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Pharm > Lecture 7 > Flashcards

Lecture 7 Flashcards

1
Q

Where are nocicpetor cell bodies located?

A

Dorsal root ganglia near the spinal cord

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2
Q

What are specific inhibitors of pain pathways?

A

Analgesics

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3
Q

What are non-specific inhibitors of peripheral sensory. Include pain, motor and autonomic pathways.

A

Anesthetics

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4
Q

What inhibit conduction of action potentialsin all afferent and efferent nerve fibers?

A

Local anesthetics

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5
Q

Are local anesthetics hydrophobic or hydrophillic?

A

Hydrophobic

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6
Q

Local anesthetics are _____ bases either ester or amide linked

A

Weak

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7
Q

What do local anesthetics bind to in the blood?

A

Alpha-1-acid glycoprotein and albumin

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8
Q

If a local anesthetic is less hydrophobic will it have a greater or lesser plasma concentration.

A

Great plasma concentration (small Volume distribution)

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9
Q

Where will local anesthetics systemically travel to/

A

Capillary beds of the lungs

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10
Q

What are three ester linked local anesthetics?

A

Procaine, tetracaine, cocaine

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11
Q

How are ester linked local anesthetics metabolized?

A

By tissue and plasma esterases (pseudocholinesterases)

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12
Q

How are ester linked local anesthetics eliminated?

A

Via the kidney

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13
Q

What are 4 amide linked local anesthetics?

A

Lidocaine
Prilocaine
bupivicaine
articaine

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14
Q

How are amide linked local anesthetics metabolized?

A

P450 in the liver, some in the lungs

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15
Q

How are amide linked local anesthetics eliminated?

A

the kidney

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16
Q

How do local anesthetics work?

A

By individual Na channels in neuronal membranes

17
Q

When do local anesthetics work best?

A

When you are in pain this means sodium channels will be open

18
Q

What occurs when the time between action potentials is long compared to the time for dissociation of the local anesthetic from the Na channel

A

Tonic inhibition

19
Q

What happens when there isn’t enough time b/w action potential and AP conduction increasingly inhibited at higher frequency of impulses?

A

Phase inhibition

20
Q

Do local anesthetics interact w/ other channels?

A

yes they can (ex- K, Ca, ligand gated, several G-protein receptors) but usually no significant unless dealing with toxicities

21
Q

This is primarily used for infiltration anesthesia and dental procedures. Rapidly metabolized by cholinesterases. Short-acting, low hydrophoicity- low potency

A

Procaine

22
Q

Name the local anesthetic: long acting, highly potent due to high hydrophobicity. Metabolized by cholinesterases in plasma. Used for spinal and topical anesthesia.

A

Tetracaine

23
Q

Name the local anesthetic: Only naturally occuring ester based local anesthetic. Inhibits catecholamien uptake peripherally and centrally = vasoconstriction and euphoria. Used in ophthalmic and topical anesthesia.

A

Cocaine

24
Q

What are the 2 most commonly used local anesthetics, amide based?

A

Lidocaine

Prilocaine

25
Q

How are lidocaine and prilocaine metabolized?

A

P450

26
Q

Lidocaine is also used as a ______ anitarrhythmic.

A

Class 1

27
Q

Name the local anesthetic: Long DOA and highly hydrophobic (high potency) metabolized by P450 in the liver. Has cardiac toxicity because of blocking Na channels in cardiac myocytes during systole.

A

Bupivicaine

28
Q

Name the local anesthetic: new amide based but also exhibits as an ester group. Partially metabolized by cholinesterases and P450.

A

Articaine

29
Q

What does TAC stand for, used as a topical local anesthetic?

A

Tetracaine
Adrenaline (epi)
Cocaine

30
Q

What is EMLA (topical anesthetic) a combo of?

A

LIdocaine

Prilocaine

31
Q

What local anesthetic comes as a patch?

A

Lidocaine

32
Q

What are 3 local anesthetics that are used for infiltration. Must be kept at an acidic pH.

A

LIdocaine
Procaine
Bupivicaine

33
Q

In a central nerve block where is the drug delivered?

A

Near the spinal cord (epidural and intrathecal)

34
Q

What is a drug that is useful in labor because of adequate pain relief w/o significant motor block?

A

Bupivicaine

35
Q

What is a possible problem with bupivicaine?

A

Cardiotoxicity

36
Q

What are 2 safer options besides bupivicaine?

A

Ropivicaine

Levobupivicaine

37
Q

What is an intravenous regional block that is occasionally used in arm and hand surgery?

A

Bier’s block

Pharm (29 decks)

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