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Dental Anesthesia > Test 2- Pharmacology > Flashcards

Test 2- Pharmacology Flashcards

1
Q

What is sympathomimetic

A

vasoconstrictors resemble the response of adrenergic nerves to stimulation (classified as adrenergic or sympathomimetic)

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2
Q

what are the functions of vasoconstrictors

A
  • decrease absorption reducing toxicity and increasing duration
  • smaller volumes of anesth
  • increase efficency
  • reduce bleeign
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3
Q

what are direct acting sympathomimetic amines*

A

exert action directly on adrenergic receptors (EPI)

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4
Q
  • what are alpha receptors
A

smooth muscle in blood vessels.. constricts lumen

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5
Q

what are beta receptors*

A

smooth muscle relaxation (vasodilation and bronchodilation)

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6
Q

What is the most common vasoconstrictor

A

epi

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7
Q

what other vasoconstrictor is available in the US

A

levonorefrin in mepivicaine 1:20,000

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8
Q
  • 1:100,000 has how much epi
    1: 200,000
    1: 50,000
A

.01 mg/ml
.005 mg/ml
.02 mg/ml

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9
Q

concentration of epi always refers to

A

1 mL

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10
Q

*how much epi is in one CARTRIDGE @ 1:100,000

3 CARTRIDGES?

A

.018

.054

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11
Q

what is the concentration of the vasoconstrictor in a 1:100,000 solution of lidocaine

A

.01 mg/ml

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12
Q

If 2 carps of 2% lido with 1:100,000 Epi are administered what is the quantitiy of epi

A

.036 mg

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13
Q

if 4 cartridges of .5% bupivicaine with 1:200,000 epi are administred what quantity of epi was given

A

.036 mg

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14
Q

What is the other name for epi

A

adrenalin

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15
Q

what is the important ingredient in the chemical structure of epe

A

sodium bisulfite

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16
Q

what does sodium bisulfite do

A

delays deterioration

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17
Q

what is the mode of action of epi

A

alpha and beta receptors

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18
Q

what happens in the myocardium with the use of eip

A

cardiac output and heart rate are increased

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19
Q

what happens to the coronary arteries with epi

A

produces dilation of the coronary artery

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20
Q

what happens to blood pressure with epi

A

systolic is increased and diastolic is decreased

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21
Q

there is a decrease in cardiac ________ with epi

A

efficency

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22
Q

What are the side effects of epi

A

CNS Stimulation, anxiety, fear, tension, restlessnes, throbing

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23
Q

What is the other name for Levonordefrin

A

neo-cobefrin

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24
Q

what is the mode of action for levonordefrin

A

alpha receptors, some beta

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25
Q

what factors should be considered when selecting a vasoconstrictor

A
  • length of procedure
  • need for hemostasis
  • medical status of pt
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26
Q

how long does 2% lido without epi provide pulpal anesthesia for? with epi

A

10 min

60 min

27
Q

what 4 conditions must be weighed for the use of a vasoconstrictor

A
  • high blood pressure
  • cardiovascular disease
  • hyperthyroidism
  • tx with MAOI and tricyclic antidepressants
28
Q

what are absolute contraindications with tricyclics

A

levonordefrin and norepinephrine

29
Q

What can 4 carps of LA with 1:100,000 epi stimulate

A

beta action stimulates glycogenisis

30
Q

what is the rebound effect

A

bleeding postoperatively

31
Q

a 2% lido with ph of 6.8 is changed to _____ with the addition of epi

A

4.2

32
Q

What are the 2 effects of LA on blood vessels

A

Vasodilation (prilocaine)

vasoconstriction (cocaine)

33
Q

what is the effect of vasodilation of LA

A

increase absorbtion, decrease duration and quality, increases potential for toxicity

34
Q

what are the forms of LA

A

oral, topical, injection

35
Q

what LA is the only on that works

A

cocaine

36
Q

where are topical LA absorbed

A

in mucous membranes, not effective on intact skin

37
Q

after injection of LA the rate of uptake is good but is related to

A

the vascularity of the inj site and vaso activity of drug

38
Q

what organs have higher blood levels

A

highly perfuse

brain, liver, kidney, lungs, spleen

39
Q

what contains the highest percentage of LA because of its mass

A

skeletal muscles

40
Q

where does all anesthetic eventually go

A

the liver

41
Q

what does the liver do to anesthetic

A

hydrolyses it

42
Q

what has a significant bearing on the potential toxicity of a drug

A

the plasma concentration of LA

43
Q

What are blood levels influenced by

A
  • rate of adsorption in cardiovascular system
  • rate of distribution
  • elimination of drug
44
Q

what is elimination half life

A

the time needed for 50% reduction in blood levels

75% for 2 half lives

45
Q

ALL LA can cross what

A

blood brain and placental barrier

46
Q

What are people usually allergic to with esthers?*

A

PABA

47
Q

what is PABA?

A

what procaine/novacaine is hydrolyized to before excretion

48
Q

Where are esthers used

A

outside of US, mexico, Japan

49
Q

What is an example of an esther

A

procaine/novacaine

50
Q

What are esthers hydrolyzed by in the plasma

A

pseudocholinesterase

51
Q

What are all injectable dental anesthetics

A

amides

52
Q

where are amides hydrolyzed

A

in the liver

53
Q

when does pesudocholinesterase break down

A

as soon as it gets into the bloodstream which means its ability to work is bad

54
Q

What is an absolute contraindicaiton

A

documented, repeatable allergy

55
Q

what is a relative contraindication

A

SIGNIFICANT liver dysfunction, heart failure, renal disease, hypotension, CHF
-watch how much you give

56
Q

What is the primary means of excretion of LA

A

kidneys

57
Q

*LA are chemicals that:

A

reversibly block action potientials in all excitable membranes

58
Q

how does LA act in the CNS

CVS

A

as a depressant

circumoral and lingual numbness

59
Q

*what is the direct action of LA on the cardiovascular system

A

-direct action on myocardium is depression in general but more resistant than CNS

60
Q

What is the primary effect of LA on bloodpressure

A

Hypotension

61
Q

What is the effect of LA on the respiratory system at non overdose levels? overdose levels?

A

relaxant action

repiratory arrest

62
Q

Is malignant hyperthermia a concern with LA*

A

NO

63
Q

What LA has the greatest degree of protein binding

A

ones that have a longer duration of clinical activity

64
Q

how is toxicity of LA manifested

A

gen. tonic clonic convulsion

Dental Anesthesia (8 decks)

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