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29 Cards in this Set
- Front
- Back
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mechanism of local anesthetics
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interact with Na channels to decrease permeability of excited cells to Na ions (stops nerve conduction)
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two main categories of local anesthetics
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amides and aminoesters
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metabolism of amides
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biotransformation by the liver (important in liver disease)
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metabolism of aminoesters
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hydrolysis of ester linkages by plasma esterases (ex: cholinesterase)
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potential toxicities of local anesthetics
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-neurotoxicity (muscle twitching , CNS depression)
-cardiotoxicity (hypotension and dysrhythmias) |
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amide drugs
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-lidocaine
-mepivicaine -bupivicaine |
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aminoester drugs
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-benzocaine
-proparacaine |
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two different mechanisms of action of neuromuscular blockers
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-competitive/non-depolarizing
-depolarizing |
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mechanism of competitive (non-depolarizing) neuromuscular blocker action
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-binds to ACh receptor to prevent ACh transmission
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does competitive neuromuscular blocker action cause a muscle contraction?
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no
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how do depolarizing neuromuscular blockers function?
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-binds to receptor and allows influx of Na, depolarizing the end plate
-remains bound, making the end plate non-responsive |
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do depolarizing neuromuscular blockers cause a muscle contraction?
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yes
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two forms of drug elimination for neuromuscular blockers
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-liver metabolism and clearance, then renal elimination (vecuronium, pancuronium)
-hydrolysis by plasma cholinesterases (atracurium, succinylcholine) |
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competitive (non-depolarizing) drugs
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-atracurium
-vecuronium -pancuronium |
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depolarizing drugs
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succinylcholine
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is there a reversal agent for competitive/non-depolarizing drugs?
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yes - cholinesterase inhibitor
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is there a reversal agent for depolarizing drugs?
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no
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what is the effect of a cholinesterase inhibitor on a competitive/non-depolarizing drug?
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reverse action (increases ACh)
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what is the effect of a cholinesterase inhibitor on a depolarizing drug?
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enhances the drug's action (blocks its metabolism)
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are neuromuscular blockers analgesics?
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no!
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lidocaine
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amide, local anesthetic
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mepivicaine
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amide, local anesthetic
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bupivacaine
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amide, local anesthetic
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benzocaine
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aminoester, local anesthetic
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proparacaine
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aminoester, local anesthetic
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atracurium
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competitive neuromuscular blocker
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vecuronium
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competitive neuromuscular blocker
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pancuronium
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competitive neuromuscular blocker
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succinylcholine
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depolarizing neuromuscular blocker
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