Pharmacology_2 09: Local Anesthetics

Front 1

3 parts of all local anesthetics

Back 1

aromatic ring
intermediate linkage
terminal amine

Front 2

2 kinds of intermediate linkage

Back 2

ester
amide

Front 3

aromatic ring lipophilicity determines ___ (2)

Back 3

potency
duration of block

Front 4

2 kinds of terminal amine
___ amines are water soluble

Back 4

tertiary
quaternary
quaternary

Front 5

4 factors determining whether an amine is protonated

Back 5

pKa
temperature
ionic strength
surrounding medium (tissue pH)

Front 6

___ nerves have many axons encased in a single ___

Back 6

nonmyelinated
Schwann cell

Front 7

in a myelinated nerve, ___s are concentrated at nodes of Ranvier

Back 7

Na+ channel

Front 8

largest and fastest conducting fibers are ___ (2)

Back 8

Aalpha
Abeta

Front 9

Aalpha fibers carry ___ signals to/from ___

Back 9

efferent
muscle

Front 10

Abeta fibers carry ___ signals to/from ___ (2)

Back 10

afferent
skin
joints

Front 11

___ fibers are the most susceptible to nerve block. they carry ___ signals to/from ___ for ___.

Back 11

Agamma
efferent
muscles
muscle tone

Front 12

___ fibers are the 2nd most susceptible to nerve block. they carry ___ signals to/from ___ for ___ (4).

Back 12

Adelta
afferent
skin
pain
cold
touch
temperature

Front 13

all A fibers are ___

Back 13

myelinated

Front 14

3 determinants of membrane currents during an action potential

Back 14

membrane potential (E_M)
Na+ conductance (g_Na+)
K+ conductance (g_K+)

Front 15

tissue uptake of local anesthetic favors ___ form

Back 15

base (neutral)

Front 16

in voltage-clamp experiment, local anesthetics cause decrease in ___ (2) after an impulse

Back 16

Na+ current amplitude
Na+ dI/dt

Front 17

Na+ channel binds local anesthetics in ___ (2) states. in ___ state it doesn't

Back 17

open
inactivated
resting

Front 18

local anesthetics bind Na+ at TM domain ___. they interfere with ___ (2)

Back 18

6
channel opening
flow of Na+

Front 19

rates of onset and recovery for nerve block are determined by ___

Back 19

diffusion of anesthetic into/out of nerve

Front 20

esters are stable/unstable
amides are stable/unstable

Back 20

unstable
stable

Front 21

aminoesters are hydrolyzed by ___
an exception is ___, which is metabolized by ___.

Back 21

cholinesterase
cocaine
hepatic carboxylesterase

Front 22

amides are degraded by ___ and are excreted by ___

Back 22

liver enzymes
kidney

Front 23

increased anesthetic dose causes ___ (2)

Back 23

increased block duration
shorter time to block onset

Front 24

anesthetic dose can be increased by ___ (2)

Back 24

increased volume
increased concentration

Front 25

___s such as ___ are used to reduce vascular absorption of anesthetic

Back 25

vasoconstrictor
E

Front 26

most rapid onset and shortest duration is for ___ (2) injection

Back 26

subcutaneous
intrathecal (into spinal canal)

Front 27

longest latency and longest duration is for ___ blocks

Back 27

brachial plexus

Front 28

injection into subarachnoid space causes fast/slow block

Back 28

fast

Front 29

carbonation causes ___ed required concentration and ___ed time of onset

Back 29

reduced
reduced

Front 30

when you need to anesthetize a large surface area, use ___ volume of ___ anesthetic
one example of this is ___ anesthesia, used in ___

Back 30

large
dilute
tumescent
liposuction

Front 31

4 sites of injection in decreasing speed of absorption

Back 31

intercostal nerve
epidural
brachial plexus
subcutaneous

Front 32

local anesthetic is rapidly extracted by ___
highest % of anesthetic winds up in ___

Back 32

lung tissue
skeletal muscle

Front 33

local anesthetics are toxic to ___ (2)

Back 33

CNS
heart

Front 34

3 motor signs of anesthetic toxicity

Back 34

shivering
twitches
tonic-clonic convulsion

Front 35

in anesthetic toxicity there is decreased rate of depolarization in ___ (2) in heart

Back 35

Purkinje fibers
ventricular muscle

Front 36

in anesthetic toxicity there is reduced cardiac ___

Back 36

contractility

Front 37

vascular effect of all local anesthetics except cocaine

Back 37

vasodilation

Front 38

prilocaine and EMLA can cause ___

Back 38

metHbemia