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Pharmacology 1 > Local Anesthetics Dosages > Flashcards

Local Anesthetics Dosages Flashcards

1
Q

Chloroprocaine alternate name:

A

Nesicaine

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2
Q

Chloroprocaine structure

A

ester local anesthetic

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3
Q

Chloroprocaine MOA:

A
  1. Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
  2. Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
  3. Inhibit cardiac channels
  4. Block nerve conduction (autonomic, somatic sensory & motor)
  5. Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
  6. Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
  7. Easiest to block C, B A delta, A gamma, A beta, A alpha (in that order)
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4
Q

Chloroprocaine Onset:

A

6-12 min

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5
Q

Chloroprocaine pKa:

A

9.1

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6
Q

Chloroprocaine duration of action:

A

30-60 min

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7
Q

Chloroprocaine PB:

A

0%

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8
Q

Chloroprocaine Metabolism:

A

Hydrolyzed by plasma cholinesterase to inactive metabolites: 2-chloro-aminobenzoic acid and 2-diethylaminoethanol (which inhibit the action of the sulfonamides)

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9
Q

Chloroprocaine max dose plain:

A

11 mg/kg (800 mg max)

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10
Q

Chloroprocaine max dose with epi:

A

14 mg/kg (1000 mg max)

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11
Q

Chloroprocaine infiltration Brachial plexus dose:

A

30-40 mL

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12
Q

Chloroprocaine digital w/o epi dose:

A

3-4 mL

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13
Q

Chloroprocaine side effects:

A
  1. C - CNS Toxicity
  2. A - Arrhythmias
  3. L - Loss of pain
  4. L - Loss of proprioception
  5. L - Loss of movement
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14
Q

Chloroprocaine contraindications / cautions:

A
  1. L - LAST (anxiety, tinnitus, seizure)
  2. A - Allergy
  3. S - Seizures
  4. T - Tissue Damage
  5. T - Transient Neurologic symptoms
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15
Q

Lidocaine alternate name:

A

Xylocaine

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16
Q

Lidocaine structure:

A
  1. Amide – benzine ring and piperidine ring connected by an amide bond
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17
Q

Lidocaine MOA:

A
  1. Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
  2. Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
  3. Inhibit cardiac channels
  4. Block nerve conduction (autonomic, somatic sensory & motor)
  5. Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
  6. Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
  7. Easiest to block C, B A delta, A gamma, A beta, A alpha (in that order)
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18
Q

Lidocaine Onset:

A

5-10 min

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19
Q

Lidocaine pKa:

A

7.9

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20
Q

Lidocaine duration of action:

A

0.5-3 hr

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21
Q

Lidocaine PB:

A

70%

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22
Q

Lidocaine metabolism:

A

Liver CYP450 – metabolite monoethylglycinexylidide is responsible for antiarrhythmic properties even after infusion discontinuation

23
Q

Lidocaine w/o epi max dose:

A

4.5 mg/kg (max 300 mg)

24
Q

Lidocaine with epi max dose:

A

7 mg/kg (max 500 mg)

25
Q

Lidocaine Attenuate SNS dose:

A

1-1.5 mg/kg

26
Q

Lidocaine Arrhythmia dose:

A

2 mg/kg bolus followed by
1-4mg/min infusion

27
Q

Lidocaine arrest dose:

A

3 mg/kg Q 3-5 min

28
Q

Lidocaine pain dose:

A

1-3 mg/kg/hr (IBW)

29
Q

Lidocaine side effects:

A
  1. C - CNS Toxicity
  2. A - Arrhythmias
  3. L - Loss of pain
  4. L - Loss of proprioception
  5. L - Loss of movement
30
Q

Lidocaine Contraindications / cautions:

A
  1. L - LAST (anxiety, tinnitus, seizure)
  2. A - Allergy
  3. S - Seizures
  4. T - Tissue Damage
  5. T - Transient Neurologic symptoms
31
Q

Bupivacaine alternate name:

A

Marcaine

32
Q

Bupivacaine structure:

A

~ Amide - benzine ring and ~ piperidine ring connected by an amide bond
~ Racemic mixture

33
Q

Bupivacaine MOA:

A

. Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
2. Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
3. Inhibit cardiac channels
4. Block nerve conduction (autonomic, somatic sensory & motor)
5. Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
6. Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
7. Easiest to block C, B A delta, A gamma, A beta, A alpha (in that order)

34
Q

Bupivacaine Onset:

A

5-10 min

35
Q

Bupivacaine pKa:

A

8.1

36
Q

Bupivacaine duration of action:

A

2-12 hr

37
Q

Bupivacaine PB:

A

95%

38
Q

Bupivacaine metabolism:

A

Liver CYP3A4

39
Q

Bupivacaine w/o epi max dose:

A

2.5 mg/kg (max 175 mg)

40
Q

Bupivacaine with epi max dose:

A

3 mg/kg (max 225 mg)

41
Q

Bupivacaine side effects:

A
  1. C - CNS Toxicity
  2. A - Arrhythmias
  3. L - Loss of pain
  4. L - Loss of proprioception
  5. L - Loss of movement
42
Q

Bupivacaine Contraindications / cautions:

A
  1. L - LAST (anxiety, tinnitus, seizure)
  2. A - Allergy
  3. S - Seizures
  4. T - Tissue Damage
  5. T - Transient Neurologic symptoms
43
Q

Ropivacaine alternate name:

A

Naropin

44
Q

Ropivacaine structure:

A

~ Amide – benzine ring and piperidine ring connected by an amide bond
~ Pure S enantiomer

45
Q

Ropivacaine MOA:

A
  1. Reversibly block Voltage Gated Na channels- lipid soluble portion crosses lipid bilayer, while the water-soluble portion binds internally to the Na channel- this prevents propagation of AP
  2. Interrupt nerve impulse conduction (at least 3 nodes of ranvier)
  3. Inhibit cardiac channels
  4. Block nerve conduction (autonomic, somatic sensory & motor)
  5. Potency dependent on solubility, onset dependent on pKa, duration dependent on protein binding
  6. Will lose sympathetic, pain, temp, proprioception, touch, pressure, motor (in that order & will recover in reverse)
  7. Easiest to block C, B A delta, A gamma, A beta, A alpha (in that order)
46
Q

Ropivacaine Onset:

A

10-20 min

47
Q

Ropivacaine pKa:

A

8.1

48
Q

Ropivacaine duration of action:

A

2-8 hr

49
Q

Ropivacaine PB:

A

94% mainly to alpha-1-acid glycoprotein

50
Q

Ropivacaine metabolism:

A

CYP3A4

51
Q

Ropivacaine infiltration plain max dose:

A

3mg/kg (200 mg max)

52
Q

Ropivacaine side effects:

A
  1. C - CNS Toxicity
  2. A - Arrhythmias
  3. L - Loss of pain
  4. L - Loss of proprioception
  5. L - Loss of movement
53
Q

Ropivacaine Contraindications / cautions:

A
  1. L - LAST (anxiety, tinnitus, seizure)
  2. A - Allergy
  3. S - Seizures
  4. T - Tissue Damage
  5. T - Transient Neurologic symptoms

Pharmacology 1 (12 decks)

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