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46 Cards in this Set

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usually 2% or 3%
Anaesthetic
epinephrine or other sympathomimetic
Vasoconstrictor
retards oxidation of epinephrine
Antioxidant
adjusts pH of solution
sodium hydroxide
solution isotonic
sodium chloride
frequently used MDs to control cardiac arrythmias, rapid onset, 1-1.5 hrs with vasoconstrictor
Lidocaine (Xylocaine, Octocaine)
*amide
similar to lidocaine, usual vasoconstrictor is levonordefrin (Neo-Cobefrin)
Mepivacaine (Carbocaine,Polocaine, Isocaine)
*amide
less potent, less toxic than lidocaine with slightly longer duration
Prilocaine (Citanest)
*amide
less toxic, more potent than lidocaine with much longer duration of action. Good for long procedures or post-op surgery
Bupivacaine (Marcaine)
*amide
usually used as topicals
Esters
safest, frequently used as an antiarrythmic agent
procaine (Novocain)
*Esters
propoxycaine (Ravocaine)
Esters
more potent, more toxic than procaine, slow onset long
tetracaine (Pontocaine)
How are amides metabolized?
by liver
How are esters metabolized?
by blood
How are esters and amides excreted?
by the kidneys
(Adverse Reactions) to Local Anesthetics
-What two systems does toxicity affect?
CNS and C-V
1. cns- initial stimulation as restlessness,tremors, and convulsions
2. cns- depression leading to coma and death
3. c-v-myocardial depression, possible fatal arrhythmia
adverse reactions to local anesthics
What was the first local anesthetic but potential for abuse?
Cocaine
What do local anesthetics affect?
affect myelinated nerves at Nodes of Ranvier
What do local anesthetics act by?
Interference with the depolarization of the nerve membrane
Where do local anesthetics affect first?
smaller nonmyelinated nerves, then myelinated nerves
1. Benzodiazepines
2. Barbiturates
3. Nonbarbiturates
4. CNS Muscle relaxants
5. Miscellaneous agents
Antianxiety Agents
In small doses what do antianxiety drugs produce?
mild CNS depression resulting in sedation
In larger doses what do antianxiety agents do?
May induce sleep (hypnotic effect
Dizapam (Valium) is included in what category?
Benzodiazepines
Why are benzodiazepines (Valium) effective to control seizures?
due to local anesthetic toxicity
Why is are benzodiazepines beneficial with cerebral palsy or paraplegia?
It is a skeletal muscle relaxant
Where are Benzodiazepines concentrated?
In adipose tissues
What do Benzodiazepines reduce?
*anxiety, and alters perception of time
* aggression and hosility
With benzodiazepines what are some an adverse effect that could be beneficial?
*CNS-depression: fatigue, drowsiness, muscles weakness
*transiet amenesia
IV may lead to what with benzodiazepines?
Thrombophelibitis
What is the replacement for benzodiazepines in clincal use as antianxiety agents?
Barbiturates
What is an ultra-short acting barbiturate?
Methoheixtal Thiopental
What is a short acting barbiturate?
Pentobarbital
What is an intermediate acting barbiturate?
amobarbital
What is a long acting barbiturate?
phenobarbital
What are nonbarbiturates used for?
to treat insomina
Zolpiedem (Ambien)
What nonbarbiturate is used to sedate kids?
Chloral Hydrate (Nortec)
*But benzodiazipines are safer
Meprobamate (Equanil,Miltown) are similiar to?
Barbiturates
What are barbiturates primarily used as?
anticonvulsants and to induce general anesthesia
Centrally Acting Muscle Relaxants are only used for what in dentistry?
To treat TMD
Baclofen is used to treat?
Trigeminal neuralgia (A.K.A Tic Douloroux)acts at spinal level -the fifth nerve
increases force and strength of myocardium without increasing oxygen demands?
Digoxin (Lanoxin)
nifedepipine (Procardia) is the most common?
Calcium Channel blocking agents
metoprolol (Lopressor) is in what category?
Beta-adrenergic Blocking Agents