pharmacological_management_questions_answers Flashcards
What is the goal of pharmacological management in pediatric patients?
To provide a safe, painless, and positive dental experience while maintaining healthy oral structures.
Why is sedation important in pediatric dentistry?
To manage fear, anxiety, and inappropriate behavior during treatment.
What is a key consideration when deciding to sedate a child?
Assessment of the child’s suitability for a specific sedation technique.
What is the primary goal of pharmacological management?
To promote the safety and welfare of the pediatric patient.
How does pharmacological management benefit pediatric dentistry?
By enabling high-quality dentistry in a controlled, anxiety-free environment.
What defines minimal sedation?
A state where the patient responds normally to verbal commands and maintains airway independently.
What is the main characteristic of moderate sedation?
The patient responds to verbal commands and physical stimulation while maintaining protective reflexes.
What are the risks of deep sedation?
Possible need for airway assistance and depression of neuromuscular function.
What differentiates general anesthesia from other sedation levels?
The patient is completely unresponsive to any stimuli, with possible cardiovascular system impairment.
How is the airway maintained during general anesthesia?
Often requires assistance using devices like endotracheal tubes.
Which sedation level maintains normal respiratory and cardiovascular functions?
Minimal and moderate sedation.
At what sedation level is the patient unarousable by painful stimuli?
General anesthesia.
What level of sedation is commonly used for most pediatric patients?
Moderate sedation, as it ensures patient cooperation while maintaining safety.
What is conscious sedation?
A drug-induced state where the patient is cooperative and can maintain their airway independently.
What prerequisites are required for conscious sedation?
Practitioner expertise, pediatrician consultation, parental consent, and proper office facilities.
When is conscious sedation indicated?
For children with anxiety, gagging, or phobias that hinder treatment.
Why is informed consent critical for conscious sedation?
To ensure parents understand the risks and benefits.
What equipment is necessary for conscious sedation?
Oxygen supply, monitoring equipment, and emergency drugs like flumazenil.
What is the primary advantage of nitrous oxide sedation?
Rapid onset and reversibility with minimal side effects.
What are the key characteristics of nitrous oxide?
Odorless, colorless, non-explosive, and exhaled unchanged.
What are the indications for nitrous oxide sedation?
Anxious but cooperative children or those with needle phobias.
What are common contraindications to nitrous oxide sedation?
Respiratory conditions, motion sickness, or first trimester of pregnancy.
How is nitrous oxide administered?
Starting with 100% oxygen, gradually increasing nitrous oxide to 30%–70%.
What are the signs of adequate nitrous oxide sedation?
Relaxation, reduced blink rate, tingling, euphoria.
How is over-sedation with nitrous oxide managed?
Reduce nitrous oxide concentration by 5%-10% and reassure the patient.
What are psychosocial indications for sedation?
Phobias, gagging, and persistent fainting during procedures.
What are medical indications for sedation?
Conditions like asthma, epilepsy, and psychosomatic illnesses exacerbated by stress.
What dental situations might require sedation?
Difficult or unpleasant procedures where local analgesia is insufficient.
What are psychosocial contraindications for sedation?
Uncooperative patients or those lacking a responsible escort.
What are medical contraindications for sedation?
Severe systemic diseases or conditions like COPD and severe psychiatric disorders.
What are dental contraindications for sedation?
Procedures too lengthy for local anesthesia or infections threatening the airway.
Why must patients undergoing sedation be accompanied?
To ensure post-procedure safety and monitoring.
What is the goal of preoperative patient assessment?
To determine the appropriate sedation method and identify risks.
What factors are evaluated during preoperative assessment?
Medical history, dental history, ASA classification, airway assessment, and patient cooperation.
Why is understanding a child’s dental history important for sedation?
It helps predict cooperation levels and specific fears.
What is included in the ASA classification for patient assessment?
A scale from Class I (healthy) to Class V (moribund, unlikely to survive without surgery).
How does airway assessment impact sedation decisions?
It determines suitability for conscious sedation or general anesthesia.
Why is establishing rapport with the patient crucial during assessment?
To address misconceptions and build trust, ensuring better cooperation.
What should be documented during preoperative assessment?
Medical/dental history, informed consent, and patient’s ASA classification.
Why are radiographs sometimes deferred in anxious children?
To prevent exacerbating anxiety during the examination.
Why is monitoring critical during sedation?
Sedated patients are less aware of their surroundings and may not recognize changes in their body.
What are the key pieces of equipment for monitoring sedation?
Pulse oximetry, capnograph, blood pressure monitors, and oxygen supply.
How can sedation monitoring improve safety?
By detecting changes in vital signs early, allowing prompt intervention.
What visual signs indicate adequate sedation?
Relaxed demeanor, normal skin color, and responsiveness to verbal commands.
What is the purpose of electromechanical monitoring during sedation?
To continuously measure oxygen levels, heart rate, and respiratory function.
How is diffusion hypoxia prevented after nitrous oxide sedation?
By administering 100% oxygen for two minutes post-treatment.
What is a key requirement before discharging a sedated pediatric patient?
They must be sufficiently recovered to walk unaided and be accompanied by a responsible adult.
Why is postoperative communication with parents essential?
To ensure they understand aftercare and can monitor recovery at home.
What is a common sign of over-sedation?
Respiratory depression or unresponsiveness.
How is hypo-response to sedation managed?
By increasing the sedative dose cautiously or switching techniques.
What is a paradoxical reaction during sedation?
The patient becomes uncontrollable despite being sedated.
What are potential complications of intravenous cannulation?
Venospasm, hematoma formation, or extravascular injection.
Why must sedation drugs be labeled carefully?
To avoid confusion and administration errors.
What should be done if a patient experiences an adverse reaction during sedation?
Immediate supportive measures and administration of reversal agents if needed.
What is the definition of general anesthesia?
A controlled state of unconsciousness with loss of protective reflexes.
What are indications for general anesthesia in pediatric dentistry?
Severe dental diseases, uncooperative children, or those with medical disabilities.
What is the pre-anesthetic fasting protocol?
6 hours from solids/milk and 2 hours from clear fluids.
What role does nasotracheal intubation play in pediatric dental surgeries?
It provides better access for both the anesthetist and the dentist.
What is a critical step before waking a patient from general anesthesia?
Removal and accounting for all foreign materials like gauze or throat packs.
Why must dental treatment under general anesthesia be comprehensive?
To minimize the need for repeat hospitalizations and procedures.
