This is chapter five: neuro, and in this video we'll be discussing
over the counter local anesthetics and medications used for vertigo.
We'll go over kind of a hodgepodge of medications in this video. These are all over-the-counter agents used
for neuro. We'll start with local anesthetics, and we have two examples of those today. We have benzocaine -
Anbesol is the brand name, and then lidocaine or Solarcaine, which is the brand name.
Benzocaine and lidocaine are slightly different
based on their shape, and so benzocaine is an ester local anesthetic and
that just means that the shape causes it to be more allergenic,
so it's typically given topically and not usually injected.
Lidocaine on the other hand is an amide type anesthetic and
that causes it to be less allergenic and better tolerated when it's injected.
We have an example of an antihistamine which is used for vertigo,
and that is meclizine otherwise known as Dramamine or Antivert. We also have one more over-the-counter
medication which is a non opioid analgesic combined with a first generation
oral antihistamine and that is the combo acetaminophen with diphenhydramine
otherwise known as Tylenol PM.
Now we'll go over a couple of practice questions with these four medications.
Practice question one: 'A topical anesthetic that is also safe as an injectable form is?'
Ffor the remainder of the video,
we'll keep our four answers the same, so A) will be benzocaine, B) will be lidocaine
C) will be the antihistamine meclizine and then D) will be the acetaminophen diphenhydramine or the Tylenol PM.
The answer to the first question - which was a topical anesthetic that is safe as an injectable form - is a lidocaine.
As you recall,
lidocaine is an amide
type of local anesthetic so it has less allergenicity, so it's okay to be injected.
Benzocaine is incorrect because although it is a topical anesthetic,
there's more allergenicity to it, So we don't want to inject that but we can use it topically. C)and D), meclizine and
acetaminophen/diphenhydramine are incorrect because they're not available topically and they're not anesthetics.
Now we will just change the question to make the answers correct.
Practice question three: 'A drug that works by blocking axonal conduction is?' and this will be select all that apply.
The correct answer is both A) lidocaine and B) benzocaine. C) and D) meclizine and acetaminophen/diphenhydramine
are incorrect because they don't work on the axon.
Local anesthetics are known for blocking axonal conduction.
The basic cell of the nervous system, as you recall, is the neuron, and the long
protrusion off of the end of the neuron is called the axon and that is where
electrical impulses are sent. lLidocaine and benzocaine work by
blocking transmission of an electrical impulse to pain centers in the central nervous system
Practice question four: 'Patient who is leaving on a cross-country vacation asks you which medication works best for motion sickness and you say?'
A) and B) lidocaine and benzocaine are incorrect because there's no effect on dizziness.
C) meclizine is our correct answer because it works on vertigo and prevents it. The acetaminophen
diphenhydramine,
it does cause drowsiness, so that could help potentially for motion sickness, but it has no effect on the dizziness from
potentially a long car ride.
Practice question five: 'A patient has been having trouble sleeping because of aches and pains and you recommend?'
The correct answer is D) acetaminophen diphenhydramine.
A) and B) are incorrect because they will help relieve aches and pains but they are not sedating so they won't help with the sleeping difficulty.
C) meclizine is incorrect because although it is sedating, it does not provide any pain relief
Acetaminophen is a non-opioid analgesic
and the diphenhydramine is a histamine blocker which as a side effect will cause drowsiness.