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30 Cards in this Set
- Front
- Back
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The _____ form of the molecule is more lipid soluble and can more readily cross cell membranes
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Non-ionized
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The non-ionized form of the molecule in more lipid soluble and _____ less easily into the vasculature
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Diffuses
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Bicarb reduces the fraction of :
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Protonated LA
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Bicarb allows more ____ to cross the membrane
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LA
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Protonated also means
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Ionized
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____LA is less membrane permeable than the other form
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Ionized
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Faster onset of block when used with:
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Bicarb
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Bicarb is especially useful in LAs formulated with ____ by manufacturer
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Epi
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Bicarb _____ and diffuses across the cell membrane
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Dissociates
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Bicarb causes _____ CO2 inside the cell which decreases the pH
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Increased
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LA works best in ____ environments, so bicarb is helpful
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Acidic
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Too much bicarb can cause:
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Precipitation
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Lidocaine: add ____ of bicarb per 10 ml of solution
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1
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Bupivacaine: add _____ of bicarb per 10 ml of solution
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0.1
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Central neuraxial opioids is the addition of narcotics to:
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Spinal or epidural injection or infusion
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Central neuraxial opioids are more localized to the _______ than if you injected in a vein
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Correct receptors
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You can use much ______ with neuraxial opioids
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Smaller doses
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Primary targets of neuraxial opiods:
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Receptors in dorsal horn and substantia gelatinosa of SC
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Benefit of central neuraxial opioids: decreased
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CNS depression
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Benefit of central neuraxial opioids:
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Rapid, profound analgesia
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Benefit of central neuraxial opioids:
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Long duration of effect
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Benefit of central neuraxial opioids:
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No motor blockade
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Benefit of central neuraxial opioids:
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No sympathectomy
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Benefit of central neuraxial opioids: reduced doses and concentrations of
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LA
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Morphine and hydromorphone have relatively low lipid solubility, they tend to:
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Travel
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MS and dilaudid have ____ spread
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Cephalad
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Cephalad spread can cause:
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Resp depression
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Fentanyl and sufentanyl have relatively high lipid solubility so they tend to:
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Stay put
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Fentanyl and sufentanyl are taken up by ______ and released more slowly in the SC
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Yellow fat
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Increases analgesia and duration when added to LA; not used much anymore
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Clonidine
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