Flashcards in Exam 1 (1-4) Deck (50):
1
What was the first local anesthetic ever used?
cocaine
2
What is the most common LA used in dentistry?
Lidocaine
3
Best method to manage an anxious patient
Prevention
4
What age group has a higher pain tolerance?
older patients
5
How many states can administer nitrous oxide?
33 states
6
Pertains to the point at which a sensation starts to be painful and discomfort results
pain threshold
7
A neurologic experience of pain
pain perception
8
The person interpretation and response to the pain message and is highly variable among individuals
pain reaction
9
What are the clinical signs of moderate anxiety?
unnaturally stiff posture
nervous play with tissue
white knuckle syndrome
sweaty
overwillingness to cooperate with clinician
quick answers
10
Nerve tissues that lie in the periphery or the outer regions of the nervous system
PNS peripheral nervous system
11
Consists of all incoming information traveling along sensory pathways
afferent division
12
Consists of all outgoing information along motor pathways
efferent division
13
Subdivision of the efferent division of the PNS and controls the body's voluntary and reflex activities
somatic and autonomic nervous systems
14
These are the basic functional unit of the nervous system that manipulate information and respond to either excitation or inhibition
nerve cells
15
Carry information to the autonomic that control involuntary smooth muscle, cardiac muscle, or other involuntary tissue
autonomic nervous system
16
This division prepares the body to deal with fight or flight response
sympathetic
17
Within a nerve, each axon is surrounded by a layer of connective tissue called the
endoneurium
18
Each fascicle is wrapped in a layer of connective tissue called the
perineurium
19
The entire nerve is wrapped in a layer of connective tissue called the
epineurium
20
Nerves that send signals from sensory neurons towards the spinal cord or brain
afferent nerves
21
Also known as nerve impulse; a spike of positive and negative ionic discharge that travels along the membrane of a cell
action potential
22
Means that the electrical charge on the outside of the membrane is positive while the elctrical charge on the inside of the membrane is negative
polarization
23
The process whereby the action potential causes sodium channels to open, allowing an influx of sodium ions to change the electrochemical gradient
depolarization
24
When local anesthetic drugs act mainly by inhibiting sodium influx through sodium-specific ion channels in the neuronal cell membrane
voltage gated sodium channels
25
Properties of the Ideal Local Anesthetic:
potent local anesthesia
reversible local
absence of local reactions
absence of systemic reactions
absence of allergic reactions
rapid onset
satisfactory duration
adequate tissue penetration
low cost
stability in solution (long shelf life)
ease of metabolism
26
Refers to the physiological effects of drugs on the body and the mechanisms of drug action and its relationship between drug concentration and effect
pharmacodynamics
27
Improves the lipid solubility of the molecule, which facilitates the penetration of the anesthetic through the lipid rich membrane where the receptor sites are located
lipophilic aromatic ring
28
Determines if the molecule is an ester or amide, and this chain is important because it predetermines the course of biotransformation
Intermediate hydrocarbon chain
29
m=May exist in teritary form that is uncharged and lipid soluble or as a quaternary form that is positively charged and renders the molecule water soluble, which is how it is delivered from the dental hygienist's syringe into the patient's tissue
hydrophilic terminal amine
30
Two major routes of delivery of local anesthetic drugs:
topical and submucosal injection
31
Anesthetics applied to the surface of mucosal tissue that produce local insensibility to pain
topical anesthetics
32
Anesthetics that are more effective than topical routes because the solution is injected and placed in close proximity to the nerve trunk of the area to be anesthetized
submucosal injections
33
The base form of the local anesthetic (lipid soluble and penetrates the nerve)
anion
34
A positively charged ion; the active form of the molecule that binds to the receptor sites in the sodium channel
cation
35
The pka of a molecule represents the pH at which 50% of the molecules exist in the lipid soluble teritary form and 50% in the quaternary, water soluble form
dissociation constant
36
higher pka=fewer base molecules= ?
slower onset of action
37
lower pka=more base molecules= ?
rapid onset of action
38
The study of the action of drugs within the body; ADME
pharmacokinetics
39
Increased tolerance to a drug that is administered repeatedly
tachyphylaxis
40
The period of time it takes 50% of the drug to be metabolized/removed from the body
half life
41
The period from local anesthetic deposition near the nerve trunk to profound conduction block; the pKa is the primary factor
onset of action
42
Systemic effects of LA:
nature of the drug
concentration of the drug and dose administered
route of administration
rate of injection
vascularity in the area of injection
age of the patient
weight of patient
patient's health
the route and rate of metabolism and excretion of the drug
43
No longer manufactured in LA
esters
44
How many cartridges of LA can a healthy patient have?
5.5
45
The maximum recommended dose per visit of epinephrine for a healthy patient is
0.2mg
46
A synthetic vasoconstrictor that is approximately one sixth as potent as epinephrine; it is manufactured in a higher concentration to achieve the same effects as epinephrine 1:100,000
Levonordefrin
47
1899; highly effective as an analgesic and antipyrectic and proved to be remarkably safe and well tolerated by patients
Aspirin
48
Most recent anesthetic introduced in 2000
Articaine
49
perception of pain
nociception
50