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69 Cards in this Set
- Front
- Back
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T/F
Topical anesthetics blocks nerve pathway |
True
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T/F
Topical anesthetics has a long term effect |
False
** it has a short term effect |
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T/F
Topical Anesthetics is a pharmaceutical agent that is used on surface epithelium |
True
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Topical Anesthetics can not _______intact skin
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Penetrate
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Topical anesthetic is _____ effective if Not water soluble
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more
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Topical anesthetics has ______ ______ of active agent than injectables
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higher concentration
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Topical anesthetics have concentration that are higher to facilitate_______
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diffusion
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Because Topical anesthetics have higher concentrations this leads to a _____potential for toxicity
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greater
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Topical anesthetics only penetrate ____ on mucous membranes or _____
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2-3 mm
disrupted skin |
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Water soluble ester
2-4 % for topical use Vasoconstrictive may result in dysrythmias |
Cocaine Hydrochloride
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Onset is 1 min; duration is up to 2 hours
Schedule II drug, not recommended for Dentistry |
Cocaine Hydrochloride
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Ester, poor soluble in water
Poor CV absorption little risk of toxicity |
Benzocaine
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Possible localized allergic reaction
Can inhibit sulfonamides |
Benzocaine
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Amide, 2% solution
Water soluble Low incidence of allergic reaction |
Lidocaine Hydrochloride
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Which has better penetration Lidocaine Hydrochloride or Lidocaine Base?
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Lidocaine Hydrochloride
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-Poor water solubility
-Poor penetration--best penetration on ulcerated, lacerated or abraded tissue -5% liquid, ointment, gell low incidence of allergic reaction |
Lidocaine Base
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Slow onset to 10 minutes
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Dyclonine Hydrochloride
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slight water solubility, low toxicity
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Dyclonine Hydrochloride
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ketone no cross sensitization
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Dyclonin Hydrochloride
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0.5% solution
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Dyclonine hydrochloride
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This is a topical for eyes, ears, nose, and throat
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Butacaine sulfate
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This is a substitute for Cocaine and is 2x potent and 2x as toxic
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Butacaine sulfate
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4% dental ointment
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Butacaine sulfate
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Ester, highly soluble in water
Potency is 5-8 X of Cocaine and has a great potential for systemic toxicity |
Tetracaine Hydrochloride
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2% liquid
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tetracaine hydrochloride
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What are the step of application of topical before injection?
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1. explain to patient
2. dry area with 2x2 gauze 3. apply small amount with cotton applicator to area of injection 4. wait for anesthetic to take affect |
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What are the symptoms of an allergic response?
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redness,
edema of mucous membranes, Sloughing of tissue |
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Which is more likely to cause a toxic reaction of the Benzocaine, the ester type or amide type?
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ester type
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what are symptoms of overdose of topical anesthetics
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-Patient agitation
-speech irregularity -tremors, convulsions -increased BP, pulse and respirations |
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what types of intra oral tissue have the fastest rate of absorption of topical anesthetic?
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mucous membranes or
disrupted skin |
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what are the allergic responses to topical anesthetic?
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redness,
edema of mucous membranes sloughing of tissue |
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What type of topical anesthetics are most likely to produce an allergic reaction?
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ester
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what is the name of the anesthetic that is classified as a keytone?
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Dyclonine hydrochloride
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What form of topical anesthetic is not recommend for oral use and is against the law for use by dental hygienist in the state of Florida?
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Cocaine Hydrchloride
Schedule II drug |
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what was the first local anesthetic? And it was isolated from from coca leaves by who
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cocaine
Albert Niemann in Germany in the 1860s |
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Who was the first to describe the injection of cocaine into the sensory nerve trunk to create surgical anesthesia?
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William Stewart Halsted
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When was the first analog of cocaine produced?
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1905
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a chemical molecule is modified to retain and enhance certain holistic characteristics of the original substance while ridding it of other unwanted characteristics
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analog
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first synthetic local anesthetic was __?
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procaine
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Trade name for procaine
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Novocain
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The first modern local anesthetic agent
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Lidocaine, trade name Xylocaine.
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When was the first lidocaine invented?
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1940s
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Mechanism of Action of Local Anesthetics
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1. Blocks conduction of nerve impulse
2. Reduces or prevents permeability to sodium ions 3. the anesthetics binds to sodium receptor site and nerve transmission fails |
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Carpule Content
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amide anesthetic
Vasoconstritor Antioxidant--sodium metabisulfite, sodium bisulfite sterile water sodium chloride |
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characteristic of vasoconstritors
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1. slows rate at which anesthetic enters the circulation
2. increases duration of anesthetic effect 3. increases depth and profoundness of anesthetic |
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There are two types of vasoconstrictors, what are they?
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epinephrine
Levonordefrin |
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Epinephrin has 3 concentrations, what are they?
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1:50,000 (.036mg/carp)
1:100,000 (.018mg/carp) 1:200,000 (.009mg/carp) |
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Levonordefrin has 1 concentration, what is it?
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1:20,000 (.09mg/carp)
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Which % of vasoconstrictor would provide the best hemostasis?
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1:50,000
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Duration of LA:
Short Acting |
- 3% Mepivacaine 2-3 hr
-4% prilocain 1 1/2 hr |
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Duration of LA
Medium Acting |
-2% lidocaine w/epi 1:100,000 3-5hr
-2% mepivacaine w/epi 1:20,000 3-5hr |
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What are some contraindications for LA
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liver dysfunction
Severe or uncontrolled heart dz. Allergy to local anesthesia other Rx patient taking |
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Allergic Rxn to LA
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Very rare
skin rash starts STAT Edema Anaphylactic symptoms |
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Adverse Rxn to LA
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Very Common
Excitability Nervousness Sometimes hyperventilation or syncope |
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Infiltration Anesthesia
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Small area
accessory nerves close to site of operative dentistry apex of root of tooth |
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Block anesthesia
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large area
nerve trunk greater distance from it of operative area usually a foramen |
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Needle is available in different gauges, what are they?
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23, 25, 27, and 30
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there are two different lengths of the needle, what are they?
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40 mm
25 mm ** the type of injection determines the length of needle required |
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What is positive aspiration?
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blood in the cartridge
** must withdraw needle and change cartridge |
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what is negative aspiration?
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cartridge is clear of blood
** this is safe to deposit the LA agent |
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Anterior Superior alveolar nerve block
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landmark: canine eminence
Injection site: height of vestibule mesial side of canine eminence Penetrate: 3-6 mm to apex of root Tissue innervated: canine, laterals, centrals, and respective facial gingival and periosteum |
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Middle Superior alveolar nerve block
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Landmark: 2nd premolar and buccal frenum
Injection: height of vestibule @ apex of premolar Penetrate 5-8mm to apex of root Tissue innerv: Max. 1st & 2nd premolar, MB root of 1st molar and facial gingiva & periiosteum |
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PSA block
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Landmark: Max. tuberocity and PSA foramen
Injection: height of vestibule posterior to Max tuberocity Penetration: 15mm Tissue innerv. Max 3rd and 2nd Molars, 1 molar-not MBroot and facial gingiva & periosteum |
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Greater palatine Nerve block
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Landmark: greater palatine foramen
Injection: greater palatine foramen Penetration: 2-3mm Tissue innerv: mucous membrane & glands and gingiva of posterior hard palate |
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Nasopalatine Nerve Block
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Landmark: incisive Papilla
Injection: lateral to incisive papilla Penetration: 2-3 mm Tissue innerv: nasal septum, mucous membrane & gingiva of the anterior hard palate |
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Inferior alveolar nerve block
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Landmark: Pterygomandibular raphe; coronoid notch
Injection:~10mm coronal to the occlusal plane of mandibular molars; later to pterygomandibular raphe penetration: 26-28mm into the pterygomandibular space Tissue: all anterior and posterior teeth; facial gingiva of teeth anterior to the mental foramen |
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Long buccal nerve block
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landmark: anterior border of ramus
Injection: anterior border of ramus, ~1mm coronal to the occlusal plane of the mandibular molars Penetration: 2-3mm Tissue Innerv: buccal gingiva and mucous form the mental foramen posteriorly |
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Mental nerve block
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Landmark: mental foramen
Injection: depth of vestibule @ mental foramen Penetration: depth of mental foramen; but not entering the foramen Tissue innerv; facial gingiva from the mental foramen to the midline of the mandible and the skin and the mucosa of the lower lip |
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Infiltration characteristic
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Injection site: mucobuccal fold labial to tooth of interest
Penetration: 3-5mm Tissue innerv: tooth and soft tissue at site |
