

Temporary interruption of all sensations over a specific area of the anatomy without loss of consciousness

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2
Q

Component of local anesthetics that enables penetration of nerve fibers.

A

Lipophilic component; attracted to clear lipids such as the phospholipid bilayer covering of nerves

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3
Q

Component of local anesthetics that allow for the diffusion of the drug through interstitial tissues

A

Hydrophilic component

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4
Q

Prototype of ester type of LA

A

Procaine

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5
Q

Prototype of amide type of LA

A

Lidocaine

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6
Q

Enzyme responsible for metabolism of ester type of LA and where is it found

A

Plasma pseudocholinesterase; in plasma

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7
Q

Enzyme responsible for metabolism of amide type of LA and where is it found

A

Hepatic microsomal enzyme system; liver

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8
Q

Anesthetic drug that produces the greatest vasodilation

A

Procaine

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9
Q

Highly toxic LA that cannot be used alone.

A

Propoxycaine

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10
Q

LA that is/are metabolized in both plasma and liver

A

Propoxycaine and articaine

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11
Q

Concentration of combined procaine + propoxycaine and its maximum recommended dose

A

2% procaine + 0.4% propoxycaine; 6.6mg/kg

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12
Q

Vasoconstrictors added to combined procaine + propoxycaine

A

1:20,000 norepinephrine
1:30,000 levonordefrin

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13
Q

Amide type of LA (6)
(LiMePriEtiArB)

A

Lidocaine
Mepivacaine
Prilocaine
Etidocaine
Articaine
Bupivacaine

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14
Q

Gold standard LA

A

Lidocaine

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15
Q

Maximum recommended dose for lidocaine

A

7.00mg/kg

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16
Q

absolute maximum dose for lidocaine

A

500mg

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17
Q

Vasoconstrictor usually added to lidocaine

A

1:50,000 epinephrine
1:100,000 epinephrine (ideal)

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18
Q

potency and toxicity of prilocaine

A

twice as potent with the same toxicity

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19
Q

Concentration of prilocaine

A

4% with 1:200,000 epinephrine or 4% plain

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20
Q

Maximum recommended dose for prilocaine

A

8.0mg/kg

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21
Q

absolute maximum dose for prilocaine

A

600mg

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22
Q

Contraindication of prilocaine

A

patients that may have decrease oxygen carrying capacity in the blood

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23
Q

Condition described as the increase of methemoglobin in the blood and which LA does this.

Study These Flashcards
A

Methemoglobinemia; Prilocaine

24
Q

Potency and toxicity of Mepivacaine

Study These Flashcards
A

Twice as potent, 1.5-2.0x toxicity

25
LA with the slightest vasodilation
Mepivacaine
26
Concentration of mepivacaine
2% with 1:100,000 epinephrine or 3% plain
27
Maximum recommended dose for mepivacaine
6.6mg/kg
28
Absolute maximum dose for mepivacaine
400mg
29
Potency and toxicity of articaine
1.5x more potent, twice as toxic
30
Concentration of Articaine
4% with 1:100,000 or 1:200,000 epinephrine
31
Maximum recommended dose for articaine
7.0mg/kg
32
LA with a myocardial depressant property
articaine
33
Potency and toxicity of bupivacaine
4x more potent, <4x more toxic
34
Greatest vasodilating property among amide types of LA
bupivacaine
35
Concentration of bupivacaine
0.5% with 1:200,000 epinephrine
36
Contraindication for bupivacaine
Children younger than 12
37
MRD of bupivacaine
90mg (USA), 2.0mg/kg or 200mg (Canada)
38
LA withdrawn from the market
Etidocaine
39
Mrd of etidocaine
8.0mg/kg
40
Topical anesthetics (4)
Benzocaine EMLA Lidocaine 4% tetracaine HCl
41
Concentration of etidocaine
1.5% with 1:200,000
42
Content of EMLA
Lidocaine 2.5% + Prilocaine 2.5%
43
EMLA duration
20 mins
44
Formulations of topical lidocaine
Lidocaine base 5% (poor water solubility) Lidocaine Hydrochloride 2% (water soluble)
45
Contraindication of 4% Tetracaine HCl
lacerated mucosal tissue
46
What is pKa
Dissociation constant pH level where compound is half ionized, half un-ionized
47
Free base : (lipophilic/hydrophilic); Charged cation : (lipophilic/hydrophilic)
lipophilic; hydrophilic
48
High pH = shifts equilibrium to the (left/right)
right
49
Low pH = shifts equilibrium to the (left/right)
left
50
Low pKa = shifts equilibrium to the (left/right)
right
52
High pKa = shifts equilibrium to the (left/right)
left
53
First anesthetic approved for epinephrine sensitive patients
Mepivacaine
54
Incorporated to amides as an antioxidant and as a preservative
Sodium bisulfite
55
True allergy to anesthetic drug will manifest on the ____ exposure
Second
56
Added to anesthesia to make it closer to normal pH of tissue (isotope)
Sodium chloride

159 - Regional Anesthesia and Conscious Sedation (10 decks)

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