Esther Anesthetics/topica Flashcards
What are the general principles for local and ester anesthetics?
What do you need to know for each drug? 9 main concepts
- Effects on pediatric patients
- effects on geriatric patients
- Tetragencitiy or effect on developing fetus
What are the 5 classifications of drugs for FDA what do each stand for?
- FDA class A= completely safe. Almost nothing in dentistry is class A
- FDA class B= Generally regarded safe no side effects or dangers in human or animal studies
- FDA class C= side effects in animal and human epidimiology studies
- FDA class D= the benefits to the mom outweighs benefits to the fetus
- FDA class X= always high risk that outweighs the benefits
What are the seven Topical anesthetics available?
- Combination of benzocain Butamen and terracaine
- lidocaine, lidocaine+ prilocaine
What are the accepted uses of local anaesthetics?
- anaesthesia of the area prior to instrumentation
- pain relief
- Apthous ulcers
- Herpetic ulcers
- mucosal inflammation
- Denture sore spots
- tooth eruption
- periodontal scaling (Should also regard as instrumentation)
- Inhibition of gag reflex!
What is the main distinguishing feature of topical anaesthesia against injectible anaesthesia? What forms can you find them in?
- Most important is the diffusion through the mucosal barrier which many local injectible anaesthesias do not do well!
- Local anaesthesia comes in higher concentration than injectible as well this might lead to systemic complications
- Comes in many forms:
- Foam, Gel, paste, lozenges, aerosols,ointments and rinses
What are the 3 forms of topical anaesthesia?
- Amides linkage
- Dibucaine and lidocaine, prolicaine
How is topical anaesthesia absorbed?
- Either readily in the mucosa via vasculature this can be manipulated by concentration/ volume and duration of exposure
- Benzocaine on the other hand cannot be readily absorbed in mucosa it utilizes carrier vessels and this can cause senstitivty to those carriers
- Usually onset of action are 30 seconds- 15 minutes
- Duration of action is anywhere between 10-4 hours
Topical anaesthesia that has 10-20 minutes duration of action?? and the ones with 20-40 minutes duration?
- Benzocaine and Lidocaine are 10-20 minutes
- Cocaine and dyclonine is 20-40 minutes
What are some causes of toxicity of topical anaesthesia?
- Cross-sensitivity aka allergy
- FDA B is lidocaine
- FDA C is benzocaine and dyclonine
- Breastfeeding issues with lidocaine
- Black box warning for pediatric patients under 2 years of age
- Could also interact with
What is Benzocaine derived from? How readily is it absorbed in the mucosa and how likely is it to cause sensitivity?
- PABA derivative Ester type anaesthesia
- is not readily absorbed by mucosa
- Agent most likely to cause sensitization (Due to carriers)
- Available in all forms of topical anaesthesia e.g gels, paste, ointment, lozenges
- What type of linkages do Benzocaine, butane and tetracaine have?
- How long is the duration of spray should be?
- Theyre all ester types
- Duration of spray should not be more than 2 seconds
What are the uses of Dibucaine and paramoxine?
What did the FDA issue for lidocaine?
-Lidocaine had the black box warning which is basically the closest thing to withdrawing it from the market! It can no longer be used for teething pain and can cause seizures, severe brain injury and cardiac events and even death
What are some ester anaesthetics?