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Pharmacology Exam III > Local Anesthesia > Flashcards

Local Anesthesia Flashcards

1
Q

Local anesthesia

A

loss of sensation limited to local area or region of body

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2
Q

Local anesthetic

A

drugs that block generation and propagation of nerve impulses that result in REVERSIBLE REGIONAL LOSS OF FUNCTION

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3
Q

Three main types of local anesthesia

A

TOPICAL

PERINEURAL INFILTRATION

NERVE BLOCK

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4
Q

Perineural Advantage

A

EASE OF DELIVERY - specific area to be anesthetized

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5
Q

Nerve Block Advantage

A

LESS DRUG REQUIRED to block larger areas distal to injection site

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6
Q

Spinal Block

advantages?

A

injection of agent INTO CSF IN LUMBAR REGION OF SUBARACHNOID SPACE

more reliable block

minimal disruption of respiratory and cardiovascular block

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7
Q

Epidural block

A

injection of agent INTO EXTRADURAL SPACE

less reliable than spinal block

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8
Q

Local anesthetic MOA

A

BLOCKADE OF VOLTAGE GATED SODIUM CHANELS

decrease generation and conduction of action potentials

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9
Q

4 sites of action of local anesthetics

A

BIOTOXINS
LIDOCAINE
BENZOCAINE
COMBO OF 2 AND 3

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10
Q

Local anesthetics end in

Amides have

Esters have

A

-caine

two i’s

one i

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11
Q

Amides

A

longer half life

longer duration of action

METABOLIZED IN LIVER

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12
Q

Esters

A

short plasma half life

short duration of action

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13
Q

Fiber size effect on local anesthetic onset and recovery

A

Increase fiber = increase Cm - blocks B fibers first then A-alpha last

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14
Q

Cm

A

Cm - minimum anesthetic concentration

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15
Q

Site of deposition on local anesthetic onset and recovery

A

anesthesia occurs FIRST AT OUTER FIBERS as the drugs moves down concentration gradient

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16
Q

pH effect on local anesthetic onset and recovery

A

Increase pH = DECREASE Cm

17
Q

Nerve stimulation rate effect on local anesthetic onset and recovery

A

higher frequency nerves are MORE SENSITIVE

18
Q

Calcium concentration effect on local anesthetic onset and recovery

A

increase Ca = INCREASE Cm

19
Q

Addition of vasoconstrictors effect on local anesthetic onset and recovery

A

REDUCES LA TOXICITY

BUT NEVER INJECT LA with vasoconstrictor into AREAS WITH END ARTERIOLES - can cause gangrene or sloughing off of tissues

20
Q

Factors affecting Reversal

A

Dilution by ECF
Absorption into circulation
Redistribution
Use of vasoconstrictors

21
Q

Amides metabolized by

Esters metabolized by

A

LIVER –> half life can be altered with individuals with hepatic problems

PLASMA –> PABA moiety –> can cause side effects

22
Q

Potential Adverse Effect of LA

A

Hypersensitivity –MOST COMMONLY TO METHYLPARABEN

Systemic Toxicity – LESS LIKELY WITH ESTERS

23
Q

Bupivicaine systemic toxicity

A

CARDIAC EFFECTS can cause complete cardiac collapse and death

24
Q

Treatment for LAST

A

INTERVENOUS EMULSION OR INTRALIPID

forms a lipid sink

25
Q

Lidocaine Important Notes

A

REFERENCE STANDARD FOR MOST ANESTHETICS

CAN BE GIVEN TOPICALLY AND INJECTED

26
Q

Bupivicaine Important Notes

A

AGENT OF CHOICE FOR EPIDURAL INFUSION

EXCELLENT SPINAL ANESTHETIC

27
Q

Articaine Important notes

A

DENTAL ANESTHETIC

28
Q

Cocaine Important Notes

A

CURRENT USE FOR TOPICAL ANESTHETIC FOR ENT

29
Q

Benzocaine Important Notes

A

TOPICAL ONLY due to enhanced lipid solubility

30
Q

Chloroprocaine Important Notes

A

EPIDURAL AGENT FOR LABOR ANESTHESIA due to lower risk of systemic toxicity

31
Q

Exparel Liposome Important Notes

A

BUPIVICAINE ENCASED IN LIPID

better relief

32
Q

EMLA

A

eutectic mixture of local anesthetics

33
Q

TAC

A

tetracaine, adrenaline, and cocaine

34
Q

neurolytics

A

agents that are not reversible

35
Q

Topical Local Anesthetics General Rule

A

TOPICALS TOO TOXIC FOR INJECTION

Pharmacology Exam III (11 decks)

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