ANESTHETICS Flashcards
Classified into two main classes, amides and esters, based on the linkage in the .
intermediate chain.
Aromatic;
responsible for onset of activity
Intermediate (middle) chain
determines class (amide vs. ester)
Amine;
determines duration of action
amides metabolized
in the liver by the p 450 enzymes
Esters may cross react with
STPP [sulfa, thiazides, PABA, PPD (paraphenylenediamine)]
• Block neural transmission by displacing calcium ions from receptor and control sodium permeability
• Block neural transmission
risk of methemoglobinema (treat with methylene blue or ascorbic acid)
• Prilocaine:
patients on dapsone and with G6PD—can use cimetidine
with dapsone to decrease risk.
• Methemoglobinemia
cardiotoxicity
• Bupivicane
safe in liver disease patients
• Benzocaine:
Avoid in patients allergic to parapheylinediamine
benzocaine
longest acting
Tetracaine:
shortest active
• Procaine
Bupivicaine, etidocaine, and ropivacaine
tetracaine (BET)
longest duration of action +