Local Anesthetics Part 1

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Across
  1. 1. Systemic toxicity from local anesthetic, often due to intravascular injection.
  2. 5. Local anesthetic class usually metabolized by plasma cholinesterase.
  3. 10. extraction First-pass lung uptake of basic lipophilic drugs entering venous circulation. (two words)
  4. 12. Major bupivacaine danger involving conduction delay, dysrhythmias, and collapse.
  5. 13. water Additive used to make spinal local anesthetic hypobaric. (two words)
  6. 17. Preferred antiarrhythmic over lidocaine during LAST resuscitation.
  7. 18. Drug delivery vesicles that reduce free local anesthetic and prolong duration.
  8. 20. conduction Jumping conduction between nodes of Ranvier that increases nerve conduction velocity. (two words)
  9. 21. S-enantiomer of bupivacaine with reduced toxicity.
  10. 23. Rescue therapy for severe local anesthetic systemic toxicity.
  11. 24. Nerve layer that helps form the blood-nerve barrier.
  12. 27. Drug form that crosses lipid membranes more easily.
  13. 31. acid glycoprotein Plasma protein that binds local anesthetics and affects free drug fraction. (three words)
  14. 34. acidosis Condition that slows local anesthetic onset by increasing ionized drug outside the nerve. (two words)
  15. 35. Ratio of solution density to CSF density that determines spinal spread.
  16. 37. Short-acting ester historically known as Novocain.
  17. 39. binding Property most strongly related to duration of local anesthetic action. (two words)
  18. 41. bicarbonate Additive that alkalinizes local anesthetic solution and can speed onset. (two words)
  19. 42. Ester metabolite associated with higher allergy risk.
  20. 44. anesthesia Local anesthetic injection into CSF for dense neuraxial blockade. (two words)
  21. 45. Spinal solution with density similar to CSF and less gravity-dependent spread.
  22. 47. Short-acting ester with rapid hydrolysis and low systemic toxicity.
  23. 48. Electrolyte abnormality that makes resting membrane potential more negative.
  24. 49. Protonated drug form that binds sodium channels with greater affinity.
  25. 50. Vasoconstrictor additive that slows systemic absorption and prolongs duration.
  26. 51. of Ranvier Exposed myelinated axon region where sodium channels are concentrated. (three words)
Down
  1. 2. Local anesthetic class usually metabolized hepatically.
  2. 3. Action potential phase caused mainly by sodium influx.
  3. 4. anesthesia Local anesthetic injection outside dura requiring larger volume than spinal anesthesia. (two words)
  4. 6. Action potential recovery phase caused mainly by sodium channel closure and potassium efflux.
  5. 7. free Required neuraxial formulation type to reduce neurotoxicity risk. (two words)
  6. 8. blockade Pattern where autonomic and pain fibers are blocked before large motor/proprioceptive fibers. (two words)
  7. 9. Prilocaine and benzocaine toxicity causing cyanosis with impaired oxygen carriage.
  8. 11. Spinal solution less dense than CSF that rises relative to injection site.
  9. 14. Versatile amide used for infiltration, neuraxial anesthesia, airway topicalization, IV analgesia, and arrhythmias.
  10. 15. Early CNS toxicity symptom often paired with metallic taste.
  11. 16. toluidine Prilocaine metabolite associated with methemoglobinemia. (two words)
  12. 19. Outer connective tissue layer surrounding a peripheral nerve.
  13. 20. Serious CNS toxicity manifestation treated preferably with benzodiazepines.
  14. 22. Long-acting amide with high potency and greatest cardiotoxic concern.
  15. 25. Connective tissue surrounding individual axons within a fascicle.
  16. 26. neurologic symptoms Lower back, buttock, and posterior leg pain after spinal anesthesia. (three words)
  17. 28. Additive used to make spinal local anesthetic hyperbaric.
  18. 29. Property most closely tied to onset because it determines ionized versus unionized fraction.
  19. 30. equina Neural structure at risk from high-concentration intrathecal local anesthetic pooling. (two words)
  20. 32. solubility Property that increases potency and often duration of local anesthetics. (two words)
  21. 33. Spinal solution denser than CSF that sinks with gravity.
  22. 36. numbness Early CNS toxicity sign involving numbness around the mouth. (two words)
  23. 38. Local anesthetic that blocks norepinephrine reuptake and causes vasoconstriction.
  24. 40. S-enantiomer amide with less cardiotoxicity than bupivacaine.
  25. 43. Topical ester associated with methemoglobinemia risk.
  26. 46. Long-acting ester used in spinal, ophthalmic, ENT, and topical settings.