AGENTS, CONTROLLING THE FUNCTIONS OF THE PERIPHERAL NERVOUS SYSTEM - Local anesthetics

Question 1

Local anesthetics produce

Answer 1

Blocking pain sensation without loss of consciousness

Question 2

A good local anesthetic agent shouldn’t cause

Answer 2

Fast onset and long duration of action

Question 3

Most local anesthetic agents consist of

Answer 3

• Lipophylic group (frequently an aromatic ring)
• Intermediate chain (commonly including an ester or amide)
• Amino group

Question 4

Which one of the following groups is responsible for the duration of the local anesthetic action?

Answer 4

Intermediate chain

Question 5

Indicate the local anesthetic agent, which has a shorter duration of action

Answer 5

Procaine

Question 6

Which one of the following groups is responsible for the potency and the toxicity of local anesthetics?

Answer 6

Lipophylic group

Question 7

Indicate the drug, which has greater potency of the local anesthetic action

Answer 7

Bupivacaine

Question 8

Ionizable group is responsible for

Answer 8

The ability to diffuse to the site of action

Question 9

Which one of the following local anesthetics is an ester of benzoic acid?

Answer 9

Cocaine

Question 10

Indicate the local anesthetic, which is an ester of paraaminobenzoic acid

Answer 10

Procaine

Question 11

Which of the following local anesthetics is an acetanilide derivative?

Answer 11

Lidocaine

Question 12

Indicate the local anesthetic, which is a toluidine derivative

Answer 12

Prilocaine

Question 13

Which of the following local anesthetics is a thiophene derivative?

Answer 13

Ultracaine

Question 14

Local anesthetics are

Answer 14

Weak bases

Question 15

For therapeutic application local anesthetics are usually made available as salts for the reasons of

Answer 15

More stability and greater water solubility

Question 16

Which of the following statements is not correct for local anesthetics?

Answer 16

charged cationic form penetrates biologic membranes more readily than an uncharged form

Question 17

Which of the following statements is correct for local anesthetics?

Answer 17

• In a tissue they exist either as an uncharged base or as a cation
• Local anesthetics are much less effective in inflamed tissues
• Low ph in inflamed tissues decreases the dissociation of nonionized molecules

Question 18

Which one of the following statements about the metabolism of local anesthetics is incorrect?

Answer 18

Metabolism of local anesthetics occurs at the site of administration

Question 19

Which one of the following statements about the metabolism of local anesthetics is correct?

Answer 19

• Metabolism occurs in the plasma or liver but not at the site of administration
• Ester group of anesthetics like procaine, are metabolized systemically by pseudocholinesterase
• Amides such as lidocaine, are metabolized in the liver by microsomal mixed function oxidases

Question 20

Indicate the anesthetic agent of choice in patient with a liver disease

Answer 20

Procaine

Question 21

Which of the following local anesthetics is preferable in patient with pseudocholinesterase deficiency?

Answer 21

Ropivacaine

Question 22

The primary mechanism of action of local anesthetics is

Answer 22

Blockade of voltage-gated sodium channels

Question 23

A local anesthetics that is water-soluble

Answer 23

Procaine

Question 24

Indicate the local anesthetic, which is more lipid-soluble

Answer 24

Bupivacaine

Question 25

The more lipophylic drugs

Answer 25

- Are more potent - Have longer duration of action - Bind more extensively to proteins

Question 26

Which fibers is the first to be blocked?

Answer 26

B and C fibers

Question 27

The function, which the last to be blocked:

Answer 27

Motor function

Question 28

Which of the following fibers participates in high-frequency pain transmission?

Answer 28

Type A delta and C fibers

Question 29

Local anesthetics that is an useful antiarrhythmic agent?

Answer 29

Lidocaine

Question 30

Indicate the route of local anesthetic administration, which is associated with instillation within epidural or subarachnoid spaces

Answer 30

Spinal anesthesia

Question 31

The choice of a local anesthetic for specific procedures is usually based on

Answer 31

- The duration of action - Water solubility - Capability of rapid penetration through the skin or mucosa with limited tendency to diffuse away from the site of application

Question 32

What anesthetics has a short-acting drug?

Answer 32

Procaine

Question 33

Indicate the local anesthetic, which is a long-acting agent

Answer 33

Bupivacaine

Question 34

The anesthetic effect of the agents of short and intermediate duration of action can not be prolonged by adding

Answer 34

Dopamine

Question 35

A vasoconstrictor does not

Answer 35

Reduce a local anesthetic uptake by the nerve

Question 36

A vasoconstrictor does

Answer 36

- Retard the removal of drug from the injection site - Hence the chance of toxicity - Decrease the blood level

Question 37

Vasoconstrictors are less effective in prolonging anesthetic properties of

Answer 37

Bupivacaine

Question 38

Which of the following local anesthetics is only used for surface or topical anesthesia?

Answer 38

Cocaine

Question 39

Indicate the local anesthetic, which is mainly used for regional nerve block anesthesia

Answer 39

Bupivacaine

Question 40

Which local anesthetics is used for infiltrative and regional anesthesia?

Answer 40

- Procaine - Lidocaine - Mepivacaine

Question 41

Indicate the local anesthetic, which is used for spinal anesthesia

Answer 41

Tetracaine

Question 42

Which local anesthetics is called a universal anesthetic?

Answer 42

Lidocaine

Question 43

Most serious toxic reaction to local anesthetics is

Answer 43

- Seizures - Cardiovascular collapse - Respiratory failure

Question 44

Correct statements concerning cocaine include

Answer 44

- Cocaine is often used for nose and throat procedures - Limited use because of abuse potential - Causes sympathetically mediated tachycardia and vasoconstriction

Question 45

Which local anesthetics is more cardiotoxic?

Answer 45

Bupivacaine

Question 46

Most local anesthetics can cause

Answer 46

- Depression of abnormal cardiac pacemaker activity, excitability, conduction - Depression of the strength of cardiac contraction - Cardiovascular collapse

Question 47

Which local anesthetics causes methemoglobinemia?

Answer 47

Prilocaine

Question 48

Procaine has all of the following propertie

Answer 48

- It has ester linkage - Its metabolic product can inhibit the action of sulfonamides - It is relatively short-acting

Question 49

Procaine has all of the following properties EXCEPT

Answer 49

It readily penetrates the skin and mucosa

Question 50

Correct statements concerning lidocaine include

Answer 50

- It is an universal anesthetic - It widely used as an antiarrhythmic agent - It is metabolized in liver

Question 51

Correct statements concerning lidocaine include all of the following EXCEPT

Answer 51

It has esteratic linkage

Question 52

Which local anesthetics is more likely to cause allergic reactions?

Answer 52

Procaine

Question 53

Tetracaine has all of the following properties

Answer 53

- Slow onset - Long duration - High toxicity

Question 54

Tetracaine has all of the following properties EXCEPT

Answer 54

Low potency

Question 55

Correct statements concerning bupivacaine include

Answer 55

- It has amide linkage - It is a long-acting drug - An intravenous injection can lead to seizures

Question 56

Correct statements concerning bupivacaine include all of the following EXCEPT

Answer 56

It has low cardiotoxicity