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32 Cards in this Set
- Front
- Back
What phases of the sodium channel do drugs bind most readily to?
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Acitvated and inactivated sodium channels
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What are the acid-base properties of local anesthetics?
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these are weak bases with pKa's from 8.0-9.0
making them ionized in the cell, mostly |
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What are the two main types of bonds in the middle of local acting anesthetics?
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Ester or Amide bonds
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What metabolizes ester based local anesthetics?
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pesudocholinesterase
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what metabolizes amide based local anesthetics?
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cytochrome p450 in the liver
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What are the general CNS toxicities of local anesthetics?
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sleepiness, visual and auditory disturbances, mouth numbness, nystagmus, twitching, seizures, death
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What do local anesthetics do to the heart (generally)
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cardiac arrythmias and negative inotropic action
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What does Bupivacaine do to the heart?
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more cadiotoxic than the rest- widens QRS
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What does Cocaine do to the cardiovascular system?
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HTN, vasoconstriction, ischemia, arrhythmias
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What is the blood toxicity of prilocaine?
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the metabolite of prilocaine produces methemoglobinemia.
tx methylene blue |
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What local anesthetic group is common for allergic reactions?
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ester type bonds
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What kind of drug is Procaine (novocain)?
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this is an ester based local anesthetic
(PABA- allergy warning) |
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How long does Procaine (novocain) last?
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this has a short action of duration
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How does epinephrine affect Procaine (novocain)?
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this adds a vasoconstrictor effect, which decreases the rate of anesthetic absorption/breakdown
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What is the onset and duration of Tetracaine (pontocaine)?
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this has a slow onset of more than 10min, but long action 2-3 hours
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What is the common use for Tetracaine (pontocaine)?
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this is used for spinal anesthesia and for opthalmological use
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How potent is Tetracaine (pontocaine)?
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this is 10x more potent and toxic than procaine
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What is Tetracaine (pontocaine) often mixed with for spinal injection?
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10% dextrose, to increase specific gravity so the solution is heavier than the CSF
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What is Benzocaine (americaine)
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this is a topical anesthetic used to treat sunburns
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What is cocaine used for as an anesthetic?
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this is a short acting topical anesthetic of the mucous membranes
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What is the mechanism of action of cocaine?
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this acts by blocking uptake of catecholamines in nerve terminals
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What type of drug is Lidocaine (Xylocaine)?
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this is the protoype Amide
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What uses is Lidocaine (Xylocaine) preferred for?
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infiltration blocks (local injections into the skin, affects a small area) and epidural anesthesia
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How is Lidocaine (Xylocaine) broken down?
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this is absorbed after parentral administration and metabolized in the liver via P450 system (microsomal mixed function oxidases)
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How fast does Lidocaine (Xylocaine) work?
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this is a rapid onset action, with good potency and duration
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What kind of drug is Prilocaine (Citanest)
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this is a local anesthetic like lidocaine (an Amide)
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Who should not get Prilocaine (Citanest)?
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people with cardiac or respiratory disease, or with congential methemoglobinemia.
as it induces methemoglobin production |
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How long does Bupivacine (Marcaine, Sensorcaine) last?
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this has a long duration of action
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What kind of anesthesia is Bupivacine (Marcaine, Sensorcaine) preferred for?
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infiltration blocks and epidural anesthesia
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What type of drug is Bupivacine (Marcaine, Sensorcaine)?
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this is an Amide
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What kind of drug is Ropivacaine (Naropin)?
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this is a long acting Amide local anesthetic
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What is the metabolism of Ropivacaine (Naropin)?
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this is not very lipid soluble, and is cleared by the liver and is therefor less likey for adverse events
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