Local ANesthetics- Pharm Part 2

23 cards

Local Anesthetics pharm part 2


 
  
Created Feb 29, 2012
by
abbyas2003

 

 
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1
Topical Anesthesia1. mucous membranes-42. intact skin3. cut skin
 
1. bronch, endoscopy, nasal surgery, intubation2. IV start, skin grafting, circumcision3. lac...
2
Tumescent Anesthesia1. med used2. EBL/ analgesia?
 
1. Lidocaine (0.1% or less) with Epi (1:1000000)2. 12ml bld loss/ L of fat removed18-24hrs...
3
TachyPhylaxis1. def2. way to prevent?3. thot to be d/t what?
 
1. repeated injection of same dose produces dcrs response2. short dosing intervals so pain...
4
Metabolism1. estersa. pathwayb. slowest/ fastest2. amidesa. pathway and 1st stepb. dependent...
 
1a. hydrolysis of ester bond by plasma cholinesteraseb. slow- tetra. fast- chloroprocaine2a....
5
1. what will signif prolong Lidocaine's half life3. rapidly cleared?4. 2 with interned clearance?5....
 
1. hepatic dysfunction2. Renal disease3. chloroprocaine4. Lidocaine, Mepivacaine5. Bupivacaine,...
6
Lung Extraction1. pulmonary extraction of which amide LA's?2. for Bupivacainea. pulm extraction...
 
1. Lidocaine, prilocaine, Bupivacaine2a. dose-dependent/ saturableb. beta blockers (propranolol)
7
**VERY few True allergies**1. most common true allergy with esters is r/t what?2. no _____...
 
1. PABA2. cross-sensitivity3. preservative
8
Absorption of LA1. 2 things that will incr absorption systemically?2. 3 things that will dcrs...
 
1. if site is very vascular and incr dose (linear relationship btw dose and plasma lvls)2....
9
1. relationship btw concentration and bound drug (r/t protein binding)2. fetal trapping of...
 
1. incr concentration= incr % of free drug, lower % of bound drug2. fetus- acidotic; drug trapped...
10
Incidences of TNS after spinal anesthesia1. occurs more frequently with which drugs?2. which...
 
1. Lidocaine and Mepivacaine2. lithotomy, knee arthroscopy
11
Local Toxicity1. exposure of ___ nerve to high concent of LA in lab resulted in injury2. 2...
 
1. desheathed2. spinal cord and nerve root (peripheral nerve block - safe)3. nerve that is...
12
1. 3 S/S or components of neurotoxicity2. Transient neurological symptomsa. symptomsb. occurs...
 
1. non-specific patchy numbnessTNSCaudal Equina Syndrome2a. moderate to severe pain in lower...
13
1. 3 signif factors that pre-dispose pt to TNS
 
1. patient positioningneural ischemia secondary to stretchmaldistribution of LA (pooling......
14
Cauda Equina SYndrome1. diffuse injury across ___ ___ resulting in varying degrees of what...
 
1. lumbosacral plexus/ sensory loss, bladder/ bowel dysfunction, paraplegia-- toxicity of LA2....
15
1. LA and BBB2. dose-dependent pattern of symptomsa. low plasma concentrationsb. higher concentrationsc....
 
1. readily cross BBB2a. CNS depressionb. CNS excitation (seizures)c. generalized CNS depression
16
Factors in CNS Toxicity1. potential approx parallels ____2. what will increase the potential...
 
1. drug potency2. acidosisincr PCO2dcrs Pro bindingdcrs clearancerapid IV injection3. BZD,...
17
1. potential for CNS toxicity varies with type of block= how?2. likelihood of unintentional...
 
1. ICE BS2. peripheral nerve block
18
1. cardiac or CNS toxicity requires higher plasma concentrations?2. potential for cardiac toxicity...
 
1. cardiac2. potency3. high lipid solub/ high potency4. bradycardia, hypotension, hypoxia
19
Lidocaine vs Bupivacaine1. myocardial contractility2. elctrophysiologic effects3. higher affinity...
 
1. equal2. Bupiv produces greater3. Bupivacaine
20
1. TH for bupivacaine induced cardiotox is reduced in what condition?- patient's taking what?2....
 
1. pregnancy- BB, CCB, diogixin2a. inhibition of nucleus tracts solitarii in medulla - inhibition...
21
1. compare Ropivacaine/ Levobupivacaine with Bupiva. equipotent for which 2 procedures?b. when...
 
1. the exhibit 30-40% lower potential for systemic toxicitya. plexus anesthesia and nerve blockb....
22
1. good way to prevent cardiotoxicity2. other than ACLS stuff, what may be good treatment for...
 
1. appropriate dose** frequent aspiration of fractional injection**2. Lipid infusion (drug...
23
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