Sedation in medically comprimised pateints

Question 1

Which ASA pateints should be treated in specialist facilities?

Answer 1

3/4

Question 2

Which medically compromised pateints should sedation be considered in?

Answer 2

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

Question 3

If someone has 2/3 attacks of angina per week, what ASA are they?

Answer 3

3

Question 4

What is the effect of sedation on CVS?

Answer 4

it reduces the workload

Question 5

Which type of sedation is best for people with CVS disease?

Answer 5

inhaltion using NO and O

Question 6

What is the effect of NO and O on the myocardium?

Answer 6

It increases blood flow to the myocardiu

Question 7

What should be done in cases when IV sedation is used in people with CVS disease?

Answer 7

use O2 as suuplemental

Question 8

People with unstable angina, what should be done prior to sedation?

Answer 8

needs to have a medical consultation first?

Question 9

When should you use NO/O in peple with unstable anginaa?

Answer 9

only in an emergency situation

Question 10

What percentage of people that have suffered an MI and treated within 3 months pf this have another episode?

Answer 10

36%

Question 11

How long should you give before treating someone that has suffered an MI?

Answer 11

6 months

Question 12

What type od sedation should you provide in people that have suffered an MI?

Answer 12

NO/O inhaltonal

Question 13

What are the 2 types of hypertenson?

Answer 13

essential and secondary

Question 14

Which type of hypertenson, essential or secondary, is most common?

Answer 14

essential

Question 15

What is a risk for people taken anti hypertensive drugs?

Answer 15

postural hypotension

Question 16

T/F people that suffer from hypertension have a poor response to stress?

Answer 16

T

Question 17

T/F Only inhalational sedation is appropriate in people suffering from hypertension?

Answer 17

F

can use Oral, IV, Inhaltional

Question 18

What affect does hypertension have on LA?

Answer 18

Need a good quality LA so can reduce the overall amount used

Question 19

What is valvular heart disease?

Answer 19

disease involving one or more of the heart valves

Question 20

Which side of the heart are valvular heart diseases more common? which valves are therefore most commonly effected?

Answer 20

in left side due to higher pressures

Aortic and mitral

Question 21

What are the two main types of valvular heart disease?

Answer 21

Stenosis and regurgitation

Question 22

WHat is valvular stenosis?

Answer 22

narrowing stiffening thickening or fusion of the heart valves

Question 23

What is valvular regurgitation?

Answer 23

this is when the heart valves are incompetant

Question 24

What 2 things must you avoid in people with valvular heart disease?

Answer 24

stress and hypoxia

Question 25

What two common respiratory diseases benefit from sedation?

Answer 25

asthma and COPD

Question 26

How many people in the UK are affected by asthma?

Answer 26

10-15%

Question 27

What drugs should you avoid in asthmatics?

Answer 27

NSAIDS

Question 28

WHat is asthma?

Answer 28

chronic inflammatory condition of the lung airways

Question 29

What can both IV and Inhaltional sdation provide in asthmatics?

Answer 29

anxiolysis with no airway irratation

Question 30

What is COPD?

Answer 30

obsrtucive lung disease with limited airflow and persistant inflammation in the lungs

Question 31

What two diseases are a common cause of COPD?

Answer 31

chronic bronchitis and emphysema

Question 32

What are the symptoms of COPD?

Answer 32

couth sputum wheeze and breathlesssness

Question 33

How do people with COPD repsire?

Answer 33

they rely on the hypoxic drive

Question 34

What type of sedation can be used in people with thyorid disease?

Answer 34

oral inhalational and IV

Question 35

Which drugs do you need to be careful in with people suffering from hypothyroidism?

Answer 35

CNS depressants

Question 36

Which drugs do you ned to be careful in with people suffering from hyperthyroidism?

Answer 36

LA with adrenaline

Question 37

Which two systemic diseases is it important to avoid prevnt hypoxia and provide anxiolysis?

Answer 37

people suffering from a stroke | people with valvular heart disease

Question 38

Which type of sedation is more beneifical in people suffering from a stroke?

Answer 38

Inhalational sedation especially if the cognitive ability is low

Question 39

People with myasthenia gravis should be offered which type of sedaton?

Answer 39

inhaltional using NO since need to avoiud muscle relaxants eg BZD

Question 40

What is the effect of renal disease on sedation?

Answer 40

impaored renal function means increased drug blood levels however one off doses are fine

Question 41

Which type of sedation is best in people with hepatic disease?

Answer 41

inhaltional

Question 42

T/F pulse oximetry will help identify anaemias?

Answer 42

F

Question 43

People suffering from porphyria should avoid given them what?

Answer 43

BDZ

Question 44

People with malognant hyperpyrexia should be careful with what?

Answer 44

Lignocaine

Question 45

People suffering from suxamthonium apnoea should be careful with what?

Answer 45

articaine

Question 46

what drugs enance sedation efects?

Answer 46

``` alchohol opioids antidepressants antihistamines antipsychotics ```

Question 47

drugs which increase the level of midazolam include?

Answer 47

KEC ketoconazole eryhromycin Ca Channel blockers

Question 48

What is the effect of antihypertensives on sedation?

Answer 48

enhanced hypotension