Flashcards in Local Anesthetics **Drug Cards** Deck (22)
Procaine (Novocain) is only used for what type of anesthesia?
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
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.
What type of local anesthetic is procaine?
How is procaine metabolized?
by plasma cholinesterase
(to aminobenzoic acid and diethylaminoethanol)
Is procaine safe for fetuses?
it has not been established, so use cautiously when performing spinal anesthesia on fetuses
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
Procaine should be used cautiously in what types of patients?
severe distrubances of cardiac rhythm
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.
Indication for tetracaine (Pontocaine)
Spinal anesthesia for procedures requiring 2-3 hours of anesthesia
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
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)
Onset of tetracaine
Slow (per S&H; this may be for topical application) Rapid (per DailyMed)
Duration of tetracaine
Up to 2-3 hrs (spinal)
MOA of tetracaine
Parenteral administration of tetracaine hydrochloride stabilizes the neuronal membrane and prevents initiation and transmission of nerve impulses thereby effecting local anesthesia
Tetracaine: what type of LA?
Metabolism of tetracaine?
Hydrolyzed by plasma cholinesterase
Tetracaine: Safe for fetus?
Preg Cat C: No evidence of teratogenicity
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
Adverse CV effects of tetracaine?
depression of the myocardium, blood pressure changes (usually hypotension), and cardiac arrest
Contraindication of tetracaine?
Tetracaine or ester-type hypersensitivity, heart block