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Neuroscience and NeuroAnatomy > 7 - Local Anesthetics > Flashcards

7 - Local Anesthetics Flashcards

1
Q

Chemical structural components of local anesthetics

A

Aromatic Moiety
Linker region
Substituted Amine

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2
Q

How are local anesthetics classified?

A

Based on the linker region

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3
Q

Local Anesthetics - Esters

A 
Cocaine
Procaine
Benzocaine
Proparacaine
Tetracaine
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4
Q

Local Anesthetics - Amides

A 
Lidocaine
Articaine
Bupivacaine
Mepivacaine
Prilocaine
Ropivacaine
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5
Q

Local Anesthetics - Ketone

A

Dyclonine

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6
Q

Local Anesthetics - Ether

A

Pramoxine

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7
Q

Tetracaine Duration

A

30 - 60 min

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8
Q

Procaine Duration

A

30 - 60 min

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9
Q

Chloroprocaine Duration

A

30 - 60 min

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10
Q

Cocaine Duration

A

30 - 60 min

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11
Q

Bupivicaine Duration

A

2 - 5 hours

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12
Q

Lidocaine Duration

A

1 - 3 hours

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13
Q

Etidocaine Duration

A

2 - 4 hours

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14
Q

Mepivicaine Duration

A

1.5 - 3 hours

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15
Q

Tetrodotoxin

A

A potent Na+ Channel blocker. Not used as an anesthetic because it is too potent/deadly.

Produced in the liver of a Puffer fish

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16
Q

Saxitoxin

A

“Shellfish Poisoning”

A potent Na+ Channel blocker, produced by algae which is then ingested by shellfish.

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17
Q

Why administer epinephrine with local anesthetic when injecting?

A

It’s a damn vasoconstrictor, dude. It prevents the anesthetic from spreading, prolonging its effect, and keeping it from harming the rest of your shit

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18
Q

Advantages/considerations of liposomal administration of the new formulation of Bupivacaine

A

The reservoir is emptied very slowly, so there is long-lasting effect (48 - 72 hours).

Harder to control the possible toxic effects though

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19
Q

Ways to administer anesthesia

A 
Topical
Infiltration (Field Block)
Nerve Block
Intravenous Regional
Spinal
Epidural
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20
Q

Steps for Intravenous Regional Anesthesia

A

Exsanguinate the area with a tourniquet

Inject anesthesia distal to the tourniquet (to block systemic distribution)

21
Q

Difference between Epidural Anesthesia and Spinal Anesthesia

A 
Epidural = Outside the dura mater
Sinal = Penetrate the dura mater (usually at the level of the cauda equina)
22
Q

Local Anesthetics - Master List of CNS Side Effects

A 
Agitation
Convulsions
Psychosis
Depression
Sedation
Loss of Consciousness
23
Q

Local Anesthetics - Master List of Cardiovascular Side Effects

A 
Decreases in myocardial excitability
Decreases in conduction rate
Decreases in force of contraction
Vasodilation
(Others may occur when local anesthetics are used with epinephrine)
24
Q

Local Anesthetics - Master List of Smooth Muscle Side Effects

A

Relaxation of vascular and bronchial muscles

25
Q

Local Anesthetics - Master List of Skeletal Muscle Side Effects

A

Reduced neuromuscular transmission

26
Q

How many isoforms of voltage-gated sodium channels do humans express?

A

8 (Though local anesthetics are nonselective)

27
Q

Which sodium channels are preferentially expressed in peripheral neurons?

A

Nav1.3
Nav1.7
Nav1.8
Nav1.9

28
Q

Expression of Nav1.3 in peripheral sensory neurons

A

Embryogenesis - Normally expressed
Adult - Continued expression in sympathetic neurons
Post-Injury - Upregulated in DRG neurons

29
Q

Expression of Nav1.7 in peripheral sensory neurons

A

DRG Neurons - Preferentially expressed

Sympathetic Neurons - Preferentially expressed

30
Q

Expression of Nav1.8 in peripheral sensory neurons

A

DRG Neurons - Selectively expressed

31
Q

Expression of Nav1.9 in peripheral sensory neurons

A

DRG Neurons - Selectively expressed in small-diameter, nonpeptidergic DRG Neurons

32
Q

Which sodium channels provide the most information about pain?

A

Nav1.8

Nav1.9

33
Q

Inherited Erythromelalgia

A 
Nav1.7 gain-of-function Mutation
Episodes of intense pain and erythema
Affecting one or both hands
Evoked by physical activity or cold
No good treatment
34
Q

Paroxysmal Extreme Pain Disorder

A 
Nav1.7 Mutation
Starts very early
Affects sympathetic nervous system
Can have Harlequin Syndrome
Scream when they defecate or get touched in perineum
Responds to Carbamazepine
35
Q

Types of A Fibers

A

A α
A β
A γ
A δ

36
Q

Types of C Fibers

A

Sympathetic

Dorsal Root

37
Q

B Fibers

A

Preganglionic Sympathetic

Myelinated

38
Q

A α Fibers

A

Afferent to muscles & joints
Efferent from muscles & joints
Myelinated

39
Q

A β Fibers

A

Afferent to muscles & joints
Efferent from muscles & joints
Myelinated

40
Q

A γ Fibers

A

Efferent to muscle spindles

Myelinated

41
Q

A δ Fibers

A

Sensory roots
Afferent peripheral nerves
Myelinated

42
Q

Sympathetic C Fibers

A

Postganglionic

Unmyelinated

43
Q

Dorsal Root C Fibers

A

Sensory Roots
Afferent peripheral nerves
Unmyelinated

44
Q

Relationship between diameter of fibers and their susceptibility to local anesthetic

A

Inverse

The larger a fiber is, the less susceptible it is to local anesthetic

45
Q

TRP Channels

A

Sensitive to heat/cold/temperature change
Selectively expressed in pain fibers
Opened by Capsaicin
Provide a back door for selectively targeting fibers

46
Q

How do we get QX-314 into the cell interiors of pain fibers, when it normally can’t penetrate the plasma membrane?

A

Administer with Capsaicin. QX-314 goes through the TRPV1 channel to enter the cell, and finally reach its target, the Na+ channel inside

47
Q

TRP Receptors on Pain Fibers

A

TRPA1

TRPV1

48
Q

TRP Receptors on Itch Fibers

A

TRPV1
H1R
TRPA1
MrgprA3

Neuroscience and NeuroAnatomy (41 decks)

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