Toxicity Of LA Flashcards
Who are risk of LA toxicity?
Children
Elderly
Medically compromised liver
Does LA cause hyper or hypotension?
Hypotension
Why acompany adrenaline (vasoconstrictor) with LA?
Longer working time, compensates for vasodilation effects of LA, slows rate of absorption
If a patient is taking opioids… what is the effect of using LA?
It is synergistic with sedatives and opioids to produce respiratory depression
What LA does not require a vasoconstrictor?
Mepivacaine
What vasoconstrictor would you not use on a cardiac patient? what LA would you use?
Adrenaline, use mepivacaine
What does the vasoconstrictor felypressin act on?
Vascular smooth muscle, grave,s in venous over after arteriolar
What vasoconstrictor crosses the placenta?
Felylressin
Avoid in pregnancy (oxytosin)
What LA is accompanied by Felypressin?
Prilocaine
Can people be allergic to LA?
No, usually sensitivity to the vasoconstrictor
What things should you look out for on a medical history for LA administration?
- cardiovascular
-asthma - blood pressure disorders
- diabetes
- epilepsy
- Described medications
- recreational drugs
- tendency to be bruised
What are 2 aspects to consider with regards to medically compromised patients?
Underlying conditions
Drug interactions
What are cardiac problems for concern?
Arrhythmias, unstable angina, high BP
What is an example of high BP?
Systolic 200 mmHg
Diastolic 115 mmHg
Why is someone with liver failure at risk of toxicity due to LA?
High risk of toxicity due to impaired metabolism
Liver is the main site of LA metabolism of amides
Why not inject into an inflamed site?
Spread infection
Acidosis, lowers pH of tissues, less potent effect of LA
Where do you inject for a mandibular block?
Pterygomandibular space
What nerve can you hit when trying to hit the alveolar nerve?
Lingual
What LA can anaesthitise the first premolars?
Articaine
When does facial paralysis occur?
Inject Too high between
Hit the facial nerve at the parotid gland
What is a trismus?
When can an trismus occur?
Due to intramuscular injection causing bleeding into the medial pterygoid muscle
