Term
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Definition
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Term
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Definition
short acting local anes
Ester-short acting
very safe rapid metabolism
Painful muscle injection
acidic solution
binds Ca++ in muscle
Used in Epidural |
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Term
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Definition
short acting local anes
Ester-30-60 min
Topical
Toxicity>200-300 lead to Methemoglobinemia |
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Term
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Definition
short duration-ester
30-60 min duration if epi added
Safe and used in spinal |
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Term
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Definition
Intermediate acting Local Anesthesia-amide
60-120 min
120-180 min when epi added
Used in: infiltration, PNB, IV regional
, Epidural, spinal, topical |
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Term
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Definition
Intermediate acting LA-ester
Inhibits uptake of Catecholamines
Vasoconstrictor effects
Excellent topical anesthetic (mucus membrane)
Used: topical reraly used |
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Term
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Definition
Intermediate acting LA-amide
Rapid metabolism-least toxic of amides
1-2 hrs infiltration
Use: topical, infiltration, iv regional, PNB, Epidural
Commonly as Eutecti mixture> methehemoglobinemia |
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Term
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Definition
Intermediate acting LA
Amide
1-4 hrs infiltration
Used: PNB, infiltration, spinal |
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Term
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Definition
Long acting LA:2-8 hrs amide
High incidence of refractory ventricular arrhythmias when absorbed IV
Hight protein bound (esp Cardiac)
Used: infiltration, PNB, Epidural, Spinal |
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Term
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Definition
Long acting LA amide: 2-6 hrs
Much less cardiotoxic than Bupivacaine
Used: infiltration, PNB, epidural, spinal |
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Term
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Definition
Long acting LA amide: 2-8 hrs
Used: infiltration, PNB, Epidural |
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Term
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Definition
Long acting LA ester: 2-6 hrs spinal
30-60 topical
May need toxic doses for adequate Peripheral Nerve blocking (PNB), infiltration, epidural
Popular for long-duration spinal |
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Term
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Definition
common mixture
toxicity is additive |
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Term
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Definition
| Repeated injection of same dose of LA leads to decreasing efficacy |
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Term
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Definition
pain is alpha and C fiber
Sympathetic is B and C fiber |
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Term
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Definition
| block sensory more than motor |
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Term
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Definition
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Term
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Definition
| when blocking large nerve trunks, sympathetic nerves are always blocked: vasodilation |
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Term
| WHat are short acting LA? |
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Definition
Procaine
Chloroprocaine
Benzocaine |
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Term
| What are Intermediate Acting LA? |
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Definition
Lidocaine
Mepivacaine
Prilocaine
Cocaine |
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Term
| What are the long Acting LA? |
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Definition
Bupivacaine
Ropivacaine
Etidocaine
Tetracaine |
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Term
| What are the Effect of Mixture of LA? |
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Definition
No evidence that this gives a better block
Toxicity is Additive
Lidocaine and Bupivacaine common mixture: lead to rapid onset of Lido with longer duration of Bupiv |
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Term
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Definition
| repeated injection of Same dose of LA leads to decreasing efficacy |
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Term
| EMLA (Eutectic, Mixture of Local Anesthetic) cream can cross skin |
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Definition
5% Lidocaine and 5% Prilocaine in oil water emulsion to Penetrate skin
Used for superficial dermal surgery,IV or surgical wound
Lead to Methemoglobinemia toxicity |
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Term
| What is Local infiltration? |
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Definition
Injection into surgical area w/o regard to blocking specific nerves
Quick onset-blocks small terminal nerve branches
Best for superficial procedures |
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Term
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Definition
Block several sensory nerves supplying the surgical site
Best for areas where there is overlapping innervation:
used with interdigital block
part of ankle block |
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Term
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Definition
apply La directly around specific nerves supplying surgical site
Usually larger nerve trunks-slower onset
Possibility of neural injury from needle
Example: interdigital block |
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Term
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Definition
Blocks all nerves formed in plexus:
brachial plexus
Lumbar plexus
Cervical plexus |
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Term
| What is intravenous regional block (Bier Block) ? |
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Definition
Most common use: lower arm
limb is exsanguinated and a tourniquet is inflated, local anesthesia injected into extremity vein
Lidocaine most commonly used, Tourniquet deflated to terminate action of LA: operation >20 min |
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Term
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Definition
An agent that allays activity and excitement
Frequently associated with decreased awareness |
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Term
| How can the same drug act as an anxiolytic or a hypnotic? |
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Definition
| A particular drug's particular effect is usually dose dependent: Calming >anxiolysis>sedation>hypnosis>coma |
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Term
| How are barbiturates classified?' |
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Definition
Frequently classed by duration of action:
long
intermediate
short
Ultra-short |
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Term
| How can drugs which are slowly metabolized have a short duration of action? |
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Definition
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Term
| What is Barbiturate Mechanism of Action? |
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Definition
Interact with post-synaptic GaBAa receptors to decrease dissociation of GaBa
ALso mimic action of GaBa
Hyperpolarize post-synaptic cells |
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Term
| What are Ultra-short acting Barbiturates? |
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Definition
Methohexital
Thiamyl
Thiopental |
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