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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

Local anesthetic drugs bind more readily to sodium channels when?

In an activated state, thus onset of neuronal blockade is faster in neurons that are rapidly firing