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BDS2 CDS LA symposium > complications > Flashcards

complications Flashcards

1
Q

what type of LA is lidocaine?

A

amide

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2
Q

what vasoconstrictors are used in lidocaine?

A

none

1:80,000 adrenaline

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3
Q

what is lidocaine used for?

A

infiltration, blocks, others

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4
Q

where is lidocaine metabolised and excreted?

A

liver, kidney

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5
Q

describe the onset of lidocaine

A

rapid, 2-3 mins

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6
Q

what % lidocaine is used?

A

2%

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7
Q

what type of LA is priloccaine?

A

amide

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8
Q

what vasoconstrictors are used in prilocaine?

A 
none
felypressin (octapressin) 1.2 micogms
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9
Q

what are the uses of prilocaine?

A

infiltrations, blocks, others

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10
Q

what % pilocaine is used?

A

3%

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11
Q

what is the brand name of prilocaine?

A

citanest

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12
Q

what type is articaine?

A

amide

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13
Q

what % articaine is used?

A

4%

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14
Q

what vasoconstrictor is used in articaine?

A

adrenaline

1: 100,000
1: 200,000
1: 400,000

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15
Q

what is articaine most commonly used for?

A

infiltrations

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16
Q

where is articaine metabolised & excreted?

A

liver and plasma

kidney

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17
Q

describe the onset of articaine?

A

rapid

2-3 mins

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18
Q

what is 1.5x more potent than lidocaine?

A

articaine

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19
Q

what are the possible systemic complications of LA?

A 
psychogenic
interactions with other drugs
cross infection
allergy
collapse
toxicity
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20
Q

describe the psychogenic complication

A

lack of oxygenated blood to brain
fainting, palpitations, cold sweat, restlessness, excitation, trembling, weakness
lightheaded, pallor, sweat
bradycardia, nausea, pupil dilation
management: lay flat, raise legs, loosen neck clothing sweet drink

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21
Q

what drugs interact with LA?

A

cocaine- increased adrenergic activity
B blockers
non potassium sparing diuretics- lowers K
tri-cyclics - hypertension risk- limit 2 cartridge
M.A.O.I - anti-depressants

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22
Q

what are most allergic reactions caused by?

A

preservatives/antioxidant

-methylparaben/sodium bisulphite

23
Q

what allergic reactions can occur?

A

skin reactions, respiratory reactions, anaphylaxis

-not treated in general practice

24
Q

what are the symptoms of toxicity?

A

convulsions
loss of consciousness
respiratory depression
circulatory collapse

25
Q

what can induce labour?

A

octapressin

26
Q

what technique reduces toxic effects?

A

aspirating

slow injection

27
Q

what is the max dose of lignocaine?

A

5mg/kg

28
Q

how many mgs in a lignocaine cartridge?

A

44

29
Q

what effect does adrenaline have on the heart?

A

rate, force, output, excitability increase

30
Q

what effect does adrenaline have on bv?

A

coronary dilation
skin contraction
muscle dilation

31
Q

what effect does adrenaline have on bp?

A

increase systolic

decrease diastolic

32
Q

what effect does adrenaline have on lungs?

A

bronchial muscle relaxation

33
Q

what conditions should adrenaline be limited/avoided?

A

hyperthyroidism

phaechromocytoma (hypertension)

34
Q

what local complications can happen?

A 
failure
prolonged
pain
trismus
haematoma
intra-vascular injection
blanching
facial paresis
broken needle
infection
soft tissue damage
contamination
35
Q

what can cause prolonged anaesthesia?

A

direct trauma from needle
multiple passes with same needle
chemical trauma for direct injection
different depending on LA used

36
Q

how do you know if you are too close to a nerve?

A

jump/electric shock

37
Q

what is the 1st drug of choice in LA blocks?

A

lidocaine 2% w/ adr

38
Q

describe the presentation of trismus

A

w/i a few hours of IDB may severely restrict opening

can be weeks/months

39
Q

what is the cause of trismus?

A

damage to medial pterygoid
injection too low
too forcefeul/rapid

40
Q

what is the management of trismus?

A

reassurance after diagnosis
muscle relaxant
anti-inflammatory

41
Q

how to differentiate between palsy and stroke?

A

stroke can use upper half of face muscles

LA palsy- all facial nerves cant move muscles on one side

42
Q

what is the presentation of facial palsy?

A

unilateral motor nerve paralysis w/i mins of inferior dental blocks

43
Q

how to confirm facial palsy?

A

temporal branch affected

44
Q

what is the cause of facial palsy?

A

local into parotid gland

-injected too far posteriorly

45
Q

what is the management of facial palsy?

A

reassurance

cover eye with pad until blink reflex returns

46
Q

describe intra-arterial injection

A

skin blancing
visual disturbance
aural distrubance

47
Q

when do intra-venous injections usually occur?

A

inferior dental block

48
Q

what are the features of intra-venous injection?

A

adrenaline effect
palpitation
also can be anxious, restless, headache, sweating, pallor

49
Q

what is the max dose of mepivicaine 3%?

A

3mg/kg

50
Q

how many mgs in a cartridge of mepivicaine 3%?

A

66

51
Q

what is the max dose of articaine 4%?

A

7mg/kg

52
Q

how many mgs in a cartridge of atricaine?

A

88

53
Q

what is the max dose of prilocaine 3%?

A

8mg/kg

54
Q

how many mgs in a cartridge of prilocaine?

A

66

BDS2 CDS LA symposium (7 decks)

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