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local anaesthetic 2 > LA > Flashcards

LA Flashcards

1
Q

list some examples of instruments capable of causing sharp injuries?

A 
scaling instruments
ultrasonic tips
burs
scalpels
probes
syringes
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2
Q

who’s responsibility is it to safely dispose of the sharp?

A

person using it

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3
Q

a sharp containing medicine is disposed of in which bin?

A

blue

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4
Q

an empty star is disposed of in which bin?

A

orange

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5
Q

what criteria must you follow in relation to sharps bins?

A
  • temporary closure mechanism in action when not in use
  • lid always closed firmly in place
  • don’t fill above line
  • all details completed once container assembled and prior to disposal
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6
Q

what does ARC stand for in relation to sharps injuries?

A 
a = are you injured
r = remove gloves
c = check area carefully
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7
Q

what is the name of the risk assessment carried pit after a sharps injury?

A

datex

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8
Q

can a student perform a risk assessment?

A

no

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9
Q

of the 3 BBVs, which has an effective vaccine?

A

HBV

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10
Q

name 2 classes of LAs and which is used more?

A

esters and amides (used more)

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11
Q

what is the function of a vasoconstrictor in LA?

A

constrict BVs
keep LA in are for longer period
manage bleeds

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12
Q

name 2 vasoconstrictors used in LA?

A

adrenaline

felypressin

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13
Q

name the 2 preservatives that may be found in LA?

A

bisulfide

propylparaben

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14
Q

which type of patients must you never use felypressin in?

A

pregnant woman

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15
Q

what are the 2 types of LA injection?

A

infiltrations or blocks

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16
Q

which LA technique involves LA solution being deposited around terminal branches of nerves?

A

infiltration

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17
Q

which type of LA injection would you use to anaesthetise the pulp in maxillary teeth?

A

buccal infiltration

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18
Q

which type of LA injection would you use to anaesthetise the buccal gingiva of maxillary teeth?

A

buccal infiltration

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19
Q

which type of LA injection would you use to anaesthetise the palatal gingivae of maxillary teeth?

A

palatal infiltration

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20
Q

which type of LA injection would you use to anaesthetise the dental pulp of lower molars and second premolars?

A

IDB

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21
Q

which type of LA injection would you use to anaesthetise the pulp of lower premolars and canine?

A

mental nerve block

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22
Q

which type of LA injection would you use to anaesthetise the pulp of lower incisors and canines?

A

buccal/labial infiltration

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23
Q

which type of LA injection would you use to anaesthetise the buccal gingiva of the lower molars and second premolar?

A

long buccal infiltration and IDB

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24
Q

which type of LA injection would you use to anaesthetise the buccal gingiva of lower 1st premolar and canine?

A

infiltration/ long buccal/ mental block

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25
Q

which type of LA injection would you use to anaesthetise the buccal gingiva of lower incisors and canines?

A

buccal/labial infiltration

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26
Q

what tissues do you need to anaesthetise for a restoration?

A

dental pulp

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27
Q

what tissues do you have to anaesthetise for an extraction?

A

pulp and gingivae

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28
Q

what tissues do you have to anaesthetise for scaling?

A

gingivae (pulp too if root planing)

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29
Q

why is articaine commonly used intros with liver disease?

A

it is mostly processed in the plasma

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30
Q

prilocaine is commonly known as?

A

citanest

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31
Q

name the important landmarks you look for when giving an IDB?

A

coronoid notch
posterior border of mandible
pterygomandibular raphe

32
Q

in which region is the anaesthetic deposited when giving an IDB?

A

region of mandibular foramen

33
Q

what adrenaline concentration is in lidocaine?

A

1:80,000 adrenaline

34
Q

where is lidocaine metabolised?

A

liver

35
Q

what vasoconstrictor is used in citanest?

A

felypressin (octapressin)

36
Q

what concentrations of adrenaline does articaine come in?

A

1: 100,000
1: 200,000
1: 300,000

37
Q

what percentage of lidocaine is in LA?

A

2%

38
Q

what percentage prilocaine is in LA?

A

3%

39
Q

what percentage articiane is in LA?

A

4%

40
Q

where is articaine metabolised?

A

mostly plasma but also liver

41
Q

where is prilocaine metabolised?

A

liver

42
Q

which has a more rapid onset, lidocaine or articaine?

A

articaine

43
Q

list some systemic complications of LA?

A 
psychogenic
drug intercations
cross infection
allergy
collapse
toxicity
44
Q

what are some clinical features of psychogenic stress due to LA?

A

light headedness, pallor, beads of sweat, bradycardia, nausea, pupil dilation, fainting, weakness, palpitations etc

45
Q

how would you manage a patient with psychogenic stress?

A

lay flat and raise leg
loosen any neck clothing
improve room ventilation
sweet drink?

46
Q

give some examples of drugs which interact with LA?

A 
MAOI (monoxide oxidase inhibitors)
tri-cyclics
beta blockers
non potassium sparing diuretics
cocoaine
47
Q

what is LA allergy most commonly due to?

A

preservative (methylparaben or sodium bisulphate)

48
Q

list some signs of LA toxicity?

A

convulsion (seizures)
loss of consciousness
respiratory depression
circulatory collapse

49
Q

what is the max safe dose for lignocaine?

A

5mg/kg

50
Q

how many mg of lignocaine in a cartridge?

A

44mg

51
Q

what is the max safe does of articaine?

A

7mg/kg

52
Q

how many mg of articaine in a cartridge?

A

88mg

53
Q

what is the max safe dose of prilocane?

A

8mg/kg

54
Q

how many mg prilocaine in a cartridge ?

A

66mg

55
Q

list some local complications of LA?

A 
failure to achieve anaesthesia
prolonged anaesthesia
pain during or after injection
trsimus
haemartoma
intra-vascular injection
56
Q

name the 4 LA blocks?

A

mental block
infra-orbital block
IDB
posterior superior alveolar block

57
Q

what does the mental block anaesthetise?

A

skin over chin and lip

buccal mucosa from lower 4 to 1 and teeth there

58
Q

where do you inject in a mental nerve block?

A

between apices of lower 4 and 5

59
Q

what does the infra orbital block?

A

upper central later and canine

60
Q

what does the posterior superior alveolar nerve block?

A

maxillary molars

skin sensation on cheek nose and lip

61
Q

trismus is most likely due to damage of which muscle ?

A

medial petrygoid

62
Q

how would you distinguish facial palsy due to a stroke and facial palsy due to LA?

A

stroke - spares upper facial muscles

la induced - can’t move any facial muscles

63
Q

facial palsy occurs as a result of injecting too far back and into?

A

parodic gland

64
Q

what technique can be used to reduce the pain of a palatal injection?

A

chasing anaesthesia

65
Q

what device is used to control pressure when giving an intraligamentary injection?

A

peripress pen/syringe to the wand

66
Q

if a patient is numb everywhere except the tooth, what technique may you use to numb only the tooth?

A

intra-osseous injection

67
Q

which method of LA administration doesn’t involve a needle?

A

topical jet injector

68
Q

name 2 alternative techniques to an IDB?

A

gow gates technique and akinosi technique

69
Q

when may the akinosi technique be used over an IDB?

A

patient has severe trismus so can’t open mouth to get block

70
Q

name the 2 types of surface anaesthesia ?

A

physical surface anaesthesia (refrigeration anaesthesia)

pharmacological anaesthesia

71
Q

when would you not use lidocaine LA?

A

heart block and no pacemaker
allergy
hypotension
impaired liver function

72
Q

which is more effective for mandibular infiltration, lidocaine or articaine?

A

articaine

73
Q

why would you choose to use LA without adrenaline?

A

patient has BP >200mmhg systolic or >115mmghg (diastolic)

patients on diuretics

74
Q

which needle length is used for lingual/palatal anaesthesia?

A

ultra short

75
Q

which method is commonly used in paediatric dentistry when giving an intraligamentary injection?

A

wand method

76
Q

what would you do if a patient is experiencing LA toxicity?

A 
stop dental treatment 
provide BLS
call for medical assistance
protect patient from injury
monitor vital signs
77
Q

what would be the safe way to anaesthetise a lower permanent molar in a 12 year old with mild haemophilia?

A

single tooth anaesthesia using the wand

articaine with adrenaline

local anaesthetic 2 (2 decks)

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