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12 Cards in this Set
- Front
- Back
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what are the two classes of local anesthetics?
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amides
esters |
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to which class of local anesthetics can patients have a true allergy?
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esters (d/t byproduct of metabolic degradation)
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what is the most important factor in duration of local anesthetics?
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protein binding
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what is the relationship between pKa and onset of action?
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lower pKa means faster onset of action
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max dose of epi (when added to LA)
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10 mcg/kg peds
200-250 mcgs adults |
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what can you add to LA to speed onset of blockade?
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NaHCO3 (increases pH, which lowers pKA --> faster onset of action)
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rank the following fibers from first to last onset of blockade:
A alpha A beta A delta A gamma B fibers C fibers |
1. B fibers
2. C fibers 3. A-delta then: 4. A-alpha 5. A-beta 6. A-gamma |
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rank blood flow of tissue (with respect to possible toxicity -- higher blood flow associated with greater risk of toxicity)
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TICPEBSS
Tracheal Intercostal Caudal Paracervical Epidural Brachial plexus Subarachnoid, sciatic, femoral Subcutaneous |
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one of the earliest signs of toxicity of LA
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1. circumoral/tongue numbness
(lightheadedness, tinnitus would be next, followed by visual disturbance) |
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one of the latest signs of LA toxicity
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CV collapse (only cure is bypass until drug metabolized)
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Another symptom of LA toxicity?
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methemoglobinemia (from prilocaine doses >500mg)
benzocaine, cetacaine, EMLA also rarely with NTG, SNP, sulfonamides |
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Treatment of methemoglobinemia
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methylene blue 1.5mg/kg
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