LA - Lidocaine Flashcards
What is the typical induction dose of Lidocaine?
A. 0.5-1 mg/kg
B. 1-1.5 mg/kg, max of 100 mg
C. 2-3 mg/kg
D. 0.5-1.5 mg/kg
B. 1-1.5 mg/kg, max of 100 mg
For breakthrough pain during a Continuous Lumbar Epidural (CLE), what is the recommended post-CLE dose of Lidocaine?
A. 4 mL 0.5% Lidocaine
B. 4 mL 2% Lidocaine with 4 mL 0.2% Ropivacaine
C. 6 mL 1% Lidocaine
D. 2 mL 1% Lidocaine with 6 mL 0.2% Ropivacaine
B. 4 mL 2% Lidocaine with 4 mL 0.2% Ropivacaine
(dose after CLE is running when the patient has breakthrough pain)
What is the maximum dose of Lidocaine allowed for infiltration?
A. 100 mg
B. 200 mg
C. 300 mg
D. 400 mg
C. 300 mg
What is the maximum dose range for Tumescent Anesthesia?
A. 25 mg/kg
B. 35 mg/kg
C. 45 mg/kg
D. 55 mg/kg
D. 55 mg/kg
For a patient less than 5 kg (0-3 months) receiving EMLA, what is the maximum allowable dose for an area of 10 cm²?
[EMLA Dose Range: concentration:
5% EMLA is 50/50 2.5% lidocaine and 2.5% prilocaine]
A. 0.5 g
B. 1 g
C. 2 g
D. 5 g
B. 1 g
For a child weighing more than 5 kg (or 3-12 months), what is the maximum allowable dose of EMLA for an area of 20 cm²?
A. 1 g
B. 2 g
C. 5 g
D. 10 g
B. 2 g
What is the maximum dose of EMLA for an area of 100 cm² in a child weighing more than 10 kg (1-6 years old)?
A. 2 g
B. 5 g
C. 10 g
D. 20 g
C. 10 g
For a child weighing more than 20 kg (7-12 years old), what is the maximum dose of EMLA for an area of 200 cm²?
A. 5 g
B. 10 g
C. 15 g
D. 20 g
D. 20 g
What is the recommended maximum single dose of Lidocaine for topical use?
A. 100 mg
B. 200 mg
C. 300 mg
D. 500 mg
C. 300 mg
For infiltration, what is the concentration range of Lidocaine and the maximum recommended single dose with epinephrine?
A. 0.25-0.5%, 300 mg
B. 0.5-1%, 300 mg
C. 0.5-1%, 500 mg with epinephrine
D. 1-1.5%, 500 mg with epinephrine
C. 0.5-1%, 500 mg with epinephrine
What is the duration of action for Lidocaine when used for intravenous regional anesthesia (IVRA)?
A. 30-60 minutes
B. 60-120 minutes
C. 120-180 minutes
D. 180-240 minutes
A. 30-60 minutes
Which concentration of Lidocaine is used for spinal anesthesia and what is the recommended maximum single dose?
A. 0.25-0.5%, 300 mg
B. 1.5-2%, 300 mg
C. 1.5-5%, 100 mg
D. 4%, 300 mg
C. 1.5-5%, 100 mg
For peripheral nerve blocks (PNB), what is the recommended maximum single dose of Lidocaine with epinephrine?
A. 100 mg
B. 200 mg
C. 300 mg
D. 500 mg
Answer: D. 500 mg
What is the onset and duration of action for Lidocaine when used topically?
A. Slow onset, 30-60 minutes duration
B. Fast onset, 30-60 minutes duration
C. Fast onset, 60-120 minutes duration
D. Slow onset, 60-120 minutes duration
B. Fast onset, 30-60 minutes duration
For epidural anesthesia, what is the concentration range of Lidocaine and the recommended maximum single dose with epinephrine?
A. 0.5-1%, 300 mg
B. 1-1.5%, 300 mg
C. 1.5-2%, 300 mg
D. 1.5-2%, 500 mg with epinephrine
D. 1.5-2%, 500 mg with epinephrine
What is the mechanism of action (MOA) of Lidocaine?
A. Ester anesthetic, anti-dysrhythmic
B. Amide anesthetic, anti-dysrhythmic
C. Amide anesthetic, anti-inflammatory
D. Ester anesthetic, anti-inflammatory
B. Amide anesthetic, anti-dysrhythmic
How is Lidocaine incorporated to prolong its duration of action and decrease toxicity?
A. Mixed with opioids
B. Administered as a patch
C. Incorporated into liposomes
D. Combined with vasoconstrictors
C. Incorporated into liposomes
What is the onset of action for Lidocaine?
A. Slow
B. Moderate
C. Rapid
D. Very slow
C. Rapid
What is the pKa of Lidocaine?
A. 6.8
B. 7.4
C. 7.9
D. 8.5
C. 7.9
What is the percentage of Lidocaine that is non-ionized at physiological pH (7.4)?
A. pk 7.7, 10%
B. pK 7.9, 25%
C. pK 8, 50%
D. pk 7.7, 70%
B. 25%
How much of Lidocaine is protein-bound?
A. 30%
B. 50%
C. 70%
D. 90%
C. 70%
What is the duration of action for Lidocaine?
A. 30-60 minutes
B. 60-90 minutes
C. 60-120 minutes
D. 120-180 minutes
C. 60-120 minutes
What is the primary metabolic pathway for Lidocaine?
A. Hydrolysis in the liver
B. Oxidative dealkylation in the liver, then hydrolysis
C. Direct renal excretion
D. Conjugation in the kidneys
B. Oxidative dealkylation in the liver, then hydrolysis
What is the primary metabolite of Lidocaine?
A. Lidocaine-N-oxide
B. Xylidide
C. Monoethylglycinexylidide (MEGX)
D. Hydroxy-Lidocaine
B. Xylidide
What is the elimination half-life of Lidocaine?
A. 30 minutes
B. 60 minutes
C. 96 minutes
D. 120 minutes
C. 96 minutes
What is the primary route of elimination for Lidocaine?
A. Renal excretion
B. Hepatic metabolism
C. First-pass pulmonary extraction
D. Gastrointestinal excretion
C. First-pass pulmonary extraction
Which cytochrome P450 enzymes are responsible for the metabolism of Lidocaine?
A. CYP2D6 and CYP3A4
B. CYP1A2 and CYP2C19
C. CYP3A4 and CYP1A2
D. CYP2E1 and CYP2C9
C. CYP3A4 and CYP1A2
In addition to Na+ channels, which other types of channels and receptors can Lidocaine affect?
A. Only Na+ channels
B. K+, Ca2+, and GPCR
C. K+ channels and GPCR only
D. Ca2+ channels and K+ channels only
B. K+, Ca2+, and GPCR
Action: Binds to the H-gate (ɑ subunit) of Na+ channel to prevent depolarization during inactivated and activated states. Can also affect K+, Ca2+, and GPCR
What effect does pregnancy-induced hypertension have on Lidocaine clearance?
A. It accelerates Lidocaine clearance.
B. It prolongs Lidocaine clearance.
C. It has no effect on Lidocaine clearance.
D. It reduces Lidocaine sensitivity.
B. It prolongs Lidocaine clearance.
How does pregnancy affect plasma cholinesterase levels?
A. Pregnancy increases plasma cholinesterase levels.
B. Pregnancy has no effect on plasma cholinesterase levels.
C. Pregnancy decreases plasma cholinesterase levels.
D. Pregnancy affects plasma cholinesterase levels only in the third trimester.
C. Pregnancy decreases plasma cholinesterase levels.
Can amide local anesthetics cross the placenta?
A. No, they cannot cross the placenta.
B. Yes, they can cross the placenta.
C. They cross the placenta only in the first trimester.
D. They cross the placenta only in the third trimester.
B. Yes, they can cross the placenta.
