Anesthesia and Inhaled Anesthetics

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What factor can make acidic tissues difficult to anesthetize with local anesthetic?

Ester hydrolysis

Increased lipid solubility

Alkaline pH (correct)

Vasoconstriction

How does small doses of epinephrine added to local anesthetic affect duration of anesthesia?

Increases blood flow to the site

Decreases lipid solubility

Prolongs duration through vasoconstriction (correct)

Enhances ester hydrolysis

Which type of metabolism do ester local anesthetics predominantly undergo?

Ester hydrolysis (correct)

Reduction

Oxidation

Glycosylation

How does cocaine affect vasoconstriction?

Potentiates adrenergic effects Signup and view all the answers

How does increased lipid solubility influence the onset time of local anesthetics?

Shortens the onset time Signup and view all the answers

What characteristic of local anesthetics is influenced by lipid solubility?

Duration of action Signup and view all the answers

Which of the following is the most important factor affecting the speed of onset of an inhaled anesthetic?

The partial pressure of the anesthetic in the lungs Signup and view all the answers

How does the solubility of an inhaled anesthetic affect its pharmacokinetics?

High solubility requires more drug to be absorbed into the body to achieve the desired partial pressure, leading to slower onset of action Signup and view all the answers

How does the solubility of an inhaled anesthetic affect its elimination from the body?

High solubility correlates with slower elimination because more drug had to be dissolved into the body initially to achieve the desired partial pressure Signup and view all the answers

How can vessel-poor tissues affect the pharmacokinetics of an anesthetic during a long procedure?

Vessel-poor tissues act as a sink, slowly absorbing drug at the start and then releasing it at the end, prolonging elimination Signup and view all the answers

Which of the following is the most important factor affecting the distribution of an intravenous anesthetic in the body?

The volume of distribution of the anesthetic in the body Signup and view all the answers

How does the rate of hepatic metabolism affect the pharmacokinetics of an intravenous anesthetic?

Rapid hepatic metabolism leads to a faster onset of action and faster elimination of the anesthetic Signup and view all the answers

Which enzyme is responsible for the metabolism of amide-type local anesthetics?

Microsomal P-450 enzymes Signup and view all the answers

What is the main pathway of metabolism for amide-type local anesthetics?

N-dealkylation and hydroxylation by microsomal P-450 enzymes Signup and view all the answers

Which local anesthetic is associated with methemoglobinemia and is typically used only topically?

Benzocaine Signup and view all the answers

Why is chloroprocaine not used in spinal anesthesia?

Neurotoxicity Signup and view all the answers

Which local anesthetic has a butyl group attached to its aromatic group, allowing it to stay in the tissue surrounding a nerve for an extended period of time?

Tetracaine Signup and view all the answers

What is the main reason for the low potency, slow onset, and short duration of action observed in ester-type local anesthetics?

Rapid hydrolysis by circulating esterases Signup and view all the answers