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Local Anesthesia Chapter 4 - Vasoconstrictors
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1What are the 4 functions of Vasoconstrictors?
[blank_start]Constrict[blank_end] blood vessels at site = decrease dose of LA
increase [blank_start]duration[blank_end] of LA = 6 times as long
Provides [blank_start]hemostasis[blank_end] at injection site
decrease [blank_start]absorption[blank_end] rate of LA = decrease risk of toxicity.- AConstrict
- Bduration
- Chemostasis
- Dabsorption
2All LA are vasoconstrictors.
- ATrue
- BFalse
3All LAs are vasodilators.
- ATrue
- BFalse
4The two types of vasoconstrictors used in the US are:
[blank_start]Epinephrine[blank_end]
[blank_start]Levonordefrin[blank_end]- AEpinephrine
- BLevonordefrin
5Epinephrine, levonordfrin, both, neither.
[blank_start]Both[blank_end] are absorbed from injection site into bloodstream.
[blank_start]Both[blank_end] are unstable in solution.- ABoth
- BBoth
6[blank_start]Sodium Bisulfite[blank_end] is the preservative added for stability. About 10% of asthmatics are allergic.
- ASodium Bisulfite
7Epi in LAs have identical structure to the natural hormone.
- ATrue
- BFalse
8Epinephrine targets these two groups of receptors located in most tissues:
[blank_start]alpha[blank_end]
[blank_start]beta[blank_end]- Aalpha
- Bbeta
9Alpha receptors: [blank_start]vasoconstriction[blank_end]; [blank_start]bronchodilation[blank_end]
beta receptors: [blank_start]vasodilation[blank_end]; [blank_start]increase HR[blank_end]; [blank_start]increase force of heart contraction[blank_end].- Avasoconstriction
- Bbronchodilation
- Cvasodilation
- Dincrease HR
- Eincrease force of heart contraction
10high levels of epi - [blank_start]alpha[blank_end] receptors override [blank_start]beta[blank_end] receptors = vasoconstriction
[blank_start]Low[blank_end] levels of epi - beta receptors override alpha receptors = [blank_start]vasodilation[blank_end].- Aalpha
- Bbeta
- CLow
- Dvasodilation
11concentrations of vasoconstrictors in LA solutions are referred to as a ratio of [blank_start]grams[blank_end] of epi per [blank_start]mL[blank_end] of solution.
- Agrams
- BmL
12The highest concentration of epi available in the US is 1:[blank_start]50,000[blank_end]
This is only used for [blank_start]hemostasis[blank_end] --> usually via [blank_start]infiltration[blank_end].- A50,000
- Bhemostasis
- Cinfiltration
13Rebound vasodilation occurs after [blank_start]6[blank_end] hours and the [blank_start]beta[blank_end] receptors are prominent.
- A6
- Bbeta
14Rebound vasodilation occurs during the [blank_start]highest[blank_end] concentrations of epi are used
- Ahighest
15The lowest concentration of epi available in the US is [blank_start]1:200,000[blank_end].
Lower the concentration is [blank_start]ineffective[blank_end]
Produces [blank_start]fewer[blank_end] side effects- A1:200,000
- Bineffective
- Cfewer
16Levonordefrin is only [blank_start]15[blank_end]% as potent as epi
Only available in US as [blank_start]1:20,000[blank_end] concentration in 2% [blank_start]Mepivacaine[blank_end]/[blank_start]carbocaine[blank_end]
The 1:20,000 has the same clinical effect as [blank_start]1:100,000[blank_end] epi- A15
- B1:20,000
- CMepivacaine
- Dcarbocaine
- E1:100,000
17Epi affects alpha receptors [blank_start]50[blank_end]% and beta receptors [blank_start]50[blank_end]%
Levonordefrin affects the alpha receptors [blank_start]75[blank_end]% and the beta receptors [blank_start]25[blank_end]%.- A50
- B50
- C75
- D25
18compared to epinephrine, levonordefrin has the same cardiac affects like increased HR, stroke volume, CO, increased dysrhythmias, and dilating of coronary arteries but to a [blank_start]lesser[blank_end] degree.
- Alesser
19Levonordefrin is a great choice of LA with vasoconstrictor because blood sugar increase is to a [blank_start]lesser[blank_end] degree.
- Alesser
20[blank_start]Levonordefrin[blank_end] causes potent bronchodilation to a lesser degree and less hemostasis
- ALevonordefrin
21Both epi and levonordefrin have sodium bisulfite
- ATrue
- BFalse
22EPI MRD
healthy: [blank_start]0.2[blank_end]mg
CV ds: [blank_start]0.04[blank_end]mg
Levonordefrin MRD
healthy: [blank_start]1.0[blank_end]mg
CV ds: [blank_start]0.2[blank_end]mg- A0.2
- B0.04
- C1.0
- D0.2
23OD occurs via
[blank_start]intravascular[blank_end] injection
administering more than [blank_start]MRD[blank_end]
symptoms will occur within [blank_start]60[blank_end] seconds
body clears drug within [blank_start]5[blank_end]-[blank_start]10[blank_end] minutes via [blank_start]re-uptake[blank_end]- Aintravascular
- BMRD
- C60
- D5
- E10
- Fre-uptake
Information
- Description
- DH LA Chapter 4 Vasoconstrictors
- Author
- Jesica Ashby
- Language
- English
- Views
- 9
- History
- Created on 15 May 2018 · updated on 16 May 2018
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