Anaesthetics Flashcards
chemical structure of local anesthetics = lipophilic synthetic aromatic or heterocyclic residue, with intermediate ester/amide linkage and weakly basic tertiary amine terminal.
true
myelination enhances anesthetic sensitivity, independent of diameter
true
T/F: small diameter nerves tend to be MORE sensitive than large diameter nerves.
true
anesthetic targets:
pain > cold > warmth > touch > deep pressure > motor.
true
_______ was the first local anesthetic isolated in 1860 and was a popular pre-op topical ocular anesthetic.
cocaine!
Procaine and lidocaine were the first _______ derivatives of cocaine.
synthetic derivatives
Tetracaine, benoxinate, proparacaine, and lidocaine are the most commonly used topical anesthetics in eye care.
true
Tetracaine, Procaine, lidocaine, and bupivicaine are the most widely used anesthetics on the market today.
true
esters have one “i” while amides have two “i”
true
When used as a topical anesthetic, ______ does NOT have any visible effect on the corneal epithelium, unlike most others.
lidocaine (amide)
proparacaine and tetracaine have the same indications, while benzocaine is for OTC oral, dental and cough; cocaine is for otolaryngology.
true
which ester anesthetic has the LEAST sting?
a. tetracaine
b. benzocaine
c. benoxinate
d. proparacaine
proparacaine
which amide anesthetic is used for chalazion surgery?
a. lidocaine
b. mepivicaine
c. etidocaine
d. prilocaine
lidocaine (3.5% topical gel)
which two amide anesthetics can be used for obstetrics?
a. bupivicaine & etidocaine
b. bupivicaine & prilocaine
c. ropivacaine & bupivicaine
d. ropivacaine & prilocaine
bupivicaine & ropivacaine
BR
T/F: Etidocaine is an amide anesthetic used for ONLY LA (local anesthesia).
True
injectable anesthetics are used for subconjunctival cases (uveitis, cystoid macular edema, several corneal ulcer), facial nerve block, and retrobulbar block.
true
which two anesthetics have the longest durations? and why?
etidocaine and bupivicaine.
(5-10 hours, 4-12 hours) because they have high protein binding.
lidocaine duration is doubled when used with epinephrine for vasoCONSTRICTION.
true.
which anesthetic has the following adverse effects?
excitement, convulsions, rapid palpitations, nausea, delirium, desquamation, mydriasis and lid retraction.
cocaine
which of the following are ocular adverse effects of anesthetics?
a. desquamation
b. corneal edema
c. conjunctival hyperemia
d. allergic conjunctivitis
e. all of the above
all of the above!
how do anesthetics adversely effect the cardiovascular system?
a. increase excitability, increase cardiac conduction, causing hypertension.
b. decrease excitability, decrease cardiac conduction, causing hypotension and cardiac collapse.
b. it decreases the heart’s ability to function.
Potency of anesthetics is ______ related to lipid solubility, while toxicity is _______ related to dose. (ie. double dose is 4x more toxic)
a. inversely, exponentially
b. directly, inversely
c. directly, exponentially
directly , exponentially.
what is the FIRST SIGN of (topical) anesthetic abuse syndrome??
yellow-white stromal ring at active site.
1% benadryl and saline are the injectable non-aesthetic alternatives
true
EMLA eutectic mixture (lidocaine/prilocaine), iontophoresis (lidocaine sponge) and lidoderm patch are the topical non-anesthetic alternative.
true
