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Ch. 26 Local Anesthe
Pharmacology for Nursing
Question | Answer |
---|---|
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 |