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38 Cards in this Set
- Front
- Back
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how to identify an ester vs an amide local anesthetic?
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ester has ONE I
Amide has 2 I's |
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Where are ester LA's broken down?
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in the bloodstream by cholinesterases, via ESTER HYDROLYSIS
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What type of LAs are broken down in blood by cholinesterases?
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Esters
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where are amide LAs broken down?
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in the LIVER.
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What type of LAs are broken down in the liver?
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Amides
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Which type of LAs are preferred in the dental office?
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Amides - longer acting- have to get to the liver before metabolized
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What is unique about articaine (septocaine)?
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it is an amide WITH an ester group, so it is broken in blood
BUT it also penetrates tissues better |
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what amide has an ester group too?
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articaine (septocaine)
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Mechanism of LAs, which form of the LA is needed to do this?
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physically block NA channels...the non-ionized foorm
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LA toxicity is...
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CNS effects - restless, Tremors/Convulsions, Depression, Slowed respiration, Coma
CV - bradycardia, reduction in output |
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which has more sensitivity, amides or esters?
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esters
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what type of symptoms occur in an amide-type LA allergic rxn? is this more or less common than esters?
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dermatologic rash
asthmatic less common |
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what type of symptoms occur in an ester type LA allergic rxn? is this More or less common than amies?
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nasio-labial swelling, itching, oral mucosal swelling
More common |
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An additive to LA sometimes is ____which helps the vasocnstirctor by_____, sometimes gives a hypersensitivity reaction resulting in____.
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bisulfites
being a ppreservative of epinephrine asthmatic syndrome |
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which drug can you give if patient is allergic to bisulfites?
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mepiacaine 3%
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Of the following, which are TRUE allergy reaction symptoms of LA?
Fainting feeling itching @ injection site sweating tachycardia swelling @ injection site wheezing rapid breathing |
wheezing
itching swelling @ injection |
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what is a psychogenic response?
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a response such as sweating or feeling faint due to fear of the injection
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why LA less effective in inflamed tissue?
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LOWER pH (less than 7.4)
therefore less non-ionized LA |
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6 LAs available in toipical
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Benzocaine
dibucaine tetracaine lidocaine prilocaine pramoxine |
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What is the name of combo of lidocaine and prilocaine?
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oraquix
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What is oraquix? How/whenis it given?
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Prilocaine + lidocaine
topical anesthetic given for perio, in maximum 5 cartridges |
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what are the 2 vasoconsrictor used?
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epinephrine (adrenalin)
levonordefrin (neo-cobefrin) |
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what is levonordefrin?
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neo-cobefrin
a vasoconstricotr of mepivican |
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vasoconstrictor in mepivicain?
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levonordefrin
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how much levonordefrin in mepivicain?
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1:20,000
in 1.8 mL cartridge (.09mg) |
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how much epi in an LA cartridge?
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1:100,000,
in a 1.8mL cartridge (.018mg) |
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3 reasons for vasoconstrictor
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1- hemostasis (local bleeding controlled)
2 - keep anesthetic for longer period 3 - delay absorption into systemic, less toxicity |
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T or F
A hypersensitivity reaction caused by LA is asthamtic wheezing |
T
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T or F
the protonated form of LA penetrates the nerve |
F
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T or F
LA block @ nerve site by preventing sodium influx |
T
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T or F
LAs prevent an AP along the axon |
T
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T or F
ester LAs are metabolized by the liver |
F
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T or F
Ester LAs have amino group |
F
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T or F
Amides have longer duration |
T
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T or F
Low pH @ LA site enhances the effectiveness |
F
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T or F
nause is a sign of LA hypersens |
F
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T or F
Oraquix is an injection near nerve trunk to produce block |
F
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T or F
Hypertension is a sign of LA toxicity |
F
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