Local Anesthetics

Question 1

local anesthetics inhibit _____ neuron pathways

Answer 1

affarent and efferent

Question 2

name the 4 esthers

Answer 2

procaine, tetracaine, benzocaine, and cocaine

Question 3

name the 3 amides

Answer 3

lidocaine, bupivacaine, mepivacaine

Question 4

the ____ the pKa and the more ___ the drug is the faster it will act

Answer 4

lower pKa

more uncharged

Question 5

more hydrophbic agents will bind more to ____ and ____

Answer 5

alpha -1 acid glycoprotein

albumin

Question 6

less hydrophobic = _____ plasma concentration = ____Vd(volume of dist) and _____ duration of action

Answer 6

greater concentration
smaller volume dist
longer

Question 7

Esther linked drugs are metabolized….

Answer 7

by tissue and plasma esterases within minutes and eliminated by the kidney (short acting)

Question 8

amide linked drugs are metabolized….

Answer 8

by hepatic enzymes (P450), metabolites eliminated via kidney ( possibly longer DOA bc longer to break down)

Question 9

hypersensitivity though rare is much more common in ______ types

Answer 9

esther

Question 10

how do local anesthetics work?

Answer 10

bind to Na channels blocking them

Question 11

what are the three injectible local anesthetics?

Answer 11

procaine, lidocaine, bupivacaine

Question 12

Procaine has ___ hydrophobicity, and ____ potency. Primarily used in ____ anesthesia in _____ procedures

Answer 12

low, low

infiltration dental procedures

Question 13

lidocaine is frequently mixed with _____, it has a _____ hydrophobicity, and _____ potency. It has a ____ onset, and a ____ DOA.

Answer 13

epinephrine; moderate hydrophob, moderately potent

rapid (2-5) min onset, medium DOA (30-60 mins)

Question 14

Lidocaine doses may be repeated every ___ hrs. Doses for blocks are ____ than for infiltration.

Answer 14

2-4hrs

lower

Question 15

lidocaine can also be used as a

Answer 15

class I antiarrythmic via IV

Question 16

Bupivacaine is typically mixed with _____. it has a _____onset, _____ DOA, and is ______ hydrophobic

Answer 16

Epi
quick onset(2-3 min), long DOA(3-6 hrs peak ~35 mins), highly hydrophobic(High potency)

Question 17

Bupivacaine ___ enantomer has a lower risk of toxicity

Answer 17

s —- is for “safe”

Question 18

______ is an opthalmic anesthetic

Answer 18

tetracaine

Question 19

1-2 drops of tetracaine lasts ___–___ mins

Answer 19

5-10

Question 20

tetracaine is ____ acting and ____potent b/c of it’s high hydrophobicity

Answer 20

long highly

Question 21

what is ELMA made of, what is it used for?

Answer 21

5% mix of lidocaine and prilocaine (2.5 of each); used for topical app.

Question 22

ELMA has on onset of action at about ____mins after application and ____ duration of action after removal.

Answer 22

60 mins

1-2 hrs

Question 23

Liposomal lidocaine is a ____% topical solution with onset at ____mins and max app time at ___ mins

Answer 23

4%

30 min onset max 60 mins

Question 24

what is zingo?

Answer 24

0,5mg lidocaine hydrocholride monohydrate; applied via intradermal injection via jet spray; onset of action = 10mins

Question 25

what is J-tip?

Answer 25

needleless delivery syst, pressurized CO2 drives lidocaine into skin; onset: 1-3 mins; .02-.25mL volumes can be used

Question 26

cocaine is a __% topical solution, with ____ potency and DOA

Answer 26

4%, medium

Question 27

____ is the only naturally occuring esther

Answer 27

cocaine

Question 28

What is TAC solution? amount applied? onset?

Answer 28

tetracaine, epi, and cocaine

5-10mL on gauze; onset 10 mins

Question 29

What is LET solution? amount applied? onset?

Answer 29

lidocaine, epi, tetracaine

5mL cotton ball; onset 10-30 mins

Question 30

what is hurricaine spray?

Answer 30

benzocaine 20% anesthetic lubricant for oral

Question 31

what is cetacaine

Answer 31

benzocaine, tetracaine, and butyl amino benzoate; spray fro 1-2 sec

Question 32

viscous lidocaine is typically ___% , used for ___ and ____

Answer 32

2% for oral/pharygeal mucosa irritation/inflam or upper GI

Question 33

lidocaine jelly is typically __% and used on the ____; dwel time= ____, max dose=_____

Answer 33

2%, in the urethra of the penis
5-10 min dwell
max= 600mg per 12 hrs