Test 2- Mod 6- Nitrous Flashcards
what had been the greatest medical advance before n20
sutures
what is the combination of of nitrous and local anesthesia
relative anaglesia
What abilities does nitrous have
sedative and antianxiety
what is analgesia
relief of pain without loss of conciousness
what is anesthesia
loss of pain to permit surgery, with or without loss of conciousness
what is concious sedation
control of airway
who posed as a physican and did shows with nitrous
samuel colt
who was the first dentist to use nitrous for a tooth extraction
horace wells
did most patients recover from nitrous use
yes
what 2 things were discovered after nitrous
ether-general surger
choloroform- general surgery
who was the first to mix nitrous as oxygen
edmund andrews
what percent of dentists use nitrous today?
56 general dentists
85 oral surgeons
what are physical properties of nitrous
- colorless
- heavier than air
- no predictable odor or taste
how is nitrous marketed
liquid nitrous
when does nitrous turn from the liquid to the gaseous state
when it is released, the changen absorbs heat and the cylinder will feel cold
nitrous is a _____drug
insoluble
what does N20 replaces what in the blood
N2
when are the peak clinical effects seen
within 3 -5 minutes
Nitrous is not metabolized____
in the liver
where is 99% of nitrous eliminated
the lungs
where is the remaining 1% of nitrous metabolized
in the GI tract and skin
what does N20 change
the patients perception of pain
what percent of mixure of N20 and 02 produces analgesic effects if 10 -15 mg of morphine
20-80% mixture
what effect does n20 have on the central nervous system
general depressant effect
what may happen in the mechanisms of action of n20
stabilize axon membranes, act on opiate receptors
what is the mechanism of action of n20
unknown
what are indications for nitrous in dentistry
anxiety, painful perception of tx, increased pharyngeal reflex activity,long appts
what is the greatest benefit in dentistry of nitrous
minimizes patients aprehension and fear
what are contraindications for n20
compulsive personality- not like feeling of losing conrol
claustrophobic patient
children w/severe behavior problems
debilitating cardiac or cerebrovascular disease
COPD
personality disorders
What is the stimulus in COPD
lowered blood 02
can HIV patients have N20
ask questions, alot have compromised cardiovascular problems that contraindicate
can pregant patients have n20
not in first trimester
can patients with nasal obstructions like cold, upper respiratory infecftions, deviated nasal septums have n20
not recommended
nitrous can enhance drugs that are used to induce sleep t/f
true
should patients who appear to be under the influence be administered
no
what is the titration
the method of administration where nitrous is introduced in incremental doses until pt has reached a comfortable state
what is the significance of titration*
- provides amt of drug necessary
- minimizes side effects
- allows for variability in each individual
can you ever leave a patient alone
no
its is below the standard of care to not have
scavenger nasal hood
what is the number one cause of nitrous contamination in the office
patient talking
wha tcolor is oxygen
green
what color is nitrous
blue
what is the minimum oxygen liter flow
3L/min
what will turn off when the oxygen is depleted
nitrous
what does the oxygen flush button do
allows 100% oxygen to be delivered
how full should you fill the resivoir bag
3/4 full
what are the 3 purposes of the resivoir bag
provide additional gas, monitor pts respiration, funcion in emergency
what level of nitrous are we not allowed to exceed
3L/min
what are characteristics of comfortable sedation
pt is at ease, comfortable and ready to proceed
what are characteristics of inappropriate sedation
slurred speech, incoherent, nausea or inablility to verbally respond
what are additonal signs of sedation
- glazed or twinkling look
- tingling
- heaviness
- agitated or physically uncomforable
waht are signs of oversedation
-uncontrolled laughing detachment warmnes drowsy agitated or physically uncomfortable
how many liters per minute do you introduce when you are titrating
1 l
what do you set the oxygen at, at the beginning of the procedure
5L
what do you need to periodically check durin the administration
the bag
how do you terminate sedation
turn nitrous flow off
how long do you deliver oxygen at the termination of nitrous
5 min
what is diffusion hypoxia
low oxygen levels to the tissues, when patientsj dont breath enough oxygen
what are symptoms of diffusion hypoxia
headache
nausea
lethargic
hangover
when are you able to use nitrous without LA
-emergency exam removal of temp crowns and bridges occ adj. matrix bands and wedges inital perio exam apprehensive pt
