LA: Sytemic Pharmacology Flashcards
What three factors affect the Vascular Uptake of the LA?
Vascularity of Area
Vasodilation of Agents
Quantity Injected
How are ester-type LAs metabolised?
Circulating plasma, renal excretion
How are amide-type LAs metabolized
Hepatic, renal excretion
Which is the only LA that isn’t a vasodilator?
Cocaine
Rank the order of Vasodilation?
Bupivicaine > Lidocaine > Mepivicaine
Why are LAs decent anti-arrythmics?
They decrease conduction velocity
Automaticity
blood pressure
Epinephrine is a non-selective agonist for which receptors?
Alpha 1,2
Beta 1, 2
How does epi affect the alpha receptors?
Alpha 1: Vasoconstriction via smooth muscle contraction
Alpha 2: Inhibits norepi
How does epe affect the beta receptors?
B1: Increased heart rate and contraction force
B2: Relax smooth muscle to cause bronchodilation
What does epi do for LAs?
Slows systemic absorption prolongs duration Intensifies depth of anesthesia helps local hemostasis reduced systemic toxicity
What drugs can have interactions with epi?
Tricyclic antidepressants Prilocaine and methemoblobinemia Beta blockers Cocaine and Amphetamine Halothane and Epinephrine
What is the affect with non-selective beta blockers?
Exaggerated effects
A1: Increased blood pressure
B1,2: blocked
What drug should you avoid with norepinephrine and why?
Levonordefrin
Exaggerated alpha adrenergic effects
What LA should be avoided in patients with methemaglobinemia?
Prilocaine
What are the two severe interactions of cocaine and LA?
Toxicity of LA itself
Toxicity of Epi
