Pharmacology Behaviour_LA Flashcards Preview

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Flashcards in Pharmacology Behaviour_LA Deck (19):
1

What are the different methods used pharmacologically for behaviour management?

-Conscious sedation
-Deep sedation
-GA

2

What are some factors to consider before deciding to use pharmacological agents to manage behaviour?

-Patient age, behaviour, co-operation
-MHx
-SHx (distance travelled to clinic and language)
-Informed consent
-Benefits + risks
-Treatment to be performed
-Practitioner's experience

3

What pharmacological agents are available for behavioural management?

-LA
-Nitrous
-Oral sedation
-IV sedation
-GA

4

Can sedation substitute for LA for pain management?

No

5

What is the most important management objective?

-Removal of pain, if can not manage pain then can not do treatment
-Remember if child can not handle local likely can't handle drill

6

What should be considred in treatment planning LA?

-No medical contraindications
-Maximum allowable dose
-Previous pt history with LA
-Pros and cons of most affected vs least affected first
-Pros and cons of block vs infiltration first appointment
-Need for pharmacological behaviour

7

T or F? Infiltrations are less traumatising than blocks for children?

F
Children normally can't tell the difference between the two, generally fine with both or freak out with both

8

What is the maximum dose of LA recommended for kids?

4.4mg/kg

9

How much should a 5-6 year old weigh on average?
How many carpules can you use on them?

20kg

4.4mg * 20 = 88 mg maximum dose

One cartridge contains 44mg of LA

Hence 88/44=2 carpules maximum

If 0.1g of topical applied, this adds another 5mg of dosage, thus 88-5=83; 83/44= 1.8 carpules

10

If you have given one carpule of lignocaine, and your tutor has given the second and neither has worked, what can you do?

Top up with articaine, using different agents can avoid overdose of a single agent

11

What are some complications involved with using LA?

-Lip and cheek biting
-Overdose (via intravascular injection or excessive dose)

12

What are some signs of overdose?

CNS depression
Seizures
Disorientation
Loss of consciousness

Decreased CO, CV collapse

13

What is the maximum dosage of articane?

7mg/kg

14

How many carpules can be adminstered in a 5-6 year old?

5-6 year old=20kg

Max dose = 7 * 20 = 140mg

Max carpules= 1.5 (for some reason)

15

What is a contra-indication of articaine for use in children?

Can not use in children under 4 years

16

Should you use articane as a substitution for an IANB?

-No, always use IANB with the articaine infiltration, don't want to risk kid going crazy

17

What extra steps can be used to make a palatal infiltration more comfortable?

-Do intrapapillary injections on mesial and distal of tooth-->numbs up the tissues slightly in preparation for palatal injection

18

How should the needle be passed to you?

Behind the head

19

What behavioural management techniques can be used with LA?

Distraction
Non-verbal communication
Warning child of "funny feeling", may tickle a lot