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Local Anesthesia > Module 9 > Flashcards

Module 9 Flashcards

0
Q

What one letter always comes before the suffix in Amide LA generic names?

A

i

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1
Q

All Amides end in what suffix?

A

Caine

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2
Q

What was the very first LA in dentistry?

A

Novacaine

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3
Q

What are two other names for Novacaine?

A

Procaine

Propoxycaine

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4
Q

What year did Amides take over?

A

1940

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5
Q

Generic Name: Articaine

What are the trade names it’s also known by?

A

SOAZ

Septocaine
Orabloc
Articadent
Zorcaine

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6
Q

Generic Name: Prilocaine

What are the trade names it’s also known by

A

Citanest

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7
Q

Generic Name: Lidocaine

What are the trade names it’s also known by

A

LOX

Lignospan
Octocaine
Xylocaine

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8
Q

Generic Name: Bupivicaine

What are the trade names it’s also known by

A

MV

Marcaine
Vivicaine

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9
Q

Generic Name: Mepivicaine

What are the trade names it’s also known by

A

PICS

Polocaine
Isocaine
Carbocaine
Scandanest

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10
Q

What problem does someone have who is allergic to Esters?

A

Atypical Plasma Cholinesterase

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11
Q

If someone has ever been diagnosed with Methhemoglobinemia what LA can we NOT use?

A

Prilocaine (Citanest)

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12
Q

If someone has significant cardiac problems what do we have to limit our use of?

A

Epinephrine

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13
Q

What two LA’s can we use without worry on someone with significant cardiac issues?

A

Mepivicaine 3% (plain)

Prilocaine 4%

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14
Q

If someone has clinical hyperthyroidism we have to stay away from what?

A

Racemic epinephrine gingival retraction cord

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15
Q

What are two types of LA someone can have an actual allergy to?

A

Esters

Bisulfites

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16
Q

If someone is allergic to Bisulfites what can we NOT give them?

A

LA with vasoconstrictors

Because it has to be mixed with Bisulfites to preserve it from expiring fast

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17
Q

What are 5 things that influence the duration if LA?

A 
Type of injection 
Accuracy of injection technique
Status of oral tissue (infections)
Anatomical variations
Personal response (hypo/hyper)
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18
Q

What type of LA responder stays numb longer?

A

Hyper

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19
Q

Hypo responders do what?

A

Get un-numb fast

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20
Q

An infiltration injection is more commonly known as a?

A

Supraperiosteal

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21
Q

If you give someone LESS than the recommended dose of LA you will have a ——– duration?
What if you gave them MORE than the recommended dose?

A

Shorter

No change in duration but a higher chance of toxicity

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22
Q

What is the #1 reason for a FAILED attempt to get someone numb?

A

Bad Deposition Location

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23
Q

If someone presents with an infection, inflamed tissues, or pain before they get an injection what two aspects of the LA will be decreased? Why?

A

Depth (how far into the nerve it penetrates)
Duration (time length it lasts)

Because there is an increase in vascularity so anesthetic is removed from the site of deposition faster

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24
Q

What is the second most common reason for a failure to anesthetize a patient?

A

Pt anatomy

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25
Q

The % listed on a carpule
(Ie: 2% Lidocaine) tells you the
——– of LA in that carpule?

A

Concentration in mg/ml of solution

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26
Q

To figure out how much DRUG is in 1 full carpule of anesthetic you take the ——— X ———-?

A

Concentration X 1.8ml/carpule

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27
Q

How much DRUG is in 1 carpule of 2% Lidocaine?

A

20mg/ml X 1.8ml/carpule

36mg(drug)/carpule

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28
Q

What is the concentration (mg/ml) for Prilocaine?

A

40mg/ml

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29
Q

What is the concentration (mg/ml) for Lidocaine?

A

20mg/ml

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30
Q

What is the concentration (mg/ml) for Mepivicaine

A

30mg/ml

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31
Q

What is the concentration (mg/ml) for Articaine

A

40mg/ml

32
Q

What is the concentration (mg/ml) for Bupivicaine

A

5mg/ml

33
Q

Mepivicaine is most commonly sold at a —–% or known as plain! What other concentration is it sold in?

A

3%

2% with vasoconstrictor

34
Q

Mepivicaine 2% has ———- as it’s vasoconstrictor?

A

Levonordefrin

35
Q

What is the ration of Levonordefrin in a carpule of Mepivicaine 2%
Why?

A

1:200,000

Very weak vasoconstrictor so you have to have a lot in it!!!

36
Q

How many mg/ CARPULE?

Orabloc

A

72mg/carpule

37
Q

How many mg/ CARPULE?

Isocaine

A

54mg/ml

38
Q

How many mg/ CARPULE?

Vivicaine

A

9mg/carpule

39
Q

How many mg/ CARPULE?

Octocaine

A

36mg/carpule

40
Q

How many mg/ CARPULE?

Citanest

A

72mg/carpule

41
Q

What dose MRD stand for?

A

Max Recommended Dose

42
Q

What does ASA stand for?

A

American Society of Anesthesiologists

43
Q

What are 3 categories of patients who we should decrease the MRD for?

A

Debilitated
Elderly
Medically compromised
(ASA 3/4)

44
Q

Why would you use Lidocaine 2% with 1:50,000 Epi?

A

For hemostasis

45
Q

What are two groups of Epi “sensitive” patients?

A

Cardiovascular patients

Clinical Hyperthyroid patients

46
Q

How much epinephrine can a Epi “sensitive” patient receive?

What is the Epi MRD

A

0.04mg

47
Q

How much epinephrine is in a cartridge with 1:100,00 Epi?

A

0.018mg

48
Q

What is the allowable mg/lb

(of body weight) for Prilocaine

A

3.6mg/lb

49
Q

What is the allowable mg/lb

(of body weight) for Scandanest

A

3.0mg/lb

50
Q

What is the allowable mg/lb

(of body weight) for Zorcaine

A

3.2mg/ml

51
Q

What is the allowable mg/lb

(of body weight) for Marcaine

A

0.9mg/lb

52
Q

What is the allowable mg/lb

(of body weight) for Lignospan

A

3.2mg/lb

53
Q

What LA’s have a 3.2mg/lb allowance?

A

Articaine

Lidocaine

54
Q

Lost the LA generic names from highest to lowest allowable mg/lb ratio?

A

Prilocaine. 3.6
Articaine and Lidocaine. 3.2
Mepivicaine. 3.0
Bupivicaine 0.9

55
Q

List the LA’s from lowest to highest MRD?

A 
Bupivicaine.      90
Mepivicaine.    400
Lidocaine.        500
Prilocaine         600
Articaine.          NA
56
Q

What is the MRD for Articadent

A

NA

57
Q

What is the MRD for Prilocaine

A

600

58
Q

What is the MRD for Polocaine

A

400

59
Q

What is the MRD for Bupivicaine

A

90

60
Q

What is the MRD for Xylocaine

A

500

61
Q

If you start with Lidocaine and switch to Mepivicaine which MRD would you stop at? Why?

A

Mepivicaine

Always go with the smaller MRD of the two!!!

62
Q

Prilocaine can be used on —– sensitive patients?

A

Epi

63
Q

One of the disadvantages of Prilocaine is?

A

Reduces O2 carrying ability due to carbon dioxide end product

64
Q

Prilocaine is hydrolyzed by?

A

Hepatic amidases

65
Q

What LA should we NEVER use for nerve blocks?

A

Articaine

66
Q

What makes Articaine so different from other Amides?

A

It is a hybrid between an Ester and an Amide

67
Q

Which LA is 4 times as potent as Lidocaine?

A

Bupivicaine

68
Q

What procedures do dentists opt to use Bupivicaine? Why?

A

Oral surgery

Lessen the need for opioid pain killers after surgery because they stay numb for so long!!

69
Q

Topical anesthetic are of what class?

A

Esters

70
Q

What is the name of the most popular topical anesthetic?

A

Benzocaine

71
Q

Topical anesthetics have a ——- concentration than injectables?

A

Higher

72
Q

Topical anesthetics diffuse through ——– membranes how far?

A

Mucous

2-3mm

73
Q

What is a side effect of topical anesthetics being so highly concentrated?

A

Higher chance of toxicity

74
Q

Topical anesthetics are ——- in water and are absorbed ——?

A

Insoluble

Slowly

75
Q

What does EMLA stand for?

A

Eutetic Mixture of Local Anesthetics

76
Q

What is an EMLA made up of?

A

Lidocaine and Prilocaine

77
Q

What is one BIG advantage of EMLA’s

A

Can soak through intact skin giving pupal anesthesia for a short time frame

Local Anesthesia (7 decks)

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