Oral Sedation Flashcards
6 advantages of oral sedation
1-mostly universally acceptable 2-easy administration 3-cheap 4-low adverse reaction 5-adverse reaction are less severe 6-no needles
T/F drug can be taken at home
True. But it is best in the office
- monitor CNS
- proper dosage and time of admin
- Observe for bad reaction
7 disadvantages of oral admin
1-reliance on px compliance 2-prolonged latent period 3-erratic/incomplete GI absorption 4-inablitly to titrate 5-unable to control level of sedation 6-long duration of action 7-need class 3 anesthesia permit
6 ways to guard against px non-compliance
1-TELL the px amount and when to take
2-WRITE down instruction
3-MARK RX with same instruction
4-only PRESCRIBE the amount px should take
5-RECORD instructions in px chart
6-for kids with unreliable parents, have kid come to office and hour early to take there
What is the length of latency period of typical oral sedation?
- 30 min for minimum effective level of drug
- 60 min for peak blood levels
where does the bulk of absorption happen?
small intestine
more lipid soluble is more or less absorptive?
more
Bases are more or less absorbed in GI tract?
Less
what is the biggest disadvantage to oral sedation?
inability to titrate
slow onset of action helps or hinders drug titration?
hinders
what drug is the most popular to manage dental fear?
benodiazepine
what level of sedation do benzos give?
minimal to moderate
what are the 3 benzo types?
diazepam, midazolam, triazolam
what happens to respiration on benzos?
respiratory depression
what appens to CV on benzos?
stays the same
3 contraindications of benzos
1-allergies
2-psychoses
3- acute narrow angle glacoma
3 adverse effects to benzos
1-crosses placental barrier and can cause congeital malformations in 1st trimester
2-excreted in breast milk
3-drowsiness–don’t mix with alcohol
what is the most prescribed psychoactive drug in the us?
triazolam
3 advanges to triazolam
1-short half life (1.5-5.5 h) with peak levels in 1.3 hours
2-no active metabolites
3-no hangover
what can you combine with triazolam to allow for titration effect?
nitrous oxide
what is the rescue drug for benzodiazepines?
Fumazenil
*must be given IV
what are the four parts an an RX?
1- suprascript
2- insription
3-subscript
4-signatura
what is the purpose of the suprascript?
convetnioal Rx symbol on all rx pads
what is the inscription on an rx?
name and dose of drug
what is the subscript on an rx?
directions to the pharmacist
what is the signatura on the rx?
directions to the patient
**NOT the Dr. Signature
Will benzos interact with anticoagulants?
no
When selecting an proper dose for sedation, do you use the amount listed on the box?
NO! the recommended dose often leads to inadequate anxiety reduction in the dental (stressful) setting
