Lec 1 Flashcards
6 components of local solution
LA agent
Vasoconstrictor
Reducing agent
Preservative
Fungicidal and bacteriostatic agent
Vehicle
All la are
Amhipathic
Structurally la have
Lipophiloc aromatic ring connected to a hydrophilic group by intermediate chain
Intermediate chain can be
Amide or ester
Esters of Benzoic acid
Cocaine
Esters of paraaminobenzoic acid
Procaine
Amides are used than esters
More
Amides are
Articaine
Lidocaine
Mepivacaine
Prilocaine
If a patient has liver problems you cannot use
Amides
If local anesthetic as 2 I in its name its a
Amide
Most common la in dentistry is
Lidocaine
Lidocaine belongs to a
Amide class- a littl allergenic reaction hypoallergenic. Sets on quickly produce desired anesthesia effect for several hours
Lidocaine metabolised in
Liver by microsomal fixed function oxidases
Half life of lidocaine is
90 minutes
Mrd of lidocaine is w epinephrine
7mg\kg body weight w epinephrine not to exceed 500 mg
Mrd without epinephrine is
4.4mg\kg not to exceed 300mg.
Mepivacie is a
Rapid acting amide LA
Onset time longer wout vasoconstrictor non allergenic
Mrd of mepivvacaine is
6.6mg\kg not to exceed 400 mg
Most commonly used mepivacaine % is
3% wout vasoconstrictor
Prilocaine is _________ than lidocaine
Less toxic
It’s an amide
Onset of action slow
Mrd of Prilocaine is
8mg\kg with max 600 mg
Prilocaine is contraindicated in
Idiopathic congenital methemoglobinemia
Hemoglobinopathies
(Sickle cell anemia)
Anemia
Cardiac, respiratory failure induced by hypoxia
A hybrid molecule classified as amide is
Articainne
Articaine is metabolised in
Liver and plasma
Metabolised faster
Articaine is contrainidicated in person with
Sensitivity to amide type La
Sulfite sensitivity person (some asthmatic patient with allergic type asthma)
Bupivacaine is ____ time potent than lidocaine
$ times potent than lidocaine mepivacaine Prilocaine
4 times less than lidocaine and mepivacaine
Vasodilator activity greater than lidocaine Prilocaine mepivacaine
Why do we not use bupivacaine a lot ?
Duration is too long 9 hours
Slower onset time than la
Irritating to tissue can case pain
Can be used in management of post surgical pain cancer patient
Factors in selecting LA
Length of Time of pain control necessary
Potential need for post treatment control
Requirement for hemostasis
Presence of any contraindications (absolute or relative) to local anesthetic solution selected for administration.
Patient allergies liver failure don’t use amide
Las are chemicals that reversibly block
Action potentials in cell excitable membranes
