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d b review > 29. Anesthesiology > Flashcards

29. Anesthesiology Flashcards

1
Q

A drug which, when applied “locally” in a concentration without toxic effects, reversibly blocks the conduction of nerve impulses (*both sensory and motor)

A

Local anesthetics

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2
Q

Action of local anesthetics: Blocks what?

A

Blocks sodium channels preventing depolarization (intracellular)

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3
Q

Injectable form of local anesthesia

A

Ionized form or Water soluble

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4
Q

Unionized free base form

A

Lipid soluble

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5
Q

Aka “acid dissociation constant”

Determines acidity of compound (ability to donate protons)

A

pKa

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6
Q

aka “power of hydrogen”

A

pH

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7
Q

pKa is aka

A

Acid dissociation constant

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8
Q

Lidocaine pKa = 7.8
pH = 7.8 (basic)
Ionized 💦:
Unionized:

A

Lidocaine pKa = 7.8
pH = 7.8 (basic)
Ionized 💦: 50%
Unionized: 50%

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9
Q

Lidocaine pKa = 7.8
pH = 4 (acidic)
Ionized 💦:
Unionized:

A

Lidocaine pKa = 7.8
pH = 4 (acidic)
Ionized 💦: >50%
Unionized: <50%

  • kaya di nageeffect ung anes pag may infection
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10
Q

Lidocaine pKa = 7.8
pH = 10 (more basic)
Ionized 💦:
Unionized:

A

Lidocaine pKa = 7.8
pH = 10 (more basic)
Ionized 💦: <50%
Unionized: >50%

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11
Q

BQ: Order of Loss of Sensation

“PaT ToPS”

A 
(“PaT ToPS”)
Pain
Temperature
Touch
Pressure
Skeletal muscle tone
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12
Q

Increase dosage of anesthesia in bloodstream

A

Toxicity

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13
Q

Toxicity:

A

Toxicity:
✅Rapid induction of LA
✅Vessel deposition
✅Over dosage

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14
Q

Maximum number of carpules

A

7

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15
Q

Overdosage effects:
CNS-
Cardiac-

A

CNS: Anxiety
Heart: ⬇️fxn of heart > ⬇️blood to brain ➡️ Syncope

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16
Q

BQ: Most common medical emergency in the dental clinic

A

Syncope

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17
Q

Management of syncope

A

Trendelenburg position

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18
Q

H1 receptor : Bronchoconstriction and vasodilation

Examples of H1 blocker?

A

Diphenhydramine
Cetirizine
Loratadin

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19
Q

H2 - sTWOmach = ⬆️gastric sec = pain

Examples of H2 blockers?

A

Cemetidine

Ranitidine

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20
Q

Preservative of LA

- prevents contamination from microbes

A

Methylparaben

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21
Q

BQ: Antioxidant of vasoconstrictors (reducing agent)

A

Sodium bisulfites

Sa boards iniiba lang spelling ng “bisulfites”

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22
Q

Ester has highest incidence of LA allergic reaction because of

A

PABA (similar to methylparaben)

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23
Q

Bacteriostatic Drug that mimics PABA (⬆️allergy)

A

Sulfonamides

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24
Q

Most common vasoconstrictor

A

Epinephrine

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25
BQ: Most impt function of vasoconstrictors?
Increase duration of effect of LA
26
BQ: What is the maximum dosage of vasoconstrictors for NORMAL Patients?
0.2mg or 200mcg
27
BQ: What is the max dosage of vasoconstrictors for CARDIOVASCULAR COMPROMISED patients?
0.04mg or 40mcg
28
Maximum number of cartridges given to CARDIOVASCULAR COMPROMISED patients
2 cartridges
29
BQ: What is the max number of LA carpule for AVERAGE pxs?
7 carpules
30
BQ: True or False. All local anesthetics are vasoCONSTRICTORS.
False! [All LAs are vasoDILATORS] #except: Cocaine (vasoconstrictor)
31
LA with vasoconstrictor or epinephrine is contraindicated to pxs with
Hyperthyroidism ❌ ✅hypertension
32
BQ: 2% Lidocaine with 1:100,000 epi = 1.8ml Mg of lidocaine?
20mg x 1.8ml = 36mg lidocaine
33
1: 100,000 Epi = ____mg
0.01mg
34
1:10,000 epi = ___mg
0.1mg
35
1:1000 epi = ___mg
1mg
36
mg of Epi in 1:100,000
{0.01mg x 1.8ml} = 0.018mg of epi
37
Generic name of Citanest
Prilocaine
38
“Weak vasodilator”
Mepivacaine
39
Amide local anes without vasoconstrictor
3% Mepivacaine
40
BQ: “longest acting anesthesia”
Bupivacaine
41
BQ: shortest acting AMIDE / amide with shortest duration of action
Mepivacaine 3%
42
BQ: LA contraindicated to pediatric patients
Bupivacaine
43
LA sometimes used for Toc douloureux
Bupivacaine
44
BQ: LA “rapidly metabolized by the body”
Articaine (metabolized by plasma and liver)
45
BQ: What amide local anes is combined to produce Topical anesthesia
Lidocaine + Prilocaine
46
BQ: What is the most common local anesthesia?
Lidocaine
47
BQ: Which amide LA is safe for children and patients with cardiovascular problems
Mepivacaine
48
BQ: Only LA that is a vasoconstrictor
Cocaine | Mepivacaine
49
1st LA
Cocaine
50
Synergist to catecholamines = ⬆️BP (not used anymore)
Cocaine
51
“1st synthetic LA”
Procaine
52
“Shortest acting LA”
Procaine
53
Most common topical anesthesia
Benzocaine
54
BQ: remember: majority of LA used today are:
Tertiary amines (amide)
55
Short needle = _mm
Short: 20mm
56
Long needles: _mm
Long : 32mm
57
Ultrashort = _mm
Ultrashort - <20mm
58
Most commonly fractured gauge of needle
30g
59
Most common site of needle fracture
Hub
60
Gauge used for high risk of positive aspiration (eg. APLASTIC ANEMIA)
25g
61
BQ: What needle is used in mandiblock in PEDIA
Child: 27g Short | [Adult: 27g Long]
62
BQ: What needle is used for intraligamentary injection?
30g ultrashort
63
BQ: What is the level of the needle when doing classic mandibular blocking in CHILDREN?
45 degrees - below occ plane
64
BQ: What is the angulation of the needle when doing classic mandiblock in ADULTS?
Parallel to occ plane
65
BQ: 1st IANB fails: what will you do next?
Inject HIGHER | Baka nagmigrate ung pterygomn space bec of bony deposition
66
Most common Complication assoc with PSAN block
Hematoma
67
“true asan block”
Infraorbital nerve block
68
BQ: Reference in infraorbital nerve block
1st PM | 2nd option: distal of canine
69
BQ: Most common complication assoc with Infraorbital nerve block
Ecchymosis
70
Infraorbital nerve block includes what nerves
Asan ✅ | Msan (sometimes)
71
BQ: Rx app of “nasopalatine duct cyst”
Heart shape rx app
72
Cyst located in the incisive foramen
Nasopalatine duct cyst
73
“Nerve of scarpa”
Nasopalatine nerve
74
“Anterior palatine nerve”
Greater palatine nerve
75
“Posterior palatine nerve”
Lesser palatine nerve
76
BQ: GPNB blocks: A. Post 2/3 of hard palate B. Post 2/3 of hard palate ON THE SIDE OF INJECTION
B!!! On the side of injection!
77
Why contralateral side in mandiblock?
To prevent BELL’S PALSY
78
Most common muscle involved in trismus
Medial pteygoid muscle
79
“True mandibular blocking”
Gow gates technique | - block V3 (nerve trunk)
80
“Closed mouth mandibular blocking”
Akinosi vazirani
81
Technique used for pxs with trismus or for pediatric pxs
Akinosi vazirani
82
Reference point of Akinosi vazirani
Mx area or occ plane

d b review (38 decks)

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