Term
| how do anesthetics cause vasodilation? |
|
Definition
-carry away LA from intended site
-decrease in duration of LA
-Increased systemic toxicity
-Increased bleeding |
|
|
Term
| what do vasoconstrictors do? |
|
Definition
-decrease blood flow to area of LA
-reduce amount of LA required to anesthetize
-increase duration of LA
-lows absorption of LA into CVS reducing toxicity |
|
|
Term
| what are 2 types of vasoconstrictors? |
|
Definition
epinephrine (most common; benchmark)
levondefrin |
|
|
Term
| what are 2 sympathetic drugs that act on sympathetic nervous system? |
|
Definition
catecholamine
adrenergic drugs |
|
|
Term
| why can a person with history of MI avoid local with epi? |
|
Definition
| blood vessels already clogged due to MI could cause more heart problems. |
|
|
Term
| what could happen if a person with hyperthyroidism is given local with epi? |
|
Definition
thyroid storm could occur
high bp
high pulse
high temp
fatal!!! |
|
|
Term
| what is endogenous epinephrine? |
|
Definition
it is excreted by adrenal glands
it can compound adverse effects with these pts:
MI
uncontrolled hyperthyroidism
angina
cva
arrythmia |
|
|
Term
| what is a relative contraindication? |
|
Definition
can recieve epi at least possible dose, must be monitored closely. 0.04mg per appt using best technique.
aspiration/injects slowly |
|
|
Term
| what is absolute contraindication? |
|
Definition
absolute contraindication cannot get epi!!!!
MI
coronary bypass
uncontrolled high bp
uncontrolled angina
uncontrolled arrythmias
sulfite allergies(sulfite is a preservative in epi)
uncontrolled hyperthyroidism
cocaine/meth
glaucoma |
|
|
Term
| what type of receptors are responsible for excitatory actions that cause vasoconstriction of heart and increase in HR? |
|
Definition
|
|
Term
what are the receptors responsible for :
-increased force
constriction of coronary arterioles
direct stimulation
increased velocity
inhibitory actions
and relaxing bronchioles
|
|
Definition
|
|
Term
| what is the strongest ratio for epi? |
|
Definition
1:50,000 (most hemostasis)
|
|
|
Term
| what is the most common ratio for epi? |
|
Definition
| 1:100,000 is most common for epi |
|
|
Term
| when would you use 1:200,000 ratio for epi? |
|
Definition
| for relative contraindications |
|
|
Term
| as epi declines in tissues (wears off)what happens to vessels? |
|
Definition
| vessels dilate as epi declines |
|
|
Term
| WHAT IS THE MAXIMUM RECOMMENDED DOSE OF EPI FOR NORMAL pts? |
|
Definition
| 0.2 mg is maximum recommended dose |
|
|
Term
| what is the dose used for cardiac compromised or relative contraindication pts? |
|
Definition
|
|
Term
what to know about levondordefrin (neo-cobefrin)
|
|
Definition
it is 1/6 (15%) as potent as epi
it is used in 1;20,000 ratio and used with 2% mepivicaine
it is weak!!!! |
|
|
Term
| when can you use felypressin? |
|
Definition
may be given to uncontrolled hyperthyroid pt, or pt taking tricyclic antidepressents or MAO inhibitors.
used in great britain
has few side effects |
|
|
Term
| what are signs of accidental overdose of epi? |
|
Definition
CNS stimulation
Dysrhythmias
Ventricular fibrillation
increase in HR
Cardiac arrest
shaky, stimulated, arrythmia |
|
|
Term
| what to do if accidental overdose of epi occurs? |
|
Definition
| sit them up and take vitals |
|
|
Term
how long will the effects take for epi?
what is the half life |
|
Definition
effects 5-10 min
half life 1-3min |
|
|
Term
| what are good alternatives for a patient who cannot get epi? |
|
Definition
| mepivicaine 3% and prilocaine 4% have lowest vasodilating properties. does not last long!!! |
|
|
Term
| which ratio of epi gives greatest bleeding control? |
|
Definition
1;50,000
note if sodium bisulfate is added to prevent oxidation allergies can occur |
|
|
Term
| when would you use 1;1000 |
|
Definition
| in anaphylactic reaction or asthmatic attack |
|
|
