Local Anesthetic Pharmacology Flashcards
where is regional anesthesias principle site of action?
in the neuraxial
what are the 2 types of regional anethesia?
- spinal
- epidural
what are the 4 aminoesters?
- chloroprocaine
- cocaine
- procaine
- tetracaine
what are the 4 aminoamides?
- bupivacaine
- lidocaine
- mepivacaine
- ropivacaine
what structures are hydrolyzed by pseudocholinesterases?
esters
what structures are enzymatically transformed in the liver?
amides
what is there an inflow of in depolarization?
sodium
what is there an outflow of in repolarization?
potassium
the closer the pka to tissue pH the _____ the onset
faster
true or false: ionized forms have a faster onset
false
which aminoamide is a more potent vasodilator?
lidocaine
______ solubility increases potency
lipid
what aminoamide has hih=gh lipid solubility?
etidocaine
an increase in protein binding = _____ duration of action
increased
rank the following aminoamides in order of most to least protein binding:
lidocaine, bupivacaine, ropivacaine
bupivacaine> ropivacaine> lidocaine
where should you not use epinephrine?
in places with no collateral blood flow
what is the max dose used for bupivicaine?
2.5 mg/kg
what is the max dose for lidocaine +/- epinephrine?
7 mg/kg
what is the max dose used for procaine?
7 mg/kg
how are the aminiamides given?
as a single subcutaneous shot
what is the order of blockade (simple terms)?
- pain
- temperature
- deep pressure
- motor function
what is the motor of blockade?
- C. fiber
- A-delta
- A-beta
- A-alpha
what is a major SE of bupivaciane?
severe ventricular arrhythmias
what aminoamide had an increased therapeutic index?
ropivacaine
