local anesthesia + alcohol + recovery

local anesthesia lec

Cardiotoxicity rescue
intravenous lipid emulsion

Bupivacaine toxicity
cardio toxicity

prilocaine toxicity
Large doses of prilocaine yield o-toluidine, which oxidizes hemoglobin to methemoglobin. Treat with I.V. methylene blue or vit. C.

Alcohol Lec

Lidocaine toxicity
associated with cauda equina syndrome

Drugs used in chronic alcoholism
Naltrexone, Acamprosate, Disulfiram

Drugs used for acute ethanol withdrawal:
Diazepam, chlordiazepoxide, lorazepam, oxazepam

Drugs used in acute methanol or ethylene glycol toxicitiy:
Fomepizole and ethanol.

Acamprosate
MANAGEMENT OF PSYCHOLOGICAL DEPENDENCE
Competitive inhibitor of NMDA receptors

Disulfiram
Blocks Aldehyde Dehydrogenase

Fomepizole
blocks alcohol dehydrogenase

clonidine
Alpha-2 adrenergic receptor agonist
Reduces symptoms of nicotine withdrawal and shows effects on smoking cessation
Advantages: no exposure to nicotine
Disadvantages: Side effects

varenicline
partial nicotine agonist

chlorprocain
short acting give with epinephrin

watch out for CNS excitation with lidocaine use with infiltrative anesthesia

prevent/stop seizure
benzodiazepine (diazepam) I.V.
Also, small doses of short-acting barbiturates (thiopental IV)
neuromuscular blocking, short acting (succinylcholine, I.V.)

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