First Aid 2008 Errata

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MadameLULU

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Okay, I figure we should go ahead and get a running list of errors going.

p.91 It says that the rate limiting enzyme for de novo pyrimidine synthesis is Aspartate transcarbamylase. RR Biochem and I think newer studies say that CPS II is the rate limiting enzyme.

P. 91 Fructose 1, 6 bisphosphatase is the rate limiting enzyme for gluconeogenesis, not pyruvate carboxylase

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If we knew how various errors occurred (particularly the right-to-wrong ones), we would have caught and corrected them before printing. (There are no elves, though.) As Topher mentioned elsewhere, though each member of the team reviews others' work, having thousands of students reading the text means thousands more critical eyes. The vast majority of the errors are rather minor anyway (eg, misspelling of "viable" in notdeadyet's post). We want to turn out the best product possible, and we welcome constructive criticism and potential errata, but complaining is not helpful to anyone...
 
If we knew how various errors occurred (particularly the right-to-wrong ones), we would have caught and corrected them before printing. (There are no elves, though.) As Topher mentioned elsewhere, though each member of the team reviews others' work, having thousands of students reading the text means thousands more critical eyes. The vast majority of the errors are rather minor anyway (eg, misspelling of "viable" in notdeadyet's post). We want to turn out the best product possible, and we welcome constructive criticism and potential errata, but complaining is not helpful to anyone...
Minor? Are you serious? Can you not read the list that was made in this thread? If you cant then you must read...... like all the FA editors.
 
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The Raidal nerve should be lateral and the Axillary nerve should be medial.
I don't mean to press the point, but the axillary nerve looks lateral in most of the pictures I've seen. It doesn't seem like a big deal to me, but we should try to make sure our "official" ;) errata list stays as accurate as possible. Am I missing something obvious here (like usual)?

BTW, thanks to everyone for sharing the errors they catch!

Brachial_plexus.JPG
 
Yes, minor -- in other words, things that really don't impact one's understanding of the chapter: spelling mistakes or missing arrows in diagrams. Many "corrections" we receive end up being unsubstantiated. (The debate over the brachial plexus seems likely to be one such example, though I'll try to clarify everything.) Regardless, I do agree with some of the changes proposed here, so attacking the editors is frankly rather childish.
 
p353, Pseudogout

FA states "No treatment". Got this wrong today on a quiz. Harrison's states "treatment by joint aspiration and NSAIDs, or colchicine, or intraarticular glucocorticoid injection may result in return to prior status in 10 days."

Maybe what it should say is that allopurinol and probenecid have no effect (because there is no elevated urate level) but that NSAIDS, colchicine, etc. relieve symptoms.
 
When it comes to an exam as significant as the USMLE, there's no such thing as a "minor" error.

I don't know, maybe that's just me.
 
Yes, minor -- in other words, things that really don't impact one's understanding of the chapter: spelling mistakes or missing arrows in diagrams. Many "corrections" we receive end up being unsubstantiated. (The debate over the brachial plexus seems likely to be one such example, though I'll try to clarify everything.) Regardless, I do agree with some of the changes proposed here, so attacking the editors is frankly rather childish.

While I agree that some of the errors noted above are minor or irrelevant, the fact remains that many of them are not. Personally, I don't expect First Aid to be error-free. There are probably few books in which every line and arrow are subjected to the level of scrutiny to which First Aid is. Therefore, there are bound to be some mistakes. I don't expect the editors of First Aid to be superhuman.

What I do find surprising, however, is what seems to be a somewhat defensive attitude towards students reporting these errors. It shouldn't be surprising that the accuracy of study materials is extremely important to students studying for Step 1. In fact, in many discussions about First Aid on this board, students advise against purchasing new editions of First Aid, simply due to fear about the number of unreported errors. I also think it's worth pointing out that the students contributing to this thread are the ones who did go out and buy the new edition - in other words, the proponents and primary customers of First Aid 2008!

I humbly suggest that rather than sparring with customers over possible errors, publishing timely errata should become a much greater priority for the First Aid editorial team. Many of the errors listed above are easily confirmable and have been posted here and presumably submitted at firstaidteam.com for weeks, making it difficult for students to understand why, over a month later, only one "official" error has been acknowledged.

It is unreasonable to expect perfection from First Aid, but timely acknowledgment and correction of errors would go a long way towards maintaining, and even improving confidence in First Aid.
 
I think you're quite right. As a newly-hired writer for the 2009 edition, it is my first reaction to get defensive (even though I had no role in 2008 and myself submitted errors for the 2007 edition). The complaint, it seems, is that FA is trying to create errors so as to fell future editions, or being sloppy in the editing process in the first place, and it's hard not to be a little insulted by that. But regardless, we have already received over 100 proposed errors or clarifications (many in duplicate), which take some time to get reviewed. I imagine they think it a better idea to produce monthly errata, rather than post individual ones. Or perhaps they expect the text to be used more towards June, and therefore don't need official errata until a few months before. Either way, I'll bring your concerns to my editor. Keep in mind that in producing errata, we want to make sure we're not accepting incorrect changes, so though I think several things here are correct, I can't confirm them until my editor has agreed. Anyway, thanks for your post.
 
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Here's an idea... publish two versions of FA each year.

For this year, for example, in January release the 2008 edition and the 2007+ edition. Next January, release the 2009 and 2008+ editions.

The 2008/2009 in the above example would be just what is released now - the latest version with new information, updates, resource reviews, reorganized etc.

The + versions would be the previous year's edition with all official errata corrected, and with the introduction and resource review sections of the new version.

Leave it to students to decide which to buy. I can't see how that could result in lower sales (perhaps the opposite by just a fraction), and probably just a marginal increase in total publication costs. I guess students might get put off by having two versions and having to make that decision? Maybe, but most students realize they are having to make that decision anyway, and more than a handful that would purchase a new copy (to not have someone else's markings) instead purposefully find a used copy to make sure errata are corrected.
 
Here's an idea... publish two versions of FA each year.

For this year, for example, in January release the 2008 edition and the 2007+ edition. Next January, release the 2009 and 2008+ editions.

The 2008/2009 in the above example would be just what is released now - the latest version with new information, updates, resource reviews, reorganized etc.

The + versions would be the previous year's edition with all official errata corrected, and with the introduction and resource review sections of the new version.

Leave it to students to decide which to buy. I can't see how that could result in lower sales (perhaps the opposite by just a fraction), and probably just a marginal increase in total publication costs. I guess students might get put off by having two versions and having to make that decision? Maybe, but most students realize they are having to make that decision anyway, and more than a handful that would purchase a new copy (to not have someone else's markings) instead purposefully find a used copy to make sure errata are corrected.

I think there's a false assumption here that there are significant improvements year to year that justify annual editions of First Aid. Step I does not change from year to year that much. I would still recommend my 2005 edition (with corrections) to anyone.

A better solution would be to stop releasing a new edition every year, and take the time to write a good, well-edited book with updates for content every 3-5 years. Maintain a good errata list online, and add updates to reviews of new books and question banks. How new errors get added each edition to previously correct material is beyond me, but get to the bottom of that and stop doing it.

Every book has errors, and a book under the intense scrutiny that First Aid gets is going to have lots of them identified. This is not a problem. People will also identify nit-picky things that aren't really errors and complain about them. Not a concern. The problem is that despite using (I assume) the same files year after year with minor additions, there are changes in the content that go from correct to incorrect. I have not seen this in any other series.
 
I think there's a false assumption here that there are significant improvements year to year that justify annual editions of First Aid. Step I does not change from year to year that much. I would still recommend my 2005 edition (with corrections) to anyone.

A better solution would be to stop releasing a new edition every year, and take the time to write a good, well-edited book with updates for content every 3-5 years. Maintain a good errata list online, and add updates to reviews of new books and question banks. How new errors get added each edition to previously correct material is beyond me, but get to the bottom of that and stop doing it.

Every book has errors, and a book under the intense scrutiny that First Aid gets is going to have lots of them identified. This is not a problem. People will also identify nit-picky things that aren't really errors and complain about them. Not a concern. The problem is that despite using (I assume) the same files year after year with minor additions, there are changes in the content that go from correct to incorrect. I have not seen this in any other series.

Spot on. Usually you just get the file and correct the problems from the year before which would result in an almost perfect version. However FA decides for some unknown reason to re-write what was already correct----> and make it incorrect. I am sure no other books do this. There should not be new writers since the info doesnt change that significantly. Just shell some money out for quality editors and fire the new useless writers.

Ps. for the FA "writer" replying to these post with childish remarks and being insulted about stuff that they didnt even write (kind of retarted) . Why dont you stop posting that gradeschool insecurites and use that time to rell your company to do its job better. (or at least publish the errata in a TIMELY manner).

Good-day
...
 
It is not a question about money or "bad" writers/editors. Each year the text receives tons of suggestions on how to improve it - ie, what was low yield and should be eliminated and what was unclear. This is why they have a yearly edition. Personally, I don't think that's necessary, either, and an old edition with the errata sheets is probably sufficient. The choice is up to you what, if anything, to buy. With regard to the new errors, again, I don't know how they occur. It isn't because the text is rewritten every year, however. Of the handful of proposed errors I've read thus far (I haven't had the time this week to review them all), one was in new material and one was an error that was not corrected (nor reported) last year. If it would put your mind at ease, I'll go back and see how many times things changed from right to wrong. Just so I'm clear -- what would be considered "timely" correction of errata? We'll have monthly sheets starting in about 2 weeks, which is ample time to prepare for the exam, no? And as for insecurities, I think it nothing more than to expect common courtesy from a fellow medical student -- especially one who complains about typos but makes plenty him/herself.
 
It is not a question about money or "bad" writers/editors. Each year the text receives tons of suggestions on how to improve it - ie, what was low yield and should be eliminated and what was unclear. This is why they have a yearly edition. Personally, I don't think that's necessary, either, and an old edition with the errata sheets is probably sufficient. The choice is up to you what, if anything, to buy. With regard to the new errors, again, I don't know how they occur. It isn't because the text is rewritten every year, however. Of the handful of proposed errors I've read thus far (I haven't had the time this week to review them all), one was in new material and one was an error that was not corrected (nor reported) last year. If it would put your mind at ease, I'll go back and see how many times things changed from right to wrong. Just so I'm clear -- what would be considered "timely" correction of errata? We'll have monthly sheets starting in about 2 weeks, which is ample time to prepare for the exam, no? And as for insecurities, I think it nothing more than to expect common courtesy from a fellow medical student -- especially one who complains about typos but makes plenty him/herself.

Except I am not selling a product with my typos in it.....
 
I think there's a false assumption here that there are significant improvements year to year that justify annual editions of First Aid.
Nah... my assumption was that any substantial change in how the FA team creates, modifies, and publishes the book would not include cutting out the yearly "update" due to financial considerations. My suggestion was aimed at a compromise - keep yearly updates available, but also have a 2-year cycle by which a "plus" edition was available that was much more error free. Students would have a choice between "already corrected" and "potentially includes something important not in the older version" and could purchase accordingly. My other assumption is that total sales between the two versions should not be less than for a single new edition as is the case now, and that publishing fewer of two editions yearly would be only marginally more expensive than publishing the total quantity in one edition only. I don't know anything about publishing - perhaps that is a bad assumption, but in the quantities we are talking about I doubt it (should have already surpassed the economics-of-scale point even with half the quantity, no?).

edit - or maybe they count on people not wanting to take the chance on the new error-prone version to instead help clear out stock of the remaining previous year edition in bookstores everywhere? Seems like on the surface that would be a retailer problem, but maybe there are supply-line trickle back effects that would kick in after a year or two of that sales model.
 
Guys, I have the 2006 edition, which I have yet to open.

Would I really need to get the 2008 edition?? The material has got to be the same in both books.

Plus, considering that the errata sheet for the 06 is already out, as opposed to the 08 errata sheet.
 
Guys, I have the 2006 edition, which I have yet to open.

Would I really need to get the 2008 edition?? The material has got to be the same in both books.

Plus, considering that the errata sheet for the 06 is already out, as opposed to the 08 errata sheet.
I would use the 2006. The 2008 has so many errors and the index if F'd up as well. 06 isnt that old so not much new info would be in the new one. If you have the erata sheet your golden, unless they still missed some errors. I may end up getting the 2006 just to correct my 2008 version. SO IMHO save you 40 bucks!
 
Nah... my assumption was that any substantial change in how the FA team creates, modifies, and publishes the book would not include cutting out the yearly "update" due to financial considerations. My suggestion was aimed at a compromise - keep yearly updates available, but also have a 2-year cycle by which a "plus" edition was available that was much more error free. Students would have a choice between "already corrected" and "potentially includes something important not in the older version" and could purchase accordingly. My other assumption is that total sales between the two versions should not be less than for a single new edition as is the case now, and that publishing fewer of two editions yearly would be only marginally more expensive than publishing the total quantity in one edition only. I don't know anything about publishing - perhaps that is a bad assumption, but in the quantities we are talking about I doubt it (should have already surpassed the economics-of-scale point even with half the quantity, no?).

edit - or maybe they count on people not wanting to take the chance on the new error-prone version to instead help clear out stock of the remaining previous year edition in bookstores everywhere? Seems like on the surface that would be a retailer problem, but maybe there are supply-line trickle back effects that would kick in after a year or two of that sales model.

I think you're overthinking it a bit.

They wouldn't sell a "plus" edition because it implies that they have lots of errors justifying a new printing. Most people (ie. people not on SDN Step I forum) aren't aware that there are quite a few errors.

It would also imply that it is not necessary to get the new annual edition (because the older one is available in "plus" form), and the whole business model of FA is based around the idea that they are adding important information that would cost you points if you don't buy the newest edition. Nonsense, of course, but some people really think that First Aid somehow has an inside track into each year's Step I and is adjusting their text accordingly.
 
Would I really need to get the 2008 edition??

No.

Here's a good 2006 errata thread. Don't forget to scroll down for some errata of the errata list.

I think that FA never incorporated most of these errors in their official correction sheet, although I also think they fixed them in the 2007 edition.
 
I think you're overthinking it a bit.

They wouldn't sell a "plus" edition because it implies that they have lots of errors justifying a new printing.

lol, I think you are right. Most of my class looked at me with crossed eyes when I told them to be aware of the errors in their 2007 editions and look for the errata lists. :laugh:

And I probably am overthinking it - same reason I keep missing those "easy" behavioral science questions on qbank! Gotta fix that or I won't be invited to join the sdn super-cool board-buster club. ;)
 
You're going to be a doctor. 40 dollars is nothing, especially compared to many students' "required" textbooks. You can also buy older editions, etc. From one med student to another (ie, not speaking as a writer), I don't think this is a real concern for most.

As for the 2007 errata, the layout was changed in the fall. The previous editions were only 2 pages long, and about half that was simple typos. But regardless, and as I said before, there probably needn't be "yearly" editions. I'll see if I can find out from my editor why we have them. New editions don't stop you from buying an older one and making those corrections... I understand your point and I think we're in agreement on several things, so I guess it comes down to a couple questions that haven't been answered (definitions of terms that have been used here):

How many errors (of any type) are "acceptable" or "forgiven" in a "good to superior" text? I'll assume most people will say zero - which is the goal - but still a team of 15 may miss things a country full of medical students will find.

What do you consider "timely" for production of errata? The way they are produced currently is they are first organized into a list from the website submissions, next researched, then resubmitted for approval by the editors, and finally published monthly. It's hard to start this any earlier than March, as if we were aware of errors in the text when we published it in December, we would have fixed them first. Do you suggest starting the errata in February, then?
 
What do you consider "timely" for production of errata? The way they are produced currently is they are first organized into a list from the website submissions, next researched, then resubmitted for approval by the editors, and finally published monthly. It's hard to start this any earlier than March, as if we were aware of errors in the text when we published it in December, we would have fixed them first. Do you suggest starting the errata in February, then?

We live in an internet age, where things happen in real-time. Optimally, errors should be dealt with on a daily basis, or as close to it as realistically possible. Frequent, incremental updates to the official on-line list would go a long way to helping students feel that First Aid is on top of the errors and doing everything in their power to correct them as quickly as possible.

Since this errata list has been running since Jan 3rd, I would say it's pretty clear that you need to begin the errata process long before March. Given the market-share of First Aid, it doesn't seem unreasonable to hire a dedicated editor to deal with errors on a much faster basis.

As an overworked med student ;), being generous, it took me ~30 minutes to flip through my textbooks/online and confirm/unconfirm the errors listed on this page, the majority of which are very obvious. If, using your current editorial process, the same procedure takes 2 months, I would say that's a big problem and something your customers are not going to be happy about. If an error is more ambiguous, then by all means, table it for further editorial discussion. But, it should be pretty clear from the comments in this thread, that the current errata process and timeline is unacceptable to many of your customers.

Edit: I just wanted to add that I appreciate your willingness to sit in the "hot seat" and listen to and respond to students' feedback about First Aid.
 
You're going to be a doctor. 40 dollars is nothing...

Yeah, in like eight years $40 will be nothing. Until then its a week of groceries.

This statement provides no comfort. Some of us (and it sounds like you aren't one) are borrowing a lot of money to pay for outrageous tuition costs, living expenses, etc. The fact that I will actually be earning money in 2.5 years (~40k/year), and then substantially more than that in 5+ additional years doesn't make me feel any better about the situation. I would much rather have the $40 I spent on this edition and my 2006 edition back. At least all the errors in that edition have (hopefully) been found and I wouldn't have to wonder whether I am memorizing incorrect facts.

While you are correct that most med students take Step 1 over the summer, there are a substantial amount that take it early. There are several US schools that take less than two years to get through the material and then there are international students who are on a different schedule as well. Providing early errata updates would help us a lot. Please tell your editors to peruse this thread for ideas to implement in the future. Those of us taking the test this year may not benefit, but those who come after us might.
 
Your comments are duly noted: I will see what we can do about starting the process earlier next year and having "rolling" corrections. I agree that 30 minutes checking out potential errors on your own can feel like an eternity.

Of course I cannot speak to anyone's specific financial situation, but I really do believe there are funds out there - local scholarships, a small part-time job, subsidized Stafford loans, in-state tuition (assuming you considered a state school)... And still, $40 pales in comparison to the $400+ for taking the USMLE...

Well, I hope my comments here have been more reassuring than inflammatory. I had no idea this seat would be so hot! ;)
 
Well, I hope my comments here have been more reassuring than inflammatory. I had no idea this seat would be so hot! ;)
You probably have just not had much experience in customer service. ;) In general, you can't go wrong with the principle that the customer is always right, even when they're wrong. Medicine is a service profession, and it works the same way. Arguing with someone who is upset with the service you have provided about why they should not be upset is not very effective; in fact, it is likely to upset the customer even more, as you have seen here. If you would like to be "reassuring" and defuse the situation, it would be much more effective to tell these users that you are sorry they have been inconvenienced by the errors and the uncertainty, and that you will bring their issues and suggestions to the attention of your editors immediately and report back what the editors say. Then just make sure to report back so that you fulfill your promises. :)
 
Arguing with someone who is upset with the service you have provided about why they should not be upset is not very effective; in fact, it is likely to upset the customer even more, as you have seen here.

Especially in a case like this, where I'm sure that none of the frustration expressed about the errors in First Aid is actually in part displaced anxiety about Step 1...:rolleyes:

If I don't get a 240+, I can already tell it will definitely be because of these errors :D.
 
When I worked answering (MCAT) questions for another test-prep company, I wasn't in quite the same position. I have offered reassurance, but I'm only human... I guess I don't have to defend the previous authors, but somehow I feel responsible, and I want everyone to be happy. Catcher in the Rye much? :)
 
Perhaps it's better to dedicate this thread solely to specific examples of FA errata. It'll make it easier to sift through these posts until the OFFICIAL errata sheet is released by FA. If we want to continue on the discussion about how FA can improve it's product, we can start another thread and I can move some of the posts in this thread in there. Just a suggestion....
 
I think there's a false assumption here that there are significant improvements year to year that justify annual editions of First Aid. Step I does not change from year to year that much. I would still recommend my 2005 edition (with corrections) to anyone.

A better solution would be to stop releasing a new edition every year, and take the time to write a good, well-edited book with updates for content every 3-5 years. Maintain a good errata list online, and add updates to reviews of new books and question banks. How new errors get added each edition to previously correct material is beyond me, but get to the bottom of that and stop doing it.

Every book has errors, and a book under the intense scrutiny that First Aid gets is going to have lots of them identified. This is not a problem. People will also identify nit-picky things that aren't really errors and complain about them. Not a concern. The problem is that despite using (I assume) the same files year after year with minor additions, there are changes in the content that go from correct to incorrect. I have not seen this in any other series.

I want to add that there is absolutely no transparency as to how the books are rated. What does an A mean? Just how many thought it is an A vs. B? I started thinking about it after one of Rapid review books got an A and a C or whatever the lowest score in the SAME (2008) edition. Makes one wonder whether there is any real review of books going on! One could just go on SDN and get a gist of what people think of a book. Voila. You got a 'recommendation'.

No, really, but how do the guys at FA manage to mess up the right things? Do you not use ... ahem... computers? :laugh:

I think that FA will keep coming out every year not because USMLE changes every year - I can bet that knowing 10yr old books cold will still give you a 250+ but because med students ARE 100% connvinced that FA IS the bible, and discussions such as these are just beginning to take place.

Also, what do the FA editors actually do? Most of the book is pretty much a reprint.
 
Perhaps it's better to dedicate this thread solely to specific examples of FA errata. It'll make it easier to sift through these posts until the OFFICIAL errata sheet is released by FA. If we want to continue on the discussion about how FA can improve it's product, we can start another thread and I can move some of the posts in this thread in there. Just a suggestion....

would it be possible for you to add new errors as they are discovered to your first post on here? I think that would be very helpful.
 
FA editors edit. ;) They take out what's not useful, fix what's wrong (most of it, anyway), and add in new material. Most of the text doesn't change - it's true - but we do review everything and try to improve the product. I could always blame right-to-wrong answers on the non-medical personnel who help us illustrate and do layout, but there's no reason to pass the buck. Again, we're working to keep this from happening, and of course I don't know why it occurs.

I don't think a "member's only" section of the website is necessary, but I will bring up the concern for earlier (and/or more frequent) updates. Please remember, too, that though I started reading the forum here, we generally only know about mistakes when they are submitted through the website.
 
It's hard to start this any earlier than March, as if we were aware of errors in the text when we published it in December, we would have fixed them first. Do you suggest starting the errata in February, then?

Can you start ASAP? Many schools are moving up their schedules in order to get more clinical elective time for 4th year. May/June is way too late. I need the real finished book now. :(
 
  1. The kaplan med essential book is amazing.
  2. no mistakes thus so far
  3. it is a little more detailed and longer than 1st aid.
  4. check it out.
 
Perhaps it's better to dedicate this thread solely to specific examples of FA errata. It'll make it easier to sift through these posts until the OFFICIAL errata sheet is released by FA. If we want to continue on the discussion about how FA can improve it's product, we can start another thread and I can move some of the posts in this thread in there. Just a suggestion....


I totally agree, or maybe since the firstaid have a website we could start a thread about the mistakes there.
 
At the end of the day forget all the fights. our main topic is getting the 2008 mistakes available for the students who are taking there exam very soon.

Is there neway, that when a student submits the correction to the firstaid website, someone can look into it right away and post the correction?

thank You
 
Let me know if this appeals to y'all: Since I am the primary one working on the errata (at least initially), I will post my responses to proposed corrections here as I work through them. This means you'll get a "preview" of each month's corrections. The downside is that they will NOT be "official," since my editor will not yet have reviewed my work. (And Lord help me if I make a mistake in the forums!) I don't know if that's substantially better than you all debating suggestions amongst yourselves, but I hope it's a step in the right direction. I can post "official" errata here as well, if you like, but those will be on our website, too.
 
Let me know if this appeals to y'all: Since I am the primary one working on the errata (at least initially), I will post my responses to proposed corrections here as I work through them. This means you'll get a "preview" of each month's corrections. The downside is that they will NOT be "official," since my editor will not yet have reviewed my work. (And Lord help me if I make a mistake in the forums!) I don't know if that's substantially better than you all debating suggestions amongst yourselves, but I hope it's a step in the right direction. I can post "official" errata here as well, if you like, but those will be on our website, too.
That will be appreciated, thanks.
 
Yes, it is a step in the right direction. :thumbup: I think this is a very good idea. Please know that your efforts and responsiveness to our ideas and concerns are much appreciated. :)
She is right . So get cracking on the updates NOW. (whether officical or not put them here)
 
Whats up docs? I am new to the site and here is my first post...I am not 100% about this being a mistake, so any thoughtful discussion about the topic is encouraged: FA 08 pg 397 states that local anesthetics "preferentially bind to ACTIVATED Na+ channels , so most effective in rapidly firing neurons" This seems similar to the action of lidocaine as an antiarrhythimic, but is not the way these drugs work as anesthetics from the research I have done. Na+ channel toxins like Tetrodotoxin, saxitoxin, ciguatoxin, and batrachotoxin all bind to ACTIVATED Na+ channels on the outside of cells and either decrease Na influx or cause inactivation. Conversely, local anesthetics cross the axonal membrane in their uncharged form and bind to INACTIVATED channels in their charged forms. This slows recovery and prevents propagation of AP's. Sources: Lippencott, and Kaplan Pharmacology 2008 pg 147. What do you guys think?
 
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