Chapter 10 LA Flashcards
amides
- lidocaine
- prilocaine
- ropivicaine
- bupivicaine
- articaine
- mepivacaine
esters
- cocaine
- procaine
- chloroprocaine
- tetracaine
- benzocaine
miscellaneous LA
- EMLA cream
- hyaluronidase (wydase, virtase, others) –> sometimes added to LA to help spread
intermediate chain is an
ester or amide linkage
T/F benzene ring is lipophilic
True
T/F Quaternary amide is hydrophilic
True
LA have 3 things always
- lipid soluble side
- water-soluble side
- amide/ester linkage
amide’s have a __ in chain
nitrogen
ester’s have a __ in chain
oxygen
how are esters broken down?
catalyzed by plasma and tissue cholinesterase via hydrolysis; occurs throughout the body
IS RAPID
esters have a __ allergy potential
higher
if patients exhibit an allergy to any ester drug, all other esters should be
avoided
what is the longest acting ester?
tetracaine
amides are metabolized in the
liver by CYP1A2 and CYP3A4
and thus a significant blood level may develop witha rapid absorption
T/F allergy to amides are extremely common
false
extremely rare
amides are longer acting because they are more
lipophilic and protein-bound and require transport to the liver for metabolism
absorption =
offset
absorption of LA offsets its action, its done working
there is no __ __ among amide class or between the ester and amide agents
cross allergy
just allergic to that amide NOT all the amides
Type A beta fiber:
function, myelination/diameter, anesthetic block onset
- touch, pressure
- heavy 5-12 µm
- intermediate
Type A gamma fiber:
function, myelination/diameter, anesthetic block onset
- muscle tone
- heavy 3-6 µm
- intermediate
Type alpha A fiber:
function, myelination/diameter, anesthetic block onset
- proprioception, motor
- heavy, 12-20 µm
- last
Type A delta fiber:
function, myelination/diameter, anesthetic block onset
- pain, cold temperature, touch
- heavy 1-5 µm
- intermediate
Type B fiber:
function, myelination/diameter, anesthetic block onset
- preganglionic autonomic vasomotor
- light, < 3
- early
Type C dorsal root fiber:
function, myelination/diameter, anesthetic block onset
- pain, warm and cold temperature, touch
- none, 0.4-0.12
early