local anesthetics continued drugs Flashcards
these two locals are in emla cream and used for?
lidocaine
prilocaine
topical admin
Most to least cardiac toxic 4
Big
L
Really
Like
cake
bupivacaine
levobupivacaine
ropivacaine
lidocaine
related to lipophilicity
this concertation of what drug highest risk for neurotoxicity
5% lidocaine
More caution has to be taken in regards to neurotoxicity when doing these types of blocks (location/type)
neuraxial
what type of local is metabolized to PABA
esters
methemoglobinemia S/S
cyanosis
chocolate colored urine
headache
What two drugs can cause methemoglobinemia
benzocaine
prilocaine
least effective and most effective LA to use in inflamed tissue ?
bupivacaine least
mepivacaine most
procaine/nonvaccine
short/long acting?
lipophilicity?
Toxicity is?
short acting
low lipophilicity
toxicity is uncommon
Chloroprocaine? short/long acting? lipophilicity? Toxicity is? toxicity would be increased by?
Chloroprocaine rapid onset/short acting moderate lipophilicity can be used at high concentrations with low toxicity plasma cholinesterase deficiency
What drug can be made using the preservative methylparaben
Chloroprocaine
methylparaben is bad why
neural inflammation
what ester LA is the longest acting
why?
tetracaine
highly lipophilic
Tetracaine is excellent for ?
topical anesthetic
tetracaine is used for _____ but not ____
spinals but not epidural
which LA ester has high protein binding
Tetracaine
this drug would be used for ophthalmic and topical anesthesia
cocaine
cocaine at what speed dissociates from the NA channel
slowly
this ester LA would be used for pain control and gagging
cetacaine
benzocaine butamben, tetracaine
this drug is approved for mucous membranes for ENT procedures
cetacaine
benzocaine butamben, tetracaine
this drug is banana colored and flavored and used as a spray
cetacaine
benzocaine butamben, tetracaine
only spray cetacaine
benzocaine butamben, tetracaine for ____seconds
___second sprays contraindicated
1
2
This is the longest acting amide LA
why?
bupivacaine
high lipophilicity
This is the most commonly used LA
Lidocaine
Lidocaine
short/long acting?
lipophilicity?
moderate lipophilicity
medium duration of action
This drug has a higher therapeutic index than bupivacaine R/T lower Cardiac and CNS toxicity
lidocaine
Acidosis increases the toxicity of this drug due to decreased plasma protein binding
lidocaine
this drug has properties similar to lidocaine but lower lipophilicity
prilocaine
this drug isn’t used often due to risk of methemoglobinemia
Prilocaine
This preparation of this drug is banned by the FDA for obstetrics
0.75% bupivacaine
this drug has a high risk of cardiac toxicity due to fast on slow off the heart and binds more avidly and longer than lidocaine
bupivacaine
The S enantiomer of bupivacaine that is less CNS and cardiac toxic
levobupivacaine
the patient may not see aura of CNS toxicity prior to CV collapse if using this drug
bupivacaine
this is a less potent S enantiomer, moderate lipophilic, reduced CV toxic than bupivacaine, but less potent
ropivacaine
used extensively for epidural and regional peripheral blocks, but not approved for spinal anesthesia
ropivacaine
ester LA in order least to most lipophilic
3
procaine/novocain
Chloroprocaine
Tetracaine
