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Flashcards in Local Anesthetics **Drug Cards** Deck (22)
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1

Procaine (Novocain) is only used for what type of anesthesia?

spinal anesthesia

2

Procaine (Novocain) dose, max dose, onset, duration:

dose: 75mg (T10), 125mg (T6), 200mg (T4)

max dose plain: 100mg or 1.5 mg/kg

max dose w/epi: 200mg or 2.5 mg/kg

onset: 2 - 5 min

duration plain: 30 - 45 min

duration w/epi: 60 - 75 min

3

Procaine mechanism of action.

just like the other locals: stabilizes the neuronal membrane and prevents the initiation and transmission of nerve impulses, thereby effecting local anesthesia.

4

What type of local anesthetic is procaine?

an amino-ester

5

How is procaine metabolized?

by plasma cholinesterase

(to aminobenzoic acid and diethylaminoethanol)

6

Is procaine safe for fetuses?

it has not been established, so use cautiously when performing spinal anesthesia on fetuses

7

Procaine should not be used when a sulfonamide drug is also being used. Why?

the aminobenzoic acid metabolite of procaine inhibits the action of sulfonamides

(knowledge!)

8

Procaine should be used cautiously in what types of patients?

severe distrubances of cardiac rhythm

shock

heart block

9

Adverse effects of procaine:

Excitatory CNS effects: nervousness, dizziness, blurred vision, tremors

Cardiovascular system: reactions include depression of the myocardium, hypotension (or sometimes hypertension), bradycardia, and even cardiac arrest.

10

Indication for tetracaine (Pontocaine)

Spinal anesthesia for procedures requiring 2-3 hours of anesthesia

11

Dose (spinal doses here) of tetracaine

4-8 mg (0.5%) lower limbs; 10-12 mg (0.5%) lower abd; 10-16 mg (0.5%) upper abd

12

Max Dose of tetracaine

1.2-1.5 mg/kg; 3 mg/kg w epi (or 20 mg in a single spinal dose/ 100 mg in a single topical dose)

13

Onset of tetracaine

Slow (per S&H; this may be for topical application) Rapid (per DailyMed)

14

Duration of tetracaine

Up to 2-3 hrs (spinal)

15

MOA of tetracaine

Parenteral administration of tetracaine hydrochloride stabilizes the neuronal membrane and prevents initiation and transmission of nerve impulses thereby effecting local anesthesia

16

Tetracaine: what type of LA?

Ester

17

Metabolism of tetracaine?

Hydrolyzed by plasma cholinesterase

18

Tetracaine: Safe for fetus?

Preg Cat C: No evidence of teratogenicity

19

Adverse CNS effects of tetracaine?

nervousness, dizziness, blurred vision, or tremors, followed by drowsiness, convulsions, unconsciousness, and possibly respiratory and cardiac arrest. Since excitement may be transient or absent, the first manifestation may be drowsiness, sometimes merging into unconsciousness and respiratory and cardiac arrest. Other central nervous system effects may be nausea, vomiting, chills, constriction of the pupils, or tinnitus

20

Adverse CV effects of tetracaine?

depression of the myocardium, blood pressure changes (usually hypotension), and cardiac arrest

21

Contraindication of tetracaine?

Tetracaine or ester-type hypersensitivity, heart block

22

Do not use tetracaine with what medicine?

Tetracaine hydrochloride should not be used if the patient is being treated with a sulfonamide because aminobenzoic acid inhibits the action of sulfonamides