Term
|
Definition
Lidocaine
Prilocaine
Mepivacaine
Bupivacaine
Ropivacaine |
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Term
|
Definition
Amides are metabolized in liver by P450s
Contraindicated in severe hepatic failure pts |
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Term
|
Definition
Most common topical OTC anesthetic
Low solubility |
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Term
|
Definition
| Potential methemoglobinemia |
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Term
|
Definition
Long acting local infiltration anesthetic
Sensory blockade occurs much faster than motor blockade
Typically not used topically
Levo-bupivicaine (S-enantiomer) |
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Term
|
Definition
Lidocaine
Prilocaine
Bupivacaine (long Sgx, but cardiotoxic)
Ropivacaine (fewer CV effects than Bupivacaine) |
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Term
|
Definition
Done either via epidural or intrathecal
Can block ANS
Baricity determines direction of rx flow |
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Term
|
Definition
Local topical anesthetic used only in ears, nose, throat bc of vasoconstriction dec bleeding
Systemic absorption can occur
Blocks NE uptake |
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Term
|
Definition
Procaine
Cocaine
Tetracaine
Benzocaine |
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Term
|
Definition
Esters form PABA (para amino benzoic acid), which can INHIBIT SULFONAMIDES
and can cx ALLERGIC RXNS
Degraded by plasma esterases |
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|
Term
| Important Spinal anesthetics |
|
Definition
Lidocaine
Tetracaine
Bupivacaine |
|
|
Term
|
Definition
Lidocaine
Prilocaine
Mepivacaine |
|
|
Term
| Intravenous regional anesthesia |
|
Definition
IV administration into tourniquet-occluded limb
Lidocaine w/o EPI used most frequently
Used for forearm and hand sgx |
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Term
|
Definition
| determined by protein binding and hydrophobicity |
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Term
|
Definition
|
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Term
|
Definition
Most popular local anesthetic
Infiltrative and topical
Used topically in combo w prilocaine can achieve anesthesia at 5mm |
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Term
|
Definition
| Doses cxing CNS toxicity cx CV depression |
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Term
|
Definition
| determined mainly by lipid solubiity |
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|
Term
| Local anesthetics mechanism |
|
Definition
| Block "fast" voltage-gated Na channels in the inactivated state |
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Term
|
Definition
Bupivacaine
Ropivacaine
Tetracaine
Etidocaine |
|
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Term
|
Definition
|
|
Term
| Mepivacaine contraindications |
|
Definition
|
|
Term
| Order of functional block |
|
Definition
1. pain, autonomic C-fibers
2. cold
3. warmth
4. touch
5. deep pressure
6. motor
*Recovery in reverse order
Small fibers more susceptible
(autonomic)> pain fibers> sensory> motor |
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Term
|
Definition
Used to produce greater areas of anesthesia than infiltration
Minor blocks involve single nerve
Major blocks involve multiple nn
Brachial plexus most commonly |
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Term
|
Definition
| In combo w lidocaine can achieve anesthesia 5 mm deep topically |
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Term
|
Definition
| potential methemoglobinemia |
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Term
|
Definition
Local infiltration anesthetic
Slow onset, short duration |
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Term
|
Definition
Local anesthetic
Typically not used topically |
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Term
|
Definition
|
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Term
|
Definition
Sympathetic block
Vasodilation common
Blood pooling
Redcued Cardiac ouput
Age dependent |
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Term
|
Definition
Local anesthetic
Slower metabolism
More systemic toxicity |
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|
Term
| Toxicity of Local anesthetics |
|
Definition
CNS stimulation => depression
Dec CV activity (conduction, force, excitability)
Dec BP
Dec GI activity
Hypersensitivity rxns (dermatitis, asthma) |
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