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DH200 Int Clinic > Ch 36 Anxiety And Pain Control > Flashcards

Ch 36 Anxiety And Pain Control Flashcards

1
Q

Physical process of receiving a painful stimulus, transmits to brain and interpreted

A

Pain perception

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2
Q

Interpretation of and response to pain message

Highly variable among individuals

Many factors influence

A

Pain reaction

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3
Q

Varies among individuals

High and low

A

Pain threshold

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4
Q

Pain control mechanisms (6)

A

Remove the painful stimulus
-fulcrum

Block the pathway of pain message
-LA

Prevent pain reaction by raising threshold
-Nitrous oxide

Depress dental nervous system
-general anesthesia

Paychosedation methods
-reduce anxiety result of clinicians behavior or actions

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5
Q

Nonopioid analgesics

What drug is used and when to use them

A

NSAIDs
Acetaminophen (Tylenol)

Use for mild to mod pain during and post procedure

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6
Q

When should NSAIDs be used with caution

A

Bleeding is a concern

Hemostasis during tx

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7
Q

State of conscious sedation

Used for pain control and anxiety

Some degree of analgesia and higher pain threshold

A

Nitrous oxide oxygen sedation

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8
Q

Chemical and physical properties of nitrous

A

Gas
Heavier than air
Nonallergenic
Nonflammable

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9
Q

Blood solubility of nitrous

Where do the gas molecules pass readily to tissue

Solubility results in

Can diffusion hypoxia occur if 100% oxygen not administered

A

Relatively soluble (3-5 min)

Alveoli blood interface and blood brain interface

Rapid onset and recovery

Yes

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10
Q

True or false

Nitrous remains unchanged in blood and tissues bc it is not metabolized in body

Enters through lungs and exits though blood

A

True

False_ enters and exits almost entirely through lungs

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11
Q

Three basic parts of nitrous

A

Gas storage cylinder

Gas delivery system

  • scavenger system with nasal hood (mask)
    (reduces exposure of clinician administering )
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12
Q

Color code of cylinders

Oxygen
Nitrous

A

Green (white international)
Blue

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13
Q

What makes up the sum of the total gas flow rate

A

Nitrous and oxygen (adjusted independently )

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14
Q

Mask/hood

Scavenger system

A

Delivers and collects exhaled gas and directs it to scavenger system

Removed exhaled gas to keep nitrous oxide levels low in room. Connected to evac sys

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15
Q

Minimum oxygen flow

Oxygen fail safe systems will automatically shut off if oxygen falls below min.

A

30% or 3L/min

True

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16
Q

Absolute contraindications (5)

A

Chronic respiratory disease

Upper tract infection or other acute conditions (sinus, mouth breather, cough)

Tympanic membrane graft

Recent ophthalmic surgery

Pregnancy (FIRST trimester )
May cross placenta

17
Q

Relative contraindications

A

Current antidepressants or other psychotropic drugs

Recovering drug or alcohol addiction

Certain phobias

Unable to understand directions

Blew,chin therapy

18
Q

Scavenger system is connected to

A

High speed volume evacuation

19
Q

Order for turning on gas cylinders

A

1- oxygen

2-nitrous oxide

20
Q

Avg adults gas flow

Avg for children

A

6-7 L/min
4-5L/min

21
Q

Increasing percentage of nitrous until optimum sedation level is achieved

A

Titration

22
Q

Titration started at

(Then assess after 1-2 minutes)

If adjustment needed up or down by

20-40% of nitrous results in adequate sedation

How much time needed for titration

A

10-15% concentration

5-10%

True

5minutes

23
Q

Completion of sedation

Oxygen for a full _ minutes

A

5 or longer if needed but no less

24
Q

Method for minimizing occupational exposure

A

Effective scavenging system that can move 45 L/min or air

25
Q

Advantages

A

Reduce pts reaction to pain by raising pain threshold

Reduce gag reflex

Very safe with few side effects

26
Q

Disadvantages

A

Low potency

Able and willing to breath through nose

Expensive

Potential for rec abuse by health pros

27
Q

Widely used in topical

High allergic reactions

Elimination via kidneys

A

Esters

28
Q

Safe effective and min side effects

Metabolized by liver

A

Amides

29
Q

Time for intermediate acting amide

Influencing duration

A

60 minutes

Vascularity at site of injection

30
Q

Lidocaine max dose

A

500 mg

31
Q

Longest acting and onset of all LA (recd for posttx pain control and good for procedures greater than 60min)

Most potent

1:200,000

A

Bupivacaine

32
Q

What procedures require LA

A

SRP 4mm or greater

Extensive instrumentation

Challenging pockets, furcations, surfaces etc

Soft tissue manipulation

33
Q

Best choice for heart failure

A

2% lidocaine 1:100,000

(Cardiac dosage for epi)

34
Q

Oraqix combo

A

2.5% lido 2.5% Prilocaine

Subgingival liquid rod gel delivery

35
Q

Buffering increases ___ of LA

A

pH

DH200 Int Clinic (15 decks)

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