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N929: Advanced Pharmacology > Nerve & Local Anesthetics focused > Flashcards

Nerve & Local Anesthetics focused Flashcards

(50 cards)

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1
Q

Function of type A fibers

A

alpha- proprioception, motor

beta- touch, pressure

gamma- muscle tone

delta- pain, cold temp, touch

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2
Q

Function of type B fibers

A

preganglionic autonomic vasomotor (SNS)

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3
Q

Function of type C fibers

A 
Postganglionic vasomotor (SNS)
pain, warm, cold temp, touch (dorsal root)
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4
Q

Which types of fibers are myelinated?

A

Type A have HEAVY myelination

Type B have light myelination

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5
Q

Which types of fibers are unmyelinated?

A

Type C fibers

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6
Q 
What is the diameter of type A fibers:
Alpha:
Beta:
Gamma:
Delta:
A

Alpha - 6-22mm

Beta - 6-22mm

Gamma - 3-6mm

Delta - 1-5mm

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7
Q

What is the diameter of type B fibers?

A

<3mm

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8
Q

What is the diameter of type C fibers?

A

SNS - 0.3-1.3mm

Dorsal root - 0.4-1.2mm

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9
Q 
What is the block onset of type A fibers:
Alpha:
Beta:
Gamma:
Delta:
A

Alpha - Last

Beta - Intermediate

Gamma - Intermediate

Delta - Intermediate

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10
Q

What is the block onset of type B fibers?

A

Early

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11
Q

What is the block onset of type C fibers?

A

Early

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12
Q

What are the 4 subtypes of type A fibers?

A

Alpha
Beta
Gamma
Delta

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13
Q

What type of fibers are blocked first?

A

Type B

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14
Q

What are 5 ester local anesthetics?

A 
procaine
chloroprocaine
tetracaine
cocaine
benzocaine
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15
Q

What are 6 amide local anesthetics

A 
lidocaine
mepivacaine
prilocaine
bupivacaine
ropivacaine
articaine
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16
Q

Maximum dose of lidocaine

A

4mg/kg

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17
Q

Maximum dose of Mepivacaine

A

4mg/kg

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18
Q

Maximum dose of Bupivacaine

A

3mg/kg

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19
Q

Maximum dose of Ropivacaine

A

3mg/kg

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20
Q

Maximum dose of Procaine

A

12mg/kg

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21
Q

Maximum dose of Chloroprocaine

22
Q

Maximum dose of Prilocaine

23
Q

Maximum dose of tetracaine

24
Q

Maximum dose of lidocaine with epinephrine

25
Maximum dose of mepivacaine with epinephrine
7mg/kg
26
Maximum dose of bupivacaine with epinephrine
n/a
27
Maximum dose of ropivacaine with epinephrine
n/a
28
Maximum dose of procaine with epinephrine
n/a
29
Maximum dose of chloroprocaine with epinephrine
14mg/kg
30
Maximum dose of prilocaine with epinephrine
8.5mg/kg
31
Maximum dose of tetracaine and epinephrine
n/a
32
What is the pKa, ionized %, and protein binding % of procaine?
pKa 8.9 97% ionized 6% protein binding
33
What is the pKa, ionized %, and protein binding % of tetracaine?
pKa 8.5 93% ionized 94% protein binding
34
What is the pKa, ionized %, and protein binding % of lidocaine?
pKa 7.9 76% ionized 64% protein binding
35
What is the pKa, ionized %, and protein binding % of bupivacaine?
pKa 8.1 83% ionized 95% protein binding
36
Duration of action of procaine
60-90min
37
Duration of action of chloroprocaine
30-60min
38
Duration of action of tetracaine
180-600min | 3-10H
39
Duration of action of lidocaine
90-120min
40
Duration of action of mepivacaine
120-240min | 2-4H
41
Duration of action of ropivacaine
180-600min | 3-10H
42
Duration of action of bupivacaine
180-600min | 3-10H
43
What patients should NOT get prilocaine?
< 6yo pregnant women patients taking oxidizing drugs
44
What is the treatment for methemoglobinemia from prilocaine?
methylene blue 1-2mg/kg over 3-10 minutes
45
What can prilocaine cause?
methemoglobinemia d/t metabolite o-toluidine
46
Effect of lidocaine plasma concentration 1-5mcg/mL
Analgesia
47
Effect of lidocaine plasma concentration 5-10mcg/mL
``` circumoral numbness tinnitis skeletal muscle twitching systemic hypotension myocardial depression ```
48
Effect of lidocaine plasma concentration 10-15mcg/mL
seizures | unconsciousness
49
Effect of lidocaine plasma concentration 15-25mcg/mL
apnea | coma
50
Effect of lidocaine plasma concentration of >25mcg/mL
cardiovascular depression

N929: Advanced Pharmacology (6 decks)

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