Module 9 Flashcards by kristen linford

What one letter always comes before the suffix in Amide LA generic names?

How well did you know this?

Not at all

Perfectly

All Amides end in what suffix?

Caine

How well did you know this?

Not at all

Perfectly

What was the very first LA in dentistry?

Novacaine

How well did you know this?

Not at all

Perfectly

What are two other names for Novacaine?

Procaine

Propoxycaine

How well did you know this?

Not at all

Perfectly

What year did Amides take over?

1940

How well did you know this?

Not at all

Perfectly

Generic Name: Articaine

What are the trade names it’s also known by?

SOAZ

Septocaine
Orabloc
Articadent
Zorcaine

How well did you know this?

Not at all

Perfectly

Generic Name: Prilocaine

What are the trade names it’s also known by

Citanest

How well did you know this?

Not at all

Perfectly

Generic Name: Lidocaine

What are the trade names it’s also known by

LOX

Lignospan
Octocaine
Xylocaine

How well did you know this?

Not at all

Perfectly

Generic Name: Bupivicaine

What are the trade names it’s also known by

Marcaine
Vivicaine

How well did you know this?

Not at all

Perfectly

Generic Name: Mepivicaine

What are the trade names it’s also known by

PICS

Polocaine
Isocaine
Carbocaine
Scandanest

How well did you know this?

Not at all

Perfectly

What problem does someone have who is allergic to Esters?

Atypical Plasma Cholinesterase

How well did you know this?

Not at all

Perfectly

If someone has ever been diagnosed with Methhemoglobinemia what LA can we NOT use?

Prilocaine (Citanest)

How well did you know this?

Not at all

Perfectly

If someone has significant cardiac problems what do we have to limit our use of?

Epinephrine

How well did you know this?

Not at all

Perfectly

What two LA’s can we use without worry on someone with significant cardiac issues?

Mepivicaine 3% (plain)

Prilocaine 4%

How well did you know this?

Not at all

Perfectly

If someone has clinical hyperthyroidism we have to stay away from what?

Racemic epinephrine gingival retraction cord

How well did you know this?

Not at all

Perfectly

What are two types of LA someone can have an actual allergy to?

Esters

Bisulfites

How well did you know this?

Not at all

Perfectly

If someone is allergic to Bisulfites what can we NOT give them?

LA with vasoconstrictors

Because it has to be mixed with Bisulfites to preserve it from expiring fast

How well did you know this?

Not at all

Perfectly

What are 5 things that influence the duration if LA?

Type of injection 
Accuracy of injection technique
Status of oral tissue (infections)
Anatomical variations
Personal response (hypo/hyper)

How well did you know this?

Not at all

Perfectly

What type of LA responder stays numb longer?

Hyper

How well did you know this?

Not at all

Perfectly

Hypo responders do what?

Get un-numb fast

How well did you know this?

Not at all

Perfectly

An infiltration injection is more commonly known as a?

Supraperiosteal

How well did you know this?

Not at all

Perfectly

If you give someone LESS than the recommended dose of LA you will have a ——– duration?
What if you gave them MORE than the recommended dose?

Shorter

No change in duration but a higher chance of toxicity

How well did you know this?

Not at all

Perfectly

What is the #1 reason for a FAILED attempt to get someone numb?

Bad Deposition Location

How well did you know this?

Not at all

Perfectly

If someone presents with an infection, inflamed tissues, or pain before they get an injection what two aspects of the LA will be decreased? Why?

Depth (how far into the nerve it penetrates)
Duration (time length it lasts)

Because there is an increase in vascularity so anesthetic is removed from the site of deposition faster

How well did you know this?

Not at all

Perfectly

What is the second most common reason for a failure to anesthetize a patient?

Pt anatomy

The % listed on a carpule (Ie: 2% Lidocaine) tells you the -------- of LA in that carpule?

Concentration in mg/ml of solution

To figure out how much DRUG is in 1 full carpule of anesthetic you take the --------- X ----------?

Concentration X 1.8ml/carpule

How much DRUG is in 1 carpule of 2% Lidocaine?

20mg/ml X 1.8ml/carpule 36mg(drug)/carpule

What is the concentration (mg/ml) for Prilocaine?

40mg/ml

What is the concentration (mg/ml) for Lidocaine?

20mg/ml

What is the concentration (mg/ml) for Mepivicaine

30mg/ml

What is the concentration (mg/ml) for Articaine

40mg/ml

What is the concentration (mg/ml) for Bupivicaine

5mg/ml

Mepivicaine is most commonly sold at a -----% or known as plain! What other concentration is it sold in?

3% 2% with vasoconstrictor

Mepivicaine 2% has ---------- as it's vasoconstrictor?

Levonordefrin

What is the ration of Levonordefrin in a carpule of Mepivicaine 2% Why?

1:200,000 | Very weak vasoconstrictor so you have to have a lot in it!!!

How many mg/ CARPULE? | Orabloc

72mg/carpule

How many mg/ CARPULE? | Isocaine

54mg/ml

How many mg/ CARPULE? | Vivicaine

9mg/carpule

How many mg/ CARPULE? | Octocaine

36mg/carpule

How many mg/ CARPULE? | Citanest

72mg/carpule

What dose MRD stand for?

Max Recommended Dose

What does ASA stand for?

American Society of Anesthesiologists

What are 3 categories of patients who we should decrease the MRD for?

Debilitated Elderly Medically compromised (ASA 3/4)

Why would you use Lidocaine 2% with 1:50,000 Epi?

For hemostasis

What are two groups of Epi "sensitive" patients?

Cardiovascular patients | Clinical Hyperthyroid patients

How much epinephrine can a Epi "sensitive" patient receive? | What is the Epi MRD

0.04mg

How much epinephrine is in a cartridge with 1:100,00 Epi?

0.018mg

What is the allowable mg/lb | (of body weight) for Prilocaine

3.6mg/lb

What is the allowable mg/lb | (of body weight) for Scandanest

3.0mg/lb

What is the allowable mg/lb | (of body weight) for Zorcaine

3.2mg/ml

What is the allowable mg/lb | (of body weight) for Marcaine

0.9mg/lb

What is the allowable mg/lb | (of body weight) for Lignospan

3.2mg/lb

What LA's have a 3.2mg/lb allowance?

Articaine | Lidocaine

Lost the LA generic names from highest to lowest allowable mg/lb ratio?

Prilocaine. 3.6 Articaine and Lidocaine. 3.2 Mepivicaine. 3.0 Bupivicaine 0.9

List the LA's from lowest to highest MRD?

``` Bupivicaine. 90 Mepivicaine. 400 Lidocaine. 500 Prilocaine 600 Articaine. NA ```

What is the MRD for Articadent

What is the MRD for Prilocaine

600

What is the MRD for Polocaine

400

What is the MRD for Bupivicaine

What is the MRD for Xylocaine

500

If you start with Lidocaine and switch to Mepivicaine which MRD would you stop at? Why?

Mepivicaine Always go with the smaller MRD of the two!!!

Prilocaine can be used on ----- sensitive patients?

Epi

One of the disadvantages of Prilocaine is?

Reduces O2 carrying ability due to carbon dioxide end product

Prilocaine is hydrolyzed by?

Hepatic amidases

What LA should we NEVER use for nerve blocks?

Articaine

What makes Articaine so different from other Amides?

It is a hybrid between an Ester and an Amide

Which LA is 4 times as potent as Lidocaine?

Bupivicaine

What procedures do dentists opt to use Bupivicaine? Why?

Oral surgery Lessen the need for opioid pain killers after surgery because they stay numb for so long!!

Topical anesthetic are of what class?

Esters

What is the name of the most popular topical anesthetic?

Benzocaine

Topical anesthetics have a ------- concentration than injectables?

Higher

Topical anesthetics diffuse through -------- membranes how far?

Mucous | 2-3mm

What is a side effect of topical anesthetics being so highly concentrated?

Higher chance of toxicity

Topical anesthetics are ------- in water and are absorbed ------?

Insoluble | Slowly

What does EMLA stand for?

Eutetic Mixture of Local Anesthetics

What is an EMLA made up of?

Lidocaine and Prilocaine

What is one BIG advantage of EMLA's

Can soak through intact skin giving pupal anesthesia for a short time frame