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Ocular Pharmacology > Lecture 3 - Anaesthetics > Flashcards

Lecture 3 - Anaesthetics Flashcards

1
Q

What is the clinical use of LA?

A

Reversible blockage of nerve impulse generation and conduction

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2
Q

What are the 4 desireable properties?

A

Rapid Onset, Adequate duration of action, Minimal side effects, and Minimal local tissue damage

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3
Q

What is the activity of LA?

A

Myelinated enhances and highly active small diameter nerves respond more favourably. (Bind quicker and less LA needed to bind due to small diameter)

Vs.

Unmyelinated nerve

Note: Large diameter nerves are less sensitive and recover quickest

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4
Q

Are all chemical structures lipophillic or hydrophillic?

A

Lipophilic, since it crosses the blood brain barrier and gets into the CNS

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5
Q

True or False, Due to the Amine terminal of an LA, it is also water soluable?

A

True

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6
Q

What is the main target used for activity for an individual who needs LA?

A

Pain.

Note: Motor is the least

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7
Q

What was the first LA Anesthetic created?

A

Cocaine - schedule 2

Note: Toxicity of Cocaine, let the development of Procaine and Lidocaine

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8
Q

Which drug would you consider using if a pt. is allergic to proparacaine?

A

PABA drug type

Tetracaine, Benzocaine, Procaine and Benoxinate

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9
Q

True or False, A LA will produce a dry eye when administered?

A

True, in away the corneal tight junctions are broken down and different layers of the cornea start to break down

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10
Q

What are the 2 types of effects that can occur if a topical fluid is administered prior to a LA?

A

Blink reflex and tear film

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11
Q

What is Pachymetry?

A

It is a test by probing the eye

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12
Q

What do you must do when conducting Schirmer 1?

A

Anesthetic measure is needed. Measured by Nasal and Basal tearing

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13
Q

How is schirmer 2 evaulated?

A

evaluates reflex tearing by irritating the nasal mucosa w/ a cotton swab after strip insertion; wetting that exceeds Schirmer I is normal and suggests lacrimal gland is intact

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14
Q

What is forced duction?

A

If a pt. has had a TED or blunt trauma will allow you to move the eye in certain direction to find out what muscle is being inforced upon

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15
Q

What type of LA will likely to not aggravate a dry eye

A

Lidocaine

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16
Q

If corneal epithelial debridement needs to occur?

A

Use Cocaine.

Note: The tight junctions are effected thus damaging the corneal epithelial cells

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17
Q

If a pt. has basement membrane complications what type of surgical procedure must occur?

A

Corneal puncture

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18
Q

Tonometry, gonio, sutures, nasolacrimal massage, ultrasound, what type of LA would you use?

A

Proparacaine or Tetracaine

19
Q

What LA can be used for Benoxinate?

A

Tonometry

20
Q

What LA is used for Herpetic Neuralgia (injection)?

A

Procaine

21
Q

What LA is used for OTC oral, dental, cough?

A

Benzocaine

22
Q

What type of Amide is used for LA, RA, Chalazion surgery?

A

Lidocaine

Note: 3.5% for Chalazion surgery

23
Q

What are injectable anesthetics needed for?

A

Nerve blockage, macular edema and uveitis

24
Q

What is the onset and duration of anesthetics for topicals?

A

0.5 minutes and 1/4 hr for duration

25
Q

What is the onset and duration for Lidocaine and Procaine?

A

L - 4 to 6 and 2/3-1

P - 7-8 and 1/2 - 2/4

26
Q

What anesthetic is doubled when used with epinephrin for vasconstriction?

A

Lidocaine

27
Q

An anesthetic has intrinsic vasodilation but what specific health problem should be considered, according to Dr. McNaughton when analyzing anesthetics?

A

Allergy or intrinsic effect

28
Q

What are 4 benefits of an anesthetic and vasoconstrictor being used?

A

Reduce abosorption/systemic toxicity, reduce metabolism, sustain a local effect and reduce bleeding at the injection site

29
Q

How many milligrams of drop of 100,000 of Epi?

A

Epinephrine 1:100,000

30
Q

What are the systemic effects of Cocaine?

A

Excitement, convulsions, rapid palpitations, nausea and Delirium

Note: Only one that causes VASOCONSTRICTION and causing the cardiac system to work hard, thus not getting adequate nourishment

31
Q

What are the ocular effects of Cocaine?

A

Desquamation (outer epithelial cells fall off), mydriasis and lid retraction

32
Q

What muscle is stimulated in the eye, for an individual who was on Cocaine?

A

Muellers muscle - lid retraction

33
Q

If you have an individual who is a pass cocaine abuser and you would like to administer NOR-EPI which drugs would you avoid?

A

Guanethidine and Resperine

34
Q

What is the cause of conjunctival hyperemia?

A

Anesthetics don’t allow for nerve junctions to function

35
Q

What will cause an allergic reaction with anesthetics?

A

Amides

36
Q

What is Lacrimation caused by?

A

Difference in pH from the eye

37
Q

True or False, Anesthetic combination: toxicity is not additive?

A

True

38
Q

What age is desquamation common and causing a reduced blink rate?

A

50+.

Note: Make sure to give lubricating drops to help with dry eye. Also make sure pt. does not rub there eye, may tear off corneal epithelium

39
Q

True or False. Esters will most likely cause an allergic reaction of hypersensitivity compared to amides.

A

True.

Note: A perservative could also cause the allergic reaction

40
Q

What is a vaso vagal syncope?

A

Vagus nerve get intiated and can supress oxygen to the brain, thus causing fainting

41
Q

True or False, Hypothyroidism pt, is an adverse effect of an anesthetic adverse effect?

A

False. It has to be hyperthyroidism

42
Q

What is the key effect of anesthetic abuse syndrome?

A

Retard mitosis and cell migration

43
Q

What is one sign to be pathopnumonic, what would be a sign for topical anesthtic abuse syndrome?

A

1 degree sign: yellow white stromal ring @ active site

Ocular Pharmacology (7 decks)

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