Local Anesthetics

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Can you name the Local Anesthetics?

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SE: similar to tetracaine. However more cardiotoxic (arrythmias and hypotension), may be irreversible. Tx with epi, atropine, and bretylium.
SE: similar to tetracaine
Procaine class
Cocaine class
Ropivacaine class
Bupivacaine class
Medium duration ester
SE: Can also block NE --> vasoconstriction and CV toxicity (HTN, cerebral hemorrhage, arrhythmias, and MI's)
Long duration ester
Short duration ester
Etidocaine class
Surface active ester
SE: metabolized to products which can cause methemoglobinemia (treat with methylene blue)
Medium duration amide
Prilocaine class
HintAnswer
Nerve selectivity: rapid firing, small diameter 'C' fibers and medium diameter, myelinated B sympathetic preganglionic fibers.
Tetracaine class
Class P-kinetics cont: Most bound by plasma PRO, which effects clinical effects and toxicity.
Class P-kinetics: Similar in absorption & distribution and ionization to esters. Metabolism via CYP in liver (longer duration), liver function important in metabolism.
MOA: State dependent blockage of voltage dependent Na channels, prevent depolarization and conduction of APs in excitable cells esp. neurons when localized next to neurons
Benzocaine class
Long duration amide
SE cont: All are vasodilators (except cocaine). Heart block, arrythmias, low BP. Can form metabolites that create hypersensitivity reactions.
Lidocaine class
Nerve selectivity: large diameter, slow firing, myelinated 'A' type motor neuron fibers
SE: light headedness, sedation, restless, nystagmus, tonic-clonic convulsions (tx with sedative hypnotics). Resp and CV collapse. High [ ] may permanent damage nerves.
Class P-kinetics: systemic absorption is proportional to vascularization, widely distributed in not locally injected.
Class of P-kinetics cont: pH dependent (HH principles) ionization important. Hydrolyzed relatively rapidly via butyrylcholinesterase (except benzocaine which is topical only)
Class P-kinetics cont: Weak base which must be lipophilic to pass through cell membrane to internally block channels and hydrophilic to bind channel.
Mepivacaine class

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Created Sep 18, 2011ReportNominate
Tags:Nintendo, local