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Pharmacology > Local Anesthetics > Flashcards

Local Anesthetics Flashcards

1
Q

what characteristic of local anesthetics allows them to cross cell membranes

A

they’re amphipathic- both lipophilic and hydrophilic characteristics

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2
Q

are ester linked or amide linked local anesthetics more prone to rapid hydrolysis and inactivation

A

ester

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3
Q

are ester linked or amide linked local anesthetics at high risk for causing hypersensitivity

A

ester

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4
Q

are ester linked or amide linked local anesthetics used more on mucous surfaces

A

ester

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5
Q

what is the mechanism of action of local anesthetics

A

bind with cytoplasmic receptors and inhibit VGNaC, prolonging the channel in the inactive form

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6
Q

do local anesthetics have high affinity for resting, activated, or inactivated VGNaC

A

inactivated

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7
Q

the effects of local anesthetics are pronounced in __ and not in __

A

in rapidly firing axons
not in resting neurons

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8
Q

how many nodes of ranvier are sufficient to induce local anesthesia

A

2-3

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9
Q

does an increase in extracellular calcium increase of decrease the effects of local anesthesia

A

increase

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10
Q

tetrodotoxin comes from __

A

puffer fish

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11
Q

saxitoxin comes from __

A

algae

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12
Q

ciguatoxin comes from __

A

exotic fish

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13
Q

batrachotoxin comes from __

A

frogs

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14
Q

what is the order of blockage between motor, sensory, and autonomic fibers

A

autonomic first, then sensory and motor

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15
Q

what is the order of recovery between motor, sensory, and autonomic fibers

A

motor, sensory, then autonomics

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16
Q

are smaller or larger fibers more sensitive to blockade

A

small

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17
Q

are myelinated or unmyelinated fibers more sensitive to blockade

A

myelinated

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18
Q

what fibers, A/B/C, are affected first due to their response to low concentration of local anesthetic

A

B

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19
Q

what is an example of a differential blockade in which local anesthetics block sensory impulses while sparing motor and proprioception

A

labor analgesia

20
Q

diffusion of local anesthetics is in the __ (unionized basic or charged) form, which is then converted to the __ (unionized basic or charged) form inside the axon

A

diffusion= unionized basic
converted to charged

21
Q

what is the relationship between local anesthetic effect and inflammation

A

inflammation produces lactic acid products. acidification of tissues slows the local anesthetic effectiveness

the anesthetic becomes charged and is unable to penetrate the nerve cell membrane

22
Q

what can be done to eliminate the effect of increased acidity with inflammation when giving a local anesthetic

A

enhance with sodium bicarbonate to increase the pH

23
Q

amide linked local anesthetics use is cautioned in those with __, __, and those taking __

A

hepatic disease
congestive heart failure
beta blockers

24
Q

local anesthetics have drug-drug interaction with what 2 classes of drug

A

alpha 2 agonist
opioids

25
Q

the duration of action of local anesthetics is proportional to ))

A

the duration of contact with the nerves

26
Q

what can be used to prolong the effect of local anesthetics

A

vasoconstrictors

27
Q

vasoconstrictors with local anesthetic use is contradicted in procedures involving what body sites

A

tip of nose
feet
toes
penis
fingers

28
Q

what is the effect of local anesthetic use on the CNS

A

stimulation then depression

29
Q

what is the mechanism of action of cocaine as a local anesthetic

A

blocks reuptake of NE
causes vasoconstriction

30
Q

what local anesthetic is used in the ocular and tracheobronchial regions to reduce bleeding

A

cocaine

31
Q

is cocaine lipid soluble?
does cocaine have a high or low potency?

A

lipid soluble
high potency

32
Q

procaine is a local anesthetic with a lower potency and shorter course of action as compared to cocaine. procaine reduces the effect of what drug class

A

sulfonamides

33
Q

what local anesthetic is used as an antiarrhythmia and is the drug of choice in ventricular fibrillation following MI

A

lidocaine

34
Q

in what cases with a vasoconstrictor now be used with a local anesthetic

A

during cases of arrhythmia, as vasoconstrictors can worsen arrhythmias

35
Q

what local anesthetic is long acting and produces more sensory block and motor block, thus being preferred during labor

A

Bupivacaine

36
Q

Bupivacaine causes more __ but less __

A

more cardiotoxicity
less nephrotoxicity

37
Q

what local anesthetic has less risk for transient neurologic symptoms

A

Bupivacaine

38
Q

what local anesthetic should be avoided in pregnancy

A

Mepivacaine

39
Q

how does Prilocaine differ from lidocaine

A

it can be used without a vasoconstrictor
it’s used for IV regional block

40
Q

what 2 drugs make up Eutectic Mixture of LAs (EMLA)

A

lidocaine
Prilocaine

41
Q

Eutectic Mixture of LAs (EMLA) is effective for __ but should not be used for __

A

effective for procedures involving skin and superficial tissue

not effective for mucous membranes or abraded skin

42
Q

where is the local anesthetic injected into with spinal anesthesia

A

subarachnoid space

43
Q

what is the limitation with spinal anesthesia

A

duration is only 1-4 hours

44
Q

what is one main initial CNS symptom of local anesthetic system toxicity

A

tongue paralysis

45
Q

local anesthetic system toxicity can present with __ and __

A

tonic clonic seizures
respiratory depression

46
Q

what are 2 ways in which local anesthetic system toxicity is treated

A

IV diazepams for seizures
succinylcholine to suppress muscle reactions

47
Q

what local anesthetic is the most cardiotoxic

A

Bupivacaine

Pharmacology (16 decks)

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