Procaine tetracaine drug effect paralysis first

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Procaine Tetracaine Drug Effect: Paralysis First, autonomic activity is lost then pain and other sensory functions are lost, lastly motor activity is lost – as drug wears off, recovery occurs in reverse order (motor, sensory, then autonomic activity is restored) Indications Local anesthesia is used for: surgical, dental and diagnostic procedures, treatment on chronic pain, spinal (childbirth and surgical procedures) Local anesthetics are given by: infiltration and nerve block Minor surgeries and dental procedures: Injection of the anesthetic solution intradermally, subcutaneously, or submucosally across the path of nerves supplying the target area May be given in a circular pattern around operative area Infiltrations anesthesia and epinephrine Some local anesthetics used for infiltration or nerve block are combined with vasoconstrictors
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To prevent systemic absorption of anesthetic To help confine local anesthetic to injected area To reduce local blood loss during the procedure (epinephrine, phenylephrine, and norepinephrine) Nerve block anesthesia Used for surgical, dental, and diagnostic procedures Also used for therapeutic management of pain The anesthetic drug is injected directly into or around the nerve trunks or nerve ganglia that supply the area to be numbed Adverse Effects Usually limited Adverse effects result if Inadvertent intravascular injection occurs Excessive dose or rate of injection is given Slow metabolic breakdown occurs Injection into highly vascular tissue occurs “Spinal headache”: treated with an epidural blood patch Neuromuscular Blocking Drugs Also known as NMBDs Prevent the transmission in certain muscles, resulting in muscle paralysis Used with anesthetics during surgery When used during surgery, artificial mechanical ventilation is required These drugs paralyze respiratory and skeletal muscles Patient cannot breathe on their own Do not cause sedation or pain relief Patient may be paralyzed yet conscious Subcategories 1. Depolarizing drugs (Succinylcholine) Works similarly to neurotransmitter acetylcholine, causing depolarization Metabolism is slower than Ach, so as long as succinylcholine is present, repolarization cannot occur Results in: flaccid muscle paralysis 2. Nondepolarizing drugs Short-acting: Mivacurium Intermediate-acting: Atracurium, Vercuronium, and Rocuronium Long-acting: Doxacurium Prevents Ach from acting at neuromuscular junctions Nerve cell membrane is not depolarized; muscle fibers are not stimulated Skeletal muscle contraction does not occur Neuromuscular Blocking Drugs First sensation is muscle weakness followed by total flaccid paralysis. Small, rapidly moving muscles are affected first (fingers, eyes) then limbs, neck and
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trunk. Finally, intercostals muscles and diaphragm are affected resulting in cessation of respirations.
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