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8 Cards in this Set

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Local Anesthetics
(general mechanism and side effects)
Mechanism: Hydrophobic aromatic moiety permits diffusion thourgh membrane to to intracellular side of Na channel.
LAs block fast Na channels by slowing inactivation recovery.
Repeated LA injection -> local acidosis -> refractoriness
Distal areas anesthetize first and recover first
Analgesia precedes loss of other sensory and motor function, recovery occurs in opposite order

Side Effects: Class I antiarrhythmic, conduction failure, Vfib
B/c LAs are mixed with epinephrine to delay diffusion outside site of injection, can cause vasodilation. At end arteries could cause gangrene
low dose: sedation, high dose: convulsions
allergic dermatitis and asthma
Types of local anesthetics
Injection: Bupivacaine, mepivacaine, lidocaine, tetracaine and procaine
Opthalmology: Tetracaine b/c least corneal damage or mydriasis
Ointments
Low Solubility: Benzocaine
Procaine
low potency, slow onset, and short duration
Lidocaine
3-4x more potent than procaine
more rapid, longer duration
Mepivacaine
similar to lidocaine
effective without vasoconstrictor (can be used with CV disease)
Bupivacaine
10x more potent than procaine
epidural anesthesia
Tetracaine
10x more potent than procaine
Slower onset of action
Benzocaine
Topically only