Term
|
Definition
Metabolised ester hydrolysis plasma
Side effects increased by PABA preservative
cocaine
procaine
tetracain
benzocaine (sunburn) |
|
|
Term
|
Definition
Metabolized liver (last longer)
lidocaine
bupivicaine
mepivicaine
REMEMBER 2 I's in AMIDE and there is an I in liver |
|
|
Term
| local anestetics pharmacodynamics |
|
Definition
1. B crosses membrane
2. B gaines H+ charge
3. BH+ enters open Na+ channel
4. BH+ blocks Na+ propagation of signal |
|
|
Term
Decrease of local anestetic dose needed:
(pH, nerve size, active vs. inactive) |
|
Definition
1. small diameter
2. high tissue pH
3. Active nerves
4. sensory fibers |
|
|
Term
| Local anesthetic absorption |
|
Definition
anestetics typically vasodilate
(given with epi to keep on site)
exception is cocaine |
|
|
Term
| local anestetic potency and binding rules |
|
Definition
1. more potent = more lipophilic
2. more binding = longer duration
alkalyzation increases speed onset
acidification increases length |
|
|
Term
| typical local uses anestetics |
|
Definition
cocaine: ENT
Lido/tetra: nose/mouth/throat
benzo: otc/sunburne
EMLA = lido + prilo for iv site
Lido for suture site
bupivicaine for wound injection |
|
|
Term
| local anestesia systemic toxicity |
|
Definition
1. CNS excitation seizures or depression via Na block
2. nonrecoverable cardiac injury --> bupivocaine worse because longest duration
3. methemoglobinemia: PRILOCAIN/BENZOCAINE rx = methylene blue |
|
|
Term
| 1. pre-anestetic anxiolytic |
|
Definition
midalozam = h2O soluble = less irritating
administered in coke
reversible with flumazenil |
|
|
Term
|
Definition
Opioid morphine/fentyl
-preop pain
increases post op nause/vomiting
causes respiratory depression
histamine release with morphine |
|
|
Term
| pre-anestetic for post op nausea vomit |
|
Definition
1. 5ht3 ondansetron (choice cyp450)
2. dexamethazone
3. scopolamine (anti-M = dry mouth)
4. propofol
female/smoker/opioid/hx of ponv |
|
|
Term
|
Definition
1. NPO
2. Metoclopramide (kinetic)
3. H2 inhibitor such as Na citrate |
|
|
