Local Anesthetics Flashcards Preview

Pharm II-Exam 3 > Local Anesthetics > Flashcards

Flashcards in Local Anesthetics Deck (28)
Loading flashcards...
1

List the Esters

1 letter i
1. Procaine
2. Tetracaine
3. Cocaine, Benzocaine

2

List the Amides

2 letter i
1. Lidocaine
2. Bupivacaine
3. Levobupivicaine
3. Ropivacaine

3

Esters and Amides MOA

1. Blocks Na+ channels
2. Reduce influx of Na+ ions
3. Prevents depolarization of membrane
4. Blocks conduction of AP

4

Describe the nonionized and ionized relationship

Non-ionized=uncharged=Reaches receptor site
Ionized=Charged=Causes local anesthetic EFFECT

5

How can you accelerate the onset of action of local anesthetic?

Sodium Bicarb

6

How can you PROLONG the duration of SHORTER acting local anesthetic agents?

Epi= Alpha-agonist sympathomimetic

7

What significantly decreases the amount of anesthesia delivered?

Acidic environment:
1. Abscess
2. Infxn

8

How are esters metabolized?

Plasma Cholinesterases=Very rapid

9

How are amides metabolized?

Liver

10

List the fiber types that will respond quicker to local anesthetics?

1. Small fibers
2. Mylenated fibers
3. Fibers located in the periphery

11

Which type of nerve fibers are blocked first?

Delta: Pain, temperature

12

Which type of nerve fibers are blocked last?

Alpha: Proprioception, motor

13

What are the possible ADE/SE's of Central Neuraxial Techniques (spinal or epidural)

1. Impair respiratory activity d/t motor paralysis
2. Hypotension d/t autonomic nerve blockade

14

What are the disadvantages of motor paralysis during/post surgery?

1. Limit ability to push during delivery (epidural)
2. Increased risk of fall: limits ability to ambulate
3. Bladder dysfunction/urinary retention: residual autonomic block

15

List the order evolution of block components

1. Sympathetic transmission
2. Temperature
3. Pain
4. Light touch
5. Motor block

16

Define Epidural Block

Local anesthetic injected EXTRADURALLY

17

Define Caudal block

Specific epidural block: Needle inserted into CAUDAL CANAL via sacral hiatus

18

Define Perineural block

Injection around PERIPHERAL NERVES

19

Define Spinal block

Injection into CSF in SUBARACHNOID SPACE

20

Why did the FDA ban Bupivacaine in OB?

Cardiotoxicity

21

Bupivacaine antidote

Lipid resuscitation

22

What is the average elimination half-life of Lidocaine?

1.6 hrs

23

What is the elimination half-life of Lidocaine in patient's with severe liver dz?

6 hrs

24

Amides and Esters CNS Effects

1. Light headedness or sedation
2. Restlessness
3. Nystagmus
4. Tonic-Clonic Sz's

25

Amides and Esters CV Effects

1. Vasodilator
2. Heart block
3. Arrhythmias
4. Hypotension

26

What is a unique ADE of Prilocaine?

Converts hemoglobin to Methemoglobin

27

How do you manage the ADE's of Amides/Esters?

IV Diazepam for convulsions
No antidote

28

What is EMLA cream?

Lidocaine 2.5% + Prilocaine 2.5% Topical Cream
Used in kids prior to venipuncture or IV