Local Anesthetics Flashcards
General MoA
blocks generation and propagation of nerve impulses.
Types of Local Anesthesia
Topical, perineural infiltration, Nerve block, Spinal block (subarachnoid), Epidural Block
Amides
Longer half life and longer duration. Metabolized in liver
Esters
Metabolized in the plasma
Vasocontstrictors and LA
Prevents LA from moving systemically, but cannot use with end arterioles.
Vasocontstrictors and LA
Prevents LA from moving systemically, but cannot use with end arterioles.
Reversal Factors
Dilution, absorption into circulation, Redistribution, Vasocontrictors.
LA Toxicity
Intervenous Lipid Emulsion forms a lipid sink to absorb lipophilic toxin.
Lidocaine
Can be given topically or by injection. 1-2 hr duration, doubled with epi. Used for epidurals when total motor block is desired.
Bupivacaine
Agent of choice for epidural in labor and post op pain. Excellent spinal anesthetic. Cardio collapse risk. Levobupivicaine is less toxic.
Articaine
Dental anesthetic
Cocaine
Current use: topical anesthetic for ear, nose, and throat procedures.
Benzocaine
Topical only due to enhanced lipid solubility.
Chloroprocaine
Epidural agent for labor anesthesia (C-section) due to lower risk of systemic toxicity and fetal exposure.
Exparel-Liposome
Encased bupivicaine that provides relief for 72 hours. Injection, high cost.
