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Ocular Pharmacology > Packet 4: Ocular Anesthetics > Flashcards

Packet 4: Ocular Anesthetics Flashcards

1
Q

Novocain: Other name

A

Procaine

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2
Q

esters are broken down by ?

A

pseudocholinesterase: in most tissues

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3
Q

amides are broken down by?

A

liver

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4
Q

benoxinate:

A

esters of PARA-amino benzoic

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5
Q

tetracaine:

A

ester of PARA- amino benzoic

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6
Q

Proparacaine:

A

ester of META

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7
Q

Lidocaine: ester or amide?

A

Amide

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8
Q

xylocaine:

A

lidocaine

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9
Q

other name for lidocaine:

A

xylocaine & akten

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10
Q

what percentage can be used for procaine?

A

.5%

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11
Q

what percentage can be used for benzocaine?

A

20-30%

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12
Q

where do LA work?

A

INSIDE the cell:

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13
Q

what do LA do?

A

block the Na+ channel = no cell membrane depolarization

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14
Q

order of loss of sensation:

A

pain, temp, touch (vibration), pressure, motor

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15
Q

what is the order to recover?

A

motor, pressure, touch, temp, pain

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16
Q

what effects differential sensitivity?

A

more sensitive:

  • unmylentated,
  • smaller neurons (diameter)
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17
Q

2 things to use LA for (that are not obvious)

A

funds cl exam & electroretinography

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18
Q

what is ionizable?

A

N group

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19
Q

does combining two LA’s increase effectiveness?

A

No, combining will not increase their effect beyond additive

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20
Q

max concentration for proparacine:

A

.5%

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21
Q

max conc. for benoxinate?

A

.5%: but not really used

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22
Q

max conc. for tetracaine?

A

1% - but not commercially used at this dosage

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23
Q

max conc. for cocaine?

A

20% - but not commercially used at this dosage

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24
Q

what conc is benoxiate used at ?

A

.4% commercially, but .5% max

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25
Q

when will the LA be less effective?

A

if there is inflammation and we have a more acidic environment or if inflamed conj so more is pulled into the conj systemically

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26
Q

LA are bad to use with schemer’s. why?

A

because it decreases tear secretion up to 40% but the lid margins are still sensitive so it could increase tear flow = difficult to interpret.

27
Q

T/F: we can use LA to treat long term abrasion?

A

False, this decreases healing and an ulcer can develop at the site of original damage

28
Q

when can we see folds in descemets?

A

epithelial toxicity: usually 1 per 1000

29
Q

when do we see more epi damage?

A

above 50

30
Q

when will healing start again after using LA?

A

usually 30 minutes

31
Q

what allergic hypersensitivity can you see with LA?

A

type 4: delayed allergic hypersensitivity

32
Q

T/F: no systemic allergic reactions have been reported after topical ocular use?

A

True

33
Q

LA’s are ?

A

Central Depressant Drugs

34
Q

what do central depressants show up like?

A

1st: excitatory
2nd: depressive

35
Q

what dose should you not exceed with tetracaine?

A

5 mg

36
Q

what dose should you knot exceed with proparaciane?

A

10 mg

37
Q

T/F more concentrations will linearly increase toxicities?

A

FALSE: toxicities are geometric progression, more than linearly

38
Q

when should you use LA’s more conservatively?

A

with myasthenia graves and glaucoma

39
Q

Take culture before/after LA?

A

BEFORE

40
Q

what LA’s are preserved with cholobutanol?

A

tetracaine, benoxinate

41
Q

what is cocaine preserved with?

A

nothing

42
Q

what is proparacine hydrochloride preserved with ?

A

benzakonium chloride

43
Q

what is proparacine hydrochloride with fluorescein sodium preserved with?

A

thimerosol

44
Q

what is fluress?

A

benoxinate hydrochloride with fluorescein sodium

45
Q

which is a prototype drug?

A

tetracaine

46
Q

which has the least irritation?

A

proparacaine

47
Q

ophthaine: other name

A

proparacaine

48
Q

proparacaine: other name

A

ophthaine

49
Q

is allergy common or uncommon with tetracaine?

A

uncommon

50
Q

propane with fluorescein is preserved with?

A

thimerosal

51
Q

who has a greater response with LA? older or younger

A

above 40 = even .125% was therapuetic

52
Q

which is a good bactericidal?

A

benoxinate

53
Q

what is fluress?

A

benoxinate with flouresceine preserved with benzokonium chloride

54
Q

akten: other name

A

lidocaine

55
Q

which is used as a gel?

A

lidocaine

56
Q

lidocaine available in what form?

A

3.5% gel formulation

57
Q

onset time of lidocaine gel?

A

60 seconds

58
Q

cross reaction of lidocaine with esters?

A

no because lidocaine is an amide

59
Q

how is cocaine available?

A

4& and 10% solutions for topical use

60
Q

which is most toxic to the cornea?

A

cocaine

61
Q

does epi work with epinephrine?

A

no benefit in longer acting i.e. bupivacaine

62
Q

hyaluronidase: what does it do

A

use when treating larger area with lots of connective tissue and it will break down intersitiatl matrix and make more effectiveness in that area.

63
Q

epipherine: what does it do to chances of systemic toxicities?

A

decreases them; because less gets out into the systemic area

64
Q

____ metabolism is slowed with AchE inhibitors

A

Esters

Ocular Pharmacology (6 decks)

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