LA

Question 1

What is the loss of all sensation?

Answer 1

anaesthesia

Question 2

what is loss of pain sensation?

Answer 2

analgesia

Question 3

what type of LA is used on surface tissues?

Answer 3

topical

Question 4

what forms does topical LA come in?

Answer 4

solution, spray, gel or ethyl chloride

Question 5

what anatomical structure makes infiltrations difficult?

Answer 5

zygomatic process

Question 6

what type of LA may work better on dense outer cortical bone?

Answer 6

articaine

Question 7

what nerves are commonly blocked with regional (block) anaesthesia?

Answer 7

IAN
Mental and incisive
Lingual
Long buccal

greater palatine
nasopalatine

Question 8

what are the 2 supplementary techniques?

Answer 8

intraosseous - drill hole in bone
down PDL

Question 9

what does a cartridge of LA contain?

Answer 9

anaesthetic agent
vasoconstrictor
stabilizer/ preservative
isotonic carrier medium

Question 10

what anaesthetic agent is in lignospan?

Answer 10

lidocaine hydrochloride 2%

Question 11

how much anaesthetic agent is in a cartridge?

Answer 11

44mg

Question 12

what is the vasoconstrictor?

Answer 12

adrenaline 12.5ug/ml

Question 13

what is the preservative?

Answer 13

sodium/potassium metabisulphite

Question 14

what is the max dose of LA you can administer?

Answer 14

4.4mg/kg body weight
max 300mg

Question 15

in what circumstances can you not use LA?

Answer 15

unstable angina
severe cardiac dysrhythmia
allergy to any components
cardiac conditions

Question 16

what are 5 types of LA?

Answer 16

Lidocaine
Prilocaine
Mepivacaine
Bupivacaine
Articaine

Question 17

what LA has high protein binding so is therefore long acting?

Answer 17

bupivacaine

Question 18

what LA would you use to avoid adrenaline?

Answer 18

Prilocaine

Question 19

what is an alternative LA to prilocaine?

Answer 19

mepivacaine

Question 20

what LA has the best diffusibility?

Answer 20

articaine

Question 21

what are all LA?

Answer 21

vasodilators

Question 22

what are the easiest nerves to block?

Answer 22

C fibres

Question 23

when would you reduce the dose of LA administered?

Answer 23

liver disease
beta blockers
Ca channel blockers
drug abuse

Question 24

what may LA do to the CNS?

Answer 24

cause depression

Question 25

What can LA to do blood pressure?

Answer 25

hypotension

Question 26

what can LA do to the heart?

Answer 26

calm it down

Question 27

where is articaine metabolised?

Answer 27

plasma

Question 28

where is prilocaine metabolised?

Answer 28

lungs

Question 29

where are amidases metabolised?

Answer 29

liver

Question 30

what classifies LA as an amidase?

Answer 30

amide linkage

Question 31

why has articaine got a shorter half life?

Answer 31

its broken down in plasma before it reaches liver

Question 32

what is LA mode of action?

Answer 32

blocks Na channels

Question 33

what is specific receptor theory?

Answer 33

lipophilic to pass through lipid membrane
hydrophilic to bind to Na channels

Question 34

what is the purpose of a vasoconstrictor?

Answer 34

increase speed of onset
counteracts vasodilatory effects
extends duration
lowers blood levels
reduce haemorrhage

Question 35

what are the 2 types of vasocontrictors?

Answer 35

sympathomimetic amines - adrenaline (epinephrine)
synthetic polypeptides - felypressin (octapressin)

Question 36

why does LA require a preservative?

Answer 36

adrenaline has short shelf life

Question 37

what should be avoided in pregnancy?

Answer 37

felypressin