Posted by Josh BSN RN on September 1, 2008, 12:09 am, in reply to "Re: CRNAs == AAs"
Really?
Think about that for a second. Or two.
We'll regroup later and come to a consensus.
But I'll leave you with a paragraph I had bookmarked on Local Anesthetics in Lange's Basic and Clinical Pharmacology, 8th Edition [just happened to be sitting out on my desk, honestly]:
"The smaller and more lipophilic the molecule, the faster the rate of interaction with the sodium channel receptor. Potency is also positively correlated with lipid solubility as long as the agent retains sufficient water solubility to diffuse to the site of action. Lidocaine, procaine, and mepivacaine are more water-soluble than tetracaine, etidocaine, and bupivacaine. The latter agents are more potent and have longer durations of action. They also bind more extensively to proteins and will displace or be displaced from these binding sites from other drugs. In the case of optically active agents, eg, bupivicaine, one isomer can usually be shown to be moderately more potent than others."
Now I'm sure that ICU experience is better at making sense of pharmacology than organic chemistry, but...yeah.