Podcast
Questions and Answers
What is the duration of pulpal anesthesia for 2% mepivacaine?
What is the duration of pulpal anesthesia for 2% mepivacaine?
- 20-40 minutes
- 2-3 hours
- 60 minutes (correct)
- 3-5 hours
What is the maximum recommended dose of mepivacaine for adults based on body weight?
What is the maximum recommended dose of mepivacaine for adults based on body weight?
- 7.0 mg/kg
- 6.6 mg/kg (correct)
- 5.5 mg/kg
- 8.0 mg/kg
What is the primary reason for using 4% prilocaine with a vasoconstrictor?
What is the primary reason for using 4% prilocaine with a vasoconstrictor?
- To provide maximal hemostasis
- To reduce the risk of methemoglobinemia
- To enhance the duration of anesthesia (correct)
- To increase the intensity of anesthesia
Which vasoconstrictor is mentioned as being used with 2% mepivacaine?
Which vasoconstrictor is mentioned as being used with 2% mepivacaine?
What condition is a contraindication for the use of prilocaine?
What condition is a contraindication for the use of prilocaine?
What classification of local anesthetics is based on their chemical structure?
What classification of local anesthetics is based on their chemical structure?
Which of the following local anesthetics is known for having a short duration of action?
Which of the following local anesthetics is known for having a short duration of action?
What is the mechanism of action for all local anesthetics?
What is the mechanism of action for all local anesthetics?
Which local anesthetic is typically used for its long duration of action?
Which local anesthetic is typically used for its long duration of action?
Which local anesthetic is derived from para-amino benzoic acid esters?
Which local anesthetic is derived from para-amino benzoic acid esters?
What is an example of a vasoconstrictor commonly used with local anesthetics?
What is an example of a vasoconstrictor commonly used with local anesthetics?
Which one of these local anesthetics is known to cause less systemic toxicity?
Which one of these local anesthetics is known to cause less systemic toxicity?
Which of the following local anesthetics is classified as an amide?
Which of the following local anesthetics is classified as an amide?
What happens at high blood levels of local anesthetics in the central nervous system?
What happens at high blood levels of local anesthetics in the central nervous system?
Which cardiovascular effects are associated with local anesthetic overdose?
Which cardiovascular effects are associated with local anesthetic overdose?
What is the role of sodium chloride in a local anesthetic solution?
What is the role of sodium chloride in a local anesthetic solution?
Which local anesthetic is classified as an ester and has rapid metabolism in plasma?
Which local anesthetic is classified as an ester and has rapid metabolism in plasma?
What is the primary action of a vasoconstrictor added to local anesthetic solutions?
What is the primary action of a vasoconstrictor added to local anesthetic solutions?
Which local anesthetic is noted for producing the greatest vasodilation?
Which local anesthetic is noted for producing the greatest vasodilation?
What potential effect can non-overdose levels of local anesthetics have on the respiratory system?
What potential effect can non-overdose levels of local anesthetics have on the respiratory system?
What is the anesthetic half-life of Procaine?
What is the anesthetic half-life of Procaine?
Which local anesthetic is primarily used as a surface anesthetic and is soluble?
Which local anesthetic is primarily used as a surface anesthetic and is soluble?
What primarily affects the time to achieve peak blood levels of local anesthetics?
What primarily affects the time to achieve peak blood levels of local anesthetics?
Which of the following local anesthetics is metabolized primarily in the liver?
Which of the following local anesthetics is metabolized primarily in the liver?
Which type of local anesthetics undergoes hydrolysis in the blood plasma?
Which type of local anesthetics undergoes hydrolysis in the blood plasma?
What is the primary excretory organ for local anesthetics and their metabolites?
What is the primary excretory organ for local anesthetics and their metabolites?
Which statement regarding local anesthetics is correct?
Which statement regarding local anesthetics is correct?
What determines the degree of vasoactivity of local anesthetics?
What determines the degree of vasoactivity of local anesthetics?
Which local anesthetic is an example of an injectable anesthetic?
Which local anesthetic is an example of an injectable anesthetic?
What is the primary reason for combining procaine with propoxycaine?
What is the primary reason for combining procaine with propoxycaine?
Which statement about lidocaine is correct?
Which statement about lidocaine is correct?
What is the maximum recommended dose of lidocaine with epinephrine for adult patients?
What is the maximum recommended dose of lidocaine with epinephrine for adult patients?
Which of the following anesthetics has the shortest half-life?
Which of the following anesthetics has the shortest half-life?
Which anesthetic is primarily metabolized by the liver using microsomal fixed-function oxidases?
Which anesthetic is primarily metabolized by the liver using microsomal fixed-function oxidases?
Which anesthetic produces only slight vasodilation?
Which anesthetic produces only slight vasodilation?
Which property distinguishes lidocaine from procaine?
Which property distinguishes lidocaine from procaine?
What is the ideal use of 2% lidocaine with 1:50,000 epinephrine?
What is the ideal use of 2% lidocaine with 1:50,000 epinephrine?
Study Notes
Local Anesthetics Classification
- Local anesthetics are classified based on chemical structure, duration of action, biological site and mode of action, and mode of application.
- Ester local anesthetics include benzocaine, cocaine, tetracaine, and procaine.
- Amide local anesthetics include articaine, bupivacaine, etidocaine, lidocaine, mepivacaine, and prilocaine.
- Short-duration local anesthetics include mepivacaine HCl 3%.
- Intermediate-duration local anesthetics include lidocaine HCl 2% + epinephrine 1:1,00,000.
- Long-duration local anesthetics include bupivacaine HCl 0.5% + epinephrine 1:2,00,000, and etidocaine.
Pharmacokinetics of Local Anesthetics
- Local anesthetics are absorbed into the blood and then distributed to all the tissues of the body.
- The peak blood level of local anesthetics depends on the route of administration; intravenous route has the fastest peak blood level.
- Ester local anesthetics are metabolized by pseudocholinesterase in the blood plasma.
- Amide local anesthetics are mainly metabolized in the liver.
- Local anesthetics and their metabolites are primarily excreted by the kidneys.
Systemic Actions of Local Anesthetics
- Local anesthetics can have systemic effects if they reach high blood levels.
- Central nervous system effects include generalized tonic-clonic convulsions.
- Cardiovascular system effects include myocardial depression, decreased electrical excitability of the myocardium, decreased force of contraction, and hypotension.
- Respiratory system effects include bronchodilation but may lead to respiratory arrest at high doses.
Composition of Local Anesthetics Solution
- Local anesthetics are typically administered in solutions that contain several components.
- Local anesthetic drug is the primary component that blocks nerve conduction.
- Sodium chloride is added to make the solution isotonic.
- Sterile water is used to adjust the volume.
- Vasoconstrictors such as epinephrine are added to increase the depth and duration of anesthesia, reduce absorption of the local anesthetic, and minimize toxicity.
- Sodium meta bisulfite is an antioxidant for the vasoconstrictor.
- Methyl paraben is a bacteriostatic agent.
Clinical Action of Specific Agents (Part 1)
- Procaine is an ester local anesthetic with a short duration of action. It produces the greatest vasodilation of all currently used local anesthetics.
- Propoxycaine is an ester local anesthetic typically used in combination with procaine to provide more rapid onset and prolonged duration of anesthesia.
- Lidocaine is an amide local anesthetic with a moderate duration of action. It has a more rapid onset and longer duration of action than procaine.
- Mepivacaine is an amide local anesthetic with a moderate duration of action. It produces minimal vasodilation and is often used in pediatric and geriatric patients.
- Prilocaine is an amide local anesthetic with a moderate duration of action. It is often used in epinephrine-sensitive individuals.
- Articaine is an amide local anesthetic with a moderate duration of action. It is often used in dentistry due to its high potency and rapid onset.
- Bupivacaine is an amide local anesthetic with a long duration of action. It is commonly used for post-operative pain control.
Topical Anesthetics
- Topical anesthetics are used for surface anesthesia, such as for minor procedures or pain relief.
- Cocaine is a potent topical anesthetic, but its use is limited due to its addictive properties.
- Lidocaine is a commonly used topical anesthetic that is available in various formulations.
- Benzocaine is an insoluble topical anesthetic that is often used for teething pain.
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Description
This quiz covers the classification of local anesthetics based on their chemical structure, duration of action, and pharmacokinetics. Test your knowledge on ester and amide local anesthetics, their applications, and absorption processes in the body. Perfect for students in pharmacology or dentistry courses.
