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FreakinLOCALanesthesia!!! > Part 3-Anesthetic AgentsONE > Flashcards

Part 3-Anesthetic AgentsONE Flashcards

1
Q

IN THIS COUNTRY! we only inject _____ type LAs

A

amide

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2
Q

IN THIS COUNTRY! we use _____ type LAs for topical purposes

A

ester

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3
Q

How long do short acting anesthetics last?

A

20-40 min

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4
Q

How long do intermediate acting anesthetics last?

A

up to 70 min

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5
Q

How long do long acting anesthetics last?

A

up to 8 freakinnnn hours man

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6
Q

Please tell me the duration of action: Lidocaine 2%

A

short

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7
Q

Please tell me the duration of action: Mepivacaine 3%

A

short

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8
Q

Please tell me the duration of action: Prilocaine 4% (infiltration)

A

short

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9
Q

Please tell me the duration of action: Prilocaine 4% (nerve block)

A

intermediate

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10
Q

Please tell me the duration of action: Lidocaine 2% with epinephrine 1:50,000

A

intermediate

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11
Q

Please tell me the duration of action: Lidocaine 2% with epinephrine 1:100,000

A

intermediate

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12
Q

Please tell me the duration of action: Mepivacaine 2% with levonordefrin 1:20,000

A

intermediate

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13
Q

Please tell me the duration of action: Articaine 4% with epinephrine 1:100,000

A

intermediate

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14
Q

Please tell me the duration of action: Articaine 4% with epinephrine 1:200,000

A

intermediate

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15
Q

Please tell me the duration of action: Prilocaine 4% with epinephrine 1:200,000

A

intermediate

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16
Q

Please tell me the duration of action: Bupivacaine 0.5% with epinephrine 1:200,000

A

Long

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17
Q

What are the 4 factors in selecting a LA agent?

A

1.Length of time needed 2.post-tx pain control 3.hemostasis 4.possible contraindications

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18
Q

_________ = effect lasts beyond what is expected

A

Hyper-responders

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19
Q

__________ = effect dissipates quickly

A

Hypo-responders

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20
Q

What is a hypo-responder NOT attributed to?

A

not related biotrans/elimination…just a receptor reaction

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21
Q

Deposition ________ to nerve provides GREATER depth and duration

A

CLOSER

22
Q

Depth of anesthesia will be ______ in less vascular regions

A

GREATER

23
Q

_________ provides longer duration of both pulpal and soft tissue anesthesia compared to supraperiosteal infiltration

A

Nerve block

24
Q

Larger than recommended doses do NOT increase _______

A

DURATION…saturation principle

25
Q

What are our 2 BEST LAs for LONG duration? (post-op pain expected)….

A

1.bupivacaine 0.5% (8-12hr soft tissue) 2.Prilocaine 4% w/ 1:200,000 epi (5-8 hours soft tissue)

26
Q

What are 2 go-to’s for LAs with SHORT duration? (pets/IDs)….

A

1.mepivacaine 3% 2.prilocaine 4% (infiltration)…NOTICE no vasoconstrictor present

27
Q

How much epi should be in my LA if I am really shooting for HEMOstasis??

A

1:50,000 or 1:100,000 epi (do local infiltration)

28
Q

What are the only 2 ABSOLUTE contraindications we discussed in class to LAs?

A
  1. True, documented, reproducible allergy…very rare with amides 2.Cocaine use w/in 24 hrs
29
Q

For people with possible relative contraindications-have ___ different drugs of varying duration of action available.

A

2

30
Q

What was the FIRST synthetic LA? (generic and brand please)

A

pro-caine…NOVOcaine

31
Q

What LA produces the GREATEST vasodilation of all currently used LAs?

A

Procaine (novocaine)

32
Q

Does procaine have a high or low pKa? What does that mean for onset?

A

HIGH pKa so SLOW onset

33
Q

BACK in the day, what was procaine paired with for those with absolute contraindication to amide LAs? (ONLY combo ester!)

A

procaine HCl + PRO-POXY-caine

34
Q

What was the end result of adding procaine, proxycaine and norepi?

A

necrosis..yeah, they stopped.

35
Q

What was the 1st amide LA to be marketed?

A

Lidocaine HCl

36
Q

Compare the potency of Lidocaine and Procaine:

A

Lido is 2x as potent as procaine

37
Q

Which LA is the GOLD STANDARD that the other LAs are compared to?

A

Lidocaine HCl

38
Q

How is lido metabolized? (hint: 2/3 in one way, 1/3 in another)

A

2/3 liver…1/3 hydolysis

39
Q

How is lido excreted?

A

kidneys

40
Q

Compare lidocaine and prilocaine in their vasodilation abilities…

A

lido more vasodilating than prilocaine

41
Q

What is the onset of lidocaine?

A

Rapid 2-3min

42
Q

What is the effective [ ] of lidocaine HCl?

A

2%

43
Q

Can you use lido topically?

A

yes! the [ ] can go up to 10% for this purpose

44
Q

What is the FDA pregnancy category for lidocaine? Is it safe during lactation?

A

B…safe, does not enter milk

45
Q

What are the three formulations of lidocaine?

A

1.lidocaine 2% (plain-blueFEW applications c/o vasodilation) 2.lidocaine 2% with epi 1:50,000 (green) 3.lidocaine with epi 1:100,000 (red)

46
Q

Lidocaine: _______ and ________ of anesthesia is equivalent with lidocaine 2% with epinephrine 1:50,000 or 1:100,000

A

Duration and depth

47
Q

lidocaine 2% with epinephrine 1:______ is preferred drug for most dental procedures

A

1:100,000….1:50,000 is concentration of choice but is risky for Heart DIsease

48
Q

Signs and Symptoms of lidocaine toxicity: CNS ________ followed by CNS _______

A

stimulation followed by depression

49
Q

Signs and Symptoms of lidocaine toxicity: First signs and symptoms of overdose may be drowsiness, leading to loss of consciousness and ________ arrest

A

respiratory

50
Q

Umm side note? Lidocaine possesses anticonvulsant properties…Prevents/terminates seizures by decreasing ________ of cortical neurons (raises seizure threshold)

A

excitability

FreakinLOCALanesthesia!!! (11 decks)

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