Local Anesthetics

What physiochemical property of local anesthetics is described as the most important by Barash?

How does the percentage of a local anesthetic in its neutral, non-protonated form relate to its pKa value?

Which characteristic of a local anesthetic molecule would lead to rapid entry into the lipid bilayer but potential sequestration?

What property is associated with the rapid penetration of the lipid membrane by a local anesthetic?

How does increased lipid solubility affect the onset of action of a local anesthetic?

What factor is primarily responsible for increasing the duration of action of a local anesthetic?

Which type of nerve fibers would be affected first with differential blockade?

Which factor has the GREATEST influence on the amount of local anesthetic in the systemic circulation?

Which local anesthetic has the SLOWEST rate of metabolism by hepatic enzymes?

What is the relationship between protein binding and plasma concentration of local anesthetics?

Which local anesthetic has the FASTEST rate of metabolism by plasma cholinesterase?

Which property of local anesthetics is considered the most important physiochemical property according to the text?

What effect does increased protein binding have on the duration of action of local anesthetics?

In relation to onset speed, what is the impact of increasing the dose/concentration of local anesthetics?

Which local anesthetic is highlighted as an exception due to its vasoconstrictive properties?

How does increasing the lipophilicity of a local anesthetic impact the time to release the drug from lipid depots?

Which factor most reliably correlates with the pKa of a local anesthetic according to the text?

Which pharmacologic property correlates with a decrease in drug duration?

What effect does increased myelination have on nerve conduction?

What is the mechanism behind disrupting impulse conduction by local anesthetics?

In Tonic Inhibition, slower firing fibers are less susceptible to blockade due to what characteristic?

Which nerve type is MOST susceptible to blockade by local anesthetics?

What condition increases the action potential frequency, making fibers more susceptible to blockade?

What is the clinical sequence of nerve blockade when increasing local anesthetic concentrations?

Which fiber type is considered least susceptible to blockade by local anesthetics?

What factor can prolong lidocaine metabolism and elimination the most?

Which local anesthetic has a chemistry that can potentially produce methemoglobinemia at high doses?

Historically, which local anesthetic was primarily used in spinal anesthesia but is now rare outside dental applications?

Which local anesthetic is mainly used topically in ophthalmology and provides a profound motor and sensory block?

What is the primary purpose of adding vasoconstrictors to local anesthetics?

Which local anesthetic is known for its intense vasoconstriction properties and is primarily used in nasopharyngeal procedures?

Where are vasoconstrictors commonly added to local anesthetics?

Which local anesthetic has a slow onset and short duration, and was historically used mainly in spinal anesthesia?

Chloroprocaine (Nesacaine) is primarily used for epidural analgesia conversion to anesthesia.

Benzoicaine (Hurricaine) has a duration of 60-90 minutes.

Mepivacaine (Carbocaine) has a slower onset compared to lidocaine.

Adding vasoconstrictors to local anesthetics decreases the density of blockade.

Local anesthetics like lidocaine are primarily used for chronic neuropathic pain management.