Sedation and Systemic Conditions affecting Dentistry Flashcards
what is diabetes
high blood sugar which is caused by lack of insulin within the body
insulin transports glucose into cells to be used for energy
what are symptoms for diabetes
polyuria
polydipsia
lethargy
blurred vision
what is the HbA1c
glycated haemoglobin
less than 42mmol/mol in health or 48mmol/mol in diabetics
measures long term control over the last 8-12 weeks
what is anaemia
problem of not having enough healthy red blood cells or haemoglobin to carry oxygen to body tissues
what is associated with microcytic anaemia
iron deficiency
thalassemia
what is associated with macrocytic anaemia
pernicious anaemia
vit B12 or folate deficiency
what is associated with normocytic anaemia
bleeding, pregnancy
how does anaemia present
fatigue, tachycardia, shortness of breath
oral ulceration (recurrent aphthous stomatitis)
angular cheilitis
glossitis
what are indications for sedation
MH aggravated by stress
handicap/ parkinsons
phobia, gagging, fainting
procedure is long and unpleasant
what are contraindications for sedation
severe uncontrolled systemic disease
narcolepsy
hypothyroidism
COPD
hepatic insufficiency
pregnancy/ lactation
describe IV sedation
sedative into a vein
if you a nervous about dental treatment or having a procedure that may be more complex IV sedation is effective and safe
you will remain awake and be able to respond to dentist
what is the drug used in IV sedation
midazolam
what are properties of midazolam
rapid onset - 2-3mins
half life of 90-150 mins
titrated via in dwelling canula in dorsum of hand of cubital fossa
comes in 5mg/ 5ml preparation
what is the max amount of midazolam to give a patient
7.5mg
what drugs increase effect of midazolam
alcohol
opioids
antidepressants
recreational drugs
what are signs of IV sedation end point
slurring and slowing of speech
relaxation
delayed response
willingness to accept tx
how is IV sedation reversed in emergency
flumazenil 500mcg in 5ml
what is the discharge criteria following IV sedation
patient is orientated in time, place and person
vital signs are stable and within normal limits for pt
pain addressed
haemostasis
cannula removed
written and verbal post op instructions appropriate for sedation and the dental tx carried out
how should a patient be prepared for IV sedation
inform them they will require an escort who will stay with them for the rest of the day
inform pt they must leave in private car or taxi
inform pt they are not able to drink alcohol that day
inform pt they may need to take the following day off work
inform pt they should arrange childcare
what is inhalation sedation
light form of sedation ‘happy air’ using nitrous oxide and oxygen breathed through a nosepiece
patient never breathes less than 30% oxygen
what are indications for IS
anxiety
needle phobia
gagging[
traumatic procedures
medical conditions aggravated by stress (asthma)
unaccompanied adults requiring sedation
what are contraindications of IS
common cold or blocked nose
tonsillar/ adenoidal enlargement
severe COPD
first trimester of pregnancy
claustrophobia
pts under 7
what are pre-op instructions for IS
have a light meal before appt
take routine medicine as usual
children accompanied by competent adult
do not drink alcohol day of appt
wear sensible clothing
arrange care of children
plan to remain in clinic for up to 30 mins after tx
