Pharmacology Winter Test 2 L1 Local Anesthetics

Front 1

What phases of the sodium channel do drugs bind most readily to?

Back 1

Acitvated and inactivated sodium channels

Front 2

What are the acid-base properties of local anesthetics?

Back 2

these are weak bases with pKa's from 8.0-9.0
making them ionized in the cell, mostly

Front 3

What are the two main types of bonds in the middle of local acting anesthetics?

Back 3

Ester or Amide bonds

Front 4

What metabolizes ester based local anesthetics?

Back 4

pesudocholinesterase

Front 5

what metabolizes amide based local anesthetics?

Back 5

cytochrome p450 in the liver

Front 6

What are the general CNS toxicities of local anesthetics?

Back 6

sleepiness, visual and auditory disturbances, mouth numbness, nystagmus, twitching, seizures, death

Front 7

What do local anesthetics do to the heart (generally)

Back 7

cardiac arrythmias and negative inotropic action

Front 8

What does Bupivacaine do to the heart?

Back 8

more cadiotoxic than the rest- widens QRS

Front 9

What does Cocaine do to the cardiovascular system?

Back 9

HTN, vasoconstriction, ischemia, arrhythmias

Front 10

What is the blood toxicity of prilocaine?

Back 10

the metabolite of prilocaine produces methemoglobinemia.

tx methylene blue

Front 11

What local anesthetic group is common for allergic reactions?

Back 11

ester type bonds

Front 12

What kind of drug is Procaine (novocain)?

Back 12

this is an ester based local anesthetic
(PABA- allergy warning)

Front 13

How long does Procaine (novocain) last?

Back 13

this has a short action of duration

Front 14

How does epinephrine affect Procaine (novocain)?

Back 14

this adds a vasoconstrictor effect, which decreases the rate of anesthetic absorption/breakdown

Front 15

What is the onset and duration of Tetracaine (pontocaine)?

Back 15

this has a slow onset of more than 10min, but long action 2-3 hours

Front 16

What is the common use for Tetracaine (pontocaine)?

Back 16

this is used for spinal anesthesia and for opthalmological use

Front 17

How potent is Tetracaine (pontocaine)?

Back 17

this is 10x more potent and toxic than procaine

Front 18

What is Tetracaine (pontocaine) often mixed with for spinal injection?

Back 18

10% dextrose, to increase specific gravity so the solution is heavier than the CSF

Front 19

What is Benzocaine (americaine)

Back 19

this is a topical anesthetic used to treat sunburns

Front 20

What is cocaine used for as an anesthetic?

Back 20

this is a short acting topical anesthetic of the mucous membranes

Front 21

What is the mechanism of action of cocaine?

Back 21

this acts by blocking uptake of catecholamines in nerve terminals

Front 22

What type of drug is Lidocaine (Xylocaine)?

Back 22

this is the protoype Amide

Front 23

What uses is Lidocaine (Xylocaine) preferred for?

Back 23

infiltration blocks (local injections into the skin, affects a small area) and epidural anesthesia

Front 24

How is Lidocaine (Xylocaine) broken down?

Back 24

this is absorbed after parentral administration and metabolized in the liver via P450 system (microsomal mixed function oxidases)

Front 25

How fast does Lidocaine (Xylocaine) work?

Back 25

this is a rapid onset action, with good potency and duration

Front 26

What kind of drug is Prilocaine (Citanest)

Back 26

this is a local anesthetic like lidocaine (an Amide)

Front 27

Who should not get Prilocaine (Citanest)?

Back 27

people with cardiac or respiratory disease, or with congential methemoglobinemia.

as it induces methemoglobin production

Front 28

How long does Bupivacine (Marcaine, Sensorcaine) last?

Back 28

this has a long duration of action

Front 29

What kind of anesthesia is Bupivacine (Marcaine, Sensorcaine) preferred for?

Back 29

infiltration blocks and epidural anesthesia

Front 30

What type of drug is Bupivacine (Marcaine, Sensorcaine)?

Back 30

this is an Amide

Front 31

What kind of drug is Ropivacaine (Naropin)?

Back 31

this is a long acting Amide local anesthetic

Front 32

What is the metabolism of Ropivacaine (Naropin)?

Back 32

this is not very lipid soluble, and is cleared by the liver and is therefor less likey for adverse events