vasoconstrictors

Question 1

5 contents of an LA carpule

Answer 1

La agent

vasoconstrictor

antioxidant

preservative

ph adjusting agent

Question 2

what is the antioxidant thats usually in a carpule

Answer 2

sodium metabisulfite (allergies)

Question 3

what is the preservative that is usually in carpules (multidose only)

Answer 3

methylparaben (can cause allergies too)

Question 4

plain local anesthetics are … by nature

Answer 4

vasodilators

Question 5

how much max epi in CV patients

Answer 5

0.04 mg (2 cartridges of 1:100,000 epi)

Question 6

what happens when you give a VC with alpha blockers (such as phenothiazines and butyrophenones)

Answer 6

hypotension and tachycardia

Question 7

what happens when you give VC with non-selective beta blockers

Answer 7

hypertension and bradycardia

Question 8

what happens when you give VC with a selective beta blocker (b1)

Answer 8

no effects since a1 will increase BP and b2 will decrease

Question 9

what happens when yo u give VC with tricyclic antidepressants (amitriptyline/ elavil)

Answer 9

exogenous epinephrine may produce exaggerated effects since TCAs block reuptake of epi and norepi

Question 10

are patients on TCAs contraindicated for VC

Answer 10

no but dont give more than 0.2

Question 11

what happens when you give VC with patients on MAO inhibitors (phenylzine/Nardil)

Answer 11

little change since epi is also metabolized by COMT

Question 12

what happens if you give VC with amphetamines/cocaine?

Answer 12

exaggerated response.

Should wait 24 hours!!!

Question 13

5 contraindications to using vasoconstrictors

Answer 13

severe CV disease (ASA IV)

acute MI

anginal episodes at rest (unstable angine)

cardiac dysrhythmias that are refractory to drug treatent

patient with uncontrolled hyperthyroidism