Local Anesthetics Flashcards
local anesthetics inhibit _____ neuron pathways
affarent and efferent
name the 4 esthers
procaine, tetracaine, benzocaine, and cocaine
name the 3 amides
lidocaine, bupivacaine, mepivacaine
the ____ the pKa and the more ___ the drug is the faster it will act
lower pKa
more uncharged
more hydrophbic agents will bind more to ____ and ____
alpha -1 acid glycoprotein
albumin
less hydrophobic = _____ plasma concentration = ____Vd(volume of dist) and _____ duration of action
greater concentration
smaller volume dist
longer
Esther linked drugs are metabolized….
by tissue and plasma esterases within minutes and eliminated by the kidney (short acting)
amide linked drugs are metabolized….
by hepatic enzymes (P450), metabolites eliminated via kidney ( possibly longer DOA bc longer to break down)
hypersensitivity though rare is much more common in ______ types
esther
how do local anesthetics work?
bind to Na channels blocking them
what are the three injectible local anesthetics?
procaine, lidocaine, bupivacaine
Procaine has ___ hydrophobicity, and ____ potency. Primarily used in ____ anesthesia in _____ procedures
low, low
infiltration dental procedures
lidocaine is frequently mixed with _____, it has a _____ hydrophobicity, and _____ potency. It has a ____ onset, and a ____ DOA.
epinephrine; moderate hydrophob, moderately potent
rapid (2-5) min onset, medium DOA (30-60 mins)
Lidocaine doses may be repeated every ___ hrs. Doses for blocks are ____ than for infiltration.
2-4hrs
lower
lidocaine can also be used as a
class I antiarrythmic via IV
Bupivacaine is typically mixed with _____. it has a _____onset, _____ DOA, and is ______ hydrophobic
Epi quick onset(2-3 min), long DOA(3-6 hrs peak ~35 mins), highly hydrophobic(High potency)
Bupivacaine ___ enantomer has a lower risk of toxicity
s —- is for “safe”
______ is an opthalmic anesthetic
tetracaine
1-2 drops of tetracaine lasts ___–___ mins
5-10
tetracaine is ____ acting and ____potent b/c of it’s high hydrophobicity
long highly
what is ELMA made of, what is it used for?
5% mix of lidocaine and prilocaine (2.5 of each); used for topical app.
ELMA has on onset of action at about ____mins after application and ____ duration of action after removal.
60 mins
1-2 hrs
Liposomal lidocaine is a ____% topical solution with onset at ____mins and max app time at ___ mins
4%
30 min onset max 60 mins
what is zingo?
0,5mg lidocaine hydrocholride monohydrate; applied via intradermal injection via jet spray; onset of action = 10mins
what is J-tip?
needleless delivery syst, pressurized CO2 drives lidocaine into skin; onset: 1-3 mins; .02-.25mL volumes can be used
cocaine is a __% topical solution, with ____ potency and DOA
4%, medium
____ is the only naturally occuring esther
cocaine
What is TAC solution? amount applied? onset?
tetracaine, epi, and cocaine
5-10mL on gauze; onset 10 mins
What is LET solution? amount applied? onset?
lidocaine, epi, tetracaine
5mL cotton ball; onset 10-30 mins
what is hurricaine spray?
benzocaine 20% anesthetic lubricant for oral
what is cetacaine
benzocaine, tetracaine, and butyl amino benzoate; spray fro 1-2 sec
viscous lidocaine is typically ___% , used for ___ and ____
2% for oral/pharygeal mucosa irritation/inflam or upper GI
lidocaine jelly is typically __% and used on the ____; dwel time= ____, max dose=_____
2%, in the urethra of the penis
5-10 min dwell
max= 600mg per 12 hrs
