Oral Sedation

Question 1

6 advantages of oral sedation

Answer 1

1-mostly universally acceptable
2-easy administration
3-cheap
4-low adverse reaction
5-adverse reaction are less severe
6-no needles

Question 2

T/F drug can be taken at home

Answer 2

True. But it is best in the office

• monitor CNS
• proper dosage and time of admin
• Observe for bad reaction

Question 3

7 disadvantages of oral admin

Answer 3

1-reliance on px compliance 
2-prolonged latent period
3-erratic/incomplete GI absorption
4-inablitly to titrate
5-unable to control level of sedation
6-long duration of action
7-need class 3 anesthesia permit

Question 4

6 ways to guard against px non-compliance

Answer 4

1-TELL the px amount and when to take
2-WRITE down instruction
3-MARK RX with same instruction
4-only PRESCRIBE the amount px should take
5-RECORD instructions in px chart
6-for kids with unreliable parents, have kid come to office and hour early to take there

Question 5

What is the length of latency period of typical oral sedation?

Answer 5

• 30 min for minimum effective level of drug

- 60 min for peak blood levels

Question 6

where does the bulk of absorption happen?

Answer 6

small intestine

Question 7

more lipid soluble is more or less absorptive?

Answer 7

more

Question 8

Bases are more or less absorbed in GI tract?

Answer 8

Less

Question 9

what is the biggest disadvantage to oral sedation?

Answer 9

inability to titrate

Question 10

slow onset of action helps or hinders drug titration?

Answer 10

hinders

Question 11

what drug is the most popular to manage dental fear?

Answer 11

benodiazepine

Question 12

what level of sedation do benzos give?

Answer 12

minimal to moderate

Question 13

what are the 3 benzo types?

Answer 13

diazepam, midazolam, triazolam

Question 14

what happens to respiration on benzos?

Answer 14

respiratory depression

Question 15

what appens to CV on benzos?

Answer 15

stays the same

Question 16

3 contraindications of benzos

Answer 16

1-allergies
2-psychoses
3- acute narrow angle glacoma

Question 17

3 adverse effects to benzos

Answer 17

1-crosses placental barrier and can cause congeital malformations in 1st trimester
2-excreted in breast milk
3-drowsiness–don’t mix with alcohol

Question 18

what is the most prescribed psychoactive drug in the us?

Answer 18

triazolam

Question 19

3 advanges to triazolam

Answer 19

1-short half life (1.5-5.5 h) with peak levels in 1.3 hours
2-no active metabolites
3-no hangover

Question 20

what can you combine with triazolam to allow for titration effect?

Answer 20

nitrous oxide

Question 21

what is the rescue drug for benzodiazepines?

Answer 21

Fumazenil

*must be given IV

Question 22

what are the four parts an an RX?

Answer 22

1- suprascript
2- insription
3-subscript
4-signatura

Question 23

what is the purpose of the suprascript?

Answer 23

convetnioal Rx symbol on all rx pads

Question 24

what is the inscription on an rx?

Answer 24

name and dose of drug

Question 25

what is the subscript on an rx?

Answer 25

directions to the pharmacist

Question 26

what is the signatura on the rx?

Answer 26

directions to the patient

**NOT the Dr. Signature

Question 27

Will benzos interact with anticoagulants?

Answer 27

no

Question 28

When selecting an proper dose for sedation, do you use the amount listed on the box?

Answer 28

NO! the recommended dose often leads to inadequate anxiety reduction in the dental (stressful) setting