Pharmocology Test 4

Front 1

Cardiac dose of epinephrine

Back 1

0.04
or
2 cartrages

Front 2

difference of amide and ester local anesthetics

Back 2

Amids: is hydrophilic (water soluble) and metabolized by the liver

Front 3

Guedel's stages of anesthisia
Stage 1 analgesia:

Back 3

This stage is characterized by the development of analgesia or reduced sensation to pain. The pt. is conscious and can still respond to command. Reflexes and respiration are regular. Nitrous oxide in dental maintains the pt in stage 1. The end of this stage is marked by the loss of consciousness.

Front 4

Guedel's stages of anesthisia
Stage 2 delirium or excitement:

Back 4

This stage begins with unconsciousness and is associated w/ involuntary movement and excitement. Respiration=irregular. Sympathetic stimulation produces tachycardia, mydriasis (dilation of pupils), and hypertension.

Front 5

Guedel's stages of anesthisia
Stage 3 surgical anesthesia:

Back 5

This is the stage in which most major surgery is performed. This stage is further divided into four planes that are differentiated based on eye movements, depth of respiration, and muscle relaxation.

Front 6

Guedel's stages of anesthisia
Stage 4 respiratory or medullary paralysis

Back 6

characterized by complete cessation of all respiration and subsequent circulatory failure. Pupils are dilated and B/P falls. If patient is not reversed immediately, pt will die.

Front 7

Flagg’s approach of anesthesia

Back 7

Induction, Maintenance, and Recovery.

Front 8

Induction:

Back 8

this phase encompasses all the preparation and med’s necessary for the pt. up to the time the operation begins, including preoperative medication, adjunctive drugs to anesthesia, and anesthetics required for induction

Front 9

Maintenance:

Back 9

this phase begins with the pt’s at a depth of anesthesia sufficient to allow surgical manipulation and continues until completion of the procedure

Front 10

Recovery:

Back 10

the recovery phase begins with the termination of the surgical procedure and continues through the postoperative period until the pt. is fully responsive to the environment

Front 11

Nitrous Oxide contraindications

Back 11

Respiratory obstruction = B/C the nasal passages are used for gas exchange, upper respiratory obstruction or a stuffy nose is an absolute contraindication.

Chronic Obstructive Pulmonary Disease= ventilation is compromised

Emotional Instability = Pt’s takin psychotherapeutic med’s must be carefully evaluated. Med’s include phenothiazines, tricyclic antidepressants, and lithium.

Pregnancy= 3rd trimester pts can recieve nitrous only if neccessary. Can cause spontanious abortion, misscarage and less fertile

Abuse = chronic abuse have reported neuropathy. Symptoms include numbness and paresthesia of the hands or legs that progress to more severe neurologic symptoms.

Front 12

drugs that interact with epinephrine

Back 12

Tricyclic antidepressants
B-blockers, nonselective Antidiabetics
interactions NOT significant in dentistry (phenothiazines) ex. Chlorpromazine; and MAO’s Monoamine oxidase inhibitors.

Front 13

drugs that are used to treat asthma

Back 13

Adrenergic agonist (inhaler) B2-agonist: stimulates b2 receptors/ bronchodilation. (short acting) & (long acting) b-2= 2 lungs.
Corticosteroids, inhaled.
Anticholinergics ; and
Leukotriene antagonist

Front 14

What is the role of steroids in the treatment of asthma?

Back 14

Steroids work by in habiting aairway inflammation at all levels of the respiratory passage. They also increase the number and responsiveness of 2-recepors. Steroids are used for both acute and maintenance therapy of asthma

Front 15

Adverse reactions to long-term treatment of steroids

Back 15

Impaired wound healing, osteoporosis, which can affect alveolar bone, increase intraocular pressure, exacerbation of glaucoma, cataracts, sodium and water retention, adrenal crisis, and oral candidacies from oral steroid. Electrolyte and fluid balance. Other reactions are as followed: Metabolic-moon face, buffalo’s hump (fat on back of neck) also referred to as Cushing’s Syndrome (excess steroids), weight gain, muscle wasting, and hyperglycemia. CNS- mood swings, behavioral changes, agitation, psychosis, euphoria, depression.

Front 16

Know which drugs are used to treat most oral ulcerations

Back 16

Viscous Lidocaine
topical diphenhydramine (benadryl) liquid rinse combo of benadryl w kaopectate, maalow, and mylanta

Front 17

What are steroids used for?

Back 17

Replacement therapy for Addison’s disease, (steroid deficiency)
Treatment of shock
Treatment of inflammatory and allergic situations

Front 18

Which drugs are used to treat recurrent apthous ulcers?

Back 18

Topical corticosteroids- reduce inflammation associated w/aphthous stomatitis
Amelorex- reduces the duration of aphthous stomatitis by 0.7 days

Front 19

Be familiar with the most commonly used topical anesthetic

Back 19

Most common= Benzocaine (Ester) used topically
Also Lidocaine (Amides)

Front 20

Know the level 1 (critical) emergency drugs

Back 20

Albuterol-
Dephenhydramine- benadryl
Epinephrine- used for cardiac arrest, anaphylaxis, or acute asthmatic attack
Glucose, oral- liquid like OJ, cake frosting, hard candies
Nitroglycerin- sublingual tablet

Front 21

Level 2 drugs: don’t need to know, but I would recognize

Back 21

Benzodiazepines-treatment of most convulsions
Aromatic ammonia spirits- treat syncope
Morphine- opiod analgesics
Methoxamine- vasoconstriction, mild increase in B/P
Hydrocortisone- allergic reaction, anaphylaxis and adrenal crisis
Dextrose-hypoglycemic episodes
Glucagons-severe hypoglycemic reaction
Atropine-increase cardiac rate
b-blockers-

Front 22

advantages of nitrous

Back 22

colorless, no odor, least soluble in blood
provides anxiety relief
rapid onset 3-5 min and rapid recovery
excepted by chidren

Front 23

procedure of nitrous

Back 23

100% oxygen for 2-3 min, raised in 5-10% increments till desired sedation, when terminating nitrous- pt should be on 100% oxygen for at least 5 min

Front 24

pt comfort range w nitrous

Back 24

10-50% average 35%

Front 25

diffusion hypoxia

Back 25

occurs with rapid outward flow of nitrous accompanied with oxygen and carbon dioxide

Front 26

pharmalogical reactions to nitrous

Back 26

cns depression
cardio
vasodialation
nausea

Front 27

trade and generic names of local dental anesthetics

Back 27

lidocaine- xylocaine
mepivicaine- carbocaine
bupivicaine- marcaine
prilocaine- citanest
ethyaminobenzoate- benzocaine

Front 28

when do supplemental steroids need to be taken?

Back 28

in pts using chronic steroids and about to undergo stressful dental procedure, or if pain is anticipated dose should last for the following day. only for severe stress

Front 29

drugs to tread anaphalaxis?

Back 29

perenteral epipen- may be givin in the deltoid, or under tongue. if vasoconstrictor is predominant administer albuterol. after life threatening symptoms have been controlled you can use intra muscullar diphenhydramine and aminophylline

Front 30

composition of local dental anesthetic

Back 30

vasoconstrictor
antioxidant
sodium hydroxide
sodium chloride
methylparaben and propylaparaben

Front 31

vasoconstrictor

Back 31

epinephrrine- retards absorption into blood, reduces systemic toxicity, prolongs duration of action

Front 32

antioxidant

Back 32

retards oxidation of epinephrine, prolongs shelf life

asthma pts should be monitored due to vasoconstrictor and sulfite
sulfite= asthmatic hypersensitivity

Front 33

sodium hydroxide

Back 33

alkalinizes ph of solution between 6 and 7

Front 34

sodium chloride

Back 34

makes injectable solution isotonic

Front 35

methylparaben and propylparaben

Back 35

prevents bacterial growth