Anesthetics and Analgesics Flashcards
Combining 2+ LA
bad - increases toxicity risk
Cocaine Ocular Use
testing Horner’s Syndrome
Cocaine Contraindications
in patients with systemic hypertension
taking adrenergic agonists
SE of Cocaine
visible grayish pits and irregularities
loosening of corneal epithelium- erosions
systemic toxicity
Tetracaine Use
GAT, cataract surgery
SE of Tetracaine
overdoses if dose is higher than 1.5mg/kg of body weight
structural damage to cell membrane
weakening of corneal epithelium
stinging/ burning
Benoxinate
combo of Na-fluorescein and Na-fluorexon (Fluress and Flurasafe)
antimicrobial
wont stain contact lenses
Benoxinate use
GAT
Proparacaine
causes less pain than tetracaine and has fewer side effects
Which is a more powerful anesthetic, Proparacaine or Tetracaine?
Tetracaine
stings more as well
Major SE of Anesthetic Drops
inhibits corneal epithelial cell healing
Most common injected anesthetic
lidocaine hydrochloride
SE of anesthetic injection
retrobulbar hemorrhage, globe puncture, ON damage, mm palsy, 7th nerve complications
Anesthetic Injection is contraindicated in…
patients on anticoagulants or antiplatelet agents
LA do nothing for…..
muscle actions- some procedures require patient to be completely still
Fluorescein Use
help visualize corneal epithelial defects
Adrenaline (Epinephrine) Use
in injected LAs
not added to eye drops
Hyaluronidase Use
increase tissue permeability to injected fluid
Prostaglandins released in eye may cause….
increased IOP
mitosis
increased vascular permeability
MOA of Ophthalmic NSAIDs
inhibits COX 1 and 2, limiting prostaglandin production
gives analgesic and anti-inflammatory activity
Diclofenac
NSAID
inhibits adherence of Staph. Epidermidis to soft lens material
Bromfenac
NSAID
least amount of stinging on instillation
Ketorolac
NSAID
combine with cyclosporine A for chronic dry eye treatment
Nepafenac
NSAID
converted by ocular tissue hydrolases into active form Amfenac
longer lasting
