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Drugs 1 of 4
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34
Medical
Graduate
04/27/2011

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Term
name 5 ester anesthetics
Definition
chloroprocaine, procaine, cocaine, benzocaine, tetracaine
Term
which anesthetic causes vasoconstriction?
Definition
cocaine
Term

1. how are amide anesthetics metabolized?

2. how are ester anesthetics metabolized?

Definition

1. liver

2. pseudocholinesterases

Term

1. how do anesthetics cause hypersensitivity?

2. how do ester anesthetics cause hypersensitivity?

Definition

1. procaine and benzocaine are metabolized into PABA

2. esters come in methylparaben-containing solution

Term
what can be used for differential sensory blockade?
Definition
bupivacaine, ropivacaine
Term
how do you treat bupivacaine toxicity?
Definition
intralipid
Term
signs of bupivacaine toxicity
Definition
circumoral and tongue paresthesia, tinnitus; restlessness, agitation; slurred speech, stupor, coma, tonic-clonic seizures
Term
what is an indicator of onset of action and duration of action in local anesthetics?
Definition
lipophilicity
Term
what determines rate of termination for local anesthetics?
Definition
vascularity of area
Term
what causes methemeglobulinemia?
Definition
prilocaine and benzocaine metabolites
Term
how do you treat prilocaine and benzocaine toxicity?
Definition
methylene blue
Term
what inhibits Na channels extracellularly?
Definition
tetradotoxin
Term
what is similar to bupivacaine but has less toxicity?
Definition
ropivacaine
Term
what channels/receptors do local anesthetics affect?
Definition
Ca, K, NMDA
Term
what is harder to block, sensory or motor nerves? large or small? myelinated or unmyelinated?
Definition
motor, large, unmyelinated
Term
is there more hypotension in spinal or epidurals?
Definition
spinal
Term
how much anesthesia solution do you put in a spinal injection? epidural?
Definition
2-5ml in spinal; ~10ml in epidural
Term
4 factors that affect potency of local anesthetics
Definition
fiber, pH, frequency, electrolytes
Term
4 safety measures to avoid intravascular injections with local anesthetics
Definition
awake pt, slow push, epinephrine first, use ultrasound
Term
opioid that can be used as a cough suppressant
Definition
codeine
Term
used to treat opioid OD (2); which is longer acting?
Definition
naltrexone, naloxone; NALTREXONE is longer acting
Term
used to treat opioid withdrawal and addiction
Definition
methadone
Term
opioid receptor partial agonist; can be used to treat opioid dependence
Definition
buprenorphine
Term
very strong opioid receptor agonist used for light sedation
Definition
meperidine
Term
very strong opioid agonist used for anesthesia and perioperative pain; can be administered as a patch
Definition
fentanyl
Term
rank these drugs in order of potency: hydromorphone, codeine, oxycodone
Definition
codeine < oxycodone < hydromorphone
Term
what receptors do enkephalins bind to? dynorphins?
Definition
enkephalins bind to mu and delta; dynorphins bind to mu and kappa
Term
which opioids cannot be taken orally?
Definition
meperidine and morphine (except sustained release morphine)
Term
AE of opioids (8)
Definition
respiratory depression, miosis, nausea/vomiting, constipation, chest wall rigidity, pruritus, seizures, orthostatic hypotension
Term
what 3 brain structures are involved in descending pain pathways?
Definition
rostral ventral medulla, periaqueductal gray, and locus coeruleus
Term
treatment for status epilepticus; AE: arrhythmias
Definition
fosphenytoin
Term
tx for status epilepticus (5)
Definition
diazepam, lorazepam, phenobarbital, fosphenytoin, levetiracetam
Term
AE: gingival hyperplasia, hirsutism, megaloblastic anemia, osteomalacia
Definition
fosphenytoin, phenytoin
Term
pharmacokinetics of fosphenytoin
Definition
zero order elimination
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