Pharmacological Behaviour_Oral Sedation

Question 1

Is oral sedation often used in Australia and why?

Answer 1

No, GA is safer than oral sedation + nitrous (which is when it is normally used) and Australia has plenty of GA facilities available

Oral sedation often used in US

Question 2

What is the most common agent used for oral sedation? What is the dosage used?

Answer 2

Midazolam

0.5mg/kg up to 15mg

Question 3

What effects does oral sedation have?

Answer 3

-Anxiolysis
Hypnotic
Anticonvulsant
Muscle relaxant
Some amnesia
But no analgaesia

Question 4

What are some adverse effects of oral seedation?

Answer 4

• Risk of apnoeic attack–>monitor breathing
• Angry child syndrome
• Can enhance tohe sedative effects of other medications–> be cautious

Question 5

Where does oral sedation midazolam act?

Answer 5

GABA receptors

Question 6

What are some signs of oral sedation overdose?

Answer 6

-Deeper plane of sedation
-Confusion
Impaired coordination
Loss of protective reflexes
Loss of consciousness
Loss of spontaenous breathing
REspiratory arrest
Cardiac arrest
Death

Question 7

What should be done in the case of overdose?

Answer 7

Adminster reversal agent: Flumazenil
(IV adminstration: 5 micrograms/kg every minute up to a total of 40 micrograms/kg)
Emergency resuscitatiion

Question 8

What precaution is necessary if using oral sedation?

Answer 8

Continous oximeter mointoring and recovery support

Require extra training and qualifiacations