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Dental Nurse Sedation Post Qual Exam > IV sedation > Flashcards

IV sedation Flashcards

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1
Q

Indications for IV sedation..

A

Psychological
Difficult tx
MH
Gag reflex
To avoid GA

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2
Q

Contraindications for IV sedation..

A

Allergy
Children
Extensive tx
Needle phobia
No escort
IV drug user
Pregnancy
Liver or renal disease
Obese BMI over 35

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3
Q

Iv sedation advantages…

A

Rapid onset
Controllable - titrated
Anxiolytic
Amnesic
IV access - for emergency drugs

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4
Q

Iv sedation disadvantages…

A

Gaining IV access
Time consuming
Needle phobic

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5
Q

What are the 4 intravenous agents?

A

Diazepam
Midzolam
Propofol
Fentanyl

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6
Q

How can diazepam be given?

A

Orally, IM or IV

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7
Q

What is the half life of diazepam?

A

43 hours

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8
Q

How long can recovery take with diazepam?

A

72 hours

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9
Q

What family does Midazolam belong to?

A

Benzodiazepine

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10
Q

Midazolam has a…

A

Rapid onset

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11
Q

What is the short half life of midazolam?

A

1.9hrs

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12
Q

What does midzolam do?

A

Muscle relaxant, anticonvulsant, amnesia, analgesia

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13
Q

How long does it take for midazolam to travel from the arm to the brain?

A

35 seconds

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14
Q

How is midazolam redistributed?

A

Muscle and fatty tissue

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15
Q

How is midazolam eliminated?

A

liver and excreted by kidney

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16
Q

What is Flumazenil?

A

Midazolam reversal

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17
Q

What is the brand name of flumazenil?

A

Anexate

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18
Q

What is the half life of Flumazenil?

A

50 mins

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19
Q

What airway assessment will be completed for IV sedation?

A

Mallampati classification

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20
Q

What is a common benzodiazepine pre-medication?

A

Temazepam 5mg
x2 tabls one night before and one 1hr before app
Escort required

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21
Q

Pre op instructions for IV sedation?

A

No food/drink 2 hrs before - light meal
Escort
Appropriate travel
No alcohol 24hrs before
Medication take as normal
Bring inhalers / GTN spray
Nail varnish removed

22
Q

Post op instructions for IV sedation?

A

No alcohol for 24 hrs
No driving/ operating machinery
Not to be left alone
No important decisions
Avoid social media

23
Q

What would happen if the treatment changed during IV sedation?

A

Treatment cannot be consented to, so pt will have to be brought back to discuss options

24
Q

What size is the green IV cannula?

A

18G

25
Q

What size is the pink IV cannula?

A

20G

26
Q

What size is the blue IV cannula?

A

22G

27
Q

What size is the yellow IV cannula?

A

24G

28
Q

Which is the flow rate of the yellow IV cannula?

A

20 ml/min

29
Q

Which is the flow rate of the blue IV cannula?

A

33ml/min

30
Q

How should Iv drugs be administered?

A

Titrated

31
Q

what does bolus mean?

A

Rapid administration

32
Q

How should IV midazolam be administered ?

A

1mg bolus over 30sec
wait 1 min

33
Q

Common areas for cannulation?

A

Dorsum - hand
Antecubital fossa - infront of elbow

34
Q

Benzodiazepines are

A

Sedation, muscle relaxants, and anterograde amnesia

35
Q

What other name is midazolam known by?

A

Hypnovel

36
Q

What year was midazolam available in the UK?

A

1983

37
Q

what schedule of controlled drug is midazolam classified as?

A

schedule III controlled drug

38
Q

midazolam is available in what presentations

A

10mg in 5ml
10mg in 2ml
5mg in 5ml

39
Q

What does the blue dot on the ampoule represent?

A

Signifies the place to hold to get ease for opening

40
Q

What is the PH of midazolam?

A

3.4

41
Q

If a patient had an allergic reaction to midazolam, how would the reaction be managed

A

adrenaline IV - 0.5ML 1:10000
IM - O.5ML 1:1000

42
Q

What does Anxiolytic mean?

A

Reduces anxiety

43
Q

Midazolam binds to which receptors in the CNS?

A

Benzodiazepine receptors

44
Q

Benzodiazepine receptors run parallel to which other receptors?

A

Gamma-aminobutyric acid (GABA)

45
Q

Benzodiazepine enhances the effect of neurotransmitters on the GABA receptors leading the brain to do what?

A

Decreased brain activity

46
Q

What is half-life?

A

The time it takes for plasma levels of the drug to drop in half

47
Q

Name the two stages that form the Benzodiazepines half-life?

A

Alpha & Beta

48
Q

What does the Alpha half-life do?

A

Distribution and redistribution - travels to the brain and then from the brain to other tissues in the body.

49
Q

How long is the Alpha half-life?

A

4-18 minutes

50
Q

What does the Beta half-life do?

A

Metabolism & Excretion (the body breaks down so it is no longer active, then removed from the body)

51
Q

How long is the Beta half-life?

A

1-4 hours (can be longer for elderly/teens)

Dental Nurse Sedation Post Qual Exam (11 decks)

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