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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
which type of LA injection would you use to anaesthetise the buccal gingiva of lower incisors and canines?
buccal/labial infiltration
26
what tissues do you need to anaesthetise for a restoration?
dental pulp
27
what tissues do you have to anaesthetise for an extraction?
pulp and gingivae
28
what tissues do you have to anaesthetise for scaling?
gingivae (pulp too if root planing)
29
why is articaine commonly used intros with liver disease?
it is mostly processed in the plasma
30
prilocaine is commonly known as?
citanest
31
name the important landmarks you look for when giving an IDB?
coronoid notch posterior border of mandible pterygomandibular raphe
32
in which region is the anaesthetic deposited when giving an IDB?
region of mandibular foramen
33
what adrenaline concentration is in lidocaine?
1:80,000 adrenaline
34
where is lidocaine metabolised?
liver
35
what vasoconstrictor is used in citanest?
felypressin (octapressin)
36
what concentrations of adrenaline does articaine come in?
1: 100,000 1: 200,000 1: 300,000
37
what percentage of lidocaine is in LA?
2%
38
what percentage prilocaine is in LA?
3%
39
what percentage articiane is in LA?
4%
40
where is articaine metabolised?
mostly plasma but also liver
41
where is prilocaine metabolised?
liver
42
which has a more rapid onset, lidocaine or articaine?
articaine
43
list some systemic complications of LA?
``` psychogenic drug intercations cross infection allergy collapse toxicity ```
44
what are some clinical features of psychogenic stress due to LA?
light headedness, pallor, beads of sweat, bradycardia, nausea, pupil dilation, fainting, weakness, palpitations etc
45
how would you manage a patient with psychogenic stress?
lay flat and raise leg loosen any neck clothing improve room ventilation sweet drink?
46
give some examples of drugs which interact with LA?
``` MAOI (monoxide oxidase inhibitors) tri-cyclics beta blockers non potassium sparing diuretics cocoaine ```
47
what is LA allergy most commonly due to?
preservative (methylparaben or sodium bisulphate)
48
list some signs of LA toxicity?
convulsion (seizures) loss of consciousness respiratory depression circulatory collapse
49
what is the max safe dose for lignocaine?
5mg/kg
50
how many mg of lignocaine in a cartridge?
44mg
51
what is the max safe does of articaine?
7mg/kg
52
how many mg of articaine in a cartridge?
88mg
53
what is the max safe dose of prilocane?
8mg/kg
54
how many mg prilocaine in a cartridge ?
66mg
55
list some local complications of LA?
``` failure to achieve anaesthesia prolonged anaesthesia pain during or after injection trsimus haemartoma intra-vascular injection ```
56
name the 4 LA blocks?
mental block infra-orbital block IDB posterior superior alveolar block
57
what does the mental block anaesthetise?
skin over chin and lip | buccal mucosa from lower 4 to 1 and teeth there
58
where do you inject in a mental nerve block?
between apices of lower 4 and 5
59
what does the infra orbital block?
upper central later and canine
60
what does the posterior superior alveolar nerve block?
maxillary molars | skin sensation on cheek nose and lip
61
trismus is most likely due to damage of which muscle ?
medial petrygoid
62
how would you distinguish facial palsy due to a stroke and facial palsy due to LA?
stroke - spares upper facial muscles | la induced - can't move any facial muscles
63
facial palsy occurs as a result of injecting too far back and into?
parodic gland
64
what technique can be used to reduce the pain of a palatal injection?
chasing anaesthesia
65
what device is used to control pressure when giving an intraligamentary injection?
peripress pen/syringe to the wand
66
if a patient is numb everywhere except the tooth, what technique may you use to numb only the tooth?
intra-osseous injection
67
which method of LA administration doesn't involve a needle?
topical jet injector
68
name 2 alternative techniques to an IDB?
gow gates technique and akinosi technique
69
when may the akinosi technique be used over an IDB?
patient has severe trismus so can't open mouth to get block
70
name the 2 types of surface anaesthesia ?
physical surface anaesthesia (refrigeration anaesthesia) | pharmacological anaesthesia
71
when would you not use lidocaine LA?
heart block and no pacemaker allergy hypotension impaired liver function
72
which is more effective for mandibular infiltration, lidocaine or articaine?
articaine
73
why would you choose to use LA without adrenaline?
patient has BP >200mmhg systolic or >115mmghg (diastolic) | patients on diuretics
74
which needle length is used for lingual/palatal anaesthesia?
ultra short
75
which method is commonly used in paediatric dentistry when giving an intraligamentary injection?
wand method
76
what would you do if a patient is experiencing LA toxicity?
``` stop dental treatment provide BLS call for medical assistance protect patient from injury monitor vital signs ```
77
what would be the safe way to anaesthetise a lower permanent molar in a 12 year old with mild haemophilia?
single tooth anaesthesia using the wand | articaine with adrenaline

local anaesthetic 2 (2 decks)

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