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FreakinLOCALanesthesia!!! > Part 3-Anesthetic AgentsTWO > Flashcards

Part 3-Anesthetic AgentsTWO Flashcards

(56 cards)

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1
Q

What LA am I???? Available in 3% solution without vasoconstrictor (tan) and a 2% solution with the vasoconstrictor levonordefrin 1:20,000 (brown)

A

Me-Piv-A-Caine

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2
Q

WHAT is the ONLY LA with LecoNordephrine as the vasoconstrictor?

A

Me-Piv-A-Caine

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3
Q

Chemically, MePivAcaine is very similar to ________, but pharmacologically, its actions are very similar to _______

A

bu-piv-a-caine…lidocaine (lacks duration of bupivacaine)

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4
Q

Which LA is the WEAKEST vasodilator of all the injectables?

A

MePivAcaine

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5
Q

Like lidocaine, _________ possesses anticonvulsant

properties

A

MePivAcaine

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6
Q

How does the potency of MePivAcaine compare to lidocaine and prilocaine?

A

EQUAL

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7
Q

What is the onset of action? In fact, here’s something interesting….some clinicians inject 3% solution to take effect prior to administration of bupivacaine which has much slower onset

A

RAPID 1-2min

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8
Q

Me-Piv-A-caine use caution with prego and lactating women…a category ___ drug

A

C

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9
Q

When first brought to market, it was thought that _______ could provide similar clinical effectiveness as lidocaine with significantly decreased toxicity

A

Pri-lo-caine

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10
Q

Review: which LA caused methemoglobinemia again?

A

Pri-lo-caine

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11
Q

What is the distinguishing studtural difference between prilocaine and lido/mepivacaine?

A

Aromatic ring is linked to a SECONDARY amine (the others are linked to a tertiary amine)

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12
Q

What is the major end product of prilocaine metabolism?

A

Carbon Dioxide

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13
Q

Which LA can turn the patient blue??

A

Pri-lo-caine! (methemglobinemia)

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14
Q

Which LA has the FASTEST RENAL CLEARANCE???

A

PRI-LO-CAINE

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15
Q

What are the three places for biotrans of prilocaine?

A

liver, kidney, lungs

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16
Q

What are the two available formulas for Prilocaine?

A

Prilocaine 4% (plain-black)…prilocaine 4% with epi 1:200,000 (yellow)

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17
Q

Is prilocaine a weak or a strong vasodilator?

A

weak! not as weak as mepivacaine

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18
Q

Which LA has the least epi concentration?

A

Prilocaine-it is a weak vasodilator

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19
Q

Please list the following drugs in order of potency from weakest (6) to strongest (1): Lidocaine, bupivicaine, prilocaine, procaine, mepivacanine, articaine.

A
  1. procaine 5.lidocaine (t) 4.mepivacaine (t) 3. prilocaine (t) 2.articaine 1. bupivicaine
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20
Q

FDA pregnancy category for Prilocaine?

A

B

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21
Q

This LA used to be known as “carticaine”….what is special about its structure?

A

ARTICAINE- it has sulfur AND an ester side chain on the aromatic ring…MORE LIPID SOLUBLE!!

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22
Q

How is articaine biotransformed?

A

Since its a little of both worlds….ester-plasma, amide-liver

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23
Q

What is unique about articaine’s half life?

Study These Flashcards
A

Its SHORT!-20 minutes

24
Q

How does articaine’s onset compare to the 5 other LAs?

25
What are the two formulas for articaine in the US?
articaine 4% with epi 1:100,000 (gold)...articiaine 4% with epi 1:200,000 (silver)
26
Because articaine has a rapid metabolism....what is its toxicity level?
LESS risk for system toxicity
27
What are the two CONTROVERSIAL side effects of the metabolism of articaine?
1.PABA allergy (sulfer) 2.methmoglobemia but NO cases reported
28
Whats the pregnancy category for articaine?
C
29
What are the 2 indications in dentistry for BUPIVACAINE?
1. Long procedures 2.manage post-op pain
30
How does bupivacaine's onset compare to the other 5? What is its relative pKa?
SLOWEST onset (6-10min)....HIGHEST pKa
31
What type of patients are at risk for use of bupivacaine because of the prolonged anesthesia?
kids and Int. Disabled
32
How does bupivacaine's vasodilation compare to the other amides? how about the ester (procaine)?
most potent vasodilator of the amides, not as potent as procaine
33
While bupivacaine toxicity is RARE because we use it in LOW doses in dentistry, what is the MAIN target of toxicity?
CARDIOtoxic
34
What is the ONLY formulation of bupivacaine?
bupivacaine 0.5% with epi 1:200,000 (blue)
35
Whats the prego risk for bupivacaine?
C may enter breast milk
36
Concentration for the same drug applied topically is ______ than what is used via injection
HIGHER
37
The purpose for topical is for _______ injection technique (fancy!)
atraumatic injection technique
38
Local anesthetics are _________ = topical agents do not contain _________
vasodilators....vasoconstrictors
39
What is the ONLY injectable LA that we discussed that can also carryover to topical?
lidocaine!
40
What is available as a topical anesthetic, but is NOT recommended in dentistry because it is a schedule II drug?
co-caine
41
What type of LA is benzocaine?
ESTER
42
What LA is found in Orajel?
Benzocaine
43
Why could localized allergic reactions occur with benzocaine?
PABA is a metabolite! (along with articaine and prilocaine)
44
What is our only KETONE LA (topical)?
DY-CLO-NINE hydro-chloride
45
What drug shares the same potency as a topical to dyclonine hydrochloride?
co-caine
46
What is the onset like for dyclonine?
SLOW-10 min, but lasts an hour
47
Which drug is in one of MY personal fav's...CEPACOL
dyclonine hydrochloride
48
What are the two preps for topical lidocaine? What is the main difference?
1.Lidocaine base-not water soluble 2.Lidocaine hydrochloride-water soluble
49
What is the MOST potent dental topical anesthetic?
TETRAcaine hydrochloride
50
What is the onset for TETRAcaine?
SLOW-long duration (45min)
51
WOAH! What are the three magic esters in CETAcaine? How is it applied?
benzocaine, tetracaine, and butamben...a spray (remember the nasty not sterile spray tip??
52
Are eutectic mixtures fast or slow on skin?
SLOW..better on mucous membranes
53
What is the specially formed EMLA (eutectic mix) used in Dentistry? What 2 LAs are in it?
OraQix....2.5% lidocaine, 2.5% prilocaine
54
What is the main area we use the EMLA-OraQix?
INTRAPOCKET!
55
What is the onset and duration for the EMLA-OraQix? HEY! YOU'VE seen this used before!!
onset-1 min...duration 20 min
56
Dr. S recommends that we avoid ______ administered topical.
spray

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