Pharm Exam 4

Why would a physician choose a local anesthetics over a general anesthetic?

• Local anesthetic have less risk than general anesthetics

• It suppresses pain without depression of entire nervous system

• Local anesthetics are selective modifiers of neuronal function

• Local anesthetics suppress pain by blocking axonal nerves conduction

The nurse knows that local anesthetics stop axonal conduction by blocking what?

• Potassium channels in the axonal membrane

• Sodium channels in the axonal membrane

• Calcium channels in the axonal membrane

• Protein channels in the axonal membrane

Which of the following shows the correct sequence of effect for local anesthetics?

• Loss of perception of cold, deep pressure, pain, touch, and warmth

• Loss of perception of pain, cold, warmth, touch, and deep pressure

• Loss of perception of deep pressure, pain, touch, warmth, and cold

• Loss of perception of touch, deep pressure, warmth, cold and pain

The nurse is explaining differential sensitivity to the nursing student with regard to the use of local anesthetics. The nurse explains that which perception is lost first?

• Cold

• Pain

• Warmth

• Touch

Which of these local anesthetic agents is most likely to cause an allergic response?

• Procaine [Novocain]

• Lidocaine [Xylocaine]

• Bupivacaine [Marcaine]

• Ropivacaine [Naropin]

The nurse is caring for a patient who is to receive a local anesthetic with lidocaine and epinephrine. What is the primary purpose of the epinephrine?

• To reduce the risk of an allergic reaction

• To improve transport of anesthetic into the axon

• To delay systemic absorption of the anesthetic

• To suppress excitability of the myocardium

T or F - Local Anesthetics block sensation in small, non-myelinated neurons faster than larger myelinated neurons

• True

• False

There are 2 classes of local anesthetics - Esters & Amides. Which of the following statements apply only to Esters

• Metabolized by plasma esterases

• Metabolized by hepatic enzymes

• They have a very low incidence of allergic reaction

• They can promote more of an allergic reaction than the other

• Procaine (Novocaine) and Cocaine are examples

T or F = Local anesthetics only affect sensory neurons

• True - Only sensory neurons are affected

• False - Both motor and sensory neurons are affected

Which of the following best explains why epinephrine + local anesthetics should never be injected in the finger, toes, or ears?

• Epinephrine can cause necrosis of the tissue

• It can cause methemoglobinemia, a blood disorder that alters hemoglobin

• It can cause a hypersensitivity reaction

• It can result in bradycardia and CNS depression