anesthetics

Question 1

lidocaine plain 2%

Answer 1

light blue
short acting
no epi
1.8 or 2.2 ml
36 mg per cartridge
max dose 300 mg (abs) - about 8.3 carps
4.5 mg/kg max dose
not used for a block
class B

Question 2

mepivicaine plain 3% (carbocaine, isocaine)

Answer 2

plain tan
short acting
no epi
1.8 or 2.2 ml
54 mg per cartridge
block - 30-45 minutes
Max dose 400 mg (abs) - about 7.4 carps
6.6 mg/kg
Class C

Question 3

Prilocaine Plain 4% citanest

Answer 3

black
short acting
no epi
1.8 or 2.2 ml
72 mg per cartridge
pulpal block 45-60 minutes
max dose 600 (abs) - 8.3 carps
8 mg/kg
do not use in patients with anemia or methemoglobinemia
Class B

Question 4

articaine 4% septocaine or zorcaine 1:100,000 epi

Answer 4

gold 
intermediate duration
1.7 or 2.2 ml
pulpal block up to 120 minutes
68 mg per carpule
no abs max dose
7 mg/ kg - 7 cartridges in 70 kg adult
Class C

Question 5

articaine 4% 1:200,000 epi (septocaine)

Answer 5

silver
intermediate duration
1.7 or 2.2 ml
pulpal block 120 minutes
68 mg per carpule
max dose:7 mg/kg - about 7 carps for 70 kg adult
Class C

Question 6

lidocaine 2% 1:100,000 xylocaine

Answer 6

red
intermediate duration
1.8 or 2.2 ml
pulpal block 80-90 minutes
36 mg per carpule
max dose 500 mg abs - 13.8
7 mg/kg - about 13.5 carpus in 70 kg adult
Class B

Question 7

lidocaine 2% 1:50,000 (xylocaine)

Answer 7

green
intermediate duration
1.8 or 2.2 ml
pulpal block 80-90 minutes
36 mg/ carpule
max dose is 7 carpules or 252 mg
.1 carpule/kg
Class B

Question 8

mepivicaine 2% with levonordefrine 1:20,000

Answer 8

brown 
intermediate acting
1.8 or 2.2 ml
pulpal block 60-90 minutes
36 mg per carpule
max dose 400 mg (abs) 11.1 carps
6.6 mg per kg
Class C

Question 9

prilocaine 4% 1:200,000

Answer 9

yellow
intermediate acting
1.8 or 2.2 ml
pulpal block 50 -70 minutes
72 mg/carpule
max dose 600 abs - 8.3 carps
8 mg/kg
do not use in patients with anemia or methemoglobinemia
Class B

Question 10

bupivicaine (marcaine) .5% 1:200,000

Answer 10

blue
long acting
1.8 or 2.2 ml
pulpal block - 7 hours
9 mg per carpule
max dose 90mg ( 10 carpules)
2 mg/ kg
do not use in pregnant patients or children under 12
do not use in cardiac patients can cause cardiac depression
Class C

Question 11

epi max dose

Answer 11

.2 normal patient

.04 cardiac patient - 2 carpules 1:100,000

Question 12

reasons to avoid anesthetic

Answer 12

patients with reactions to

amide or esther anesthetics sulfites (antioxidants for vasoconstrictor), para aminobenzoic acid (paraben preservative)

Question 13

use as little epi as possible

Answer 13

alpha blockers - prazosin, haloperidol
catechol- 0- methyltransferase blockers (tolcapone, entacapone)
cns stimulants ( amphetamines)
levodopa and thyroid hormones
methyldopa, neuronal blocking agents (guanfacine)
beta blockers (propanolol) monitor blood pressure

Question 14

use no epi

Answer 14

cocaine

Question 15

consult with physician due to epi

Answer 15

digitalis, digoxin ( could lead to dysrhythmias)

hydrocarbon inhalation anesthetics (halothane)

Question 16

Determine amount of anesthetic and epi

lidocaine 2% 1:100,00 epi

Answer 16

amount of local anesthetic and epinephrine per carpule
2 g/100 ml = 20 mg/ml
1.8 x 20 = 36 mg per carpule
epi 1:100,000 = 1g/100,000 ml = 1000 mg/ 100,000ml = 1 mg/ 100 ml = .01 mg/ ml
.01 mg/ml x 1.8 = .018 mg per carpule
.2/.018 = 11 carpules for max dose of epi