Local Anesthetics - pharmacology

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Local Anesthetics- pharm

Created Feb 28, 2012
by abbyas2003

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1	1. diff btw myelinated and unmyelinated2. myelinated= myelin covering interrupted by ____ which...	1. unmyelinated= many axons- myelinated= 1 axon covered by many layers of schwann cell2. nodes...
2	1. "pain, temp, touch"- fast fibers2. "dull pain, temp, touch"- slow fibers3. diameter r/t...	1. A delta2. c fibers3. A fibers= larger diameterB fibers (sympathetic)= middle diameterC fibers...
3	Impulse Conduction1. na channels open. Na enters cell. potential reaches -65, what happens?**all...	1. ALL Na channels open- Na rushes in. K begins to be pumped out (more slowly)2. they change...
4	1. how do highly lipophilic drugs work?- their effects?2. How do moderately lipophilic drugs...	1. cross into phospholipid bilayer and are sequestered or stuck. attached to "side" of Na channel...
5	1. Closed/ resting Na channel= affinity for local anesth?2. affinity for open and inactivated...	1. very low affinity2. higher affinity3. increased time before channel returns to resting conformation
6	1. blocksa. time btw action potentials exceeds time for dissociation of local anesthetic from...	1. tonic blockb. phasic block2. (1) drug with high potency and high affinity (2) rapidly...
7	1. susceptibility of various fibers to local anesthetic block2. two situations in which rate...	1. B fibers (symp, pregang) --> small myelinated A gamma and A delta **sensory...
8	1. how does differential block work?2. early detection of where block is going?3. chemistry=...	1. give small enuf doses of local anesthetic to see if pain is from sympathetic.. or a little...
9	1. 5 things that determine onset, duration and potency2. pka= lower?3. NET result in increased...	1. pkalipid solubilityprotein bindingconcentrationvasoconstrictive/ vasodilatory properties2....
10	1. incr protein binding has what effect?2. incr dose/ concentration has what effect?3. vasodilators/...	1. incr DOA2. faster onset and longer DOA3. most are vasodilatorsexceptions: cocaine, ropivacaine,...
11	1. addition of vasoconstrictors= decrs rate of what?-- results in what 2 things?2. effectiveness...	1. vascular absorption-- denser block- more drug reaches site of action-- longer duration-...
12	1. pH adjustment?2. technique?3. of particular value with what?	1. alkalinization - more unionized - faster onset - greater depth - incr...
13	1. toxicity should be presumed to be ____- don't assume u can give max doses of multiple drugs2....	1. additive2. intracellular side3. phasic inhibition occuring as a result of increased conduction...
14	1. lower pKa2. incr lipid solubility3. incr protein binding4. incr concentration5. incr dose6....	1. more un-ionized-> faster onset2. incr duration, incr potency3. incr duration4. faster...
15	1. injection of local anesthetic into infected (acidotic tissue)	1. relatively ineffective
16	Procaine1. brand name/ class2. signif3. derivative of ___ = result?4. pka, solubility,...	1. novacaine/ ester2. 1st injectable LA3. PABA- allergic reactions4. high pka, low lipid sol,...
17	chloroprocaine1. brand/ class2. derivative of what?3. signif?4. primarily used for what?5....	1. nesacaine/ ester2. procaine3. most rapidly metabolized (plasma T1/2 30sec)4. as epidural...
18	Tetracaine1. brand/ class2. used primarily - 2 things?3. duration?4. solubility?5. protein...	1. pontocaine/ ester2. topical (eye) and spinal anesthesia3. long4. highly lipid sol5. high 6....
19	Benzocaine1. brand/ class2. unique?3. best suited for what?4. onset?5. duration6. disadvantage-...	1. hurricane/ ester2. weak acid (pka 3.5)3. topicalization of mucous membranes- endoscopy-...
20	Cocaine1. class2. produces intense ____3. used for what?4. low __ __; high ___ ___	1. ester2. vasoconstriction3. 4% or 10% sol'n for nasopharyngeal topical4. therpeutic index/...
21	Lidocaine1. brand/ class2. signif3. onset4. DOA5. uses? (IM Losing Some Brain In A Night)	1. xylocaine/ amide2. 1st aminoamide introduced/ most widely used3. rapid onset4. intermediate...
22	Mepivacaine1. brand/ class2. very similar to ____3. minor difference4. similar incidence of...	1. carbacaine/ amide2. lidocaine3. slightly longer DOA since less vasodilation4. TNS (transient...
23	Prilocaine1. brand/ class2. very similar to ___3. three exceptions?4. most commonly used how?5....	1. citanest/ amide2. lidocaine3. slightly longer DOA d/t less vasodilationdcrs CNS toxmore...
24	Bupivacaine1. brand/ class 3 uses 2. onset (with what 2 exceptions?3. DOA4. concentrations...	1. Marcaine/ amide spinal, epidural, peripheral nerve block2. slower (except in spinals/...
25	Ropiviacaine1. brand/ class2. similar to ___3. differences4. unique aspect	1. Naropin/ amide2. bupivacaine3. may produce less motor block- less cardiac/ neuro toxicity...
26	LevoBupivacaine1. Brand/ class2. _____ of bupiv.3. similar to bupiv but with what diff?4. advantage?5....	1. chirocaine/ amide2. S-enantiomer3. possibly slightly longer DOA4. less cardiac/ neruo toxicity5....
27	1. ___ of LA varies with application2. good drug for peripheral nerve block3. good drug for...	1. potency2. mepivacaine3. bupivacaine
28	Infiltration Anesthesia1. most LA effective2. two most commonly used3. concentration?4. do...	2. bupivacaine and lidoc3. effective at low concentrations4. addition of neutracaine (sodium...
29	Beir Block1. most common drug used= concentrations/ amt used fora. armb. leg2. using ester...	1. Lidocaine WITHOUT EPIarm- 40-50ml of 0.5% sol'nleg 50-100ml of 0.25%2. thrombophlebitis
30	Peripheral Nerve Blocks1. diff btw major and minor2. drug of choice?	1. minor - single nervemajor- all others2. determined by required duration of block
31	Epidural Anesthesia1. single shot techniques (caudal in children)- what is important?2. catheter...	1. DOA2. speed of onset, characteristics more important3. shorter/ interm acting drugs4. more...