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Pharmacology > local anaesthetics > Flashcards

local anaesthetics Flashcards

1
Q

reasons why you might use local anaesthetics

A
  • diagnostic purposes
  • permit minor injury
  • antiarrhythmic treatment
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2
Q

two chemical types of local anaesthetics

A
  • esters

- amides

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3
Q

ester local anaesthetics

A

procaine, chloroprocaine, oxybuprocaine, tetracaine, benzocaine, cocaine

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4
Q

amide local anaesthetics

A

lidocaine, prilocaine, mepivacaine, bupivacaine, ropivacaine, articaine

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5
Q

local anaesthetics mechanism of action

A
  • blocks action potential generation by blocking Na+ channels
  • act in cationic form
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6
Q

in which order do LAs block conduction

A
  • non myelinated axons
  • small myelinated axons
  • large myelinated axons
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7
Q

order of disappearance of nervous function

A

pain>warmth>touch>deep pressure>motor function

return of nerve function is in reverse order

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8
Q

side effects of LAs

A
  • slow heart conduction
  • CNS-inhibitiory effect
  • peripheral blood vessels dilated
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9
Q

what does cocaine do to the blood vessels

A

constricts them

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10
Q

does lidocaine cause vaosdilation

A

no

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11
Q

effect of LAs on inflammed or hypocix tissue

A

no effect

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12
Q

what does the concomitant application of vasoconstrictor medicines do to the effects of LAs

A

increases duration and decreases toxicity

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13
Q

factors determining absorption of LAs

A
  • site of application
  • dose
  • vasoconstrictive drugs
  • features of LAs
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14
Q

ester LAs are metabolised where

A

hydrolysed primarily by the plasma esterase and degraded by hepatic metabolism -> safer LAs

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15
Q

where are amide LAs mostly metabolised

A

largely degraded by hepatic inactivation and some plasma hydrolysis

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16
Q

order of clearance of amides

A

prilocaine>lidocaine>mepi>ropi>bupivacaine

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17
Q

toxicity of LAs in increasing order

A

mepivacaine

18
Q

side effects of LAs

A
  • allergy
  • asthmatic seizure
  • local tissure irritation
  • systemic effects - CNS, cardiovascular
  • effect of adjuvant
19
Q

systemic side effects of LAs in CNS

A

first mild sensory inhibiton, agitation, confusion, tremors progressing to convulsions and resp depression

20
Q

systemic side effects of LAs in cardiovascular system

A

namely myocardial depression and vasodilation, leading to fall in blood pressure

21
Q

uses of local anaesthetics

A
  • topical anaesthesia
  • local infiltration
  • perineural injection
  • intra-articular use
  • intravenous regional anaesthesia
  • epidurl and spinal block
22
Q

places of application of topical anaesthesia

A

cornea, mucous membranes or skin

23
Q

topical anaesthesia indications

A

GI-ulcers, pharngeal painful diseases, opthalmology, rectal, before examinations, burnings, sun irritation, inflammation of outer or inner ear

24
Q

local infiltration method

A

numerous SC/IM inj of small volumes 0.5-2ml

25
Q

local infiltration indications

A

minor surgery, dentistry, castration of males, subcutaneous regional anaesthesia

26
Q

local infiltration theory

A

LA injected along a line, blocking conduction in the nerves that pass through the tissue. all regions supplied by the distal section of these are blocked

27
Q

perineural injection indications

A

dentistry, minor surgery

28
Q

perineural injection what is it

A

injection of anaesthetic in the immediate vicinity of peripheral nerves

29
Q

intra-articular use therapeutic indication

A

operation of the affected joint

30
Q

intra-articular use diagnostic goal

A

to facilitate the diagnosis of lameness

31
Q

intravenous regional anaesthesia what is it

A

local anaesthetic injected IV distal to a tourniquet

extreme isolation from the rest of ciruclation, only less toxic agents allowed

32
Q

intravenous regional anaesthesia usage

A

for operations of the digit in cattle

33
Q

whats TIVA

A

total intravenous anaesthesia

34
Q

epidural and spinal block disadvantages

A

spinal cord injury

35
Q

what is epidural spinal anaesthesia

A

injecting LAs into the epidural or subarachnoid space

large areas of the body can be anaesthesied with small amounts of drug

36
Q

epidural spinal anaesthesia indications

A

surgery of perineal region, anal, peri-anal region, obstetric operations, urology

37
Q

epidrual anaesthesia place of injection horses, cattle

A

first or second intercoccigeal spaces - higher application producing limb paralysis

38
Q

epidural anaesthesia place of injection sheep, dog, pig

A

lumbosacral space

39
Q

epidural anaesthesia dose large animals

A

lidocaine 1% 60-80ml

40
Q

epidural anaesthesia dose dogs, pigs

A

according to body size eg 40cm 2ml

41
Q

can epinephrine be injected into the spinal cord or IV

A

no, with systemic use its a lot more harmful

Pharmacology (23 decks)

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