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159 - Regional Anesthesia and Conscious Sedation > Local Anesthetics > Flashcards

Local Anesthetics Flashcards

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1
Q

Main function of local anesthetics

A

Temporary interruption of all sensations over a specific area of the anatomy without loss of consciousness

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2
Q

Component of local anesthetics that enables penetration of nerve fibers.

A

Lipophilic component; attracted to clear lipids such as the phospholipid bilayer covering of nerves

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3
Q

Component of local anesthetics that allow for the diffusion of the drug through interstitial tissues

A

Hydrophilic component

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4
Q

Prototype of ester type of LA

A

Procaine

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5
Q

Prototype of amide type of LA

A

Lidocaine

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6
Q

Enzyme responsible for metabolism of ester type of LA and where is it found

A

Plasma pseudocholinesterase; in plasma

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7
Q

Enzyme responsible for metabolism of amide type of LA and where is it found

A

Hepatic microsomal enzyme system; liver

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8
Q

Anesthetic drug that produces the greatest vasodilation

A

Procaine

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9
Q

Highly toxic LA that cannot be used alone.

A

Propoxycaine

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10
Q

LA that is/are metabolized in both plasma and liver

A

Propoxycaine and articaine

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11
Q

Concentration of combined procaine + propoxycaine and its maximum recommended dose

A

2% procaine + 0.4% propoxycaine; 6.6mg/kg

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12
Q

Vasoconstrictors added to combined procaine + propoxycaine

A

1:20,000 norepinephrine
1:30,000 levonordefrin

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13
Q

Amide type of LA (6)
(LiMePriEtiArB)

A

Lidocaine
Mepivacaine
Prilocaine
Etidocaine
Articaine
Bupivacaine

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14
Q

Gold standard LA

A

Lidocaine

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15
Q

Maximum recommended dose for lidocaine

A

7.00mg/kg

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16
Q

absolute maximum dose for lidocaine

A

500mg

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17
Q

Vasoconstrictor usually added to lidocaine

A

1:50,000 epinephrine
1:100,000 epinephrine (ideal)

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18
Q

potency and toxicity of prilocaine

A

twice as potent with the same toxicity

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19
Q

Concentration of prilocaine

A

4% with 1:200,000 epinephrine or 4% plain

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20
Q

Maximum recommended dose for prilocaine

A

8.0mg/kg

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21
Q

absolute maximum dose for prilocaine

A

600mg

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22
Q

Contraindication of prilocaine

A

patients that may have decrease oxygen carrying capacity in the blood

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23
Q

Condition described as the increase of methemoglobin in the blood and which LA does this.

A

Methemoglobinemia; Prilocaine

24
Q

Potency and toxicity of Mepivacaine

A

Twice as potent, 1.5-2.0x toxicity

25
Q

LA with the slightest vasodilation

A

Mepivacaine

26
Q

Concentration of mepivacaine

A

2% with 1:100,000 epinephrine or 3% plain

27
Q

Maximum recommended dose for mepivacaine

A

6.6mg/kg

28
Q

Absolute maximum dose for mepivacaine

A

400mg

29
Q

Potency and toxicity of articaine

A

1.5x more potent, twice as toxic

30
Q

Concentration of Articaine

A

4% with 1:100,000 or 1:200,000 epinephrine

31
Q

Maximum recommended dose for articaine

A

7.0mg/kg

32
Q

LA with a myocardial depressant property

A

articaine

33
Q

Potency and toxicity of bupivacaine

A

4x more potent, <4x more toxic

34
Q

Greatest vasodilating property among amide types of LA

A

bupivacaine

35
Q

Concentration of bupivacaine

A

0.5% with 1:200,000 epinephrine

36
Q

Contraindication for bupivacaine

A

Children younger than 12

37
Q

MRD of bupivacaine

A

90mg (USA), 2.0mg/kg or 200mg (Canada)

38
Q

LA withdrawn from the market

A

Etidocaine

39
Q

Mrd of etidocaine

A

8.0mg/kg

40
Q

Topical anesthetics (4)

A

Benzocaine
EMLA
Lidocaine
4% tetracaine HCl

41
Q

Concentration of etidocaine

A

1.5% with 1:200,000

42
Q

Content of EMLA

A

Lidocaine 2.5% + Prilocaine 2.5%

43
Q

EMLA duration

A

20 mins

44
Q

Formulations of topical lidocaine

A

Lidocaine base 5% (poor water solubility)
Lidocaine Hydrochloride 2% (water soluble)

45
Q

Contraindication of 4% Tetracaine HCl

A

lacerated mucosal tissue

46
Q

What is pKa

A

Dissociation constant

pH level where compound is half ionized, half un-ionized

47
Q

Free base : (lipophilic/hydrophilic); Charged cation : (lipophilic/hydrophilic)

A

lipophilic; hydrophilic

48
Q

High pH = shifts equilibrium to the (left/right)

A

right

49
Q

Low pH = shifts equilibrium to the (left/right)

A

left

50
Q

Low pKa = shifts equilibrium to the (left/right)

A

right

52
Q

High pKa = shifts equilibrium to the (left/right)

A

left

53
Q

First anesthetic approved for epinephrine sensitive patients

A

Mepivacaine

54
Q

Incorporated to amides as an antioxidant and as a preservative

A

Sodium bisulfite

55
Q

True allergy to anesthetic drug will manifest on the ____ exposure

A

Second

56
Q

Added to anesthesia to make it closer to normal pH of tissue (isotope)

A

Sodium chloride

159 - Regional Anesthesia and Conscious Sedation (10 decks)

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