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Pharmacology 1 > Local Anesthetics > Flashcards

Local Anesthetics Flashcards

1
Q

MOA of Local Anesthetics

A

Bind and block Na+ voltages-gated channels to not allow propagation of signal - NON-SELECTIVE
Block channels in the open/inactivated state

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2
Q

T/F: The action of Local Anesthetics is terminated by redistribution

A 
True:
Use vasoconstrictors (epinephrine) to decrease distribution away from the site of action
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3
Q

Ester LA

A

Rapidly broken down by plasma pseudocholinesterases

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4
Q

Amide LA

A

Mainly metabolized by the liver

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5
Q

T/F: Motor transmission is blocked before pain and sympathetic transmission

A

False:

Pain and sympathetic transmission are blocked before motor transmission

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6
Q

List the order in which fibers are blocked: A-alpha fibers, A-delta fibers, C fibers

A

A-delta fibers
A-alpha fibers
C fibers

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7
Q

T/F: The potency increases by increasing lipid and water solubility

A

True

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8
Q

T/F: The higher the pKa, the more unionized drug enters the axon

A

False:

The LOWER the pKa, the more unionized drug enters the axon

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9
Q

Which LA are part of the Ester subclass?

A 
Procaine
Benzocaine
Proparacaine
Tetracaine
Way to remember: All Esters only have one "i" in their name; All Amides have two "i" in their name
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10
Q

Which LA are part of the Amide subclass?

A 
Lidocaine
Bupivicaine
Mepivacaine
Prilocaine
Ropivacaine
Dibucaine
Way to remember: All Esters only have one "i" in their name; All Amides have two "i" in their name
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11
Q

Clinical uses of Procaine

A

DO NOT USE THIS DRUG
Regional anesthesia
Dx lameness in horses
Ventricle arrhythmia (DONT USE WITH EPINEPHRINE)

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12
Q

Clinical uses of Benzocaine

A

Topical absorption in fish only

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13
Q

Clinical uses of Proparacaine

A

Topical corneal and conjunctival manipulation

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14
Q

Clinical uses of Tetracaine

A

Topical corneal and conjunctival manipulation

Euthanasia with Embutramide

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15
Q

Clinical uses of Lidocaine

A

Endotracheal intubation in cat
IM with Oxytetracycline (because it’s painful)
Euthanasia with Embutramide
MOST common LA in vet med

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16
Q

Clinical uses of Bupivacaine

A

Nerve block
Epidural (does not work topically)
Second most widely used LA

17
Q

Clinical uses of Mepivacaine

A

Nerve block

Dx lameness in horses

18
Q

Clinical uses of Prilocaine

A

IV regional anesthesia

19
Q

Clinical uses of Ropivacaine

A

Nerve block

Dx lameness in horses

20
Q

Clinical uses of Dibucaine

A

Euthanasia with Secobarbital

21
Q

Contraindications for Procaine

A

DO NOT USE THIS DRUG
Sulfonamide use
Toxic to horses

22
Q

Contraindications for Lidocaine

A

Do NOT use in food animals

Metabolite is considered carcinogenic

23
Q

Contraindications for Bupivacaine

A

MOST cardiotoxic

24
Q

Special considerations for Procaine

A 
DO NOT USE THIS DRUG
SLOW ONSET, SHORT DURATION
Rapidly metabolized to PABA
Slows PenG absorption from muscle
CNS stimulation in horses - TOXIC
Horses are the most sensitive species
25
Q

Special considerations for Benzocaine

A

LOWEST pKa (2.5) - ionized and low solubility

26
Q

Special considerations for Proparacaine

A 
RAPID ONSET (30 sec.) and SHORT DURATION (10-20 min)
LESS irritating than Tetracycline
27
Q

Special considerations for Tetracaine

A

LONGER duration than Proparacaine

Intrathecal

28
Q

Special considerations for Lidocaine

A 
RAPID ONSET (5 min) and MEDIUM DURATION (40-60 min)
Used parenterally or topically
Max dose = 7mg/kg - sheep most sensitive
29
Q

Special considerations for Bupivacaine

A 
SLOW ONSET (20 min) and LONGEST DURATION (8 hrs)
Max dose = 2mg/kg
30
Q

Special considerations for Mepivacaine

A

LESS irritating than Lidocaine

31
Q

Special considerations for Prilocaine

A

SIMILAR to Lidocaine but LESS toxic to cardiac muscle

Emla cream - 20-30 min to full effect (dermal analgesia)

32
Q

Special considerations for Ropivacaine

A

SIMILAR to Bupivacaine but has SHORTER DURATION and LESS toxic

33
Q

Special considerations for Dibucaine

A

MOST potent and MOST toxic LA

34
Q

T/F: All Esters cause methemoglobinemia

A

True

35
Q

T/F: All Esters cause histamine release

A

True:

Histamine release caused by PABA

Pharmacology 1 (8 decks)

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