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Flashcards in Exam 1 Deck (60):
1

Creates a numbing feeling that eliminates the feeling of sensation in a specific area without loss of consciousness

Local Anesthesia

2

routinely referred to as analgesics

Pain relievers

3

what is most useful for pain control

Opium

4

Early methods of pain reduction included

Religious techniques of scaring of demons and praying for the touch of God to stop the suffering
PLants and herbs, include roots, berries, and seeds became the prominent method for treating pain

5

A new compound containing Salicylic acid was introduced as what?

Aspirin in 1899, it was highly effective as an analgesic and antipyretic

6

The first local anesthetic

Cocaine

7

What remains the most popular anesthetic used in dentistry in the US

Lidocaine

8

What are the two vasoconstriction drugs

epinephrine
levonordefrin

9

how many states permit the administration of nitrous oxide by dental hygienists

33

10

what is it called when you are anxious and nervous during treatment

Dental-phobia

11

Studies suggest that pts who are fearful of dental tx may have?

elevated blood pressure
elevated heart rate
Salivary cortisol levels

12

what are some clinical signs of moderate anxiety in the dental chair

unnaturally stiff posture
nervous play with tissue
white knuckle syndrome
Perspiration on forehead and hands
over willingness to cooperate with clinician
quick answers

13

What type of appointments should you have for pts what have anxiety

shorter appointments, even through more app. may be needed, may help some pts reduce stress levels, as can scheduling pt during specific time periods of the day

14

What local anesthetics was available in US in 2000

Articaine 1969

15

What pts have an higher tolerance of pain

older pt than younger

16

Are nerve tissues that lie in the periphery or (outer regions) of the nervous system, consisting of 31 pairs of spinal nerves arising from the spinal cord and 12 pairs of cranial nerves arising from the brain

Peripheral nervous system (PNS)

17

What are the two divisions of the CNS and PNS

Afferent and efferent divisions

18

which division consists of all incoming information traveling alone sensory or afferent pathways

Afferent

19

Which division consists of all outgoing information along motor or efferent pathways

efferent

20

These are the basic functional unit of the nervous system that manipulate information and respond to either excitation or inhibition

Nerve cell (neurons)

21

is an excitable cell that is the basic functional unit of the nervous system, specialized in sending impulses and making all nervous system functions possible

The neuron

22

Each axon is surrounded by a layer of connective tissue called

Endoneurium

23

The nerve fibers are bundled together into groups called

Fascicles

24

Each fascicles is wrapped in a layer of connective tisse called the

Perineurium

25

The entire nerve is wrapped in a layer of connective tissue called

Epineurium

26

what nerve conducts signals from sensory neurons to the spinal cord or brain (carry toward)

Afferent nerves

27

what nerve conduct signals away from the brain or spinal cord along motor neurons to their target muscles and glands (carry away)

Efferent nerves

28

What causes more allergic reaction amide or ester

Ester

29

Along myelinated nerve fibers, gaps in the sheath between adjacent Schwann cells are called

Nodes of Ranvier

30

What are the gaps formed between the myelin sheaths generated by different cells called

Nodes of Ranvier

31

also known as a nerve impulse is a spike of positive and negative ionic discharge that travels along the membrane of a cell

Action potential

32

This occurs once the peck of the action potential is reached and the membrane potential begins to move back toward the resting potential

Repolarization

33

Local Anesthetic drug act mainly by inhibiting sodium influx through sodium- specific ion channels in the neuronal cell membrane; in particular that so- called

voltage-gated sodium channels

34

Local Anesthetic agents are divided chemically into two groups:

ester
amides

35

Due to the high degree of hypersensitivity to injectable esters, all injectable local anesthetic manufactured for dentistry today are in

the amide group

36

Local anesthetic molecule consist of 3 components

1. Lipophilic aromatic ring
2. Intermediate hydrocarbon ester or amide chain
3. Hydrophilic terminal amine

37

There are 2 major routes of delivery of local anesthetic drugs

Topical
Submucosal injection

38

drugs applied to the surface of mucosal tissue that produce local insensibility to pain

Topical anesthetics

39

injections of local anesthetics are more effective than topical routes of administration

Submucosal

40

Refers to the physiological effects of drugs on the body an the mechanisms of drug action and its relationship between drug concentration and effects

Pharmacodynamics

41

Higher pKa = fewer base molecules =

Slower onset of action

42

Lower pKa = more base molecules =

Faster onset of action

43

IS the study of the action of drugs within the body

Pharmacokinetics

44

The period from local anesthetic deposition near the never trunk to profound conduction block,

The onset of action

45

What is the primary factor determining the onset of action

pKa

46

Is defined as the time interval between the initial deposition of the anesthetic solution at the nerve site and complete conduction blockage

induction time

47

Increased tolerance to a drug that is administered repeatedly

Tachyphlaxis

48

What are vasodilators and produce a pharmacologic effect on blood vessels, varying slightly from type to type

All local anesthetics

49

THis is the period of time it takes for 50% of the drug to be metabolized/removed from the body

Half-life of a local anesthetic

50

What organ is responsible for the entire metabolic process of most amides?

Liver

51

The rate of biotransformation is slower in what type of pt

Significant liver dysfunction (cirrhosis) or pt with lower hepatic blood flow, causing an increased rick of systemic toxicity

52

What organ is the primary excretory organ for the metabolites of all local anesthetic agents

Kidneys

53

what are important additives to the local anesthetic solution because of their ability to constrict blood vessels

Vasoconstrictors

54

Two vasoconstrictors that are added to local anesthetic drugs available in the US are

epinephrine
levonordefrin

55

Epinephrine is administered intravenously, it has a half life of

1 to 3 min

56

The maximum recommended dose per visit of epinephrine for healthy pts are

0.2mg

57

The maximum recommended dose per visit of epinephrine for a cardiovascular compromised pt or a pt with tx modifications

0.04mg

58

Side effects of overdose of vasoconstrictors only last

5-10mins

59

Maximum recommended dose per visit of levonordefrin for healthy pt is

1.0mg

60

Maximum recommended dose per visit of levonirdefrin for a cardiovascularly compromised pt or a pt needed tx modifications is

0.2mg