Local Anesthetics Dosages Flashcards
(53 cards)
1
Q
Chloroprocaine alternate name:
A
Nesicaine
2
Q
Chloroprocaine structure
A
ester local anesthetic
3
Q
Chloroprocaine MOA:
A
- Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
- Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
- Inhibit cardiac channels
- Block nerve conduction (autonomic, somatic sensory & motor)
- Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
- Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
- Easiest to block B, C, A delta, A gamma, A beta, A alpha (in that order)
4
Q
Chloroprocaine Onset:
A
6-12 min
5
Q
Chloroprocaine pKa:
A
9.1
6
Q
Chloroprocaine duration of action:
A
30-60 min
7
Q
Chloroprocaine PB:
A
0%
8
Q
Chloroprocaine Metabolism:
A
Plasma esterases, Renal
9
Q
Chloroprocaine max dose plain:
A
11 mg/kg (800 mg max)
10
Q
Chloroprocaine max dose with epi:
A
14 mg/kg (1000 mg max)
11
Q
Chloroprocaine infiltration Brachial plexus dose:
A
30-40 mL
12
Q
Chloroprocaine digital w/o epi dose:
A
3-4 mL
13
Q
Chloroprocaine side effects:
A
- C - CNS Toxicity
- A - Arrhythmias
- L - Loss of pain
- L - Loss of proprioception
- L - Loss of movement
14
Q
Chloroprocaine contraindications / cautions:
A
- L - LAST (anxiety, tinnitus, seizure)
- A - Allergy
- S - Seizures
- T - Tissue Damage
- T - Transient Neurologic symptoms
15
Q
Lidocaine alternate name:
A
Xylocaine
16
Q
Lidocaine structure:
A
- Amide – benzine ring and piperidine ring connected by an amide bond
17
Q
Lidocaine MOA:
A
- Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
- Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
- Inhibit cardiac channels
- Block nerve conduction (autonomic, somatic sensory & motor)
- Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
- Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
- Easiest to block B, C, A delta, A gamma, A beta, A alpha (in that order)
18
Q
Lidocaine Onset:
A
1-2 min
19
Q
Lidocaine pKa:
A
7.9
20
Q
Lidocaine duration of action:
A
1-2 h
21
Q
Lidocaine PB:
A
75%
22
Q
Lidocaine metabolism:
A
CYP3A4 – metabolite monoethylglycinexylidide is responsible for antiarrhythmic properties even after infusion discontinuation
23
Q
Lidocaine w/o epi max dose:
A
4.5 mg/kg (max 300 mg)
24
Q
Lidocaine with epi max dose:
A
7 mg/kg (max 500 mg)
25
Lidocaine Attenuate SNS dose:
1-1.5 mg/kg
26
Lidocaine Arrhythmia dose:
2 mg/kg bolus followed by
1-4mg/min infusion
27
Lidocaine arrest dose:
3 mg/kg Q 3-5 min
28
Lidocaine pain dose:
1-3 mg/kg/hr (IBW)
29
Lidocaine side effects:
1. C - CNS Toxicity
2. A - Arrhythmias
3. L - Loss of pain
4. L - Loss of proprioception
5. L - Loss of movement
30
Lidocaine Contraindications / cautions:
1. L - LAST (anxiety, tinnitus, seizure)
2. A - Allergy
3. S - Seizures
4. T - Tissue Damage
5. T - Transient Neurologic symptoms
31
Bupivacaine alternate name:
Marcaine
32
Bupivacaine structure:
~ Amide - benzine ring and ~ piperidine ring connected by an amide bond
~ Racemic mixture
33
Bupivacaine MOA:
. Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
2. Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
3. Inhibit cardiac channels
4. Block nerve conduction (autonomic, somatic sensory & motor)
5. Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
6. Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
7. Easiest to block B, C, A delta, A gamma, A beta, A alpha (in that order)
34
Bupivacaine Onset:
5-10 min
35
Bupivacaine pKa:
8.1
36
Bupivacaine duration of action:
2-12 h
37
Bupivacaine PB:
95%
38
Bupivacaine metabolism:
Liver CYP3A4
39
Bupivacaine w/o epi max dose:
2.5 mg/kg (max 175 mg)
40
Bupivacaine with epi max dose:
3 mg/kg (max 225 mg)
41
Bupivacaine side effects:
1. C - CNS Toxicity
2. A - Arrhythmias
3. L - Loss of pain
4. L - Loss of proprioception
5. L - Loss of movement
42
Bupivacaine Contraindications / cautions:
1. L - LAST (anxiety, tinnitus, seizure)
2. A - Allergy
3. S - Seizures
4. T - Tissue Damage
5. T - Transient Neurologic symptoms
43
Ropivacaine alternate name:
Naropin
44
Ropivacaine structure:
~ Amide – benzine ring and piperidine ring connected by an amide bond
~ Pure S enantiomer
45
Ropivacaine MOA:
1. Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
2. Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
3. Inhibit cardiac channels
4. Block nerve conduction (autonomic, somatic sensory & motor)
5. Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
6. Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
7. Easiest to block B, C, A delta, A gamma, A beta, A alpha (in that order)
46
Ropivacaine Onset:
10-20 min
47
Ropivacaine pKa:
8.1
48
Ropivacaine duration of action:
2-8 hr
49
Ropivacaine PB:
95%
50
Ropivacaine metabolism:
CYP3A4
51
Ropivacaine infiltration plain max dose:
3mg/kg (200 mg max)
52
Ropivacaine side effects:
1. C - CNS Toxicity
2. A - Arrhythmias
3. L - Loss of pain
4. L - Loss of proprioception
5. L - Loss of movement
53
Ropivacaine Contraindications / cautions:
1. L - LAST (anxiety, tinnitus, seizure)
2. A - Allergy
3. S - Seizures
4. T - Tissue Damage
5. T - Transient Neurologic symptoms
