ANESTHETICS

Question 1

Classified into two main classes, amides and esters, based on the linkage in the .

Answer 1

intermediate chain.

Question 2

Aromatic;

Answer 2

responsible for onset of activity

Question 3

Intermediate (middle) chain

Answer 3

determines class (amide vs. ester)

Question 4

Amine;

Answer 4

determines duration of action

Question 5

amides metabolized

Answer 5

in the liver by the p 450 enzymes

Question 6

Esters may cross react with

Answer 6

STPP [sulfa, thiazides, PABA, PPD (paraphenylenediamine)]

Question 7

• Block neural transmission by displacing calcium ions from receptor and control sodium permeability

Answer 7

• Block neural transmission

Question 8

risk of methemoglobinema (treat with methylene blue or ascorbic acid)

Answer 8

• Prilocaine:

Question 9

patients on dapsone and with G6PD—can use cimetidine

with dapsone to decrease risk.

Answer 9

• Methemoglobinemia

Question 10

cardiotoxicity

Answer 10

• Bupivicane

Question 11

safe in liver disease patients

Answer 11

• Benzocaine:

Question 12

Avoid in patients allergic to parapheylinediamine

Answer 12

benzocaine

Question 13

longest acting

Answer 13

Tetracaine:

Question 14

shortest active

Answer 14

• Procaine

Question 15

Bupivicaine, etidocaine, and ropivacaine

tetracaine (BET)

Answer 15

longest duration of action +

Question 16

Esters should not be used in patients with

pseudocholinesterase deficiency

Answer 16

are metabolized in the plasma

by pseudocholinesterase

Question 17

most vasoconstrictive anesthetic

Answer 17

Cocaine

Question 18

Digital tourniquets can be safely left on

for 10–15 minutes

Answer 18

10–15 minutes