Neuraxial Review Part 2- LA pharmacology Flashcards
Esters include
procaine
chloroprocaine
tetracaine
Amides include
lidocaine
mepivacaine
ropivacaine
bupivacaine
The quickest onset ester is
chloroprocaine
The quickest onset amides are
lidocaine
mepivacaine
The pKa, %ionized, protein binding, onset, and DOA of procaine is
8.9 97% 6% onset- slow DOA: 60-90
The onset & DOA of chloroprocaine is
onset: fast
DOA: 30-60 minutes
The pKa, % ionized, % protein binding, onset, & DOA of tetracaine is
pKa- 8.5 % ionized: 93% 94% onset: slow DOA: 180-600
The pKA, % ionized, % protein binding, onset, & DOA of lidocaine is
pKa 7.9 % ionized: 76% 64% onset: fast DOA: 90-120
The onset & DOA of mepivacaine is
fast
DOA: 120-140
The onset & DOA of ropivacaine is:
slow
DOA: 180-600
The pKa, % ionized, % protein binding, onset, & DOA of bupivacaine is
8.1 83% 95% slow DOA 180-600
Dexmedetomidine dosing for a spinal and epidural are
spinal: 5 mcg
epidural: 20-50 mcg
Side effects of dexmedetomidine intrathecally are
profound hypotension (used in conjunction with an opioid) prolonged block
Describe the dose, onset, and DOA of duramorph
dose: 0.1-0.25 mg with LA
onset: 60-90 minutes
DOA: 24 hours
Adverse effects of duramorph include
itching
urinary retention
delayed respiratory depression*****
Describe the dose, onset, & duration of fentanyl
dose: 12.5-25 mcg mixed with LA
onset: 5-10 minutes
duration: 2-4 hours
The dose of epinephrine is
0.1-0.2 mL of 1: 1000 can bee added to prolong block
Clonidine can be used when
epinephrine is contraindicated
when mixed with lidocaine or bupivacaine has synergistic effects
central action to help with tourniquet pain
