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Pain and anxiety > Week 3 > Flashcards

Week 3 Flashcards

1
Q

MOA of topical anesthetics

A

decrease Na+ ion permeability -> decrease depolarization

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2
Q

T/F: The best method for topical anesthetics is using a cotton tip applicator.

A

False! the choice of method is based on the individual pt

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3
Q

Which TA is associated with methemoglobinemia

A

benzocaine spray

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4
Q

Why do we need the site to be dried with gauze or sponge before we apply the TA?

A

dryer site = will absorb the anesthetic better

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5
Q

Name some characteristics of benzocaine

A

it’s an ester
low toxicity
duration: 5-15 mins
no MRD
methemoglobinemia is associated with the spray version

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6
Q

Name some characteristics of lidocaine

A

it’s an AMIDE
low toxicity
lasts for 15-45 mins
MRD: 300 mg but we can give 200mg safely
category B pregnancy

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7
Q

Benzocaine + Butamben + Tetracaine = ?

A

cetacaine

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8
Q

Name some characteristics of cetacaine

A

it’s a combo product
it’s an ester
lasts for 30-60 mins
MRD: 200mg
category C pregnancy

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9
Q

T/F: The concentration of topicals are lower than injectable LA’s.

A

False!! They’re higher

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10
Q

T/F: There are NO vasoconstrictors in topicals

A

True!

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11
Q

Know the toxicity and adverse rxns of topicals

A

-irritation @ site
-sloughing
-taste alteration
-CNS effects
-CV effects

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12
Q

What do a (+) and (-) for the aspiration mean?

A

(+) means blood entered the carpule
(-) no blood but small bubble may enter carpule

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13
Q

The larger the gauge the _______ the diameter

A

smaller

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14
Q

What is the weakest part of the needle?

A

Hub + Needle Adaptor

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15
Q

what are the 2 needle lengths commonly used in dentistry?

A

Long: 32mm
Short: 20mm

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16
Q

The needle length selection is based on?

A

the amount of tissue that must be penetrated

17
Q

T/F: A long needle is always required for a mandibular block

A

True

18
Q

How much LA does the stopper remove?

A

0.2mL
the carpule has 2mL total and the solution is 1.8mL

19
Q

What can cause a pt to experience syncope?

A

drastic drop in BP
emotional response to injection

20
Q

How can we help a pt experiencing syncope?

A

-supine position
-cool damp cloth on forehead
-ammonia capsule or 100% O2

21
Q

What is the most common cause of a LA overdose?

A

injecting into a vessel

22
Q

T/F: High doses of LA result in CNS and CV depression

A

True

23
Q

Name some common causes of an allergic rxn

A

-methyparaben
-sodium bisulfite
-ester topicals

24
Q

What could cause a burning feeling during injection?

A

contaminated or expired anesthetic
heated anesthetic solution

25
Q

Name some causes of hematoma

A

puncture of blood vessel
poor technique
multiple needle penetrations

26
Q

How do we prevent facial paralysis?

A

contact bone BEFORE depositing the anesthetic

27
Q

Facial paralysis can be caused by LA being deposited into the _________ gland.

A

parotid

28
Q

List some local complications

A

1) needle breakage
2) pain during injection
3) burning during injection
4) hematoma
5) facial paralysis (transient)
6) paresthesia
7) trismus
8) infection
9) edema
10) soft tissue injury
11) tissue sloughing

29
Q

Which branch of CNV has sensor and motor

A

CN V3

30
Q

Name the 5 major branches of CNV2

A

1) nasopalatine
2) greater palatine
3) PSA
4) infraorbital -> ASA and MSA
5) zygomatic

31
Q

Which nerves emerge from the anterior and posterior trunks of CNV3?

A

anterior: long buccal N and muscular branches
posterior: IA nerve, lingual N, auriculotemporal N

32
Q

5 major branches of CNV3

A

1) long buccal
2) muscular branches
3) auriculotemporal
4) lingual
5) IA

33
Q

T/F: The facial nerve courses through the parotid gland

A

true! gotta be careful of it when doing mandibular block

34
Q

Branches of maxillary A in the infratemporal fossa

A

1) middle meningeal
2) inferior alveolar -> mental + incisive
3) mm of mastication
4) buccal

35
Q

Branches of maxillary A in pterygopalatine fossa

A

1) PSA
2) infraorbital -> ASA
3) greater palatine
4) sphenopalatine

36
Q

What protects the maxillary A from being compressed during mandibular movement?

A

pterygoid plexus

37
Q

What is associated with hematoma and spread of infection? hint: venous

A

pterygoid plexus

Pain and anxiety (4 decks)

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