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Local Anesthesia

WREB Anesthesia Study Guide

QuestionAnswer
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