Term
| two TYPES of LOCAL ANESTHETICS? specifics of each |
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Definition
ESTERS-don't cross placenta--> safe in pregnancy
-hydrolyzed in blood
AMIDES-liver metabolism, CI in liver diseased patients |
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Term
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Definition
blocks Na+ channel--> must cross membrane and work from inside (closes H gate of channel)
**WORKS MOSTLY ON HIGH FIRING NEURONS** because outside gate (M gate) is open--> easier access |
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Term
| ***what is the order of FIBER ANESTHESIA?*** |
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Definition
sympathetic fibers-->sensory fibers-->motor fibers
1) B and C fibers (vaso/visceromotor & pain/touch)
2) C dorsal root & A delta (pain/touch)
3) A alpha/beta (motor) |
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Term
| common side effects of LOCAL ANESTHETICS |
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Definition
CNS: restlessness, tremors (inhibits inhibitory neurons)
CVS: decreased contractility, conductance; arteriolar dilation
SMOOTH MUSCLE: relaxation minus uterus |
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Term
| name the ESTERS and duration of action |
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Definition
procaine-short acting
chloroprocaine-short acting
tetracaine-long acting |
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Term
| name the AMIDES and duration of action |
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Definition
**NO SHORT ACTING AMIDES**
LIDOCAINE-intermediate
PRILOCAINE-intermediate
MEPIVACAINE-long
BUPIVOCAINE-long
ROPIVOCAINE-long
ARTICAINE |
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Term
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Definition
short acting ESTER
-PABA metabolite inhibits SULFONAMIDE |
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Term
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Definition
SHORT acting ESTER
-causes back pain
**often given with BUPIVOCAINE because it is fast acting** |
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Term
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Definition
**only LONG acting ESTER**
-spinal epidural anesthesia |
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Term
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Definition
INTERMEDIATE acting AMIDE
-given with EPI to increase duration (vasoconstriction)
-also given topically
**anti-arrhythmic**
-FAST ACTING |
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Term
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Definition
INTERMEDIATE acting AMIDE
-can cause METHEMOGLOBINEMIA-->FE3+ cant be converted to FE2+ |
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Term
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Definition
LONG acting AMIDE
**toxic to NEONATES** |
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Term
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Definition
LONG acting AMIDE
-used for indwelling catheters
**cardiotoxic & arrhythmogenic**
**only AMIDE that is safe in PREGNANCY because it is highly protein bound**
-sometimes given with CHLOROPROCAINE |
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Term
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Definition
LONG acting AMIDE
-safe for childbirth |
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Term
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Definition
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