Local Anesthetics - 8/22 Kruse

Question 1

What local anesthetics have a long duration of action?

Answer 1

BRT

Bupivacaine
Ropivacaine
Tetracaine

Question 2

What drug has poor solubility in water and is used topically for derm conditions, hemorrhoids, premature cumming, and as an anesthetic lubricant?

Answer 2

Benzocaine

Question 3

What has a longer, faster, more extensive action:

Lidocaine or procaine?

Answer 3

Lidocaine

Question 4

What drug is metabolized to a P-aminobenzoic acid?

What does it inhibit?

Answer 4

Procaine

Sulfa antibiotics

Question 5

Which drugs have the highest potency and duration of action?

Answer 5

Bupivacaine
Ropivacaine
Tetracaine

BRT

Question 6

What drug is the alternative choice for people sensitive to ester local anesthetics?

Answer 6

Lidocaine

Question 7

How can a local anesthetic cause both sensory and motor paralysis?

Answer 7

Nerve trunk contact

Question 8

MOA of local anesthetics?

Answer 8

VGNa Channels

Question 9

What hydrolyzes esters?

Amides?

Answer 9

Butyrycholinesterase

CYP450s

Question 10

What type of drugs are generally shorter acting and are more prone to hydrolysis?

Answer 10

Esters

Question 11

When large doses of local anesthetic are required, what premedication can be used as a prophylaxis?

What route of administration?

Answer 11

Benzodiazepine (diazepam or midazolam)

Parenterally

Question 12

What drug is primarily used as a topical anesthetic of the upper respiratory tract?

Answer 12

Cocaine

Question 13

High [ ]’s of local anesthetics can produce what side effects?

Answer 13

Nystagmus, muscular twitching, convulsions

Question 14

What local anesthetics have a medium duration of action?

Answer 14

Lidocaine
Mepivacaine
Articaine
Cocaine

Question 15

Low [ ]’s of local anesthetics can produce what side effects?

Answer 15

Sleepiness, light-headedness, visual and auditory disturbances, and restlessness

Question 16

Where are esters metabolized?

Amides?

Answer 16

Plasma

Liver –> urine (charged substance)

Question 17

What vasoconstrictor is useful when paired with short acting drugs?

Answer 17

Epinephrine

Question 18

What drug is used as a class Ib antiarrhythmic agent?

Answer 18

Lidocaine

Question 19

When is a Bier Block used?

What else is needed?

Answer 19

For short surgical procedures of the UE and LE less than 60 min

Proximally placed tourniquet

Question 20

What are the most sensitive fibers to nerve block?

Answer 20

Type C in the dorsal root and sympathetic

Type B in the preganglionic-autonomic

Question 21

What drug is now only used as a topical cream on the skin bc of toxicity with injections?

Answer 21

Dibucaine

Question 22

What drug is used only for infiltration anesthesia?

Answer 22

Procaine

Question 23

What drug is capable of producing prolonged anesthesia and has a tendency to provide more sensory block than motor?

Answer 23

Bupivacaine

Question 24

What gets blocked 1st?

Small or large fibers?
Myelinated or non-myelinated?
Lipophilic or lipophobic?
Low or high frequency?
C or A delta fibers?

Answer 24

Small
Myelinated
Lipophilic
High f
A delta

Question 25

How do local anesthetics work?

Answer 25

Bind reversible to Na channels in nerves and block ion movement through the pore, blocking APs

Question 26

What local anesthetic has a short duration of action?

Answer 26

Procaine