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S3 Case 1 - Neurology > Local Anaesthetics > Flashcards

Local Anaesthetics Flashcards

1
Q

What do local anaesthetics produce?

A

Transient + reversible loss of sensation without loss of consciousness

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2
Q

Are they reversible?

A

YES

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3
Q

What are some examples?

A

Benzocaine
Cocaine
Lidocaine

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4
Q

What are the different types?

A

Esters - eg. cocaine
Amides - eg. Lidocaine

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5
Q

What is their general structure?

A

Aromatic ring = lipophilic portion
Intermediate linkage
Terminal amine = hydrophilic portion

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6
Q

What does the aromatic ring allow?

A

Go through the membrane

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7
Q

What happens if the linkage is longer?

A

Action is longer

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8
Q

What is the mechanism of action?

A

Block Na+ channel on the intracellular side
= artificial inactivated state
= ions can’t travel
= NO generation + propagation of AP

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9
Q

Which fibres does they act on?

A

All types
BUT structure of fibres determine how long it works

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10
Q

Which fibre do they work longest on?

A

C fibres
= unmyelinated

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11
Q

What type of drugs are local anaesthetics?

A

Potent vasodilating

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12
Q

Describe their distribution in the body

A

Cross BBB
Cross placenta
Distribute to all tissues

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13
Q

What does it mean if they distribute to all tissues?

A

Should use low doses

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14
Q

Why would the brain, head, liver and lungs, kidneys + spleen receive high levels?

A

High level of perfusion

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15
Q

What is their duration of action dependent on?

A

Protein binding

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16
Q

What is their potency dependent on?

A

Lipid solubility
= higher solubility = use lower dose

17
Q

What is the organ for excretion of local anaesthetics?

A

Kidneys

18
Q

When do you need to caution with local anaesthetics?

A

Patients undergoing dialysis
= unable to excrete unchanged portion of esters/amides
= increasing toxicity

19
Q

What is their pharmacological action?

A

CNS depression

20
Q

At high levels what can local anaesthetics do?

A

Produce convulsions

21
Q

What are their cardiovascular effects?

A

Decreased myocardial depolarisation
Decreased myocardial excitation = decreased force of contraction
Hypotension

22
Q

What are their respiratory effects?

A

Direct relaxant of bronchial smooth muscle
Normal respiratory function unaffected unless overdose

23
Q

What is the local tissue toxicity?

A

Skeletal muscle will heal within 2 weeks of being injected
Longer acting produce more damage - eg. Bupivacaine

23
Q
A
23
Q

What are the 6 administration sites?

A

Surface/topical
Local infiltration
Peripheral nerve block
Bier block
Epidural anaesthesia
Spinal anaesthesia

S3 Case 1 - Neurology (16 decks)

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