Sedation in medically comprimised pateints Flashcards
Which ASA pateints should be treated in specialist facilities?
3/4
Which medically compromised pateints should sedation be considered in?
dental phobics and anxiety
medical illnesses aggravated by stress
involuntary movements which compromised quality of dental care
need a surgical procedure where LA alone is not good enough
If someone has 2/3 attacks of angina per week, what ASA are they?
3
What is the effect of sedation on CVS?
it reduces the workload
Which type of sedation is best for people with CVS disease?
inhaltion using NO and O
What is the effect of NO and O on the myocardium?
It increases blood flow to the myocardiu
What should be done in cases when IV sedation is used in people with CVS disease?
use O2 as suuplemental
People with unstable angina, what should be done prior to sedation?
needs to have a medical consultation first?
When should you use NO/O in peple with unstable anginaa?
only in an emergency situation
What percentage of people that have suffered an MI and treated within 3 months pf this have another episode?
36%
How long should you give before treating someone that has suffered an MI?
6 months
What type od sedation should you provide in people that have suffered an MI?
NO/O inhaltonal
What are the 2 types of hypertenson?
essential and secondary
Which type of hypertenson, essential or secondary, is most common?
essential
What is a risk for people taken anti hypertensive drugs?
postural hypotension
T/F people that suffer from hypertension have a poor response to stress?
T
T/F Only inhalational sedation is appropriate in people suffering from hypertension?
F
can use Oral, IV, Inhaltional
What affect does hypertension have on LA?
Need a good quality LA so can reduce the overall amount used
What is valvular heart disease?
disease involving one or more of the heart valves
Which side of the heart are valvular heart diseases more common? which valves are therefore most commonly effected?
in left side due to higher pressures
Aortic and mitral
What are the two main types of valvular heart disease?
Stenosis and regurgitation
WHat is valvular stenosis?
narrowing stiffening thickening or fusion of the heart valves
What is valvular regurgitation?
this is when the heart valves are incompetant
What 2 things must you avoid in people with valvular heart disease?
stress and hypoxia
What two common respiratory diseases benefit from sedation?
asthma and COPD
How many people in the UK are affected by asthma?
10-15%
What drugs should you avoid in asthmatics?
NSAIDS
WHat is asthma?
chronic inflammatory condition of the lung airways
What can both IV and Inhaltional sdation provide in asthmatics?
anxiolysis with no airway irratation
What is COPD?
obsrtucive lung disease with limited airflow and persistant inflammation in the lungs
What two diseases are a common cause of COPD?
chronic bronchitis and emphysema
What are the symptoms of COPD?
couth sputum wheeze and breathlesssness
How do people with COPD repsire?
they rely on the hypoxic drive
What type of sedation can be used in people with thyorid disease?
oral inhalational and IV
Which drugs do you need to be careful in with people suffering from hypothyroidism?
CNS depressants
Which drugs do you ned to be careful in with people suffering from hyperthyroidism?
LA with adrenaline
Which two systemic diseases is it important to avoid prevnt hypoxia and provide anxiolysis?
people suffering from a stroke
people with valvular heart disease
Which type of sedation is more beneifical in people suffering from a stroke?
Inhalational sedation especially if the cognitive ability is low
People with myasthenia gravis should be offered which type of sedaton?
inhaltional using NO since need to avoiud muscle relaxants eg BZD
What is the effect of renal disease on sedation?
impaored renal function means increased drug blood levels however one off doses are fine
Which type of sedation is best in people with hepatic disease?
inhaltional
T/F pulse oximetry will help identify anaemias?
F
People suffering from porphyria should avoid given them what?
BDZ
People with malognant hyperpyrexia should be careful with what?
Lignocaine
People suffering from suxamthonium apnoea should be careful with what?
articaine
what drugs enance sedation efects?
alchohol opioids antidepressants antihistamines antipsychotics
drugs which increase the level of midazolam include?
KEC
ketoconazole
eryhromycin
Ca Channel blockers
What is the effect of antihypertensives on sedation?
enhanced hypotension
