Unit 3-Local Anesthetics Flashcards Preview

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Flashcards in Unit 3-Local Anesthetics Deck (10):
1

Cocaine; benzocaine (Orajel); procaine (Novocain); tetracaine; chlorprocaine

Class

Ester anesthetic

2

Cocaine; benzocaine (Orajel); procaine (Novocain); tetracaine; chlorprocaine

Mechanism

Binds reversibly to the intracellular portion of the voltage-gated sodium channel and inactivates it, and so blocks transmission of nociceptive nerve impulses.

3

Cocaine; benzocaine (Orajel); procaine (Novocain); tetracaine; chlorprocaine

Uses

Local anesthesia

4

Cocaine; benzocaine (Orajel); procaine (Novocain); tetracaine; chlorprocaine

Side effects

  • Local: transient neurologic symptoms (basically, really bad pain), neuronal injury. Systemic (more common with long-acting local anesthetics): circumoral numbness, dizziness, tinnitis, blurred vision, CNS excitation (restlessness, agitation, seizures), followed by CNS depression (respiratory arrest, unconsciousness); hypotension; cardic toxicity with higher doses.
  • Methemoglobinemia (primarily with benzocaine), allergic reactions
  • Used less frequently than amides; cocaine has many side effects due to action as a CNS stimulant
  • PABA allergies in esters

5

Lidocaine (Xylocaine); mepivacaine; bupivacaine; ropivacaine

Class

Amide anesthetic

6

Lidocaine (Xylocaine); mepivacaine; bupivacaine; ropivacaine

Mechanism

Binds reversibly to the intracellular portion of the voltage-gated sodium channel and inactivates it, and so blocks transmission of nociceptive nerve impulses.

7

Lidocaine (Xylocaine); mepivacaine; bupivacaine; ropivacaine

Uses

Local anesthesia

8

Lidocaine (Xylocaine); mepivacaine; bupivacaine; ropivacaine

Side effects

  • Local: transient neurologic symptoms (basically, really bad pain), neuronal injury. Systemic (more common with long-acting local anesthetics): circumoral numbness, dizziness, tinnitis, blurred vision, CNS excitation (restlessness, agitation, seizures), followed by CNS depression (respiratory arrest, unconsciousness); hypotension; cardic toxicity with higher doses.
  • Bupivicaine has highest cardiac toxicity potential; ropivicaine less potent than others (so larger therapeutic index)

9

Transient neurological syndromes not found with which ones

Bupivacaine

Chlorprocaine

10

Increased risk of transient neurological syndromes with which ones

Procaine

Mepivacaine