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AS - N931 Advanced Principles of Anesthesia > Local Anesthetics & Nerves > Flashcards

Local Anesthetics & Nerves Flashcards

1
Q

Esters

A

Plasma/tissue cholinesterase metabolism via hydrolysis (rapid) → shorter-acting
*Atypical cholinesterase ↑toxicity risk

↑allergy potential & cross-reactivity
Patient w/ ester allergy = avoid all ester local anesthetics

Procaine, Chloroprocaine, & Tetracaine

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2
Q

Procaine pKa

A

8.9

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3
Q

Procaine % Ionized

A

97%

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4
Q

Procaine Protein Binding

A

6%

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5
Q

Procaine Onset

A

Slow

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6
Q

Procaine DOA

A

60-90min

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7
Q

Procaine Max Dose w/o Epi

A

12mg/kg IBW

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8
Q

Chrloroprocaine Onset

A

FAST

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9
Q

Chloroprocaine DOA

A

30-60min

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10
Q

Chloroprocaine Max Dose w/o Epi

A

11mg/kg

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11
Q

Chloroprocaine Max Dose w/ Epi

A

14mg/kg

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12
Q

Tetracaine pKa

A

8.5

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13
Q

Tetracaine % Ionized

A

93%

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14
Q

Tetracaine Protein Binding

A

94%

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15
Q

Tetracaine Onset

A

Slow

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16
Q

Tetracaine DOA

A

180-600min

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17
Q

Tetracaine Max Dose w/o Epi

A

3mg/kg

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18
Q

Amides

A

Hepatic metabolism via CYP1A2 & CYP3A4 (slower) → longer-acting
Require transport to liver for metabolism
↑lipophilicity & protein binding

↓allergic reaction potential (extremely rare)
No cross-reactivity or between ester & amide agents

Lidocaine, Mepivacaine, Ropivacaine, & Bupivacaine

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19
Q

Lidocaine pKa

A

7.9

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20
Q

Lidocaine % Ionized

A

76%

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21
Q

Lidocaine Protein Binding

A

64%

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22
Q

Lidocaine Onset

A

FAST

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23
Q

Lidocaine DOA

A

90-120min

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24
Q

Lidocaine Max Dose w/o Epi

A

4mg/kg

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25
Lidocaine Max Dose w/ Epi
7mg/kg
26
Mepivacaine Onset
FAST
27
Mepivacaine DOA
120-240min
28
Mepivacaine Max Dose w/o Epi
4mg/kg
29
Mepivacaine Max Dose w/ Epi
7mg/kg
30
Prilocaine Max Dose w/o Epi
7mg/kg
31
Prilocaine Max Dose w/ Epi
8.5mg/kg
32
Ropivacaine Onset
Slow
33
Ropivacaine DOA
180-600min
34
Ropivacaine Max Dose w/o Epi
3mg/kg
35
Bupivacaine pKa
8.1
36
Bupivacaine % Ionized
83%
37
Bupivacaine Protein Binding
95%
38
Bupivacaine Onset
Slow
39
Bupivacaine DOA
180-600min
40
Bupivacaine Max Dose w/o Epi
3mg/kg
41
Type A Nerve Fibers
Alpha α Beta β Gamma γ Delta Δ
42
Type A Alpha Function
Proprioception & motor
43
A Alpha Diameter
6-22μm
44
A Alpha Myelination
Heavy
45
A Alpha Block Onset
Last
46
Type A Beta Function
Touch & pressure
47
A Beta Diameter
6-22μm
48
A Beta Myelination
Heavy
49
A Beta Block Onset
Intermediate
50
Type A Gamma Function
Muscle tone
51
A Gamma Diameter
3-6μm
52
A Gamma Myelination
Heavy
53
A Gamma Block Onset
Intermediate
54
Type A Delta Function
Pain, cold temperature, & touch
55
A Delta Diameter
1-5μm
56
A Delta Myelination
Heavy
57
A Delta Block Onset
Intermediate
58
Type B Function
Pre-ganglionic autonomic vasomotor
59
B Diameter
< 3μm
60
B Myelination
Light
61
B Block Onset
Early | 1st
62
Type C Sympathetic Function
Post-ganglionic vasomotor
63
C Sympathetic Diameter
0.3-1.3μm
64
C Sympathetic Myelination
None
65
Type C Dorsal Root Function
Pain, warm & cold temperature, & touch
66
C Dorsal Root Diameter
0.4-1.2μm
67
C Dorsal Root Mylelination
None
68
C Dorsal Root Block Onset
Early

AS - N931 Advanced Principles of Anesthesia (17 decks)

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