CNS DRUGS - LOCAL ANESTHETICS

Question 1

mnemonic for ESTERS local anesthetics

Answer 1

ESTERS have only 1 i in their names.

Tetracaine, Procaine, Benzocaine

Question 2

mnemonic for AMIDES local anesthetics

Answer 2

AMIDES have 2 i’s in their names.

Bupivacaine, Ropivacaine, Lidocaine

Question 3

Which local anesthetics have the shortest and longest halflives?

Answer 3

PROCAINE = shortest half-life (1-2 mins) A PRO finishes the race fastest.

ROPIVACAINE = longest half-life (4.2 hrs) At the end of the long ROPe.

Question 4

What is the treatment to Local Anesthetic Systemic Toxicity (LAST)?

Answer 4

• Treatment should be instituted during earliest sign of toxicity
• Ensure oxygenation (supplemental Oxygen) and ventilation (control airway if necessary)
• Treat seizures with benzodiazepines
• ANTIDOTE: INTRALIPID

Question 5

Give examples of ESTER local anes

Answer 5

PROCAINE, NOVOCAINE, CHOLOROPROCAINE [C]

BENZOCAINE [C], BUTAMBEN

COCAINE

TETRACAINE [C]

Question 6

All local anesthetics are vasodilators EXCEPT

Answer 6

COCAINE

Question 7

another local anesthetic commonly used in ophthalmic preparations

Answer 7

PROPARACAINE

Question 8

What will you give if patient develops methemoglobinemia secondary to PRILOCAINE/MEPIVACAINE?

Answer 8

Methylene blue

Question 9

Most cardiotoxic out of all the LA

Answer 9

BUPIVACAINE

Question 10

What will you give for cardiotoxicity secondary to BUPIVACAINE?

Answer 10

INTRALIPID/LIPOSOMAL FORMS (fat emulsion used in TPN)

Question 11

What are the components of EMLA?

Answer 11

• EMLA stands for Eutectic Mixture of Local Anesthetics

* It is a formulation of 2.5% lidocaine and 2.5% prilocaine