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Local Anesthesia properties WREB review Dental Hygiene

Terms in this set (45)

Short acting LA
3% Mepivicaine (plain); 2% Lido (plain); 4% Prilocaine (plain) as infiltrate
Intermediate
2% Lido 1:100,000 or 1:50,000; 2% Mepiviaine 1:20,000 levono; 4% Articaine 1:100,000; 4% Prilocaine
Long
4% Lido 1:200,000; .5% Bupivacaine 1:200,000
lidocaine (brand names)
xylocaine, octocaine, lignospan
Mepivicaine (brand names)
carbocaine, polocaine, scandonest
prilocaine (brand names)
citanest plaine, citanest forte (with epi)
bupivacaine (brand names)
marcaine
Articaine (brand names)
septocaine, zorcaine
MRD: lidocaine
500 mg or 3.2 mg/lb (7 mg/kg)
MRD: mepivicaine
400 mg or 3.0 mg/lb (6.6mg/kg)
MRD: prilocaine
600 mg or 4.0 mg/lb (8.8 mg/kg)
MRD: Bupivacaine
80 mg
MRD: Articaine
No absolute; 3.2 mg/lb (7.0 mg/kg)
Contraindication lidocaine
none
Contraindication mepivicaine
careful with children; NO levonordefrin with TCAs
Contraindication prilocaine
methemoglobinemia; possible paresthesia
Contraindication bupivicaine
not for kids (long duration)
Contraindication articaine
methemoglobinemia, possible paresthesia
Contraindication any amide
allergy, liver dysfunction, narcotics, tranquilizers (CNS depressants)
Contraindication epi
allergy sulfites, steroid-dependent asthmatics, uncontrolled everything, heart disease, taking non-selective beta blockers
Advantages lidocaine
safe; ok pregnancy; "gold standard"
Advantages mepivicaine
fast and short; least vasodilating
Advantages prilocaine
ok pregnancy; long anesthesia, but not as profound
Advantages bupivacaine
long duration, lower amt epi
Advantages articaine
short half life (less OD risk); use for difficult to numb patients
Duration 4% Articaine
75 / 180-300
Duration .5% Bupivacaine
90-180 / 240-540
Duration 2% Lido plain
5-10 / 60-120
Duration 2% Lido w/ epi
60 / 180-300
Duration 3% Mepivicaine plain
20-40 / 120-180
Duration 2% Mepivicaine w/ levono
60 / 180-300
Duration 4% Prilocaine plain
infiltrate 10-15 / 90-120; block 40-60 / 120-240
Duration 4% Prilocaine w/ vaso
60-90 / 180-480
What happens during depolarization?
Cell becomes more permeable to Na+; at threshold, rapid depolarization creates action potential, which is propagated up nerve.
Correct sequence of nerve conduction & LA effects
Depolarization (slow/rapid) LA works on this step; Propagation (impulse travels); repolarization (absolute/refractory)
What relevance do beta blockers have on LA choice and epi?
significant risk for acute hypertensive episodes if they receive vasopressors
MAOIS and LA
don't use vasopressors
What is the function of sodium chloride in LA?
make solution isotonic
What is the function of sodium bisulfite in LA?
preservative/antioxidant
How much epi in 1:100,000?
.018 mg
How much epi in 1:200,ooo?
.009 mg
What is the concern with asthmatics and allergy to sodium bisulfites?
higher incidence of allergy to bisulfites and can cause airway to close
What is the concern of articaine use with asthmatics?
contains sulfites (allergy can cause bronchoconstriction)
When a nerve is anesthetized, which sensation is lost first?
Autonomic or pain, depending on what review material you study...
what is the cause of layrngeal edema?
airway obstruction (either partial or complete); pt loses consciousness due to lack of oxygen
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