29. Anesthesiology Flashcards Preview

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Flashcards in 29. Anesthesiology Deck (82)
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1

A drug which, when applied “locally” in a concentration without toxic effects, reversibly blocks the conduction of nerve impulses (*both sensory and motor)

Local anesthetics

2

Action of local anesthetics: Blocks what?

Blocks sodium channels preventing depolarization (intracellular)

3

Injectable form of local anesthesia

Ionized form or Water soluble

4

Unionized free base form

Lipid soluble

5

Aka “acid dissociation constant”
Determines acidity of compound (ability to donate protons)

pKa

6

aka “power of hydrogen”

pH

7

pKa is aka

Acid dissociation constant

8

Lidocaine pKa = 7.8
pH = 7.8 (basic)
Ionized 💦:
Unionized:

Lidocaine pKa = 7.8
pH = 7.8 (basic)
Ionized 💦: 50%
Unionized: 50%

9

Lidocaine pKa = 7.8
pH = 4 (acidic)
Ionized 💦:
Unionized:

Lidocaine pKa = 7.8
pH = 4 (acidic)
Ionized 💦: >50%
Unionized: <50%

* kaya di nageeffect ung anes pag may infection

10

Lidocaine pKa = 7.8
pH = 10 (more basic)
Ionized 💦:
Unionized:

Lidocaine pKa = 7.8
pH = 10 (more basic)
Ionized 💦: <50%
Unionized: >50%

11

BQ: Order of Loss of Sensation
“PaT ToPS”

(“PaT ToPS”)
Pain
Temperature
Touch
Pressure
Skeletal muscle tone

12

Increase dosage of anesthesia in bloodstream

Toxicity

13

Toxicity:

Toxicity:
✅Rapid induction of LA
✅Vessel deposition
✅Over dosage

14

Maximum number of carpules

7

15

Overdosage effects:
CNS-
Cardiac-

CNS: Anxiety
Heart: ⬇️fxn of heart > ⬇️blood to brain ➡️ Syncope

16

BQ: Most common medical emergency in the dental clinic

Syncope

17

Management of syncope

Trendelenburg position

18

H1 receptor : Bronchoconstriction and vasodilation

Examples of H1 blocker?

Diphenhydramine
Cetirizine
Loratadin

19

H2 - sTWOmach = ⬆️gastric sec = pain

Examples of H2 blockers?

Cemetidine
Ranitidine

20

Preservative of LA
- prevents contamination from microbes

Methylparaben

21

BQ: Antioxidant of vasoconstrictors (reducing agent)

Sodium bisulfites
(Sa boards iniiba lang spelling ng “bisulfites”)

22

Ester has highest incidence of LA allergic reaction because of

PABA (similar to methylparaben)

23

Bacteriostatic Drug that mimics PABA (⬆️allergy)

Sulfonamides

24

Most common vasoconstrictor

Epinephrine

25

BQ: Most impt function of vasoconstrictors?

Increase duration of effect of LA

26

BQ: What is the maximum dosage of vasoconstrictors for NORMAL Patients?

0.2mg or 200mcg

27

BQ: What is the max dosage of vasoconstrictors for CARDIOVASCULAR COMPROMISED patients?

0.04mg or 40mcg

28

Maximum number of cartridges given to CARDIOVASCULAR COMPROMISED patients

2 cartridges

29

BQ: What is the max number of LA carpule for AVERAGE pxs?

7 carpules

30

BQ: True or False. All local anesthetics are vasoCONSTRICTORS.

False!
[All LAs are vasoDILATORS]
#except: Cocaine (vasoconstrictor)