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N929: Advanced Pharmacology > Nerve & Local Anesthetics focused > Flashcards

Nerve & Local Anesthetics focused Flashcards

1
Q

Function of type A fibers

A

alpha- proprioception, motor

beta- touch, pressure

gamma- muscle tone

delta- pain, cold temp, touch

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2
Q

Function of type B fibers

A

preganglionic autonomic vasomotor (SNS)

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3
Q

Function of type C fibers

A 
Postganglionic vasomotor (SNS)
pain, warm, cold temp, touch (dorsal root)
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4
Q

Which types of fibers are myelinated?

A

Type A have HEAVY myelination

Type B have light myelination

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5
Q

Which types of fibers are unmyelinated?

A

Type C fibers

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6
Q 
What is the diameter of type A fibers:
Alpha:
Beta:
Gamma:
Delta:
A

Alpha - 6-22mm

Beta - 6-22mm

Gamma - 3-6mm

Delta - 1-5mm

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7
Q

What is the diameter of type B fibers?

A

<3mm

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8
Q

What is the diameter of type C fibers?

A

SNS - 0.3-1.3mm

Dorsal root - 0.4-1.2mm

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9
Q 
What is the block onset of type A fibers:
Alpha:
Beta:
Gamma:
Delta:
A

Alpha - Last

Beta - Intermediate

Gamma - Intermediate

Delta - Intermediate

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10
Q

What is the block onset of type B fibers?

A

Early

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11
Q

What is the block onset of type C fibers?

A

Early

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12
Q

What are the 4 subtypes of type A fibers?

A

Alpha
Beta
Gamma
Delta

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13
Q

What type of fibers are blocked first?

A

Type B

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14
Q

What are 5 ester local anesthetics?

A 
procaine
chloroprocaine
tetracaine
cocaine
benzocaine
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15
Q

What are 6 amide local anesthetics

A 
lidocaine
mepivacaine
prilocaine
bupivacaine
ropivacaine
articaine
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16
Q

Maximum dose of lidocaine

A

4mg/kg

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17
Q

Maximum dose of Mepivacaine

A

4mg/kg

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18
Q

Maximum dose of Bupivacaine

A

3mg/kg

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19
Q

Maximum dose of Ropivacaine

A

3mg/kg

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20
Q

Maximum dose of Procaine

A

12mg/kg

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21
Q

Maximum dose of Chloroprocaine

22
Q

Maximum dose of Prilocaine

23
Q

Maximum dose of tetracaine

24
Q

Maximum dose of lidocaine with epinephrine

25
Q

Maximum dose of mepivacaine with epinephrine

26
Q

Maximum dose of bupivacaine with epinephrine

27
Q

Maximum dose of ropivacaine with epinephrine

28
Q

Maximum dose of procaine with epinephrine

29
Q

Maximum dose of chloroprocaine with epinephrine

30
Q

Maximum dose of prilocaine with epinephrine

31
Q

Maximum dose of tetracaine and epinephrine

32
Q

What is the pKa, ionized %, and protein binding % of procaine?

A

pKa 8.9
97% ionized
6% protein binding

33
Q

What is the pKa, ionized %, and protein binding % of tetracaine?

A

pKa 8.5
93% ionized
94% protein binding

34
Q

What is the pKa, ionized %, and protein binding % of lidocaine?

A

pKa 7.9
76% ionized
64% protein binding

35
Q

What is the pKa, ionized %, and protein binding % of bupivacaine?

A

pKa 8.1
83% ionized
95% protein binding

36
Q

Duration of action of procaine

37
Q

Duration of action of chloroprocaine

38
Q

Duration of action of tetracaine

A

180-600min

3-10H

39
Q

Duration of action of lidocaine

40
Q

Duration of action of mepivacaine

A

120-240min

2-4H

41
Q

Duration of action of ropivacaine

A

180-600min

3-10H

42
Q

Duration of action of bupivacaine

A

180-600min

3-10H

43
Q

What patients should NOT get prilocaine?

A

< 6yo
pregnant women
patients taking oxidizing drugs

44
Q

What is the treatment for methemoglobinemia from prilocaine?

A

methylene blue 1-2mg/kg over 3-10 minutes

45
Q

What can prilocaine cause?

A

methemoglobinemia d/t metabolite o-toluidine

46
Q

Effect of lidocaine plasma concentration 1-5mcg/mL

47
Q

Effect of lidocaine plasma concentration 5-10mcg/mL

A 
circumoral numbness
tinnitis
skeletal muscle twitching
systemic hypotension
myocardial depression
48
Q

Effect of lidocaine plasma concentration 10-15mcg/mL

A

seizures

unconsciousness

49
Q

Effect of lidocaine plasma concentration 15-25mcg/mL

A

apnea

coma

50
Q

Effect of lidocaine plasma concentration of >25mcg/mL

A

cardiovascular depression

N929: Advanced Pharmacology (6 decks)

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