Local Anesthetics Flashcards
Where are esters broken down? Amides?
Blood by pseudocholinesterases; Liver
Lidocaine is what type of LA?
Amide
Two common components of LA’s that may cause an allergic reaction.
1) PABAs found in ester LA’s.
2) Methylparabens, which used to be used as a preservative, but are no longer allowed to be used in LA’s according to the FDA.
Esters are broken down into this molecule, and often cause allergic reactions.
PABA’s
This used to be a preservative in LA carpules, but the FDA has since banned them.
Methylparabens
These drugs block Na+ channels.
LA’s, anti-arryhthmic, and anti-epileptic drugs.
Order in which nerves are preferentially blocked by local anesthetics.
Small myelinated > non-myelinated > large myelinated
________ and _____________ are blocked first.
Nociceptive; Sympathetic
How does the acidity (pH) of the tissue affect the LA?
It determines whether the LA is in the ionized or non-ionized form.
Which form of LA crosses the nerve cell membrane to bind to Na+ channels and cause anesthesia?
NON-ionized form!
Most anesthetics are weak ________.
Bases
Which has a faster onset of action: Lidocaine or Bupivicaine?
Lidocaine
LA’s with a ________ pKa have a faster onset of anesthesia.
lower
What is Kovanaze made of?
Tetracaine and Oxymetazoline
What type of anesthetic is Tetracaine?
Ester
What is oxymetazoline?
A vasoconstrictor that binds to alpha 1 receptors.
What is the pregnancy category of Lidocaine and Prilocaine?
B
Pregnancy Category C LA’s.
MAB
Mepivicaine
Articaine
Bupivacaine
A long-lasting LA
Bupivacaine
Most commonly used LA.
Lido
Increases the duration of analgesia or shortens the time of onset.
Epinephrine
3 Known Vasoconstrictors
Epi
Levonordefrin
Oxymetazoline
Actions of a vasoconstrictor
1) Delay the absorption of LA from the site
2) Prolongs the action of the LA
3) Provides the field with less blood
4) Prevents SYSTEMIC toxicity
Most widely used vasoconstrictor in dentistry
Epi
When is a vasoconstrictor contraindicated?
In HYPERthyroidism
Amitriptyline Elavil and Doxepin Sinequan
Tricyclic antidepressants
Am I trippin? No, you’re just depressed.
Which vasoconstrictors are contraindicated when taking tricyclic antidepressants bc they cause an increased pressor response (increase BP)?
Levonodefrin and Norepinephrine
Reverses vasoconstriction.
OraVerse (Phentolamine mesylate)
