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Need To Recall > Anek > Flashcards

Anek Flashcards

1
Q

Guedel’s stages of general anesthesia

A
  1. amnesia and analgesia
  2. unconscious/delirium /unstable
  3. surgical anesthesia/ desirable stage/ stable
  4. respiratory depression
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2
Q

Anes has the capacity to oxidize but the most commonly cited anes related to methemoglobinemia is? it is converted into?

A

Prilocaine (Citanest) is converted into orthotuluidine (cause methemoglobinemia)

**Risk of methemoglobinemia is also increased in articaine above recommended dose

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3
Q

Maximum dosage of epi for normal patients

A

0.2mg (200 micrograms)

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4
Q

Maximum dosage of epi for cardiovascular-compromised patients

A

0.04mg (40 micrograms)

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5
Q

Only anesthesia that is a vasoconstrictor

A

Cocaine - not used in dentistry

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6
Q

Safest local anesthesia

A

Lidocaine (Xylocaine, Lignocaine)

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7
Q

Amide Local anesthesia usally without vasoconstrictor since it is a weak vasodilator, SHORTEST acting amide

A

Mepivacaine (Marcaine)

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8
Q

Metabolized both by liver and plasma, specially designed for dentists, increased risk of paresthesia

A

Articaine

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9
Q

amide local anesthetics combined to produce topical anesthesia

A

Lidocaine + prilocaine (Eutectic Mixture of L. A.)

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10
Q

1st synthetic LA

A

procaine (novocaine)

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11
Q

shortest acting LA

A

procaine (novocaine)

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12
Q

Preservatives of LA that can cause allergic reactions

A

Methyparaben - prevent microbial contamination

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13
Q

antioxidant of vasoconstrictors of LA (reducing agent)

A

Sodium bisulfites - prevent oxidation

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14
Q

Max dose of lidocaine with epi (adult)

A

7mg of lidocaine / kg

Pero max daily pa rin 500mg

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15
Q

total max daily dose (lidocaine w. epi)

A

500mg

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16
Q

Total max daily dose (lidocaine w/o epi)

A

300mg -lidocaine w/o epi is more toxic

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17
Q

needle used in Md block in pedo px

A

27 (short -20mm)

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18
Q

needle used for intraligamentary injection

A

30 gauge (ultra short <20mm)

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19
Q

bubble in the LA is primarily due to what molecule

A

nitrogen

20
Q

Reference point for TRUE ASAN block

A

distal of canine, 1st PM

21
Q

injection site for greater palatine nerve block

A

bet mx 1st and 2nd molar

22
Q

Tissue that can be punctured during Classic Md block

A

buccinator
medial pterygoid muscle
sphenomandibular ligament

23
Q

considered the TRUE md nerve block

A

Gow-gates technique - more accurate but technique sensitive

24
Q

closed mouth md blocking

A

akinosi-vazirani

25
Q

Max dosage for norepinephrine and usual concentration on anes

A

0.34mg (n), 0.14mg (cvd)
1:30 000
**Can cause local ischemic effect (4mL)

26
Q

Levonordefrin (Neo-cobefrin)
Max Dosage, conc

A

Dosage: 1mg (n) 0.4mg (cvd)
1:20 000
Arteriolar constriction

27
Q

Phenylephrine max dose and conc

A

1:2500
Dose: 4mg (n), 1.6mg (cvd)
Longer lasting effect
Most stable, weakest

28
Q

Analog of vasopressin, NONsympathomimetic amine?? max dose??

A

Felypressin (Octapressin)
Venous microcirculation only
Safer for hyperthyroidism, MAO, TCA

Dose: 0.27 UI (9ml of 0.03IU)

29
Q

Methods of Termination of vasoconstriction action

A

Reuptake and restorage
Deactivation by extraneuronal enzymes (Catechol O methyl transferase -COMT)
Uptake by blood stream
Intraneural enzymatic destruction (Monoamine oxidase)

30
Q

Difference of esters and amides in chemical structure

A

Both has aromatic (lipophilic) and secondary/tertiary amino (hydrophilic) ends. Sa intermediate nagkakaiba. Ester and amide group

31
Q

MRD of 2% procaine + 0.4% propoxycaine

A

6.6mg /kg

32
Q

Amide type LA contraindicated with pxs receiving acetaminophen

A

Prilocaine
4% with 1:200 000
MRD: 6.0mg/kg

33
Q

LA that can be used without vasoconstrictor

A

Prilocaine - can be for epi sensitive px (slight vasodilator)

Mepivacaine - slight vasodilator (short duration?)

34
Q

Has delayed onset and long lasting anes

A

Bupivacaine
Not for children

35
Q

LA that is usually associated with paresthesia

A

Articaine and prilocaine

36
Q

Amide LA contraindicated to px allergic to sulfur containing drugs

A

Articaine

37
Q

Depth of penetration of topical anesthetics

A

Only on surface of tissues (2-3mm)

38
Q

Water insoluble vs water soluble topical anes and examples

A

Water insoluble - safer because it is not readily absorbed into ciculation
Benzocaine or ethyl aminobenzoate
Lidocaine base (5%) -indicated for ulcerated, abraded, lacerated tissues

Water soluble
Benzyl alcohol -shorter acting, very irritating on injection into the tissues
Tetracaine HCl - long duration ester, rapidly absorbed through mucous membrane –systemic toxicity
Lidocaine Hcl (2%) systemic absorption is greater than lido base thus higher toxicity

39
Q

LA with 7-8times potency than procaine

A

Propoxycaine thus not used alone

4% Procaine + 0.4% propoxycaine - for allegic to amide anes

40
Q

Long duration amide anes but faster onset

A

Etidocaine

41
Q

Articaine lipophilic portion

A

Thiophene ring.

Articaine is the only amide type LA that contains thiophene group

42
Q

Dissociation constant

A

pKa - half ionized half unionized

Low pH ▶️ inc H+ ▶️ inc RNH+ / dec RN

RN - lipid soluble, nonionized, free base

43
Q

Drug of choice for intranasal sedation in pediatrics

A

Midazolam

Intranasal onset same as IM and as effective

44
Q

Jorgensen technique

A

Barbiturates + opioids + anti-cholinergic drugs

45
Q

Neurolept anesthesia is produced by?

A

Neuroleptic agent (Droperidol) + narcotic (Fentanyl) + nitrous oxide

Neurolept anes is production of tranquility and mental detachment without marked soporific effect

Need To Recall (19 decks)

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