- What type of structure is articaine?
- is it a 5 membered thiophene ring or 6 membered benzene ring?
- What happens to the additional ester side chain in articaine?
- How long has it been in the US?
- Whats the selling point of articaine?
- What’s controversial about it?
- Amide structure that is metabolized in the liver
- Its a 5 member thiophene ring
- Additional ester chain is metabolised by esterases in blood and tissue
- Available in the US since 2000
- the selling point is that it quickly diffuses and hydrolyzed with low systemic effects
- Paraesthesia controversy
Which vasoconstrictor agents interact with SNS receptors?
- Alpha 1 and alpha 2
- Beta 1 and Beta 2
What are the two classifications of the two vasoconstrictors? and what falls into each category?
- Non Catcholamines
What are the differences between the molecular structures of epinephrine, norepinephrine and levonordefrin?
what is Epi interaction with SNS?
- Alpha 1 just peripheral vasoconstriction which is what we want
- Alpha 2 Located in CNS control SNS activity and inhibites NE release. Transient hypertension followed by hypotension
- Beta 1 increases HR and contractility we dont want that
- Positive chrontropic and inotropic
- Beta 2
- skeletal muscle vasodialation
- Low dose epi may cause hypotension
What distinguishes levonordefrin from epi?
- lower systemic toxicity
- acts primarily at alpha receptors
- maximal dosage without systemic problems is 1 mg
- Epi 50% blocks alpha activity and 50% beta activity
- Levonordefrin is 75% alpha receptors and 25% beta
What is Epinephrine FDA classification?
FDA Class C because it crosses the placenta. Lingual hernias were found to be significant in pregnant women studies
What are some drug interactions of concern?
- Beta-adrenergic blocking agents
- antianginal effects
- ad hypertensive crises
What are the drug complications of vasoconstrictors with None selective beta blockers?
Hypertensive and cardiac reactions
Vasoconstrictors with tricyclic antidepressants
- Hypertensive and cardiac reactions