LAs Flashcards
These LAs have been implicated in cauda equina syndrome
5% Lidocaine
Tetracaine
Chlorprocaine
Prilocaine
Do we place spinal catheters? Why?
No, because they have been implicated in cauda equina syndrome
Dosing for Intralipid
Give 1.5mL/kg of Intralipid 20% rapid bolus
Then begin infusion at .25mg/kg/min for 10 minutes
Incidence of true LA allergic reaction
<1%
Do LAs trigger MH?
No, dummy!
They are not IAs or sux, and will not trigger MH
This preservative may be a culprit for LA allergic reactions
Methylparaben
Uses for lidocaine
Cough Suppression
Blunting the BP and ICP response to DVL
Attenuate bronchospasm from airway irritation in asthmatics
Suppression of ventricular dysrhythmias
Two metabolites of lidocaine
Monoethylglycinexylidide (80% activity)
Xylidide (10% activity)
Mepivacaine is structurally similar to, but clinically similar to
Bupivacaine Lidocaine (but no vasodilatory effect)
This LA can cause Methemoglobin production if given in doses > _____ .
Also, what’s the treatment for methemoglobinemia?
Prilocaine
600mg
Methylene blue 1-2mg/kg over 5 min
This LA is heavily bound to Alpha-1 glycoprotein
Bupivacaine
Serum elimination 1/2 time for bupivacaine
3.5 hours
This LA is structurally similar to bupivacaine, but clinically similar to lidocaine. However, unlike lidocaine, it can’t be given
topically
Prilocaine has this metabolite
Ortho-toluene
These two meds decrease hepatic blood flow, and will thus reduce the metabolism of amino-amides and cocaine
Cimetidine and propanolol
