Pharmalogical Managment

Question 1

What approach should be taken in the treatment under the GA?

Answer 1

Radical treatment, in doubt go for the radical treatment so the patient would not have to undergo GA again

Question 2

Why preventive appointments should be done after GA treatment ?

Answer 2

To make positive impact on the patient

Question 3

What is the main difference between the GA and sedation?

Answer 3

In GA there is loss of the protective reflexes so the patient can’t cough or breath in his own for example

Question 4

How to prevent the aspiration of debris during GA ?

Answer 4

Using throat packs

Question 5

What is the objective of the GA ?

Answer 5

To eliminate motor and sensory activity to facilitate delivery of comprehensive dental treatment

Question 6

T/F A patient during the GA can’t breath by his own and needs assistance to maintain open airway and ventilation is needed

Answer 6

True

Question 7

Mention the 3 groups of conditions that GA anesthesia is performed

Answer 7

1/ out patient short case by nasal mask
2/ out patient day-stay intubation anesthesia ( in the dental clinic)
3/ in patient hospital- stay intubation anesthesia

Question 8

What are the indications for GA

Answer 8

1/ patients that need extensive dental care
2/ patients that can not cooperate
3/ patients with general medical problems

Question 9

T/F For patients with LA allergy is the sedation is an option ?

Answer 9

False , the sedation needs LA as well so the GA is the only option

Question 10

T/F patients under the age of 3 can be treated with GA

Answer 10

True

Question 11

What are the contraindications of the GA

Answer 11

1/ respiratory infection
2/ active systemic disease with elevated temperature
3/ a healthy cooperative patient with minimal dental needs.

Question 12

What are the advantages of the GA

Answer 12

1/ safe and efficient to treat the patients that can’t be treated in dental chair
2/ child doesn’t need to cooperate
3/allows for extensive treatment to be done in one visit
4/ the use of the throat packs to prevent the aspiration of debris
5/ doesn’t cause emotional trauma on the pt

Question 13

What are the disadvantages of the GA

Answer 13

1/complications are the higher compered to the conscious sedation.
2/Needs a trained team and a special equipment and facilities.
3/Needs lab tests and chest x ray before the GA
4/ The patient can not eat before 6 hrs of the GA
5/ it is expensive

Question 14

Why the GA has higher complications?

Answer 14

Because it depresses the Cv system and respiratory system and contraindicated for some medical compromised pts like cystic fibrosis patients

Question 15

Why the dentist may find a problem while treating a pt under GA?

Answer 15

1/Because the breathing tube pushes the tongue forward making it in the way
2/ the muscles are paralyzed and the dentist is dealing with a dead weight and the pt can not move so the dentist has to move
3/ it’s physically demanding and many procedures are done in one session

Question 16

What should be done on the patient before the GA procedure?

Answer 16

1/ at least 2 topical fluoride.
2/ dietary consultation regarding nursing/bottle feeding
3/assessment of the oral hygiene

Question 17

Why the oral hygiene should be assessed before the GA

Answer 17

Because the bad oral hygiene and bottle feeding cause the failure of the treatment

Question 18

What are the steps of dental treatment under the GA

Answer 18

1/ treatment of the main complain like the pain and sepsis
2/ application of topical fluoride
3/ comprehensive dental treatment

Question 19

What should be done post operatively

Answer 19

After 3 months an appointment for complain assessment and topical fluoride application

Question 20

• what are the drugs used for GA

Answer 20

Nitrous oxide
Halothane
(Flu-rane Family) enflurane , isoflurane , desflurane , sevoflurane

Question 21

Who are the team members during GA procedure

Answer 21

Dental assistant 
Dental nurse 
Anesthesiologist 
Recovery nurse 
Dentist

Question 22

What are the eliminates of monitoring

Answer 22

Continues and close observation especially oxygenation , ventilation and circulation.
Pulse oximetry
Chest breathing and skin color
Capnography

Question 23

What are the causes of complications

Answer 23

Very young age
Non-hospital facilities
Absence of well trained observers
Errors in calculation of the drugs uses

Question 24

What are the complications of the GA

Answer 24

Main : death

Minor : hypoxia , vomiting, hypothermia and prolonged recovery time

Question 25

Other complications?

Answer 25

Cv and respiratory dysfunction
Laryngeal edema
Injury to body parts
Malignant hyperthermia

Question 26

Which one is the complication of GA

hypothermia or hyperthermia?

Answer 26

Both !

Question 27

What may cause the prolonged recovery and sliding to deeper sedation phase or cardiopulmonary depression

Answer 27

The pate absorption of the drugs

Question 28

What equipment should be present for rescue before procedure?

Answer 28

SOAP ME 🧼

Suction, oxygen, airways open , pharmacy, monitors and equipment

Question 29

What the precautions in the aftercare

Answer 29

Recovery position
Discharge policy
Emergency contact

Question 30

What is the recovery position

Answer 30

On the side

Question 31

What is example of discharge policy

Answer 31

Pt walking by his own after the recovery

Adult accompany the pt after recovery