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prueba regional > AL > Flashcards

AL Flashcards

1
Q

caracter anillo aromatico

A

lipofilico

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2
Q

caracter cadena intermedia

A

ester/amida

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3
Q

grupo amina

A

hidrofilico/base debil/ protonado

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4
Q

aminoesteres ej

A

cocaina
procaina
clorprocaina
tetracaina

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5
Q

aminoamida

A 
lidocaina
prilocaina
mepivacaina
bupivacaina
etidocaina
levobupivacaina
ropivacaina
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6
Q

inicio depende de

A

pka

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7
Q

potencia depende de

A

liposolubilidad

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8
Q

duracion depende de

A

union a proteinas

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9
Q

pka lidocaina

A

7.9

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10
Q

pka bupivacaina

A

8,1

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11
Q

pka procaina

A

7.9

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12
Q

solubilidad lipidos bupivacaina

A

28

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13
Q

solubilidad lipidos lido

A

3

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14
Q

% union a proteinas bupi

A

95%

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15
Q

% union a proteinas lido

A

65%

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16
Q

lipidos 20%

A

bolo 1,5 ml/kg en 1 min
infusion 0,25 ml /kg min
repetir dosis si persiste colapso
doblar dossi si aun hipotenso
mantener infusion 10 min post estabilidad hdm
max 10 ml /kg en primeros 30 min

17
Q

proteinas que determinan duracion

A

glicoproteina alfa 1 acida y albumina

18
Q

aumenta permanencia en sitio de accion de AL

A 
trauma 
inflamacion aguda y cronica
quemados
canceer
IAM
19
Q

disminute permanencia en sitio de accion de AL

A

embarazo
RN
ACO
hepatopatias

20
Q

metabolizacion esteres

A

pseudocolinesterasa

21
Q

metabolizacion amidas

A

hepatico (P450)

22
Q

absorcion de AL de mayor a menor (segun sitio de inyeccion)

A

traqueal/intercostal/ intrapleural/caudal/epidrual/plexo braquial/ciatico-femoral/femoral/espinal

23
Q

mecanismo arritmico lido

A

bloqueo canal de sodio

24
Q

mecanismo arritmico lido

A

bloqueo canadal de potasio t calcio

25
Q

mecanismo depresion miocardica

A

bloqueo salida calcio del Reticlo SP
inhibicion alfa adrenergica /act adenilciclasa
…disminuye AMPc (mala respuesta a adrenalina)
interfiere con el ap mitocondrial

26
Q

enantionmero S

A

rpivacaina /levobupivacaina

27
Q

factores de risgo toxicidad AL

A 
inyeccion ev inadvertida
mal calculo de dosis
sitio de administracion
embarazo y ACO
hipoxemia, hperkalemia, acidosis, hipercabnia
taquicardia
uso de AL racemicos de mayor potencia
28
Q

dosis lido

A

5 mg/kg

con epi 7

29
Q

dosis bupi

A

2 mg/kg

con epi 2,5

30
Q

recomendaciones asra 2012

A

estar preparado
ser prudente
estar atento

prueba regional (8 decks)

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