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Ch. 26 Local Anesthe

Pharmacology for Nursing

Basic pharmacology of local anesthetics 1 Mechanism of action is by blocking sodium channels and preventing axonal conduction
Basic pharmacology of local anesthetics 2 Anesthetics block both sensing neurons and motor neurons (think droopy face post-dentist)
Basic pharmacology of local anesthetics 3 Commonly used with/ injected along with epinephrine
Commonly used with/ injected along with epinephrine because ... delays absorption, prolongs anesthesia and we use less anesthetic, reduces risk of toxicity, can decrease bleeding at site
Commonly used with/ injected along with epinephrine But NEVER GOES ears, nose, fingers, penis, toes
Local anesthetic Adverse Effects Can cause bradycardia, heart clock, reduced contraction, cardiac arrest, hyoptension
Procaine Hydrochloride (Novocain) Not effective topically and is administered by injection usually with epi
Procaine Hydrochloride (Novocain) Systemic toxicity is rare
Lidocaine Hydrochloride (Xylocain) most widely used today
Lidocaine Hydrochloride (Xylocain) administered topically and by injection
Lidocaine Hydrochloride (Xylocain) can be used with epi
Lidocaine Hydrochloride (Xylocain) watch for CNS, cardiac toxicity if too much injected
Lidocaine Hydrochloride (Xylocain) Can treat dysrhythmias
Lidocaine Hydrochloride (Xylocain) available in cream, ointment, jelly, solutions,aerosol, and patch
Cocaine Hydrochloride used topically
Cocaine Hydrochloride causes intense vasoconstriction and should NOT be use with epi
Cocaine Hydrochloride causes CNS excitation followed by depression up to and including respiratory depression
Cocaine Hydrochloride Causes tachycardia, fatal dysrhythmia and hypertension
Clinical Use of Local Anesthetics Topical administration(lidocaine, tetracaine, cocaine)
Clinical Use of Local Anesthetics Administration by injection
Administration by injection Epidural (lidocaine or bupivacaine); injected into the epidural space and diffusion of anesthetic across dura
Administration by injection Spinal anesthesia (bupivacaine, lidocaine, and tetracaine); local anesthetic injected into subarachnoid space
Administration by injection: Spinal watch for hypotension due to vasodilation; can cause fecal/urinary incontinence; cause urinary retention (asses foe void); spinal headaches frequently occur and can be relieved by supine postioning
Created by: emv2435