Local Anesthetics and Systemic Toxicity
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Questions and Answers

What is the primary reason systemic toxicity occurs with local anesthetics?

  • High blood pressure
  • Increased absorption into the systemic circulation (correct)
  • Low plasma protein levels
  • Inadequate dosage administration

Which organs are primarily affected by local anesthetic toxicity?

  • Digestive system and skin
  • Lungs and kidneys
  • Heart and central nervous system (correct)
  • Muscles and bones

What factors influence the rate of absorption of local anesthetics into systemic circulation?

  • Amount of local anesthetic administered and vascularity of the surrounding structures (correct)
  • Time of day and patient age
  • Type of surgical procedure and anesthesia method
  • Temperature and pH of the surrounding tissue

Bupivacaine is known for which of the following characteristics?

<p>High percentage of binding to plasma (C)</p> Signup and view all the answers

Why can the onset of symptoms from local anesthetic toxicity happen rapidly?

<p>Plasma becomes saturated with the anesthetic very quickly (B)</p> Signup and view all the answers

What role do enzymes in the plasma have concerning local anesthetics?

<p>They metabolize local anesthetics to eliminate them from the system (A)</p> Signup and view all the answers

Which statement is true regarding local anesthetic toxicity?

<p>The level of free drug can rise rapidly once plasma is saturated (A)</p> Signup and view all the answers

How does the vascularity of surrounding structures impact local anesthetic injections?

<p>It influences the rate of absorption into the systemic circulation (C)</p> Signup and view all the answers

What is necessary for the metabolism of local anesthetics in the body?

<p>Presence of enzymes in the plasma (C)</p> Signup and view all the answers

Which of the following consequences is a significant risk of local anesthetic toxicity?

<p>Life-threatening seizures and cardiac arrest (A)</p> Signup and view all the answers

Flashcards

Systemic toxicity

The process by which a local anesthetic (LA) reaches a concentration in the bloodstream that affects vital organs like the heart and brain.

Peri-neural administration

Local anesthetics are administered near nerves, but can be absorbed into the bloodstream.

Absorption rate

The speed at which LA enters the bloodstream depends on the amount used and the blood supply to the area.

Plasma binding

Local anesthetics are mostly soluble in water, so they bind readily to plasma.

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Plasma protein binding

The tendency of a specific LA to bind to plasma affects its duration of action and toxicity risk.

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Plasma saturation

When the plasma is saturated with LA, the level of free drug in the blood rapidly increases.

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Organ perfusion

The heart, brain, and liver receive a lot of blood flow, making them more susceptible to LA toxicity.

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LA metabolism

The body breaks down LA to remove it from the system, a process that requires enzymes.

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Enzyme dysfunction

Impaired enzyme function can slow down LA metabolism, prolonging toxicity.

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ATP dependence

Energy (ATP) is crucial for metabolic processes, including LA breakdown.

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