2026 QUESTIONS WITH ANSWERS GRADED
A+
◉ Amide nomenclature. Answer: Drugs with two "i"s
◉ Naturally occurring Local? Answer: Cocaine
◉ Most widely used Local? Answer: Lidocaine
◉ Reversal for Locals? Answer: Oraverse
◉ 3 Sections of a Local Anesthetic Molecule? Answer: 1. Benzene Ring
(Lipophilic-Lipid Soluble)
2. Ester (O) or Amide (N) Linkage
3. Quartenery Amine (Hydrophilic-Water Soluble)
◉ Ester metabolism. Answer: metabolized by cholinesterase, which are
found in plasma. this metabolism is rapid which makes esters short
acting.
, ◉ Longest acting ester. Answer: tetracaine
◉ Amide metabolism. Answer: metabolized by liver enzymes= longer
acting
◉ Explain allergies to Local Anesthetics. Answer: 1. Most commonly
found with esters (bc people are exposed to the lipophilic portion PABA
daily via cosmetics).
2. When allergic to an ester you're allergic to all esters but not to amides
3. When allergic to an amide youre ONLY allergic to that amide
◉ MOA of Locals. Answer: blocking Na channels in nerves
◉ Ionized portion of Locals. Answer: Water soluble, can't penetrate
nerve but able to block Na channel once inside the axoplasm.
◉ Non-ionized portion of locals. Answer: lipid soluble, penetrate nerve
◉ Exception to typical MOA of Locals? Answer: Benzocaine, is water
soluble but can penetrate and block nerve.
◉ Target site of drugs is on what side of the membrane? Answer:
cytoplasmic