Local Anesthetics

Question 1

Ester anesthetic Class

Answer 1

Esther

Question 2

Ester anesthetic MOA

Answer 2

Nonionized form crosses axonal membrane; ionized form (active form) blocks intracellular portion of inactive (refractory) voltage-gated sodium channel

Question 3

Ester Anesthetic Therapeutics

Answer 3

Local anesthesia

Question 4

Ester Anesthetic SE

Answer 4

1. Local: transient neurologic symptoms (basically, really bad pain), neuronal injury. 2. Systemic (more common with long-acting local anesthetics): CNS (early excitation: decreased inhibition, sensory disturbances, restlessness, tremor, tinnitus; later depression: lethargy, hypotension, seizures), cardiovascular (reduced conductivity, excitability, and contractility; arrhythmias (QRS widening an early sign); indirect vasodilation and bradycardia.
2. Methemoglobinemia (primarily with benzocaine and prilocaine)

Question 5

Ester Anesthetics Misc

Answer 5

Cocaine, procaine, benzocaine more likely to have allergic reaction than amides due to containing PABA derivitives; used less frequently than amides; metabolized by plasma esterases

Question 6

Amide anesthetic Class

Answer 6

Amide

Question 7

Amide anesthetic MOA

Answer 7

Nonionized form crosses axonal membrane; ionized form (active form) blocks intracellular portion of inactive (refractory) voltage-gated sodium channel

Question 8

Amide anesthetic Therapeutics

Answer 8

Local anesthesia

Question 9

Amide anesthetic SE

Answer 9

1. Local: transient neurologic symptoms (basically, really bad pain); neuronal injury 2. Systemic (more common with long-acting local anesthetics): CNS (early excitation: decreased inhibition, sensory disturbances, restlessness, tremor, tinnitus; later depression: lethargy, hypotension, seizures); cardiovascular (reduced conductivity, excitability, and contractility; arrhythmias (QRS widening an early sign); indirect vasodilation and bradycardia
2. Methemoglobinemia (primarily with benzocaine and prilocaine)

Question 10

Amide Anesthetic Misc.

Answer 10

Lidocaine, mepivicaine, bupivicaine, etidocaine, prilocaine, ropivicaine, dibucaine (names have 2 or more “i”s; metabolized in liver, cleared by kidneys