Chapter 19: Drugs for Local and General Anesthesia - Prototype Drugs Flashcards
What is the prototype drug for Amides
lidocaine
What is the MOA of lidocaine?
Acts by stopping axonal conduction by blocking sodium channels
What is lidocaine used for?
- used for brief medical or dental procedures
- may be injected as a nerve block for spinal and epidural anesthesia
- patches may be admin to relieve pain
- may be given topically before painful procedures
- may be given IV, IM or SubQ to treat dysrhythmias
- mouthwashes and rinses can be compounded to help ease pain associated with mouth and throat infections
are lidocaine side effects common when used for anesthesia?
No
What is an early symptom of lidocaine toxicity?
CNS excitement leading to irritability and confusion
What are serious adverse effects of lidocaine?
- convuslions
- respiratory depression
- cardiac arrest
how might a patient injure themselves after dental procedures where lidocaine was used?
pts may injure themselves by biting or chewing areas of the mouth that have no sensation following a dental procedure until the effect of the anesthetic diminishes
What is the route of lidocaine?
,
IV, IM, SubQ, topical
What are some adverse effects of lidocain?
- solutions of lidocain containing preservatives or epinephrine are intended for local anaesthesia only and must never be given parenterally for dysrhythmias
- do not appy topical lidocaine to large skin areas or to broken or abraded areas - significant absorptrion may occur
- do not allow it to come into contact with the eyes
What pregnancy category is lidocaine?
Pregnancy category B
Lidocaine black box warning
- use of 2% oral viscous lidocaine products, especially among infants, may lead to ingestion that cannot be predicted or controlled.
- when excessive amounts of lidocain are administered to infants and young children, or they accidentally swallow too much, it can induce seizures, brain injury, cardiac abdormalities, and death
what are lidocaine contraindications
- avoided in cases of sensitivity to amide-type local anaesthetics
- in presence of severe trauma or sepsis, blood dyscrasias, dysrhythmias, sinus bradycardia, and sever degrees of heart block
which drug may decrease the activity of lidocaine?
Barbiturates
What drugs may increase the effects of lidocaine?
cimetidine, quinidine, and beta blockers
What are lidocaine lab testes
increased creatine phosphokinase (CPK)
what are symptoms of lidocaine OD
- breathing difficulty
- swelling of the lips
- chest pain
- irregular hearbeat
- N/V
- treamors
- seizure activity
What therapy is given for lidocaine OD
Lipid infusion therapy (LipidRescue) - an intravascular infusion of lipid emulsion to treat severe, systemic drug toxicity or poisoning
inhalation agents: gaseous Agent prototype drug
Nitrous Oxide
What is the MOA of Nitrous Oxide
- acts by suppressing pain mechanisms in the CNS
- has low potency and does not produce complete loss of consciousness or profound relaxation of skeletal muscle
- because nitrous oxide does not induce surgical anesthesia (stage 3), it is commonly comvined with other surgical anesthetic agents
What is Nitrous oxide used for?
ideal for short surgical or dental procedures because the patient remains conscious and can follow instructions while experiencing full analgesia
what adverse effects of nitrous oxide to patients experience at higher doses
- anxiety
- excitement
- combativeness
what are other adverse effects of nitrous oxide?
- as it is exhaled, the patient may temporarily have some difficulty breathing at the end of a procedure
- N/V following the procedure are more common with nitrous oxide thatn with other inhalation anesthetics
what is the route of nitrous oxide
inhalation