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Clinical Neuro
Local Anesthetics
32
Biology
Graduate
01/15/2008

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Cards

Term
Name the esters of Local anesthetics
Definition

Cocaine

Procaine

Tetracaine

Benzocaine

Term
Name the Amdies of local anesthetics
Definition

1. Lidocaine

2. Mepivacaine

3. Bupivacaine

4. Etidocaine

5. Priolcaine

6. Ropivacaine

Term
What form of a Anesthetic is in the active form at the binding site
Definition
Cation
Term
What's the effect of Epinephrine & phenylephrine (Vasoconstrictors) on Anesthetics
Definition
Decrease regional blood flow, reducing systemic absorption and prolonging the effect
Term
Name the 2 spinal anesthetics
Definition
Epinephrine and Clonidine
Term
What's the mechanism of action of epinephrine and Clonidine
Definition
Acts on alpha 2 adrenergic receptors which inhibit sensory firing
Term
The esters are metabolized in the blood by
Definition
butyrylcholinesterase
Term
what are the Amides metabolized
Definition
Liver microsomal cytochrome P450
Term
The amdies can cause _______ disease or reduce _____ blood flow decreasing metabolism and increase toxicty
Definition
Liver disease
hepatic blood flow
Term
Which form of the anesthetic is excreted?
Definition
metabolite form
Term
If you want to increase excretion of an anesthetic what would you do?
Definition
Acidification of the urine
Term
Potency of a anesthetic is positively correlated w/
Definition
Lipid solubility
Term
which one of Activated, inactivated or resting channels has a higher affinity for anesthetics
Definition
Active and inactive
Term
What kinds of nerves are good for nerve blocks
Definition

1.  smaller the nerve the better, last to recover

2.  Myleinated

3.  Nerves with higher frequency of depolarization

4.  outer nerve bundle 

Term
What are the effects of anesthetics on cardiac membranes
Definition

Blocks sodium channels

Depress normal pacemaker activity, conduction

Can cause arrythmias at high concentration 

Term
Where do tetrodotoxin and saixitoxin act on?
Definition
Block extracelluar sodium channels
Term
Where does Barachotoxin, aconitine and scorpion venom bind to
Definition
Intracellular sodium channels
Term
When would you use local anesthetics
Definition
temporary complete localized area of the body
Term
When would you use spinal anesthetics
Definition

1.  Surgery, obstetric w/in the epidural or subarachnoid space

2.  Regional anesthesia of the arm and leg for short surgical procedure 

Term
What would you use for neuropathic pain
Definition
Combination of tricyclic antidepressants and an anti-convulsant
Term
What are the short acting anesthetic
Definition
Procaine and chloroprocaine
Term
What are the intermediate acting anesthetics
Definition
Lidocaine, mepivacine and priolocaine
Term
What are the long lasting anesthetics
Definition
Tetracine, bupivacine, etidocaine and ropivacaine
Term
What are the signs of Anesthetic toxicity in the CNS
Definition

1.  Numbness around the mouth, tongue and metallic taste

2.  Auditory disturbance, visual disturbance

3.  Sleepiness

4.  restlessness 

Term
If a patient who is on anesthetics starts to go into convulsions, how would you treat
Definition
Benzodiazpine or bartiturates
Term
What are the toxic effects of anesthetics on the CVS
Definition

1.  Depress pacemaker

2.  Depress strenght of contraction

3.  Hypotension 

Term
Which type of anesthetics can cause an allergic reactoin?
Definition
Ester
Term
Which anethetic converts hemoglobin to methemoglobin
Definition
Prilocaine
Term
What's an adverse effect of lidocaine
Definition
Severe neurotoxicity
Term
Cocaine blocks the re-uptake of
Definition
Norepinephrine, Epinepherine, DA and Seratoinin
Term
What are the adverse effects of cocaine
Definition
Arrhythmia, ischemia and ucleration of the nasal mucosa
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