Flashcards in Vasoconstrictors Deck (10)
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1
Q
- 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?
A
- 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
2
Q
Which vasoconstrictor agents interact with SNS receptors?
A
- Alpha 1 and alpha 2
- Beta 1 and Beta 2
3
Q
What are the two classifications of the two vasoconstrictors? and what falls into each category?
A
- Catceloamines
- Epi
- Noreepi
- Dopamine
- levonordefrin
- isoproternol
- Non Catcholamines
- Amphetamines
- Meth
- Hydroxy-amphetamine
- Ephedrine
- Mephentermine
4
Q
What are the differences between the molecular structures of epinephrine, norepinephrine and levonordefrin?
A

5
Q
what is Epi interaction with SNS?
A
- 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
- Bronchodilation
- skeletal muscle vasodialation
- Low dose epi may cause hypotension
6
Q
What distinguishes levonordefrin from epi?
A
- 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
7
Q
What is Epinephrine FDA classification?
A
FDA Class C because it crosses the placenta. Lingual hernias were found to be significant in pregnant women studies
8
Q
What are some drug interactions of concern?
A
- Beta-adrenergic blocking agents
- arrhythmia
- antianginal effects
- ad hypertensive crises
9
Q
What are the drug complications of vasoconstrictors with None selective beta blockers?
A
Hypertensive and cardiac reactions
10
Q
Vasoconstrictors with tricyclic antidepressants
A
- Hypertensive and cardiac reactions