Ocular Anesthetics- For Exam 2

Question 1

(broad) drugs causing reversible blockage of the conduction of a nerve fiber, by limiting sodium ion permeability by closing pores through which the ions migrate in the lipid layer of the nerve cell membrane

Answer 1

topical anesthetics

Question 2

Anesthetic drug that is not synthetic - natural

Answer 2

cocaine

Question 3

Deriviatives from PABA, metabolized by hydrolysis

Answer 3

Esters - cocaine, proparacaine (sx), chloroprocaine (sx), tetracaine, benoxinate, procaine

Question 4

Derivative from aniline, metabolized by liver and excreted in urine, highly water soluble

Answer 4

Amines (usually injections)- lidocaine (sx), mepivacaine (sx), bupivacaine (sx)

Question 5

anesthetic used for minor ANTERIOR SEGMENT procedures

Answer 5

Lidocaine

Question 6

pH for anesthetics

Answer 6

8-9, contributes to stability and shelf life

Question 7

Used by surgeons to cause vasoconstriction during surgery to enhance action of anesthetics

Answer 7

Epinephrine

Question 8

affinity, concentration, quantity, mode, speed

Answer 8

factors affecting anesthetic potential

Question 9

Mode used for facial nerve block, retrobulbar or peribulbar anesthesia, eyelid infiltration

Answer 9

Injectable

Question 10

Mode used for Gonio, Tono, and pretty much everything else in clinic requiring prolonged contact

Answer 10

Topical

Question 11

renal impairment is a warning for which anesthetic

Answer 11

Mepivacaine

Question 12

Hepatic function is a warning in which group of anesthetics

Answer 12

amines

Question 13

Anesthetic Drug contraindicated in children due to its strength

Answer 13

Bupivacaine

Question 14

Ester of MABA, 0.5% solution, works fast, lasts 20 min. most commonly used in clinic- tono, SE transient irritation, stinging, delayed tissue healing, erosion of eye is dry - Take IOP after refraction, allergic reactions- exacerbate conjunctiva bullae in Steven’s Johnson Syndrome

Answer 14

Proparacaine HCL

Question 15

Ester of PABA, 0.5% solution, no anesthetic effect on sclera and can cause more allergic rxn than proparacaine SE: severe keratitis and erosion

Answer 15

Tetracaine HCL

Question 16

Ester of PABA, similiar to propa and tetra, .4%, 0.35%- RGP fitting, slight risk of pseudomonas infection, SE transient burning, less toxic than propa, less allergic rxn

Answer 16

Benoxinate

Question 17

Amino amide, 3.5% viscous topical ocular anesthetic gel, 20-60 sec, lasts 5 to 30 min, 2 drops, used for all diagnostic and minor invasive therapeutic procedures where enhanced anesthesia is desired

Answer 17

Lidocaine

Question 18

Indirect sympathomimetic natural alkaloid, vasoconstrictor, force duction test, epithelial debridement (viral removal), nasal spray for dacryocystorhinostomy, causes pupil dilation

Answer 18

Cocaine

Question 19

Retrobulbar Injectable amino amide, most common for extensive retinal/cataract ocular surgeries, kidney function monitored, lasts 4 to 12 hours without epinephrine, high toxicity, better on all ocular tissues, Topical uses: superficial conj. lesions, FB removal, Suture removal, pterygium removal, SE erosions, keratitis, permanent corneal opacification

Answer 19

Bupivacaine