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Advanced Pharmacology ANE 8433 (Spring 2023) > Exam 4 LA's part 3 > Flashcards

Exam 4 LA's part 3 Flashcards

1
Q

A Pt requiring a nerve block, has an allergy to PABA, what shout not be used?

A

Esters

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2
Q

Methylparaben is a preservative contained in?

A

Amides & esters

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3
Q

What LA injection sites result in highest to lowest blood concentration?

A

IV, Tracheal, Caudal, Paracervical, Epidural, Brachial, Sciatic, SQ

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4
Q

What are 2 signs a Pt is about to have a seizure d/t LA CNS toxicity?

A

Drowsiness & facial twitch

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5
Q

What is the first sign of accidental IV bupivacaine injection?

A

Hypotension

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6
Q

What 3 LA’s are the biggest culprits to adverse CV effects?

A

(B)upivacaine > (R)opivacaine > (L)idocaine

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7
Q

What is the bolus dose for 20% lipid emulsion?

A

1.5mL/kg

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8
Q

What is the infusion rate for lipid emulsion?

A

0.25 mL/kg/min for at least 10mins

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9
Q

What is the max dose for a 20% lipid emulsion drip?

A

3.8 mL/kg

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10
Q

20% lipid emulsion is equal to how many mg?

A

200 mg

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11
Q

What med is not recommended with ASRA?

A

Vasopressin

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12
Q

A Pt complains of severe lower back pain 24hrs after a SAB, what is he/she most likely experiencing?

A

Transient Neurologic syndrome

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13
Q

What is the treatment for TNS?

A

Trigger point injections & NSAIDs

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14
Q

What are the S/S of Cauda equina syndrome?

A
  • Bowel & bladder sphincter dysfunction
  • paraplegia
  • urinary retention
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15
Q

What are possible causes of CES?

A

Lidocaine & the spinal needle

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16
Q

What are possible causes for anterior spinal artery syndrome?

A
  • Hypotension
  • vasoconstrictors
  • PVD
  • spinal cord compression
  • thrombosis
  • anterior spinal artery spasms
17
Q

What is the next step after ASAS has been identified?

A

Consult Neurology

18
Q

What are the most likely LA’s to cause methemoglobinemia?

A

Prilocaine & Benzocaine

19
Q

What is the treatment & dose for methemoglobinemia?

A

Methylene blue 1 mg/kg over 5mins

20
Q

What is the max dose for methylene blue?

A

8 mg/kg over 24hrs

21
Q

How long does the reversal of Fe³⁺ to Fe²⁺ take?

A

20 – 60mins

22
Q

Pts with what type of condition should not receive Lidocaine if possible?

A

COPD (CO2 retainers)

23
Q

Continuous or intermittent Bupivacaine epidurals to treat postherpetic neuralgia can lead to what?

A

Hepatotoxicity

24
Q

What is the effect of cocaine on a fetus?

A

Decreased UBF → fetal hypoxemia

25
Q

What is the MOA of cocaine?

A

Blocks reuptake of NE & dopamine

26
Q

What should be avoided for someone with a STEMI & cocaine on board?

A

Beta blockers

Advanced Pharmacology ANE 8433 (Spring 2023) (16 decks)

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