Local Anesthetics Flashcards
amide type drugs?
lidocaine, bupivacaine, mepivacaine, prilocaine, ropivacaine
ester type drugs?
procaine, chloroprocaine, tetracaine, cocaine
amide and ester bonds?
articaine
topical use only?
benzocaine, dyclonine, dibucaine, pramoxine
compounded projects?
EMLA, LET, phenylephrine-oxymetazoline
a reversal agent?
phentolamine
antidote to cardiotoxicity?
intralipid
ideal qualities of local?
hydrophilic and lipophilic
order of sensitivity of nerve fibers?
- B 2. C (SNS and Dorsal Root) and A delta 3. A gamma 4. A beta 5. A alpha
True or False: drug acts proximal to distal
true
true or false: recovery gradient runs distal to proximal
false
amide drugs have … metabolism?
hepatic
ester drugs have … metabolism?
non-hepatic
symptoms of minor toxicity?
ringing in ears, metallic taste, numbness of lips and tongue (if drug not applied in mouth)
Epi interaction possible w/…
B blockers; tricyclic antidepressants (imipramine), halothane, hypertension/heart block, cerebral vascular insufficiency
which metabolite of procaine might cause allergic reaction?
PABA
which preservatives might cause allergic rxn?
sulphites
lipid solubility?
potency
dissociation constant?
time of onset
chemical linkage?
metabolism
protein binding?
duration
prilocaine and to a lesser extent benzocaine cause…
methemoglobinemia
antidote for methemoglobinemia?
IV methylene blue
more potent and cardiotoxic than lidocaine/mepivacaine; prolonged activity; useful for postop analgesia?
bupivacaine
reduced cardiotoxicity; greater safety margin?
ropivacaine
better penetration into bone; higher incidence of parethesias?
articaine
topical for mouth, pharynx, larynx, trachea, esophagus, urethra?
benzocaine and dyclonine
topical for skin, not mucosal membranes?
dibucaine and pramoxine
which given for suturing?
LET
