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Wreb study for local anesthesia questions
Terms in this set (88)
Local anesthesia depresses excitation in nerve endings or inhibiting the conduction of what nerves?
LA differe from other drugs in that most other drugs are absorbed in the blood stream but LA stop their action once absorbed where?
Why are vasoconstrictors added to LA?
decrease blood flow at injection site, constrict blood vessels and allows for a longer working time more profound anesthesia and less bleeding
Why are additives and preservatives added to LA?
prolong the shelf life by using antioxidant properties
What are two examples of additives and preservatives?
sodium bisulfite and sodium metasulfite
Asthma patients are sensitive to what additive?
If a person is allergic to sodium bisulfite do you use vasoconstrictor?
What does a yellow brown tint indicate?
What should you do if there is oxidation in the carpule?
dispose of it.
Are LA's vasodilators or vasoconstrictors?
vasodilators except cocaine its a vasoconstrictor
What phase of nerve conduction has positive ca+ on the outside and negative on the inside with no movement of ions?
What phase of nerve conduction has increase permeability to NA+ ions becomes less negative within the nerve?
deolarization slow phase
What phase of nerve conduction has enough stimulous to make nerve fire with influx of sodium?
What phase of nerve conduction returns to resting state which Na goes out of the nerve and k returns in the nerve. influx of K+
What is the site of action for a LA?
LA are alkaloid bases meaning they are?
wea combine with acids to form water soluble salts.
Base form is lipophilic and non ionized or hydrohillic and ionized?
lipophilic and non ionized.
ph of normal tissue is
7.3 to 7.4
ph of local anesthesia is
ph of local anesthesia with epinephrine is
ph of inflamed tissue is
5.5 to 5.6
when there is an inflamed area it means less or more anesthesia is absorbed causing a slower or faster onset of action...meaning it reduces the potency of the drug and poor anesthesia.
slower onset, less anesthesia
Esters hydrolyzed to ______________in the blood by pseudocholinesterase.
Amides metabolized by the ___________ except prilocaine which is metabolized in the ___________
What should you avoid in patients who have liver failure?
Where do amides and esters excrete?
People who have kidney trouble renal disease have a hard time excreting which LA?
Which LA do we want to avoid if a patient is allergic to a sulfa?
What happens if a patient is allergic what happens to them?
rash or anaphylaxis
Do amides cause allergic reactions?
Vasoconstrictors have an alpha or beta effect on vasoconstrictor causing constriction of blood vessels?
Vasoconstrictors exert their action directly on the what receptors?
An overdose amount of vasoconstrictor would produce what effect alpha or beta?
Beta affect heart and smooth muscle reactions, vasodilation and bronchodilation
Persistent anesthesia or altered sensation well beyond the expected duration is called
how do you give a patient facial paralysis
deposit anesthesia near the facial (cranial 7) nerve in capsule of paratid gland
prolonged spasm of the muscles of mastication is called
Trismus happens most offten with what injections?
psa and ianb
What is the treatment for trismus
heat therapy for twenty min every hour or anti inflammatory analgesic diazepam 10mg
how can you give a patient a hematoma
nicking an artery
when is a hematoma most likely to occur what injection?
psa, ia, mental, io outside of face is psa
can you get a hematoma on the palate?
how do you treat hematoma?
ice for 2 min with reasure
burning on injection what is the cause
ph of la solution more acidic, rapid injection, contamination of LA, la too hot
if you are allergic to one ester are you allergic to all?
What is common preservative in fruit and vegies?
If a person has a allergic reaction to a sodium bisulfate is it the LA or the Vaso?
Can you have an allergy to epinephrine?
What is the most dramatic and acutely life threatening allergic reaction?
If a patient has a non lifethreatning reaction what do you do
benedryl/diphenydramine 50mg for 4 days
if the patient has a life threatning anaphylaxis immediate reaction what do you do
activate ems, administer oxygen, epi 0.3 mg every 15 min, 50 mg diphenhydramine
what is an increased tolerance to a drug that is administered repeadatly
What initiates nerve conduction
what is not involved in impulse transmission?
What are terminal branches that distribute incoming signals to various CNS nuclei responsible for processing
what is term for the ability of the impulse to jump quickly from one node to the next?
What are the smallest nerve fibers
what are the largest fibers the most rapid conducting axons and transmite sharp dental pain
what fibers are not involved in transmitting dental pain
what fibers cause dull or burning pain
Afferent or sensory nerves conduct impulses to the
Efferent or motor neurons conduct messages from
the CNS to the periphery of the body
What starts the afferent nerve conduction?
What is a long nerve fiber that runs the whole length of the nerve?
What is the axon incased nerve membrane called
axolemmas and are surrounded by myelin sheath
What is the gelatinous substance inside the axon membrane called
What is the theory that postulates that the local anesthetic interferes with the sodium channel and blocks the sodium transfer necessary for nerve conduction?
specific receptor theory
The anesthetic must permeate how many mm of the nerves length to profoundly block the generation of nerve impulse.
If an injection is done two times and still does not produce pain control why is that?
because of a lower ph of the tissues, edema, hemmorrhage or transudation of surrounding areas.
Why is anesthesia not as effective when there is an infection?
ph of the tissue is too low to allow anesthetic to penetrate the nerve
What is the largest fiber
The smallest fiber
Which fiber does not have a myeline sheath
What fibers are most easily blocked by local anesthesia
c fibers. because no myelin sheath makes it easier to access the nerve.
What can happpen with toxic blood levels?
anesthesia depress the CNS and cause patient to have convulsions.
Ester anesthetics are metabolized in the blood stream by
Esters are contraindicated in patients who report they have
atypical pseudocholinesterase production
Where are amides metabolized
Why are vasoconstrictors added to local anesthetics?
decrease the absorption of the drug, prolong the anesthetic effect reduce risk of toxisity
What are the most commonly used vasoconstrictors used in dentistry?
epinephrine and levonordefrin
Epinephrine is good for
What is the recommended topical form of lidocaine?
What is the most commonly chosen anesthetic today
lidocaine with 1:100,000 ei.
Why is 3% mepivicaine without vasoconstrictor used
patients who cannot take a vasoconstrictor or for short procedures.
What do you use if you want pulpal anesthesia for longer apointments or when post operative pain is anticipated?
Why is Bupivicaine not recommended to children or handicapped patients?
increased risk of postoperative injury (chewing on a numb lip)
Why would there be mild burning sensation during administration of anesthesia?
ph of solution, too warm, contamination.
Does an artery or vein cause hematoma?
What is treatment for trismus?
Heat therapy 20 minutes every hour. and analgesic and muscle relaxants if necessary.
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