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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
Q

Lidocaine Max Dose w/ Epi

A

7mg/kg

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26
Q

Mepivacaine Onset

A

FAST

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27
Q

Mepivacaine DOA

A

120-240min

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28
Q

Mepivacaine Max Dose w/o Epi

A

4mg/kg

29
Q

Mepivacaine Max Dose w/ Epi

A

7mg/kg

30
Q

Prilocaine Max Dose w/o Epi

A

7mg/kg

31
Q

Prilocaine Max Dose w/ Epi

A

8.5mg/kg

32
Q

Ropivacaine Onset

A

Slow

33
Q

Ropivacaine DOA

A

180-600min

34
Q

Ropivacaine Max Dose w/o Epi

A

3mg/kg

35
Q

Bupivacaine pKa

A

8.1

36
Q

Bupivacaine % Ionized

A

83%

37
Q

Bupivacaine Protein Binding

A

95%

38
Q

Bupivacaine Onset

A

Slow

39
Q

Bupivacaine DOA

A

180-600min

40
Q

Bupivacaine Max Dose w/o Epi

A

3mg/kg

41
Q

Type A Nerve Fibers

A

Alpha α
Beta β
Gamma γ
Delta Δ

42
Q

Type A Alpha Function

A

Proprioception & motor

43
Q

A Alpha Diameter

A

6-22μm

44
Q

A Alpha Myelination

A

Heavy

45
Q

A Alpha Block Onset

A

Last

46
Q

Type A Beta Function

A

Touch & pressure

47
Q

A Beta Diameter

A

6-22μm

48
Q

A Beta Myelination

A

Heavy

49
Q

A Beta Block Onset

A

Intermediate

50
Q

Type A Gamma Function

A

Muscle tone

51
Q

A Gamma Diameter

A

3-6μm

52
Q

A Gamma Myelination

A

Heavy

53
Q

A Gamma Block Onset

A

Intermediate

54
Q

Type A Delta Function

A

Pain, cold temperature, & touch

55
Q

A Delta Diameter

A

1-5μm

56
Q

A Delta Myelination

A

Heavy

57
Q

A Delta Block Onset

A

Intermediate

58
Q

Type B Function

A

Pre-ganglionic autonomic vasomotor

59
Q

B Diameter

A

< 3μm

60
Q

B Myelination

A

Light

61
Q

B Block Onset

A

Early

1st

62
Q

Type C Sympathetic Function

A

Post-ganglionic vasomotor

63
Q

C Sympathetic Diameter

A

0.3-1.3μm

64
Q

C Sympathetic Myelination

A

None

65
Q

Type C Dorsal Root Function

A

Pain, warm & cold temperature, & touch

66
Q

C Dorsal Root Diameter

A

0.4-1.2μm

67
Q

C Dorsal Root Mylelination

A

None

68
Q

C Dorsal Root Block Onset

A

Early

AS - N931 Advanced Principles of Anesthesia (17 decks)

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