Midterm Flashcards
fastest conducting fiber of all nerve fibers?
A-Alpha
largest in diameter and most heavily myelinated
slowest of the A fibers?
Delta
fiber for motor function and proprioception?
A-Alpha
Fiber for motor function, touch, and pressure sensation?
A-Beta
Fiber for Muscle spindles and reflex?
A-Gamma
Fibers for pain and temperature sensation?
A-Delta
only fibers that are unmyelinated?
C fibers
Fibers that conduct pain and temperature impulses?
C fibers
A-Delta too?
which fibers are least sensitive to local anesthetics?
A-Alpha
which fibers are the most sensitive to LA?
C fibers
what property helps LA bind inside the nerve?
A tertiary Amine
What property makes the LA lipophilic?
Unsaturated aromatic ring system
how are Ester and amide structurally different?
intermediate carbon group - The linkage between the aromatic ring system and the tertiary Amine
(this is what makes the 2 different for metabolism and allergic reactions)
an addition of what structurally results in greater protein binding?
large chemical radicals
lipid potency correlates with what?
protein binding
LAST acronym
Local anesthetic systemic toxicity
first signs of toxicity
tachycardia, hypertension, psychically “off”
CNS more susceptible than CVS
most common drug for CVS toxicity?
Bupivicaine
what to do if toxicity occurs?
intralipid infusion, at least 20-30% lipids
largest drug incidence of TNS symptoms?
Lidocaine via nerve block
What is the Eutectic (EMLA) mix of LA consist of ?
Lido and Prilocaine
The termination of action of all induction drugs is what?
Redistribution
which induction drugs form active metabolites?
midazolam
ketamine
phospropofol
what opiates form active metabolites?
Morphine and Meperidine
which opioid can prolong QT
Methadone
which “fentanyl” has N/V S/E
remifentanyl
opiate tolerance dose?
60 mg/wk
