Local Anesthetics (Msq Drill 178)

1. At low concentration of local anesthetics sodium channels are blocked. True or false?

True

False

2. Is there a possibility that a patient who has taken coccaine might develop arrythmias

Yes

No

3. In other words coccaine can act as a local anesthetic since it blocks sodium channels?

Yes

No

4. If you block calcium channels because of a high concentration of a local anesthetic you will have increased or decreased conduction?

Increased conduction

Decreased conduction

5. In order for anesthetics to work they have to block the action potential. How do they do this?

By blocking pottassium channels

By blocking sodium channels

By blocking release of acetylcholine from the presynaptic neuron

By blocking chloride channels

6. Is coccaine an amide or an ester?

Amide

Ester

7. What types of anesthetics should be used for long precedures?

Longer acting anesthetics

Shorter acting anesthetics

8. In general local anesthetics can cause central nervous system side effects. True or false?

True

False

9. Which local anesthetics are hepatically metabolized and should therefore be used cautiously in paitients with hepatic impairment?

Esters

Amides

10. Which of the following is a sodium channel blocker that also inhibits the reuptake of dopamine and norepi?

Heroin

Cannabis

Coccaine

Methamphetamine

11. Which anesthetics should be used for a long procedure?

Water soluble

Lipophilic

Water soluble anesthetics have a shorter duration.

Explanation

Water soluble anesthetics have a shorter duration.

12. In other words a low dose of a local anesthetic can block sodium channels, and lead to hyper or hypo excitalbility of cardiac muscle?

Hyper excitability

Hypo excitability

13. Would you use procaine for a long or a short procedure?

Long procedure

Short procedure

Because it is hydrophilic and therefore has a shorter duration of action.

Explanation

Because it is hydrophilic and therefore has a shorter duration of action.

14.
You should use epinephrine in distal, perfusion limited sites such as the tip on of the nose, toes and fingers. True or false?

True

False

You should NEVER use epinephrine in perfusion limited areas.

Explanation

You should NEVER use epinephrine in perfusion limited areas.

15. Which molecules would have a faster onset?

Lipophilic molecules

Hydrophilic molecules

16. Between audio-visual disturbances and convulsions, which one occurs at high concentations?

Audio-visual disturbances

Convulsions

17. Which organs will quickly feel the effects of a local anesthetic?

Organs with high perfusion

Organs with low perfusion

18. Which local anesthetics are structurally and immunologically related to p-aminobenzoic acid (PABA?)

Esters

Amides

PABA is an intermediate in the bacterial synthesis of
folate. Sulfonamide drugs are structurally similar to PABA, and their antibacterial activity is due to their ability to interfere with the conversion of PABA to folate by the enzyme dihydropteroate synthetase. Thus, bacterial growth is limited through folate deficiency without effect on human cells.

Explanation

PABA is an intermediate in the bacterial synthesis of
folate. Sulfonamide drugs are structurally similar to PABA, and their antibacterial activity is due to their ability to interfere with the conversion of PABA to folate by the enzyme dihydropteroate synthetase. Thus, bacterial growth is limited through folate deficiency without effect on human cells.

19. If a patient has a PABA allergy, do you use an amide or an ester?

Amide

Ester

20. Calcium channels are blocked by a high conentration of a local anesthetics resulting in decreased conduction. Would this lead to high or low blood pressure?

High blood pressure - hypertension

Low blood pressure - hypotension

21. What are the two structural classes of local anesthetics?

Esters

Amines

Amides

Carboxylic acids

Purines

Submit

22. Esters are preferable for patients with hepatic dysfunction. What enzyme degrades esters?

Acetylcholinestarase

Mono amine oxidase

Plasma cholinesterase

Synaptic cholinesterase

23. Local anesthetics that have one "i" in their name are esters or amides?

Esters

Amides

24. If you add epinephrine to a local anesthetic, does this increase or decrease absorption?

Increases absorption of local anesthetic

Decreases absoption of local anesthetic

25. All local anesthetics are __________ connected to an aromatic ring.

Weak acids

Strong acids

Weak bases

Stog bases

26.
Do you need a high concentration of a local anesthetic in order to induce sedation in a patient?

Yes

No

27. If oxidation of Fe2+ occurs as a result of a local anesthetics what will happen to the patient's respiratory status?

Shortness of breath

Hypoventiation

No change in respiratory status

28. Death is most definitiely resultant of a high concentration of a local anesthetic, what about nystagmus, do you need a high or a low concentration?

Nystagmus occurs at high concentrations

Nystagmus occurs at low concentrations

29. Lidocaine, mepivaciane and procaines (novocain) are lipophilic or water soluble?

Lipophilic

Water soluble

30. Oxdiation of FE2t to Fe3t with eventual cyanosis as a result of a local anesthetic will lead to cyanosis and shortness of breath. This can also be referred to:

Chocolate blood

Thick blood

Thin blood

Black blood

31. Local anesthetics can cause cyanosis due to the oxidation of Fe2+ to Fe3+. What is this process all known as?

Methylhemoglobinemia

Methomoglobinemia

Methylmyoglobiuria

32. Smaller lipophilic molecules have a faster onet. Do they also have a long duration?

Yes

No

33. If sodium channels are blocked because of a LOW concentration of a local anesthetic the cardiac tissue will experience increased or decreased automaticity?

Increased automaticity

Decreased automaticity

34. So if someone has taken coccaine and they are thus euphoric which of the following may you observe?

CNS depression

CNS stimulation

Bradycardia

Tachycardia

Hypertension

The hypertension is from an increased level of dopamine and norepi because of the reduced reuptake.

Explanation

The hypertension is from an increased level of dopamine and norepi because of the reduced reuptake.

Submit

35. In terms of cardiovascular side effects, what channels are blocked when a high concentration of local anesthetics is administered?

Sodium channels

Calcium channels

Pottasium channels

Chloride channels

36. A dose >10mg/kg of procaine is being prepared to be administered on patient. You walk in and state the following:

The patient will becone cyanotic because of the oxidation of hemoglobin

The patient will become cyanotic because of the oxidation of myoglobin

The patient will becone cyanotic because of the oxidation of iron Fe2+

The patient will become cynotic because of the reduction of Fe3+

37. A patient who has received an local anesthetic complains of a metallic taste in their mouth and a feeling of numbness around their mouth (cirumoral numbing). Are these symptoms reflective of a high or a low concentration of the local anesthetic?

High dose

Low dose

Local Anesthetics (Msq Drill 178)

1. At low concentration of local anesthetics sodium channels are blocked. True or false?

2.

What first name or nickname would you like us to use?

2. Is there a possibility that a patient who has taken coccaine might develop arrythmias

3. In other words coccaine can act as a local anesthetic since it blocks sodium channels?

4. If you block calcium channels because of a high concentration of a local anesthetic you will have increased or decreased conduction?

5. In order for anesthetics to work they have to block the action potential. How do they do this?

6. Is coccaine an amide or an ester?

7. What types of anesthetics should be used for long precedures?

8. In general local anesthetics can cause central nervous system side effects. True or false?

9. Which local anesthetics are hepatically metabolized and should therefore be used cautiously in paitients with hepatic impairment?

10. Which of the following is a sodium channel blocker that also inhibits the reuptake of dopamine and norepi?

11. Which anesthetics should be used for a long procedure?

12. In other words a low dose of a local anesthetic can block sodium channels, and lead to hyper or hypo excitalbility of cardiac muscle?

13. Would you use procaine for a long or a short procedure?

14. You should use epinephrine in distal, perfusion limited sites such as the tip on of the nose, toes and fingers. True or false?

15. Which molecules would have a faster onset?

16. Between audio-visual disturbances and convulsions, which one occurs at high concentations?

17. Which organs will quickly feel the effects of a local anesthetic?

18. Which local anesthetics are structurally and immunologically related to p-aminobenzoic acid (PABA?)

19. If a patient has a PABA allergy, do you use an amide or an ester?

20. Calcium channels are blocked by a high conentration of a local anesthetics resulting in decreased conduction. Would this lead to high or low blood pressure?

21. What are the two structural classes of local anesthetics?

22. Esters are preferable for patients with hepatic dysfunction. What enzyme degrades esters?

23. Local anesthetics that have one "i" in their name are esters or amides?

24. If you add epinephrine to a local anesthetic, does this increase or decrease absorption?

25. All local anesthetics are __________ connected to an aromatic ring.

26. Do you need a high concentration of a local anesthetic in order to induce sedation in a patient?

27. If oxidation of Fe2+ occurs as a result of a local anesthetics what will happen to the patient's respiratory status?

28. Death is most definitiely resultant of a high concentration of a local anesthetic, what about nystagmus, do you need a high or a low concentration?

29. Lidocaine, mepivaciane and procaines (novocain) are lipophilic or water soluble?

30. Oxdiation of FE2t to Fe3t with eventual cyanosis as a result of a local anesthetic will lead to cyanosis and shortness of breath. This can also be referred to:

31. Local anesthetics can cause cyanosis due to the oxidation of Fe2+ to Fe3+. What is this process all known as?

32. Smaller lipophilic molecules have a faster onet. Do they also have a long duration?

33. If sodium channels are blocked because of a LOW concentration of a local anesthetic the cardiac tissue will experience increased or decreased automaticity?

34. So if someone has taken coccaine and they are thus euphoric which of the following may you observe?

35. In terms of cardiovascular side effects, what channels are blocked when a high concentration of local anesthetics is administered?

36. A dose >10mg/kg of procaine is being prepared to be administered on patient. You walk in and state the following:

37. A patient who has received an local anesthetic complains of a metallic taste in their mouth and a feeling of numbness around their mouth (cirumoral numbing). Are these symptoms reflective of a high or a low concentration of the local anesthetic?

14.
You should use epinephrine in distal, perfusion limited sites such as the tip on of the nose, toes and fingers. True or false?

26.
Do you need a high concentration of a local anesthetic in order to induce sedation in a patient?