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Local > Test 1 SG: Chapters 1-5 > Flashcards

Test 1 SG: Chapters 1-5 Flashcards

0
Q

what does specific receptor theory propose?

A

local anesthetics act by binding to specific receptors on the sodium channel

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1
Q

most favored theory of where local anesthetics work

A

specific receptor theory

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2
Q

local anesthetics are classified by their ability to react with specific receptor sites where?

A

sodium channel

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3
Q

mV of the nerve at resting potential

A

-70mV

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4
Q

mV of nerve at rapid depolarization

A

+40mV

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5
Q

At resting state the nerve membrane is slightly permeable to what?

A

sodium ions

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6
Q

repolarization is caused by the inactivation of increased permeability to what?

A

sodium ions

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7
Q

what is the magnitude of the decrease in negative transmembrane potential that is required to initiate an action potential?

A

firing threshold

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8
Q

According to your local anesthesia book, axolemma is another name for what?

A

nerve membrane

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9
Q

methods or substances that produce a ____ and ____ state are used in clinical practice to produce local anesthesia.

A

transient

completely reversible

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10
Q

example of a potent injectable local anesthetics that is relatively ineffective when applied topically to mucous membrane

A

procaine

mepivicaine

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11
Q

why is dyclonine not administered by injection?

A

because of its tissue irritating properties

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12
Q

the rate of conduction is (higher, lower) in unmyelinated nerve fibers compared to myelinated nerve fibers. why?

A

lower

because myelinated nerve conduct impulses at much faster rate than an unmyelinated nerve of equal size

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13
Q

the potency of a local anesthetic is controlled by the ___ of the molecule

A

lipid solubility

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14
Q

the duration of action of the local anesthetic is controlled by the ___ of the molecule

A

protein binding

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15
Q

what is a fasciculi?

A

nerve bundles of 500-1000 nerve fibers

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16
Q

what is the initial action of cocaine

A

vasodilation

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17
Q

what is a potent vasodilator that can be used when peripheral blood flow has been compromised due to accidental intraaterial injection of a drug?

A

procaine

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18
Q

T/F: most local anesthetic drugs are easily absorbed from the GI tract following oral administration

A

false

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19
Q

what is a major metabolic by product of an ester local anesthetic?

A

PABA

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20
Q

what condition is a person possibly suffering from if they have an inability to hydrolyze ester local anesthetics and other chemically related drugs? what kind of trait is this condition?

A

atypical form of pseudocholinesterase

hereditary

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21
Q

what is a chemically related drug to esters?

A

succinylcholine

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22
Q

what is a short-acting muscle relaxant employed frequently during the induction phase of general anesthesia

A

succinylcholine

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23
Q

what does the plasma pseudocholinesterase do the short-acting muscle relaxant employed frequently during the induction phase of general anesthesia?

A

hydrolyzes of succinylcholine blood levels fall and spontaneous respiration resumes

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24
Q

example of a relative contraindication to the administration of amide local anesthetic drugs?

A

liver dysfunction

25
Q

a patient who has received large doses of prilocaine could possibly develop what?

A

methemoglobinemia

26
Q

what is the primary excretory organ for both the local anesthetic and its metabolites

A

kidneys

27
Q

what is the concern for patient with significant renal impairment?

A

maybe unable to eliminate parent local anesthetic compound or its major metabolites from the blood

28
Q

what is the pharmacological action of local anesthetics on the CNS

A

depression

29
Q

what LA are used to terminate or decrease the duration of both grand mal and petit mal seizures?

A

procaine
mepivicaine
lidocaine

30
Q

what is the area called where the convulsive episode originates on the brain?

A

epileptic focus

31
Q

what is the therapeutic doses of some local anesthetics for interrupting status epilepticus? give amount and rate.

A

2-3mg/kg given at rate of 40-50mg/min

32
Q

primary effect of local anesthetics on BP is

A

hypotension

33
Q

what is pharmacologic disorder in which genetic variant in individual alters that person’s response to certain drugs? what is another name for condition?

A

malignant hyperthermia

hyperpyrexia

34
Q

cyanosis, tachycardia, tachypnea, unstable BP, respiratory and metabolic acidosis, fever (108F or more), muscle rigidity and death are clinical manifestations of what condition?

A

malignant hyperthermia

35
Q

what is the chemical name of catechol?

A

orthodihydroxybenzene

36
Q

vasoconstrictors resemble the response of what type nerve stimulation

A

adrenergic

37
Q

reasons why vasoconstrictors are important additions to a local anesthetic solution

A
  1. constrict blood vessels
  2. slows absorption
  3. blood levels lowered to decrease toxicity
  4. keep local anesthetic in area longer
  5. controls bleeding at site
38
Q

how are vasoconstrictors classified?

A

sympathomimetic or adrenergic drugs

39
Q

list 5 catecholamines found in body

A 
epinephrine
norepinephrine
levonordefedrin
isoproterenol
dopamine
40
Q

what are the 4 adrenergic receptors?

A

alpha 1
alpha 2
beta 1
beta 2

41
Q

which receptor is found in lungs

A

beta 2

42
Q

which receptor is found in excitatory-postsynaptic

A

alpha 1

43
Q

what are the disadvantages of sodium bisulfite?

A

more acidic

delayed onset of anesthesia

44
Q

does levonordefrin produce more or less cardiac stimulation than epinephrine?

A

less

45
Q

what local anesthetic is a concern for patients on acetaminophen?

A

prilocaine

46
Q

bupivacaine is not recommended for what type of patients?

A

younger patients

physically and mentally disabled

47
Q

T/F: Cocaine is highly soluble in water

A

true

48
Q

what is the uncharged molecules in LA called?

A

free base form RN

49
Q

what is the charged molecule called?

A

cations

50
Q

why are local anesthetics acidified by manufacturers

A

to inhibit oxidation of vasopressor

51
Q

pH of normal tissue

A

7.4

52
Q

basic LA injected into acidic infected area

A

base + acid= salt

53
Q

neural cytoplasm known as

A

axoplasm

54
Q

pH of inflamed tissue

A

5-6

55
Q

pH of solutions with vasoconstrictor

A

3.5

56
Q

pH of solutions without vasoconstrictor

A

5.5-7

57
Q

what does acidification of tissue do to local anesthetics

A

decrease effectiveness

58
Q

what is concern of “off-centered perforation” of anesthetic carpules

A

leakage of anesthetic solution flow into patients mouth

59
Q

what does it mean if blood is visible in a cartridge

A

needle tip rests within lumen of blood vessel

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