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Pharmacology Journals > Role Of Dexmedetomidine In Pediatric Dental Sedation > Flashcards

Role Of Dexmedetomidine In Pediatric Dental Sedation Flashcards

1
Q

What is the highly selective a2 agonist receptor that is used in pedriatic dental sedative

A

Dexmedetomidine

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2
Q

Risks of administering general anesthesia

A

Bleeding
Edema of tongue or lips
Arrhythmias
Dislodge or dislocated endotracheal tube
IV infiltration or disconnection

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3
Q

Currently used sedatives in dental procedures

A

Midazolam
Chlorohydrate
Ketamine
Nitrous oxide
Profol
Promethazine
Hydroxyzine
Sevoflurane

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4
Q

Selective a2 adrenoceptor agonist

A

Dexmedetomidine
Mivazerol
Clonidine
A-methyldopa

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5
Q

Non selective a2 adrenoceptors agonist

A

Noradrenaline
Adrenaline

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6
Q

Imidazoline receptor agonist

A

Serial-no. 1-5

Monoxidine
Rilmenidine
Clonidine
Dexmedetomidine
Mivazerol

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7
Q

Imidazoline receptor binding sites have been identified in where

A

Brain
Pancreas
Kidneys

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8
Q

Is dexmedetomidine a short or long acting?

A

Short acting central a2 adrenoceptor agonist

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9
Q

It has been reported that a2-adrenoceptor agonist causes?

A

Sedation, anxiolysis, analgesia, sympatholytic and postoperative reduction of nausea and vomiting better than benzodiazepines.

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10
Q

Half life of clonidine

A

12.5h

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11
Q

How many hours does it need for clonidine to be administered before the induction o anesthesia

A

At least 1hr

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12
Q

In what year did dexmedetomidine introduced in dentistry

A

2005

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13
Q

Why is dexmedetomiine more favorable than clonidine?

A

Because dexmedetomidine has more favorable pharmacokinetic and shorter half-life than clonidine

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14
Q

Is dexmedetomidine a highly selective or non-selective drug?

A

It is a highly a2 selective adrenoceptor

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15
Q

Central effect of dexmedetomidine

A

Inhibits the release of norepinephrine by acting on the a2 adrenoceptors in the locus ceruleus,producing a state similar to natural sleep

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16
Q

Mechanism of action of dexmedetomidine

A

Stimulation an cessation of parasympathetic and sympathetic outflows.

17
Q

Sedation is primarily induced by

A

Activation of post-synaptic a2 adrenergic receptors. Because dexmedetomidine attaches to the a2 receptors in the locus ceruleus and spinal cord, providing sedation and analgesia effects

18
Q

Three subtypes of a2 adrenoceptors

A

A2A, a2B, a2C

19
Q

Where can the subtypes of a2 adrenoceptors can be found

A

Within the blood vessels, vital organs, autonomic, peripheral and CNS

20
Q

Does dexmedetomidine binds to g-protein or no?q

A

Yes they bind to g-protein

21
Q

High affinity of a2 adrenoceptor causes what?

A

Bradycardia and vasodilation

22
Q

Half life of dexmedetomidine

A

2hrs

23
Q

Excretion of dexmedetomidine

A

95% in urine
4% in feces

24
Q

Drugs that doesn’t have an affinity for GABA and opioids which does not result in respiratory depression

A

Midazolam, benzodiazepines, opioids and dexmedetomidine

25
Q

Advantage of dexmedetomidine

A
  1. Safe sedative for children and infants
  2. Induce minimal respiratory depression and inhibits tachycardia
  3. Prevents hypoxia by maintaining the airway and enabling spontaneous respiration
  4. Preserves CO2 reactivity
26
Q

Dexmedetomidine can be administered in?

A

Orally, buccally, intravenously, intranasally, intramuscularly

27
Q

Simples and popular route for drug administration

A

Oral route
\

28
Q

Buccal bioavailability and achieved its highest concentration

A

82%

29
Q

Oral bioavailability of dexmedetomidine

A

16%. Because of the hepatic first pass which metabolized high amounts of dexmedetomidine

30
Q

Time of onset for oral dexmedetomidine

A

40min before the induction of anesthesia, to attain the most favorable sedative affect

31
Q

Half life of dexmedotimidine if given intravenously

A

6min and 2h

32
Q

Administration of intranasal route in each nostril is how many ml

A

0.12 - 0.2 ml

33
Q

Bioavailability of dexmedetomidine is ___ ad it best absorbed after __ and __ administration

A

82%

Sublingual and intranasal

34
Q

How many doses of dexmedetomidine is given for intramuscular route ____ with a peak concentration within ___

A

2.5ug/kg , 15 minutes

35
Q

Common adverse effect of midazolam and dexmedetomidine if given orally

A

Decrease BP and bradycardia

Dexmedetomidine can decrease systemic outflow by decreasing plasma epinephrine and norepinephrine levels, leading to hypotension and decreased heart rate

36
Q

Suggested oral administration of dexmedetomidine

A

4ug/kg (adverse effects are only hypotension and bradycardfia)

37
Q

Main selectve a2 adrenoceptor antagonists

A

Atipamezole, idazoxan, yohimbine

38
Q

A2 adrenoceptors antagonist are a group of drugs capable of crossing te ____ and reversing the action of a2 adrenoceptors

A

Blood-brain-barrier

Pharmacology Journals (2 decks)

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