Role Of Dexmedetomidine In Pediatric Dental Sedation

Question 1

What is the highly selective a2 agonist receptor that is used in pedriatic dental sedative

Answer 1

Dexmedetomidine

Question 2

Risks of administering general anesthesia

Answer 2

Bleeding
Edema of tongue or lips
Arrhythmias
Dislodge or dislocated endotracheal tube
IV infiltration or disconnection

Question 3

Currently used sedatives in dental procedures

Answer 3

Midazolam
Chlorohydrate
Ketamine
Nitrous oxide
Profol
Promethazine
Hydroxyzine
Sevoflurane

Question 4

Selective a2 adrenoceptor agonist

Answer 4

Dexmedetomidine
Mivazerol
Clonidine
A-methyldopa

Question 5

Non selective a2 adrenoceptors agonist

Answer 5

Noradrenaline
Adrenaline

Question 6

Imidazoline receptor agonist

Answer 6

Serial-no. 1-5

Monoxidine
Rilmenidine
Clonidine
Dexmedetomidine
Mivazerol

Question 7

Imidazoline receptor binding sites have been identified in where

Answer 7

Brain
Pancreas
Kidneys

Question 8

Is dexmedetomidine a short or long acting?

Answer 8

Short acting central a2 adrenoceptor agonist

Question 9

It has been reported that a2-adrenoceptor agonist causes?

Answer 9

Sedation, anxiolysis, analgesia, sympatholytic and postoperative reduction of nausea and vomiting better than benzodiazepines.

Question 10

Half life of clonidine

Answer 10

12.5h

Question 11

How many hours does it need for clonidine to be administered before the induction o anesthesia

Answer 11

At least 1hr

Question 12

In what year did dexmedetomidine introduced in dentistry

Answer 12

2005

Question 13

Why is dexmedetomiine more favorable than clonidine?

Answer 13

Because dexmedetomidine has more favorable pharmacokinetic and shorter half-life than clonidine

Question 14

Is dexmedetomidine a highly selective or non-selective drug?

Answer 14

It is a highly a2 selective adrenoceptor

Question 15

Central effect of dexmedetomidine

Answer 15

Inhibits the release of norepinephrine by acting on the a2 adrenoceptors in the locus ceruleus,producing a state similar to natural sleep

Question 16

Mechanism of action of dexmedetomidine

Answer 16

Stimulation an cessation of parasympathetic and sympathetic outflows.

Question 17

Sedation is primarily induced by

Answer 17

Activation of post-synaptic a2 adrenergic receptors. Because dexmedetomidine attaches to the a2 receptors in the locus ceruleus and spinal cord, providing sedation and analgesia effects

Question 18

Three subtypes of a2 adrenoceptors

Answer 18

A2A, a2B, a2C

Question 19

Where can the subtypes of a2 adrenoceptors can be found

Answer 19

Within the blood vessels, vital organs, autonomic, peripheral and CNS

Question 20

Does dexmedetomidine binds to g-protein or no?q

Answer 20

Yes they bind to g-protein

Question 21

High affinity of a2 adrenoceptor causes what?

Answer 21

Bradycardia and vasodilation

Question 22

Half life of dexmedetomidine

Answer 22

2hrs

Question 23

Excretion of dexmedetomidine

Answer 23

95% in urine
4% in feces

Question 24

Drugs that doesn’t have an affinity for GABA and opioids which does not result in respiratory depression

Answer 24

Midazolam, benzodiazepines, opioids and dexmedetomidine

Question 25

Advantage of dexmedetomidine

Answer 25

1. Safe sedative for children and infants 2. Induce minimal respiratory depression and inhibits tachycardia 3. Prevents hypoxia by maintaining the airway and enabling spontaneous respiration 4. Preserves CO2 reactivity

Question 26

Dexmedetomidine can be administered in?

Answer 26

Orally, buccally, intravenously, intranasally, intramuscularly

Question 27

Simples and popular route for drug administration

Answer 27

Oral route \

Question 28

Buccal bioavailability and achieved its highest concentration

Answer 28

82%

Question 29

Oral bioavailability of dexmedetomidine

Answer 29

16%. Because of the hepatic first pass which metabolized high amounts of dexmedetomidine

Question 30

Time of onset for oral dexmedetomidine

Answer 30

40min before the induction of anesthesia, to attain the most favorable sedative affect

Question 31

Half life of dexmedotimidine if given intravenously

Answer 31

6min and 2h

Question 32

Administration of intranasal route in each nostril is how many ml

Answer 32

0.12 - 0.2 ml

Question 33

Bioavailability of dexmedetomidine is ___ ad it best absorbed after __ and __ administration

Answer 33

82% Sublingual and intranasal

Question 34

How many doses of dexmedetomidine is given for intramuscular route ____ with a peak concentration within ___

Answer 34

2.5ug/kg , 15 minutes

Question 35

Common adverse effect of midazolam and dexmedetomidine if given orally

Answer 35

Decrease BP and bradycardia Dexmedetomidine can decrease systemic outflow by decreasing plasma epinephrine and norepinephrine levels, leading to hypotension and decreased heart rate

Question 36

Suggested oral administration of dexmedetomidine

Answer 36

4ug/kg (adverse effects are only hypotension and bradycardfia)

Question 37

Main selectve a2 adrenoceptor antagonists

Answer 37

Atipamezole, idazoxan, yohimbine

Question 38

A2 adrenoceptors antagonist are a group of drugs capable of crossing te ____ and reversing the action of a2 adrenoceptors

Answer 38

Blood-brain-barrier