local anesthetics

Question 1

Ester linked LA procaine, chloroprocaine, benzocaine are metabolized to_______which can ______sulfonamide antibiotics.

Answer 1

PABA

inhibit the action of

Question 2

PABA is reconized as an_____and cause ____, ____, and_______

Answer 2

allergen
allergic dermatitis
asthmatic attack
anaphylaxis

Question 3

tetrodotoxin and Scorpio toxin bind where and act like what drug?

Answer 3

outside of voltage gated sodium channel

succinylcholine

Question 4

LA bind to the voltage gated sodium channel in what state?

Answer 4

open

inactivated

Question 5

sensory(pain) nerve fibers have a _____firing rate and a _____action potential duration.

Answer 5

high

long

Question 6

Motor fibers fire at a ____rate and have a _____action potential duration than pain fibers.

Answer 6

slower

shorter

Question 7

the length at which the axon must be exposed to LA to produce block?

Answer 7

critical length

Question 8

what two extrinsic factors affecting susceptibility to nerve block

Answer 8

peripheral nerve anatomy and concentration of local anesthetics

Question 9

small myelinated fibers are blocked______large myelinated fibers

Answer 9

before

Question 10

fibers of a similar size, one myelinated one not. who is blocked first

Answer 10

myelinated due to the high concentration of sodium channels in nodes

Question 11

order the fibers by who is blocked first

Answer 11

1-2pain Ad and c
2- temp Ad &c and touch Ab
3-proprioception Ag & Ab and skm Aa

Question 12

clonidine, dexmedetomidine, and epinephrine all increase the effectiveness of LA by binding to what? Where? How?

Answer 12

Dorsal Horn A2

inhibit pain transmission by Ad and C fibers

Question 13

caution with what three patient populations needs to be taken when using amide locals?

Answer 13

peds
elderly
liver issues

Question 14

examples of neuraxial blocks

Answer 14

central nerve block delivered near spinal cord
epidural
spinal
caudal

Question 15

which neuraxial block requires the largest volume of anesthetic

Answer 15

epidural

Question 16

list site of most vascular LA admin sites in order
I
C
E
B
ALL
S
S

Answer 16

intercostal
caudal epidural space
epidural 
brachial plexus
sciatica 
sub q

Question 17

Albumin has a ___capacity ____affinity while AAG has?

Answer 17

high
low

AAG low capacity high affinity

Question 18

This patient population____ 2___ is at higher risk for toxicity due to_____AAG.

Answer 18

pregnant women and newborns

low

Question 19

List the 9 S/S of LA toxicity

Answer 19

tongue numbness/metallic taste 
lightheadedness
Visual auditory disturbances
twitching 
Loss of cons
seizure
coma 
respiratory arrest 
cardiac arrest

Question 20

LA cause hypotension due to

Answer 20

arterial dilation, suppressing sympathetic and release of NO with lidocaine