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Local Anesthesia
WREB Anesthesia Study Guide
| Question | Answer |
|---|---|
| Allergic reaction management; immediate vs delayed | epi if immediate, benadryl if delayed |
| Amides are metabolized by what? | liver (prilocaine is in the lungs) |
| Amides are excreted by what? | kidneys |
| Asthma patients are sensitive to what additive? | sulfites (no epi) |
| Avoid esters and articaine if.... | pt.'s have atypical pseudocholinesterase, sulfur allergy, and myasthinia gravis |
| Brand name for lidocaine | xylocaine |
| brand name for mepivicaine | polocaine |
| brand name for mepivicaine plain | carbocaine |
| brand name for articaine | septocaine |
| brand name for bupivicaine | marcaine |
| brand name for prilocaine | citanest |
| difference between block and infiltration | block anesthetic is deposited close to main nerve trunk and covers a larger area,filtration is deposited near large terminal nerve endings |
| Dose of AMSA | .9-1.8 ml |
| Dose of ASA | .9-1.2ml |
| Dose of GP | .4-.6ml |
| Dose of IA | 1.5-1.8ml |
| Dose of infiltrations | .6 ml |
| Dose of LB | .2-.3ml |
| Dose of MI | .6ml |
| Dose of MSA | .9-1.2ml |
| Dose of NP | .4ml |
| Dose of PSA | .9-1.8ml |
| Esters and articaine are metabolized by what? | pseudocholinesterase in blood plasma |
| Esters and articaine are excreted by what? | kidneys |
| First sign of local anesthesia toxicity | CNS excitment |
| How far do you insert the needle into the IANB? | 20-25 mm |
| How much epi is in lidocaine 1:50,000 | .036mg |
| How much epi is in lidocaine 1:100,000 | .018mg |
| How much epi is in 1:200,000 | .009 mg |
| How much LA in one carp of 2% lido? | 36 mg |
| How much LA in one carp of 4% articaine | 72 mg |
| How much LA in one carp of 3% mepivicaine | 54mg |
| How much LA in one carp of .5% bupivicaine | 9mg |
| How much of the nerve must be bathed in LA to achieve anesthesia | 8-10mm |
| How would you best achieve hemostasis | 1:50,000 |
| If a patient is allergic to red wine, what LA would you give them? | anything plain, no vaso |
| If there is methemoblobinemia | avoid prilocaine and benzocaine |
| If they are taking beta blockers | limit or avoid vaso's |
| If they are taking phenothizides | do not use 1:50,000 |
| if they are taking tricyclic antidepressants | no levo |
| injection and landmarks for buccal tissue of mandibular molars | LB mucous membrane distal and lateral to most posterior molar |
| Injection and landmarks for maxillary incisors | ASA, height of the mucobuccal fold about the 1st premolar |
| LA overdose leads to | CNS excitation, CNS depression, Coma, convulsions, respiratory arrest |
| Management of a hematoma | cold compression and pressure to bleeding site for 3-5 min |
| Management of tismus | heat and jaw excersice |
| maxillary division of trigeminal nerve is | sensory only |
| The metabolic by-product responsible for allergic reactions to the ester classification of anesthetic is | PABA |
| Molar root does not anesthetized by the PSA | mesiobuccal root of first premolar |
| Most common LA without a Vaso | 3% mepivicaine |
| Nerve fiber that is lightly mylinated and causes sharp pain | A |
| Nerve fiber without myelin that causes dull achy pain | C |
| Nerve impulses are spread by | saltatory conductions |
| Nerve that innervates the soft palate | lesser palatine |
| on which oral tissue is topical anesthetic least effective | keratinized |
| a patient complains of a lesion on the lower lip a day after LA administration, what is it most likely | self mutulation |
| purpose of the myelin sheath | protective covering for the nerves |
| smaller needle gauge equals | larger |
| Tachyphylaxis | the rapid decreased in the response to a drug after repeated doses over a short period of time |
| volume in one carpule of LA | 1.8 ml |
| what are the most likely causes of an overdose from a local anesthetic | solution was administered too rapidly or solutions was inadvertently injected intravasculary |
| what causes psychogenic pain | mental or emotional problems that affect the experience of pain |
| what distributes the incoming signals to the CNS | axon |
| what to beta blockers do? | decrease BP |
| what does a yellow brown tint in the carpule indicate | oxidation |
| what does LA do to depolarization | inhibit the Na influx by displacing the Ca ions |
| what does the alpha adrenergic receptors do? | smooth muscle contraction in arterioles and veins |
| what does the beta adrenergic receptors do? | cardiac stimulation then smooth muscle relaxation |
| what exits the foramen ovale | mandibular nerve |
| what exits the foramen rotundum | maxillary nerve |
| what exits the incisive foramen | nasopalatine nerve |
| what exits the mandibular foramen | inferior alveolar nerve |
| what happens during depolarization | slow Na ion influx until firing threshold is reached |
| What happens during rapid depolarization | once firing threshold has been reached there is a rapid influx of sodium ions |
| what happens during repolarization | Na begins to move with concentration gradient out of the cell, there is an absolute refractory period. Na continues to move out of cell with help of sodium pump, there is a relative refractory period until resting state is reached |
| What initiates nerve conduction | dendrites |
| what is responsible for the duration of action to LA | protein binding |
| What is the function of sodium bisulfite to LA solutions | antioxidant that prevents biodegradiation |
| What is the function of sodium chloride in LA | isotonicity |
| What is the cardiac dose of epi | 0.04 |
| what is the site of action for a LA | nerve membrane |
| What sensation is lost first | pain |
| Which anesthetic affects the CVS first | bupivicaine |
| what anesthetics affect the CNS | all besides bupivicaine |
| which anesthetics are category B | lido, prilo others are C |
| Which anesthetics have a weak vasodilation | mepivicaine and prilocaine |
| which is true of topical anesthetics | no systemic issues |
| why do you use vaso | increases duration and depth of LA |
| why would there be mild burning during administration of anesthetics | ph of solution, too warm, contamination |
| Why does infiltration work better on the maxilla as opposed to the mandible | mandible has denser bone. |
Created by:
daisenmurray
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