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M4 Pharm B3 > 5 - Local Anesthetics > Flashcards

5 - Local Anesthetics Flashcards

1
Q

Local Anesthesia Defined

A

Localized loss of pain, temperature, touch, and pressure

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2
Q

Classification of Local Anesthetics: Injectable LA - LOW Potency, SHORT Duration (2)

A

Procaine

Chloroprocaine

“Pro Chloro”

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3
Q

Classification of Local Anesthetics: Injectable LA - Intermediate Potency and Duration (3)

A

Lignocaine

Mepivacaine

Prilocaine

“Ligno Mep Prilo”

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4
Q

Classification of Local Anesthetics: Injectable LA - HIGH Potency, LONG duration (3)

A

Tetracaine

Bupivacaine

Ropivacaine

“Tetra Bup Rop”

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5
Q

Classification of Local Anesthetics: Surface LA (4)

A

Cocaine

Lignocaine

Tetracaine

Benzocaine

“Coc Lig Tetra Ben”

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6
Q

Classification of Local Anesthetics: Ester Linked LA (4)

A

Procaine

Tetracaine

Cocaine

Benzocaine

“Pro Tetra Coc Benz”

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7
Q

Classification of Local Anesthetics: Amide Linked LA (1 statement + 6 drugs) - think alcoholic cirrhosis and these are the drugs you’d avoid using

A

All have “i” in first half of word

Lignonocaine

Lidocaine

Mepivacaine

Bupivacaine

Ropivacaine

Prilocaine

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8
Q

Ester Linked LA is easily broken down where?

A

Blood

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9
Q

Amide Linked LA is broken down where

A

Liver

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10
Q

Amide Linked LAs Details (3)

A

Produce more intense and longer lasting local anesthesia

Metabolized in liver

Less hypersensitivity reactions

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11
Q

Ester Linked LAs Details (3)

A

Short acting

Metabolized by plasma esterases

More hypersensitivity reactions

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12
Q

Local Anesthetics: MOA (4)

A

Decreasing the large transient increase in the permeability to Na+ which

Increases threshold of excitability

Decreases the rate of rise of action potential

Slows Impulse conduction

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13
Q

Local anesthetics block the propagation of?

A

The action potential (usually 2-3 rodes of Ranvier)

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14
Q

Local Anesthetics: Effects of Adding Vasoconstrictors (3)

A

Increase LA duration

Decrease LA toxicity

Decrease bleeding in the operative field

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15
Q

Local Anesthetics Use: Topical (4)

A

Cocaine (eso, mucus membranes, and nasopharynx)

Lidocaine

Proparacaine (eyes)

Tetracaine

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16
Q

Local Anesthetics Use: Infiltration Anesthesia (Defined)

A

Injection of LA directly into tissue without taking into consideration of the course of the cutaneous nerves (e.g. suturing lacerated wound)

17
Q

Local Anesthetics Use: Field Block Anesthesia (Defined) and don’t add what?

A

Subcutaneous injection of a solution of LA in order to anesthesize the region distal to the injections (fingers)

Don’t add vasoconstrictor (else it cuts off blood supply)

18
Q

Local Anesthetics Use: Nerve Block Anesthesia (Defined) and Examples for Nerves (3) and Plexi (3)

A

Injection of a solution of a LA into or around individual peripheral nerves or nerve plexi, producing even greater area of anesthesia

Nerves: Around ulnar, sciatic, and femoral

Plexi: Brachial, Cervical, and Intercostal nerves

19
Q

Local Anesthetics Use: IV Regional Anesthesia (Bier Block) Defined

A

After interrupting blood supply by first binding an elastic bandage, raising systolic pressure and cutting off blood supply via cuff and removing bandage, LA solution is injected into peripheral VEIN (blood doesn’t go beyond cuff)

20
Q

Local Anesthetics Use: Spinal Anesthesia (2)

A

Between L2 and the termination of the thecal sac in the sacrum

Lumbar and sacral roots are bathed in CSF

21
Q

Local Anesthetics Use: Epidural Anesthesia (2)

A

Inject LA solution into epidural space (lumbar, thoracic, and cervical space)

OB/GYN

22
Q

First Signs of LA Toxicity (2)

A

Metallic Taste

Tongue/Perioral Numbness

23
Q

LA Toxicity: CNS at Higher Concentrations - Symptoms (3)

A

Nystagmus

Muscular twiching

Overt tonic-clonic convulsions

24
Q

LA Toxicity: Cardiovascular System - Decreases in (5)

A

Electrical Excitability

Conduction Rate

Force of Contraction

CO and BP

25
Q

Bupivacaine is what when absorbed systemically, causes what, and time of action? (3)

A

Cardiotoxic; direct effects on heart

Causes Vfib and Vtach

Longer duration of action

26
Q

LA Toxicity: Allergic Reactions from what derivatives?

A

PABA (ester-linked LAs)

27
Q

Complications of Spinal Anesthesia (5)

A

Most commonly, postural headache on bending forward (CSF getting displaced)

Infection

Hematoma

Direct mechanical trauma (Cauda Equina Syndrome)

Persistent Neurological Deficits

M4 Pharm B3 (9 decks)

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