anesthetics Flashcards
which has higher allergy potential, esters or amides?
esters
can benoxinate be used alone?
no (often mixed with fluorescein)
is there cross sensitivity between amides and esters?
no
T or F- there is cross reactivity between proparacaine and benoxinate
false! there is no cross reactivity between them
1) ____ usually have one i and 2) ____ usually have 2 i’s
1) esters, 2) amides
the most commonly used ester topical anesthetics in eye care are?
tetracaide, benoxinate, and proparacaine
____ hydrozyses esters into ____, ____, and ____ products
pseudocholinesterase, PABA, MABA, BA
which are the PABA esters?
tetracaine, benoxinate, benzocaine, procaine
which are the MABA esters?
proparacaine
BA ester?
cocaine
is there cross reactivity between PABA and MABA products?
no
amides are metabolized by what?
the liver, biliary canal, or kidneys
which amide is saturable?
lidaocaine (can cause toxicity/seizures)
which is the most commonly used topical AMIDE anesthetic
lidocaine
which are longer acting with more systemic effects, esters or amides?
amides
which amide has the least sting?
proparacaine
which has the greatest corneal penetration?
tetracaine
which has the least corneal penetration?
lidocaine
which anesthetic is the best for corneal debridement?
tetracaine
which amide used topically or injected for chalazions?
lidocaine
which has more of a hypersensitive response, esters or amides?
esters
lidocaine duration (time) on eye is ____ when used with epinephrine for vasoconstriction?
doubled
intrinsic ____ will occur when anesthetic numbs nerve impulses responsible for vasoconstriction and decreases duration of action
vasodilation
high ____ ______ of drug to albumin can account for longer duration of action
protein binding
which anesthetic can transiently increase corneal thickness?
proparacaine
6 adverse effects of anesthetics
epithelial desquamation, cornemal edema, conjunctival hyperemia, contact dermatitis, burning/stinging/lacrimation, delayed wound healing, seizures/CNS depression (rare)
anesthetic combos: is their toxicity additive?
no
toxicity is ____ related to dose in systemic effects
exponentially
target of anesthetics is the ___ sodium channels
voltage gated(the anesthetic gets into nerve via lipophilic characters, binds to receptor and closes channel so impulse is not created)
you use ____compresses to treat anesthetic issues
cold
patients may cross-react to the ______ in injectables
preservatives
common topical ester based anesthetics are pregnancy category __ but lidocaine topical is category __
C, B
two non-anesthetic alternatives for “caine” allergies
antihistaminics (injectables and saline version) and saline (injectables)
anesthetic abuse syndrome: the primary sign of ____ is a yellow/white stromal ring?
disciform stromal infiltrates
anesthetic abuse syndrome: what causes loss of epithelium?
keratic precipitates
anesthetic abuse syndrome: ____ causes cells and flare
anterior uveitis
white blood cells and red blood cells settled in the anterior chamber are called _____ and ____ respectively? (effect of anesthetic abuse syndrome)
hypopyon, hyphema
in anesthetic abuse syndrome, corneal epithelial defect can lead to _____ and _____?
stromal edema, descemet’s folds
______ and _____ are classic vasoconstrictors
phenylephrine, epinephrine
a risk of vasoconstrictors?
local necrosis b/c blood supply cut off
three ocular adverse effects of cocaine?
epithelial desquamation, mydriasis, lid retraction
five systemic effects of cocaine?
myocardial infarction from vasoconstriction, convulsions, rapid palpitations, nausea, delirium
4 drug interactions of cocaine
antihypertensives, MAOIs, tricyclic antidepressants, decongestants
