Test 1 SG: Chapters 1-5

Question 0

what does specific receptor theory propose?

Answer 0

local anesthetics act by binding to specific receptors on the sodium channel

Question 1

most favored theory of where local anesthetics work

Answer 1

specific receptor theory

Question 2

local anesthetics are classified by their ability to react with specific receptor sites where?

Answer 2

sodium channel

Question 3

mV of the nerve at resting potential

Answer 3

-70mV

Question 4

mV of nerve at rapid depolarization

Answer 4

+40mV

Question 5

At resting state the nerve membrane is slightly permeable to what?

Answer 5

sodium ions

Question 6

repolarization is caused by the inactivation of increased permeability to what?

Answer 6

sodium ions

Question 7

what is the magnitude of the decrease in negative transmembrane potential that is required to initiate an action potential?

Answer 7

firing threshold

Question 8

According to your local anesthesia book, axolemma is another name for what?

Answer 8

nerve membrane

Question 9

methods or substances that produce a ____ and ____ state are used in clinical practice to produce local anesthesia.

Answer 9

transient

completely reversible

Question 10

example of a potent injectable local anesthetics that is relatively ineffective when applied topically to mucous membrane

Answer 10

procaine

mepivicaine

Question 11

why is dyclonine not administered by injection?

Answer 11

because of its tissue irritating properties

Question 12

the rate of conduction is (higher, lower) in unmyelinated nerve fibers compared to myelinated nerve fibers. why?

Answer 12

lower

because myelinated nerve conduct impulses at much faster rate than an unmyelinated nerve of equal size

Question 13

the potency of a local anesthetic is controlled by the ___ of the molecule

Answer 13

lipid solubility

Question 14

the duration of action of the local anesthetic is controlled by the ___ of the molecule

Answer 14

protein binding

Question 15

what is a fasciculi?

Answer 15

nerve bundles of 500-1000 nerve fibers

Question 16

what is the initial action of cocaine

Answer 16

vasodilation

Question 17

what is a potent vasodilator that can be used when peripheral blood flow has been compromised due to accidental intraaterial injection of a drug?

Answer 17

procaine

Question 18

T/F: most local anesthetic drugs are easily absorbed from the GI tract following oral administration

Answer 18

false

Question 19

what is a major metabolic by product of an ester local anesthetic?

Answer 19

PABA

Question 20

what condition is a person possibly suffering from if they have an inability to hydrolyze ester local anesthetics and other chemically related drugs? what kind of trait is this condition?

Answer 20

atypical form of pseudocholinesterase

hereditary

Question 21

what is a chemically related drug to esters?

Answer 21

succinylcholine

Question 22

what is a short-acting muscle relaxant employed frequently during the induction phase of general anesthesia

Answer 22

succinylcholine

Question 23

what does the plasma pseudocholinesterase do the short-acting muscle relaxant employed frequently during the induction phase of general anesthesia?

Answer 23

hydrolyzes of succinylcholine blood levels fall and spontaneous respiration resumes

Question 24

example of a relative contraindication to the administration of amide local anesthetic drugs?

Answer 24

liver dysfunction

Question 25

a patient who has received large doses of prilocaine could possibly develop what?

Answer 25

methemoglobinemia

Question 26

what is the primary excretory organ for both the local anesthetic and its metabolites

Answer 26

kidneys

Question 27

what is the concern for patient with significant renal impairment?

Answer 27

maybe unable to eliminate parent local anesthetic compound or its major metabolites from the blood

Question 28

what is the pharmacological action of local anesthetics on the CNS

Answer 28

depression

Question 29

what LA are used to terminate or decrease the duration of both grand mal and petit mal seizures?

Answer 29

procaine mepivicaine lidocaine

Question 30

what is the area called where the convulsive episode originates on the brain?

Answer 30

epileptic focus

Question 31

what is the therapeutic doses of some local anesthetics for interrupting status epilepticus? give amount and rate.

Answer 31

2-3mg/kg given at rate of 40-50mg/min

Question 32

primary effect of local anesthetics on BP is

Answer 32

hypotension

Question 33

what is pharmacologic disorder in which genetic variant in individual alters that person's response to certain drugs? what is another name for condition?

Answer 33

malignant hyperthermia | hyperpyrexia

Question 34

cyanosis, tachycardia, tachypnea, unstable BP, respiratory and metabolic acidosis, fever (108F or more), muscle rigidity and death are clinical manifestations of what condition?

Answer 34

malignant hyperthermia

Question 35

what is the chemical name of catechol?

Answer 35

orthodihydroxybenzene

Question 36

vasoconstrictors resemble the response of what type nerve stimulation

Answer 36

adrenergic

Question 37

reasons why vasoconstrictors are important additions to a local anesthetic solution

Answer 37

1. constrict blood vessels 2. slows absorption 3. blood levels lowered to decrease toxicity 4. keep local anesthetic in area longer 5. controls bleeding at site

Question 38

how are vasoconstrictors classified?

Answer 38

sympathomimetic or adrenergic drugs

Question 39

list 5 catecholamines found in body

Answer 39

``` epinephrine norepinephrine levonordefedrin isoproterenol dopamine ```

Question 40

what are the 4 adrenergic receptors?

Answer 40

alpha 1 alpha 2 beta 1 beta 2

Question 41

which receptor is found in lungs

Answer 41

beta 2

Question 42

which receptor is found in excitatory-postsynaptic

Answer 42

alpha 1

Question 43

what are the disadvantages of sodium bisulfite?

Answer 43

more acidic | delayed onset of anesthesia

Question 44

does levonordefrin produce more or less cardiac stimulation than epinephrine?

Answer 44

less

Question 45

what local anesthetic is a concern for patients on acetaminophen?

Answer 45

prilocaine

Question 46

bupivacaine is not recommended for what type of patients?

Answer 46

younger patients | physically and mentally disabled

Question 47

T/F: Cocaine is highly soluble in water

Answer 47

true

Question 48

what is the uncharged molecules in LA called?

Answer 48

free base form RN

Question 49

what is the charged molecule called?

Answer 49

cations

Question 50

why are local anesthetics acidified by manufacturers

Answer 50

to inhibit oxidation of vasopressor

Question 51

pH of normal tissue

Answer 51

7.4

Question 52

basic LA injected into acidic infected area

Answer 52

base + acid= salt

Question 53

neural cytoplasm known as

Answer 53

axoplasm

Question 54

pH of inflamed tissue

Answer 54

5-6

Question 55

pH of solutions with vasoconstrictor

Answer 55

3.5

Question 56

pH of solutions without vasoconstrictor

Answer 56

5.5-7

Question 57

what does acidification of tissue do to local anesthetics

Answer 57

decrease effectiveness

Question 58

what is concern of "off-centered perforation" of anesthetic carpules

Answer 58

leakage of anesthetic solution flow into patients mouth

Question 59

what does it mean if blood is visible in a cartridge

Answer 59

needle tip rests within lumen of blood vessel