Pharm Local Anesthetics

Front 1

Name the short acting ester local anesthetic(s).

Back 1

Procaine
Chloroprocaine

Front 2

Name the long acting ester local anesthetic(s).

Back 2

Tetracaine

Front 3

Name the major topical ester local anesthetic(s).

Back 3

Cocaine

Front 4

Name the intermediate acting amide local anesthetic(s).

Back 4

Lidocaine
Prilocaine
Articaine

Front 5

Name the long acting amide local anesthetic(s).

Back 5

Mepivacaine
Bupivacaine
Etidocaine
Ropivacaine

Front 6

Where are ester local anesthetics metabolized?

Back 6

In the plasma, by plasma esterases.

Front 7

Where are the amide local anesthetics metabolized?

Back 7

In the liver by microsomal enzymes.

Front 8

Where are modified amide local anesthetics excreted from?

Back 8

Kidneys

Front 9

A patient comes in with a history of liver disease. What local anesthetic would you give, and which would you avoid giving?

Back 9

Give: Esters
Don't give: Amides

Why? Amides are modified in the liver, so if the liver's not functioning well, then you might have problems associated with amide toxicity or something like that.

Front 10

Procaine's uses include?

Back 10

(Mainly) Infiltration anestheisa
and
(occasionally) Diagnostic nerve blocks

Front 11

Hydrolysis of procaine produces?

Back 11

Paraaminobenzoic acid (PABA), which inhibits sulfonamides.

Front 12

A patient is taking a large amount of sulfonamide drugs. What drug should you avoid giving and why?

Back 12

Avoid giving Procaine in patients taking lots of Sulfonamide drugs because Procaine gets hydrolysed to PABA (paraaminobenzoic acid), which inhibits sulfonamides.

Front 13

Procaine's onset is?
It's DOA is?

Back 13

Slow
Short (45-60 mins)

Front 14

Chloroprocaine's onset is?
It's DOA is?

Back 14

Rapid
Short (30-45 mins)

Front 15

Chloroprocaine has a reduced acute toxicty, why?

Back 15

It's rapidly metabolized, so it's not really around long enough to have toxic effects.

Front 16

Adverse effect(s) of Chloroprocaine?

Back 16

Increased back pain with EPIDURAL anestheisa.

Front 17

Tetracaine's onset?
DOA?
Is it potent?

Back 17

Slow onset
Long(est) (of the esters)
...(60-180 mins)
Very potent

Front 18

Tetracaine's use(s) include?

Back 18

SPINAL anesthesia (this is a long procedure)

Front 19

Adverse effect(s) of Tetracaine include?

Back 19

Systemic toxicity (possibly due to slow metabolism)

Hypersensitivity reaction?
Yes, so do not use for LOCAL infiltration anesthesia.

Front 20

Lidocaine's onset?
DOA?

Back 20

Quick onset
Short-Intermediate DOA (60-120)

Front 21

Lidocaine can be used how?

Back 21

Anti-arrhythmic agent

Topically (patch)
Local Infiltration
(any local anesthetic use)

Front 22

Prilocaine's onset?
DOA?

Back 22

Slow onset
Short-Intermediate DOA (60-120 min)

Front 23

Adverse effect(s) of Prilocaine?

Back 23

Methemoglobinemia in NEONATES

Front 24

Articane's usually used for what?
How does the onset/DOA relate to this use?

Back 24

Dental procedures.
Rapid onset
Short/Intermediate DOA
(60 mins)

Front 25

What local anesthetic drug combination can be used to create an occlusive dressing?

Back 25

Lidocaine and Prilocaine

Front 26

Lidocaine and Prilocaine combination is used as an anesthetic prior to?

Back 26

Venipuncture
Skin graft harvesting
Infiltration of anesthetics into genitalia

Front 27

Mepivacaine's onset?
DOA?

Back 27

Slow onset
Long DOA (90-180 min)

Front 28

Adverse effect(s) of Mepivacaine?

Contraindication(s) of Mepivacaine?

Back 28

AE: Neonatal toxicity

C/I: Pregnancy/obstetric use.

Front 29

Bupivacaine's onset?
DOA?

Back 29

Slow onset
Long DOA (240-480 min)

Front 30

Bupivacaine's adverse effect(s) include?

Contraindicatino(s) of Bupivacaine include?

Back 30

AE: Cardiotoxicity

C/I: Cardiac pt for spinal anesthesia

Front 31

Use(s) of Bupivacaine include?

Back 31

Labor
Post-operative period

(usually by continuous infusion)

More sensory than motor block (ex: brachial plexus??)

Front 32

Etidocaine's onset and DOA are?

Back 32

Slow onset
Long DOA (240-480 min)

Front 33

Which local anesthetic is no longer used in the USA?

Back 33

Etidocaine

Front 34

Ropivacaine's onset and DOA?

Back 34

Slow onset
Long DOA (240-480 min)

Front 35

A pt with a history of cardiac problems comes in for long acting pain relief treatment. You believe a local anesthetic would help. Which one would you give, and via what route/use?

Back 35

Ropivacaine
Via Spinal Anesthesia

(Suitable for both Epidural and Spinal anesthesias)