Test 1 - Topical Anesthetics (Specific Drugs) Flashcards
What is FALSE about Tetracaine?
A) Tetracaine causes the most stinging
B) Good surface and deep anesthesia
C) Para-amino benzoic acid derivative
D) Prototype LA
B) Good surface and deep anesthesia
Only good surfaace anesthesia. Not so good for deeper anesthesia.
What is FALSE about other topical LA?
A) Akten is an amide derivative that would not be cross allergic to esters and is available in gel form
B) Opthaine is the Drug of Choice because it stings the least
C) Fluress is a good bacteriostatic
D) Cocaine has more toxic effects such as CNS effects and dependence.
E) All LA’s have rapid onset 15-30 sec, duration 15-20 minutes and takes 45-60 minutes to return to normal.
What is the trade name is matched to Proparacaine, Benoxinate and Lidocaine?
B) Benoxinate is a good bacteriostatic
Benoxinate is a good bacteriocidal.
Proparacaine (Opthaine)
Benoxinate (Fluress)
Lidocaine (Akten)
What is FALSE about Injectable Local Anesthetics?
A) Rate of absorption depends on blood flow
B) Epinephrine decreases systemic toxicities
C) No long term benefit with Epinephrine because it is metabolized very quickly
D) Hyaluronidase decreases drug access to nerve site
E) Esters are metablized by esterases and amides metabolized in the liver
D) Hyaluronidase decreases drug access to nerve site
Hyaluronidase increases drug access to nerve site by breaking down protein matrix.
What is FALSE about using analgesics for Acute Ocular Pain?
A) Can use Chronic LA
B) MOA involves the nociceptors
C) Opiates can decrease perception of pain and suffering
D) Typically use systemic analgesics such as salicylates, non-salicylates and opiates
E) Use for foreign body, abrasion, trauma or post-surgery inflammation
A) Can use Chronic LA
Can’t use Chronic LA’s for acute ocular pain
What is FALSE when comparing analgesic effects of NSAID’s?
A) Ketoprofen and ibuprofen have faster onset, longer duration than ASA
B) Ketoprofen has an increased incidence of side effects
C) Ketorolac is more (equally) effective than ASA
D) Caution with non-opiates include GI upset and bleeding upset.
B) Ketoprofen has an increased incidence of side effects
Ketoprofen has lower incidence of side effects
What is TRUE when comparing analgesic effects of NSAID’s?
A) Acetaminophen has analgesic, antipyretic and anti-inflammatory effects.
B) Use Acetaminophen when patients can’t tolerate ASA or non-salicylate NSAID. Less risk of GI upset, bleeding and asparin sensitivity
C) Opiates block both pain and suffering and has no addiction liability
D) Oxycodone is equally potent compared to codeine
E) Tramadol is a non-opiate that acts on mu receptor and increases release of NE and 5-HT
B) Use Acetaminophen when patients can’t tolerate ASA or non-salicylate NSAID. Less risk of GI upset, bleeding and asparin sensitivity
- Acetaminophen doesn’t have anti-inflammatory effects
- opiates has addiction liability
- Oxycodone is 10-12x more potent than codeine
- Tramadol blocks reupate of NE and 5-HT
What is the NSAID/APAP and opiate combination for the following drugs and what Schedule?
1) Percocet
2) Percodan
3) Vicodan
4) Vicoprofen
5) Tylenol #3
6) Darvocet
1) Percocet (APAP and oxycodone)
2) Percodan (ASA and oxycodone)
3) Vicodan (APAP and hydrocodone)
4) Vicoprofen (Ibuprofen and hydrocodone)
5) Tylenol #3 (APAP and codeine)
6) Darvocet (APAP and propoxyphene)
Schedule II - Percocet, Percodan
Schedule III - Vicodan, Vicoprofen, Tylenol
Schedule IV - Darvocet
What is NOT a contraindication of using Asparin and other NSAID?
A) History of asthma, nasal polyps or ASA sensitivity
B) GI disease, bleeding, chronic liver or kidney disease
C) Pregnancy and children with flu symptoms
D) Drowsiness and dizziness
E) Hypertension, CHF
F) Pre/post cataract or other invasive surgery
G) History of heavy alcohol use
D) Drowsiness and dizziness
What is NOT a contraindication/caution of using opiates?
A) History allergic hypersensitivity to opiates B) bronchial astham and COPD C) Pregnancy or nursing children D) Kidney and liver disease E) Hypertension, CHF F) Other CNS depressants
E) Hypertension, CHF
What is TRUE about taking elderly patients taking local anesthetics?
A) Take sulindac (Clinoril) or ibuprofen to reduce GI effects
B) Opiates have less depressing effect on elderly
C) A selective COX2 inhibitor can be used to treat acute pain and decrease GI effects
D) Topical agents are recommended for long term treatment
E) Use ASA in patients with bleeding problems
C) A selective COX2 inhibitor can be used to treat acute pain and decrease GI effects
- sulindac (Clinoril) or ibuprofen are both non-toxic. misprostol (Cytotec) decreases GI effects
- Opiates have more depressing effect
- topical agents are NOT recommended for long term use
- use APAP in patients with bleeding problems
What are the brand names for the following drugs?
1) Flurbiprofen
2) Ketorolac (2 names)
3) Diclofenac
4) Bromfenac
5) Nepafenac
(Voltaren, Bromday, Nevanac, Acuvail, Ocufen, Acular LS)
Which one is non-preserved, which one is most frequently prescribed topical NSAID and which one has approved ocular penetration?
1) Flurbiprofen - Ocufen
2) Ketorolac (Acuvail, Acular LS)
3) Diclofenac (Voltaren)
4) Bromfenac (Bronmday)
5) Nepafenac (Nevanac)
- Acuvail - non preserved
- Acular LS - most frequently prescribed topical NSAID
- Nevanac - improved ocular penetration
What statement is TRUE about topical ocular NSAIDs?
A) Ketorolac is highly effective in refractive surgeries
B) Can be used to treat inflammation of post-op laser or cataract surgeries
E) Contraindicated for contact lens wearers due to perservative irritation
Which of the following is NOT a contradiction/caution for topical NSAID?
A) Contact Lens wear B) ASA sensitivity C) Pregnancy D) Asthma E) Corneal Epithelial Damage F) Bleeding History
D) Asthma
Which is the most SERIOUS toxicity related to topical NSAIDs?
A) Conjunctival Hyperemia B) Allergic hypersensitivity C) Punctate Keratitis D) Corneal erosion/thinning/ulceration, epithelial breakdown E) Decreased Wound Healing F) Ocular Bleeding
D) Corneal erosion/thinning/ulceration, epithelial breakdown
