This document provides a review of local anesthetics and anxiolytics used in dental practice. It discusses the history of local anesthetics from early use of whiskey and nitrous oxide to modern drugs like lidocaine and bupivacaine. The pharmacology of local anesthetics is covered, including how they work by blocking sodium ion channels. Factors that influence the effects of local anesthetics like pH, drug properties and injection technique are reviewed. Common local anesthetic drugs, their durations of action, adverse effects and appropriate uses are summarized. Monitoring parameters and special considerations for patient populations are also addressed.
This document discusses local anesthetic complications. It defines complications as any deviation from normal patterns during or after injection. Complications are classified as primary/secondary, mild/severe, and transient/permanent. Common complications include pain on injection, hematoma, infection, nerve injury, and syncope.
The document focuses on syncope, explaining that it is caused by cerebral ischemia from vasodilation or blood flow to muscles. Management includes placing the patient in a semi-reclined position. It also discusses factors affecting toxicity of local anesthetics, including rate of absorption, distribution, biotransformation, and excretion. Toxicity can produce cardiovascular effects like hypotension or central nervous effects like seizures. Proper management
local Anesthesia PPt for Dental students. In this presentation, we have explained the mechanism of action of local anesthetic drugs, types of local anesthesia, complications of local anesthesia , different clinical techniques of local anesthesia administration. This presentation was made from a local anesthesia book ( Handbook of local anesthesia / Stanley E Malamed )
This document provides a history of local anesthetics from ancient times to modern drugs like lidocaine and bupivacaine. It discusses the definition and classification of local anesthetics, how they work, and their mechanisms of action. Examples of commonly used local anesthetics are presented, including details about their onset, duration, dosing, and metabolism. The document also covers local anesthetic administration techniques and necessary armamentarium. In summary, it provides a comprehensive overview of the development and use of local anesthetics in oral and maxillofacial surgery.
Local Anesthesia in Oral and Maxillofacial SurgerySapna Vadera
Local anaesthesia is a loss of sensation in a circumscribed area without loss of consciousness. The document discusses the history of local anaesthesia from ancient times to modern developments. It also covers the desirable properties, mechanisms of action, classifications, pharmacology and clinical aspects of local anaesthetics. The summary provides a high-level overview of the key topics covered in the document relating to the definition, history, properties and mechanisms of local anaesthetics.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Local anaesthesia /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Local anesthetics work by reversibly blocking sodium channels in nerve cell membranes, preventing the propagation of action potentials and interrupting pain signal transmission. When injected, they take effect within a few minutes and last 1-2 hours on average. The first widely used local anesthetic was cocaine, but modern agents like lidocaine and bupivacaine are safer and longer-lasting. Vasoconstrictors like epinephrine are often added to prolong the effects. Local anesthetics provide pain relief for dental procedures and surgeries.
This document summarizes newer local anesthetic drugs and delivery systems. It discusses Articaine and Centbucridine as alternatives to Lidocaine that have faster onset, longer duration, and greater potency. It also covers Phentolamine for reversing soft tissue anesthesia, EMLA cream for topical anesthesia, and CCLAD/WAND systems that provide controlled continuous low-volume injection of local anesthetic to reduce injection pain. New intraosseous delivery systems like Stabident, X-Tip, and Intraflow are highlighted. Vibrating devices like Vibrajet and Dentvibe that use the gate control theory of pain to reduce injection discomfort are also mentioned.
This document discusses local anesthetic complications. It defines complications as any deviation from normal patterns during or after injection. Complications are classified as primary/secondary, mild/severe, and transient/permanent. Common complications include pain on injection, hematoma, infection, nerve injury, and syncope.
The document focuses on syncope, explaining that it is caused by cerebral ischemia from vasodilation or blood flow to muscles. Management includes placing the patient in a semi-reclined position. It also discusses factors affecting toxicity of local anesthetics, including rate of absorption, distribution, biotransformation, and excretion. Toxicity can produce cardiovascular effects like hypotension or central nervous effects like seizures. Proper management
local Anesthesia PPt for Dental students. In this presentation, we have explained the mechanism of action of local anesthetic drugs, types of local anesthesia, complications of local anesthesia , different clinical techniques of local anesthesia administration. This presentation was made from a local anesthesia book ( Handbook of local anesthesia / Stanley E Malamed )
This document provides a history of local anesthetics from ancient times to modern drugs like lidocaine and bupivacaine. It discusses the definition and classification of local anesthetics, how they work, and their mechanisms of action. Examples of commonly used local anesthetics are presented, including details about their onset, duration, dosing, and metabolism. The document also covers local anesthetic administration techniques and necessary armamentarium. In summary, it provides a comprehensive overview of the development and use of local anesthetics in oral and maxillofacial surgery.
Local Anesthesia in Oral and Maxillofacial SurgerySapna Vadera
Local anaesthesia is a loss of sensation in a circumscribed area without loss of consciousness. The document discusses the history of local anaesthesia from ancient times to modern developments. It also covers the desirable properties, mechanisms of action, classifications, pharmacology and clinical aspects of local anaesthetics. The summary provides a high-level overview of the key topics covered in the document relating to the definition, history, properties and mechanisms of local anaesthetics.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Local anaesthesia /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Local anesthetics work by reversibly blocking sodium channels in nerve cell membranes, preventing the propagation of action potentials and interrupting pain signal transmission. When injected, they take effect within a few minutes and last 1-2 hours on average. The first widely used local anesthetic was cocaine, but modern agents like lidocaine and bupivacaine are safer and longer-lasting. Vasoconstrictors like epinephrine are often added to prolong the effects. Local anesthetics provide pain relief for dental procedures and surgeries.
This document summarizes newer local anesthetic drugs and delivery systems. It discusses Articaine and Centbucridine as alternatives to Lidocaine that have faster onset, longer duration, and greater potency. It also covers Phentolamine for reversing soft tissue anesthesia, EMLA cream for topical anesthesia, and CCLAD/WAND systems that provide controlled continuous low-volume injection of local anesthetic to reduce injection pain. New intraosseous delivery systems like Stabident, X-Tip, and Intraflow are highlighted. Vibrating devices like Vibrajet and Dentvibe that use the gate control theory of pain to reduce injection discomfort are also mentioned.
Local anesthesia in dentistry /certified fixed orthodontic courses by Indian...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Lidocaine is a local anesthetic that has several indications and mechanisms of action. It can be used as a local anesthetic for procedures or to treat arrhythmias when given intravenously. Intravenous lidocaine may provide pain relief for postoperative, neuropathic, and chronic pain by blocking sodium channels. Studies have shown intravenous lidocaine can reduce postoperative pain and opioid use when given perioperatively, leading to benefits like shorter hospital stays. Lidocaine may be more effective than placebo for treating neuropathic pain, though epidural administration provides better pain relief than intravenous lidocaine for some surgeries. Adverse effects are typically minor when given at therapeutic doses by trained medical professionals.
Local anesthesia involves the loss of sensation, especially pain, in one part of the body through the use of local anesthetic drugs. The document discusses the historical background of local anesthesia beginning in the 1880s with cocaine. It defines local anesthesia and related terms and outlines the ideal properties of local anesthetic drugs. The document describes the composition of local anesthetic solutions, classifications of drugs, and their mechanism of action in blocking nerve conduction. It explores theories of pain and the pain pathway, which local anesthetics are able to interrupt.
The document provides an overview of local anesthesia. It begins with the historical background of local anesthetics starting with cocaine in 1860. It defines local anesthesia and discusses the ideal properties, electrophysiology of nerve conduction, and theories of the mechanism of action. It classifies local anesthetics and discusses their types, biokinetics, metabolism, and armamentarium. It also outlines various local anesthesia injection techniques and potential complications. The document contains a comprehensive but concise review of the fundamentals of local anesthesia.
This document provides information on various techniques for local anesthesia in dentistry. It discusses the mechanism of action, classifications, and maximum recommended doses of local anesthetics. It also describes in detail techniques for maxillary injections including inferior alveolar nerve block, Gow Gates, and Vazirani Akinosi techniques for mandibular anesthesia. Complications and contraindications of local anesthesia are mentioned.
This document provides an overview of local anesthesia in pediatric dentistry. It defines local anesthesia and discusses the history, classification, composition, properties, and mechanisms of local anesthetic agents. It also covers the metabolism, excretion, and systemic effects of local anesthetics. Maximum recommended doses and types of injection procedures for different regions are mentioned. Complications and recent advances in local anesthesia techniques are briefly discussed.
This document summarizes a presentation on newer local anesthetic drugs and delivery systems in dentistry. It discusses two newer local anesthetic drugs, articaine and centbucridine, that have properties making them potentially superior to lidocaine. It also reviews phentolamine mesylate, a drug used to reverse the effects of local anesthetics containing vasoconstrictors. Finally, it outlines several newer drug delivery systems aimed at reducing pain from local anesthetic injections, including electronic dental anesthesia, intraoral patches, jet injection, and iontophoresis.
Local & systemic Complications of Local AnesthesiaIAU Dent
This document discusses local anesthesia (LA), including its mechanism of action, factors influencing injection discomfort and techniques to reduce discomfort, testing the success of LA, causes and management of failed LA, complications of LA including local and systemic complications, and management of specific complications like needle breakage, pain/burning on injection, persistent anesthesia, and trismus. It provides anatomical and technical details related to achieving successful LA and avoiding complications.
Local anesthetics are commonly used in dentistry to numb areas and relieve pain during dental procedures. They work by temporarily blocking sodium channels in nerves, preventing the transmission of pain signals. The document discusses the main types of local anesthetics used in dentistry, including lidocaine, bupivacaine, prilocaine, and articaine. It describes their mechanisms of action, classifications, common uses, and potential side effects when used in dental procedures.
1. The document discusses local anaesthesia equipment and techniques used in dentistry. It describes the components of local anaesthesia syringes, needles, and cartridges.
2. Various local anaesthesia techniques are covered, including infiltration, block, and topical anaesthesia. Infiltration anaesthetizes terminal nerve fibers, while block anaesthetizes the main nerve trunk.
3. Topical anaesthesia is described as surface anaesthesia for mucosa or skin using physical or chemical methods. Its effectiveness depends on the site of application and adequate time allowed.
Local anesthetics,drugs, doses,theories, mechanismsMayank Chhabra
Local anesthesia is a transient loss of sensation in a localized area caused by blocking nerve conduction without loss of consciousness. It works by binding to receptor sites on nerve membranes and blocking sodium channels, preventing the transmission of nerve impulses. Common local anesthetics are lidocaine, prilocaine, mepivacaine and bupivacaine. Vasoconstrictors like epinephrine are often added to prolong the effects and reduce systemic absorption. Proper dosage calculation and contraindications must be considered for safe administration of local anesthesia.
This document discusses pain control in dentistry. It covers procedural pain from injections and treatments, as well as post-procedural pain management. Topical anesthetics like lidocaine or benzocaine gels can numb the surface before injections. Local anesthetics like lidocaine are commonly used during procedures. NSAIDs given before nerve blocks can improve anesthesia effectiveness. After procedures, over-the-counter NSAIDs like ibuprofen or acetaminophen combined with codeine can help manage pain. Non-pharmacological options like warm salt water rinses and cold compresses are also discussed.
It remains the responsibility of all clinicians using LA
to understand their potential
for severe systemic toxicity and to be prepared to respond immediately to these events when they occur.
This document discusses local anesthesia and pain control techniques for pediatric dentistry. It defines pain and anesthesia and covers various local anesthesia techniques including topical anesthesia, infiltration, nerve blocks, and supplemental injection techniques. It provides details on the contents of local anesthesia carpules, how local anesthetics are metabolized in the body, recommended dosages, and complications. The goal is to effectively manage pain for dental procedures in children.
This document summarizes recent advances in local anesthesia for dentistry. It discusses newer local anesthetic drugs like articaine and centbucridine that are equally or more effective than lignocaine. It also describes new delivery systems for local anesthesia like computer-controlled local anesthesia delivery systems, jet injectors, and iontophoresis that reduce injection pain and improve patient comfort. Devices like CCLADs allow controlled infusion of anesthetic for more precise needle insertion and placement.
Local anesthetics work by altering the membrane potential of nerve cells and blocking sodium channels, which prevents the propagation of action potentials and results in loss of sensation. Early local anesthetics like cocaine were derived from coca leaves and provided pain relief for surgery. Later developments included procaine, lidocaine, and other synthetic amide and ester local anesthetics. The pharmacokinetics and effects of local anesthetics depend on factors like lipid solubility, pH, vasoconstriction, and metabolism. Toxicity can occur if maximum dosage levels are exceeded.
The document discusses local anesthetics, including their definition, requirements, mechanisms of action, classifications, and biotransformation. It notes that local anesthetics work by inhibiting sodium influx through voltage-gated sodium channels in neuronal cells, blocking nerve conduction. Local anesthetics are classified based on duration of action, chemical nature, and origin. Common examples are discussed and appropriate uses along with potential complications and contraindications are outlined.
This document discusses local anesthesia used in dental procedures. It defines local anesthesia and describes the desirable properties of local anesthetic solutions. These include being non-irritating, not permanently altering nerve structures, having low systemic toxicity, and providing effective anesthesia regardless of injection site. The document outlines the electrophysiology of nerve conduction and how local anesthetics work by blocking sodium channels. It classifies local anesthetics and discusses vasoconstrictors used to prolong their effects. Complications of local anesthesia are described, including both local issues like needle breakage and hematoma, and systemic concerns like overdose and allergic reactions.
- Local anesthetics are drugs that cause reversible loss of sensation in a restricted area of the body when applied topically or injected locally. They work by blocking nerve conduction without structural nerve damage.
- Early uses of local anesthetics included chewing cocoa leaves for pain relief in Peru and spinal/epidural anesthesia developed in the late 19th century. Common types include amide drugs like lidocaine, bupivacaine, and ropivacaine as well as ester drugs like cocaine and tetracaine.
- Local anesthetics can be administered via various techniques including infiltration, nerve blocks, epidural/spinal anesthesia, intravenous regional anesthesia, and topical application. Factors like drug properties, dosage,
The document discusses guidelines for patient preparation and assessment prior to anesthesia. It describes obtaining an accurate patient history, performing a physical examination, and confirming the scheduled procedure. A thorough minimum patient database is essential and includes signalment, medications, allergies, preventive care, past illnesses, and identification. Assessments of body weight, condition, hydration, temperature and other vital signs are also important parts of preparing the patient.
This document provides information about adverse drug reactions and allergies. It discusses how adverse drug reactions are common, occurring in 10-15% of drug treatments and accounting for 3-6% of hospital admissions. It then covers different types of reactions, including allergic/immunological reactions and non-allergic reactions. Common medicines that can cause allergic reactions are discussed, including antibiotics, NSAIDs, opiates, anticonvulsants, and radiocontrast agents. Risk factors for drug allergies and approaches to prevention and treatment are also summarized.
This document discusses drug interactions in dentistry. It covers interactions between local anesthetics like prilocaine and articaine with other drugs that can affect their hepatic metabolism and clearance. It also discusses interactions between analgesics like NSAIDs and opioids with other drugs that can cause opposition of effects, increased toxicity, or CNS and respiratory depression when taken together. The document notes several examples of food and herbal interactions with various drugs that can impact their absorption, metabolism, or effects.
Local anesthesia in dentistry /certified fixed orthodontic courses by Indian...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Lidocaine is a local anesthetic that has several indications and mechanisms of action. It can be used as a local anesthetic for procedures or to treat arrhythmias when given intravenously. Intravenous lidocaine may provide pain relief for postoperative, neuropathic, and chronic pain by blocking sodium channels. Studies have shown intravenous lidocaine can reduce postoperative pain and opioid use when given perioperatively, leading to benefits like shorter hospital stays. Lidocaine may be more effective than placebo for treating neuropathic pain, though epidural administration provides better pain relief than intravenous lidocaine for some surgeries. Adverse effects are typically minor when given at therapeutic doses by trained medical professionals.
Local anesthesia involves the loss of sensation, especially pain, in one part of the body through the use of local anesthetic drugs. The document discusses the historical background of local anesthesia beginning in the 1880s with cocaine. It defines local anesthesia and related terms and outlines the ideal properties of local anesthetic drugs. The document describes the composition of local anesthetic solutions, classifications of drugs, and their mechanism of action in blocking nerve conduction. It explores theories of pain and the pain pathway, which local anesthetics are able to interrupt.
The document provides an overview of local anesthesia. It begins with the historical background of local anesthetics starting with cocaine in 1860. It defines local anesthesia and discusses the ideal properties, electrophysiology of nerve conduction, and theories of the mechanism of action. It classifies local anesthetics and discusses their types, biokinetics, metabolism, and armamentarium. It also outlines various local anesthesia injection techniques and potential complications. The document contains a comprehensive but concise review of the fundamentals of local anesthesia.
This document provides information on various techniques for local anesthesia in dentistry. It discusses the mechanism of action, classifications, and maximum recommended doses of local anesthetics. It also describes in detail techniques for maxillary injections including inferior alveolar nerve block, Gow Gates, and Vazirani Akinosi techniques for mandibular anesthesia. Complications and contraindications of local anesthesia are mentioned.
This document provides an overview of local anesthesia in pediatric dentistry. It defines local anesthesia and discusses the history, classification, composition, properties, and mechanisms of local anesthetic agents. It also covers the metabolism, excretion, and systemic effects of local anesthetics. Maximum recommended doses and types of injection procedures for different regions are mentioned. Complications and recent advances in local anesthesia techniques are briefly discussed.
This document summarizes a presentation on newer local anesthetic drugs and delivery systems in dentistry. It discusses two newer local anesthetic drugs, articaine and centbucridine, that have properties making them potentially superior to lidocaine. It also reviews phentolamine mesylate, a drug used to reverse the effects of local anesthetics containing vasoconstrictors. Finally, it outlines several newer drug delivery systems aimed at reducing pain from local anesthetic injections, including electronic dental anesthesia, intraoral patches, jet injection, and iontophoresis.
Local & systemic Complications of Local AnesthesiaIAU Dent
This document discusses local anesthesia (LA), including its mechanism of action, factors influencing injection discomfort and techniques to reduce discomfort, testing the success of LA, causes and management of failed LA, complications of LA including local and systemic complications, and management of specific complications like needle breakage, pain/burning on injection, persistent anesthesia, and trismus. It provides anatomical and technical details related to achieving successful LA and avoiding complications.
Local anesthetics are commonly used in dentistry to numb areas and relieve pain during dental procedures. They work by temporarily blocking sodium channels in nerves, preventing the transmission of pain signals. The document discusses the main types of local anesthetics used in dentistry, including lidocaine, bupivacaine, prilocaine, and articaine. It describes their mechanisms of action, classifications, common uses, and potential side effects when used in dental procedures.
1. The document discusses local anaesthesia equipment and techniques used in dentistry. It describes the components of local anaesthesia syringes, needles, and cartridges.
2. Various local anaesthesia techniques are covered, including infiltration, block, and topical anaesthesia. Infiltration anaesthetizes terminal nerve fibers, while block anaesthetizes the main nerve trunk.
3. Topical anaesthesia is described as surface anaesthesia for mucosa or skin using physical or chemical methods. Its effectiveness depends on the site of application and adequate time allowed.
Local anesthetics,drugs, doses,theories, mechanismsMayank Chhabra
Local anesthesia is a transient loss of sensation in a localized area caused by blocking nerve conduction without loss of consciousness. It works by binding to receptor sites on nerve membranes and blocking sodium channels, preventing the transmission of nerve impulses. Common local anesthetics are lidocaine, prilocaine, mepivacaine and bupivacaine. Vasoconstrictors like epinephrine are often added to prolong the effects and reduce systemic absorption. Proper dosage calculation and contraindications must be considered for safe administration of local anesthesia.
This document discusses pain control in dentistry. It covers procedural pain from injections and treatments, as well as post-procedural pain management. Topical anesthetics like lidocaine or benzocaine gels can numb the surface before injections. Local anesthetics like lidocaine are commonly used during procedures. NSAIDs given before nerve blocks can improve anesthesia effectiveness. After procedures, over-the-counter NSAIDs like ibuprofen or acetaminophen combined with codeine can help manage pain. Non-pharmacological options like warm salt water rinses and cold compresses are also discussed.
It remains the responsibility of all clinicians using LA
to understand their potential
for severe systemic toxicity and to be prepared to respond immediately to these events when they occur.
This document discusses local anesthesia and pain control techniques for pediatric dentistry. It defines pain and anesthesia and covers various local anesthesia techniques including topical anesthesia, infiltration, nerve blocks, and supplemental injection techniques. It provides details on the contents of local anesthesia carpules, how local anesthetics are metabolized in the body, recommended dosages, and complications. The goal is to effectively manage pain for dental procedures in children.
This document summarizes recent advances in local anesthesia for dentistry. It discusses newer local anesthetic drugs like articaine and centbucridine that are equally or more effective than lignocaine. It also describes new delivery systems for local anesthesia like computer-controlled local anesthesia delivery systems, jet injectors, and iontophoresis that reduce injection pain and improve patient comfort. Devices like CCLADs allow controlled infusion of anesthetic for more precise needle insertion and placement.
Local anesthetics work by altering the membrane potential of nerve cells and blocking sodium channels, which prevents the propagation of action potentials and results in loss of sensation. Early local anesthetics like cocaine were derived from coca leaves and provided pain relief for surgery. Later developments included procaine, lidocaine, and other synthetic amide and ester local anesthetics. The pharmacokinetics and effects of local anesthetics depend on factors like lipid solubility, pH, vasoconstriction, and metabolism. Toxicity can occur if maximum dosage levels are exceeded.
The document discusses local anesthetics, including their definition, requirements, mechanisms of action, classifications, and biotransformation. It notes that local anesthetics work by inhibiting sodium influx through voltage-gated sodium channels in neuronal cells, blocking nerve conduction. Local anesthetics are classified based on duration of action, chemical nature, and origin. Common examples are discussed and appropriate uses along with potential complications and contraindications are outlined.
This document discusses local anesthesia used in dental procedures. It defines local anesthesia and describes the desirable properties of local anesthetic solutions. These include being non-irritating, not permanently altering nerve structures, having low systemic toxicity, and providing effective anesthesia regardless of injection site. The document outlines the electrophysiology of nerve conduction and how local anesthetics work by blocking sodium channels. It classifies local anesthetics and discusses vasoconstrictors used to prolong their effects. Complications of local anesthesia are described, including both local issues like needle breakage and hematoma, and systemic concerns like overdose and allergic reactions.
- Local anesthetics are drugs that cause reversible loss of sensation in a restricted area of the body when applied topically or injected locally. They work by blocking nerve conduction without structural nerve damage.
- Early uses of local anesthetics included chewing cocoa leaves for pain relief in Peru and spinal/epidural anesthesia developed in the late 19th century. Common types include amide drugs like lidocaine, bupivacaine, and ropivacaine as well as ester drugs like cocaine and tetracaine.
- Local anesthetics can be administered via various techniques including infiltration, nerve blocks, epidural/spinal anesthesia, intravenous regional anesthesia, and topical application. Factors like drug properties, dosage,
The document discusses guidelines for patient preparation and assessment prior to anesthesia. It describes obtaining an accurate patient history, performing a physical examination, and confirming the scheduled procedure. A thorough minimum patient database is essential and includes signalment, medications, allergies, preventive care, past illnesses, and identification. Assessments of body weight, condition, hydration, temperature and other vital signs are also important parts of preparing the patient.
This document provides information about adverse drug reactions and allergies. It discusses how adverse drug reactions are common, occurring in 10-15% of drug treatments and accounting for 3-6% of hospital admissions. It then covers different types of reactions, including allergic/immunological reactions and non-allergic reactions. Common medicines that can cause allergic reactions are discussed, including antibiotics, NSAIDs, opiates, anticonvulsants, and radiocontrast agents. Risk factors for drug allergies and approaches to prevention and treatment are also summarized.
This document discusses drug interactions in dentistry. It covers interactions between local anesthetics like prilocaine and articaine with other drugs that can affect their hepatic metabolism and clearance. It also discusses interactions between analgesics like NSAIDs and opioids with other drugs that can cause opposition of effects, increased toxicity, or CNS and respiratory depression when taken together. The document notes several examples of food and herbal interactions with various drugs that can impact their absorption, metabolism, or effects.
This document discusses several drugs commonly used in dentistry, including their uses, dosages, and side effects. Acetaminophen is used to treat mild to moderate dental pain and fever and has few side effects but can damage the liver in an overdose. Ibuprofen and naproxen sodium are nonsteroidal anti-inflammatory drugs used to treat dental pain, reduce swelling, and fever and may cause gastrointestinal side effects with long term use. Amitriptyline is a tricyclic antidepressant that can also be used to treat chronic facial and jaw pain but has sedative side effects and drug interactions.
This document provides an overview of the differential diagnosis of keratotic white lesions in the oral cavity. It begins with an introduction and classification of keratotic white lesions. The main part of the document discusses specific lesions such as white sponge nevus, leukoedema, frictional keratosis, linea alba, smokeless tobacco-induced keratosis, nicotine stomatitis, oral hairy leukoplakia, candidiasis, and oral lichen planus. Each lesion is described in terms of etiology, clinical features, differential diagnosis from other lesions, and examples. The document concludes with a reference section.
This document discusses the rational use of antibiotics. It notes that 50% of antibiotics are used inappropriately and that many infections like diarrhea and bronchitis are viral, not bacterial. It provides details on selecting antibiotics based on the infection severity, likely bacteria, patient factors, and cost. Empiric antibiotic choices are outlined for various infections. The side effects and costs of common antibiotics are also reviewed. The document emphasizes using antibiotics appropriately only for bacterial infections.
This document provides information on various emergency drugs including atropine, adrenaline, mephentermine, ephedrine, and xylocard. It describes the class, mechanism of action, indications, dosing, administration, and side effects of each drug. Atropine is an anticholinergic that acts as a competitive muscarinic receptor antagonist. Adrenaline is a direct-acting sympathomimetic that interacts with both alpha and beta receptors to increase heart rate, contractility and blood pressure. Mephentermine and ephedrine are both sympathomimetic amines that cause increased cardiac output through alpha and beta receptor stimulation. Xylocard is a class IB antiarrhythmic sodium channel block
This document discusses the evaluation, diagnosis, and treatment of orofacial infections with an emphasis on antibiotic therapy and prophylaxis. It outlines how to assess infections through medical history, exam, and identifying signs of infection. Most oral infections involve both aerobic and anaerobic bacteria. Commonly used antibiotics include penicillin, cephalosporins, metronidazole, and clindamycin. Antibiotics should be used as an adjunct to drainage and are indicated for severe infections, inadequate drainage, or compromised hosts. Prophylactic antibiotics are recommended for high-risk dental procedures in certain patients.
This document discusses bonding to tooth structure and dentin. It describes four approaches to bonding with tooth structure: macro-mechanical attachment, chemical bonding, micro-mechanical attachment, and interpenetration. It also lists several clinical applications of adhesive bonding and some difficulties. The document then focuses on adhesive bonding to tooth enamel and dentin, outlining the chemical and micro-mechanical bonding approaches for each, as well as the development of dentin bonding systems from first to seventh generation with their characteristics and commercial examples.
Knowledge of root and root canal morphology is a prerequisite for effective non-surgical and surgical endodontic treatments. The external and internal morphological features of roots are variable and complex, and several classifications have been proposed to define the various types of canal configurations that occur commonly. More recently, improvements in non-destructive digital image systems, such as cone-beam and micro-computed tomography, as well as the use of magnification in clinical practice, have increased the number of reports on complex root canal anatomy. Importantly, using
these newer techniques, it has become apparent that it is not possible to classify many root canal configurations using the existing systems. The purpose of this article is to introduce a new classification system that can be adapted to categorize root and root canal configurations in an accurate, simple and reliable manner that can be used in research, clinical practice and training.
The document discusses antibiotics and analgesics. It begins by defining antibiotics as chemical substances produced by microorganisms that inhibit or kill other microorganisms. It then covers the classification, mechanisms of action, and therapeutic uses of various antibiotics like penicillin, cephalosporins, erythromycin, tetracycline, and others. It also discusses analgesic classification into opioid and non-opioid categories and pain management strategies. The document provides an overview of commonly used antibiotics and analgesics for treating odontogenic infections and dental pain.
1) Principles of Antibiotic Therapy discusses the definition, selection, properties, and complications of antibiotic use. Antibiotics work by interfering with intracellular bacterial processes and their effects depend on factors like dosage concentration and timing.
2) Different classes of antibiotics like beta-lactams, glycopeptides, and macrolides act on various bacterial targets including the cell wall, protein synthesis, and cell membrane. Each antibiotic has a distinct spectrum of activity and side effect profile.
3) Proper use of antibiotics requires considering the infecting organism, resistance patterns, and patient factors to maximize efficacy and minimize harm like antibiotic resistance or toxicity. Combination therapy and alternative drugs exist for resistant infections.
Unconventional modes of anaesthetic administrationSelva Kumar
This document discusses unconventional modes of anesthetic drug administration. It begins by explaining why inhalational anesthesia became conventional, due to ease of administration and reversibility. It then explores potential benefits of unconventional methods like improved patient compliance and bioavailability. Several unconventional routes are described, including transdermal, transmucosal, intranasal, rectal, intra-articular, interpleural, perineural, and intratracheal administration. Specific techniques like transdermal fentanyl patches, EMLA cream, intranasal medications, oral and sublingual opioids, ketamine premedication, and interpleural analgesia are outlined. The conclusion is that unconventional methods increase
This document discusses cholinergic agents and their effects on the autonomic nervous system. It describes how cholinergic agents mimic the effects of acetylcholine by stimulating muscarinic and nicotinic receptors. Direct-acting agents bind to cholinergic receptors while indirect agents inhibit the enzyme acetylcholinesterase. Common effects include increased salivation, lacrimation, urination, diarrhea and gastrointestinal cramping. Therapeutic uses include reducing eye pressure for glaucoma, increasing bladder and bowel motility, and treating Alzheimer's disease. Side effects result from overstimulation of the parasympathetic nervous system and include bradycardia, nausea, vomiting and bronchospasm.
This document discusses cholinergic agents and their effects on the autonomic nervous system. It describes how cholinergic agents mimic the effects of acetylcholine by stimulating muscarinic and nicotinic receptors. Direct-acting agents bind to cholinergic receptors while indirect agents inhibit the enzyme acetylcholinesterase. Common effects include increased salivation, lacrimation, urination, diarrhea and gastrointestinal cramping. Therapeutic uses include reducing eye pressure for glaucoma, increasing bladder and bowel motility, and treating Alzheimer's disease. Side effects result from overstimulation of the parasympathetic nervous system and include bradycardia, nausea, vomiting and bronchospasm.
The administration of Local anesthesia is the greatest fear a child would encounter in the dental office. Hence it is important that dentists obtain pain control with minimum discomfort to the child. This Review VEDIO provides an overview about the various local anesthetic agents used in pediatric dental practice, dosage, complications and the recent advances
local anesthesia: Uses, Types, Side effects and SafetyPrachiRathi40
This document provides an overview of local anesthesia. It begins with definitions and an introduction. It then covers the historical background, classifications, components, mechanisms of action, techniques, and complications of local anesthesia. The classifications section divides local anesthetics based on their pharmacology, route of administration, biologic site and mode of action, and duration of action. Key local anesthetic agents like lidocaine, mepivacaine, articaine, bupivacaine, and topical anesthetics are also summarized. Maximum recommended doses and specific nerve block techniques for the maxillary nerve are outlined. In conclusion, the document reviews local anesthesia in detail.
Pharmacological Management of Pain In The Dental CareCharles Sharkey
This document discusses the pharmacological management of pain in the dental care setting. It defines pain and outlines the objectives of understanding pain definition, pharmacological actions of analgesics, a stepwise pain management approach, and adverse effects of analgesics. Nonopioid drugs discussed include acetaminophen and NSAIDs. Opioid analgesics discussed include codeine, oxycodone, hydrocodone, and hydromorphone. The document provides dosing and considerations for the safe use of these drugs to manage dental pain.
Monitoring depth of anesthesia (DOA) is important for patient safety and optimal outcomes. Several methods can be used to assess DOA, including subjective measures of response to stimuli and objective measures such as the electroencephalogram (EEG). The EEG provides a non-invasive "window on the brain" during anesthesia by measuring brain wave activity. Different EEG-derived indices have been developed to quantify DOA, but it is important to remember that no single monitor can fully characterize the anesthetic state and clinical judgment is also needed when using EEG monitors to guide anesthesia administration.
Local anesthetics work by blocking sodium channels in nerves, limiting the propagation of action potentials and preventing pain sensation. Lidocaine was the first modern local anesthetic introduced in 1940. Local anesthetics are either esters or amides, with amides like lidocaine causing less allergic reactions. The onset and duration of local anesthetics is influenced by their lipid solubility, pH, presence of vasoconstrictors, and peak circulation levels to avoid toxicity.
This document provides an overview of local anaesthesia presented by Dr. Yugal Kishor. It discusses the history, definition, classification and agents of local anaesthesia. It describes newer local anaesthetic drugs like articaine and centbucridine. It also discusses local anaesthetic solutions, delivery systems like computer-controlled syringes and jet injectors. The document outlines techniques for maxillary and mandibular nerve blocks including posterior superior alveolar, infraorbital and mental nerve blocks. It provides details on the anatomy, techniques, effectiveness and precautions for different nerve block procedures.
The document discusses local anesthetics, including their definitions, classifications, mechanisms of action, routes of administration, and pharmacokinetics. Local anesthetics work by blocking sodium channels and preventing the generation and conduction of nerve impulses. There are two main classes - amides like lidocaine, which are metabolized in the liver, and esters like procaine, which can cause allergic reactions and are metabolized in plasma. Factors like lipid solubility, pH, and vasodilation influence the onset and duration of action of local anesthetics.
Local anesthesia involves applying numbing drugs to specific parts of the body to temporarily block pain sensation during surgery or other procedures. It has a long history dating back to the 1850s with early experiments using cocaine. Local anesthetics work by inhibiting sodium ion channels in nerves, preventing the generation of action potentials. While useful for minor procedures, local anesthetics can cause adverse effects if too much enters the bloodstream, possibly interfering with heart function. Proper administration is important to avoid safety issues.
Aspirin is a nonselective COX inhibitor that is rapidly converted to salicylic acid, which is responsible for its analgesic, antipyretic, and anti-inflammatory actions. At analgesic doses, its main adverse effects include nausea, vomiting, and gastric mucosal damage. At higher anti-inflammatory doses, it can cause salicylism, a syndrome with symptoms like dizziness, tinnitus, and electrolyte imbalance. Acute salicylate poisoning is more common in children and can manifest as vomiting, dehydration, breathing issues, and potentially death from respiratory or cardiovascular failure without treatment.
The document provides information on performing Bier's block and fascia iliaca compartment block (FICB). It discusses the anatomy, equipment, approach, local anesthetics, and key teaching points for each procedure. Bier's block involves injecting local anesthetic intravenously to anesthetize nerves around blood vessels in the upper extremity. FICB involves injecting local anesthetic into the fascia iliaca compartment to anesthetize the femoral and lateral femoral cutaneous nerves of the thigh. Ultrasound guidance improves the success and safety of FICB compared to the landmark-based technique for Bier's block.
Cocaine was the first local anesthetic discovered and is derived from coca plants. Other synthetic local anesthetics were later developed, including procaine and lidocaine. Local anesthetics work by reversibly binding sodium channels and inhibiting nerve conduction. There are two classes - amino amides like lidocaine and amino esters like cocaine. Proper administration of local anesthetics involves considering the patient, dose, presence of epinephrine, speed of injection, tissue vascularity, and injection technique. Dilution, addition of epinephrine, and slow administration can allow for safer use of local anesthetics.
This document discusses complications of local anesthesia. It begins by defining local anesthesia and providing a brief history. It then discusses various local complications that can occur, such as needle breakage, prolonged anesthesia, facial nerve paralysis, and soft tissue injury. Causes of these local complications include needle trauma to nerves, intraneural injection, and hematoma formation around nerves. The document also discusses systemic complications like toxicity and allergic reactions. Prevention strategies aim to avoid nerve trauma during injection and proper use and handling of local anesthetic materials. Most local complications resolve on their own, but persistent cases may require reassurance and follow-up.
This document provides an overview of monitoring depth of anesthesia. It discusses the aims of monitoring to ensure patient safety and prevent awareness during surgery. It reviews the historical background of defining anesthesia stages. Modern concepts view anesthesia as a complex interaction between stimuli, patient responses, and drug-induced effects. Factors like patient characteristics, drug combinations, and surgery duration impact correct drug dosing. Memory is gradually impaired with deeper anesthesia levels before autonomic responses. The document outlines stages of awareness and discusses specific drugs' relationships to anesthesia depth.
LOCAL ANESTHETICS 2024.pdf jdhsjsnsnejsjnsjwnsepicsoundever
Local anesthesia is the reversible loss of sensation in an area without loss of consciousness. Local anesthetics block nerve conduction when applied directly to peripheral nerves, abolishing sensation in the supplied area. They are divided into natural, synthetic, ester, and amide groups. Local anesthetics produce anesthesia by reversibly binding sodium channels, inhibiting nerve excitation. They have different durations of action and are used for various types of local anesthesia including infiltration, nerve block, spinal, and surface anesthesia. Complications can include allergic reactions and systemic toxicity at high doses.
This document discusses ambulatory anesthesia and day-care surgery. It provides a brief history of ambulatory anesthesia, noting key developments from 1903 to present day. It describes the objectives and techniques of anesthesia for day-care surgery, including premedication, induction agents, maintenance techniques, regional versus general anesthesia, advantages and disadvantages, selection criteria for patients, and discharge criteria. The success of day-care surgery depends on appropriate patient selection, facility availability, and type of surgical procedure.
Local anesthetics work by reversibly blocking sodium channels in nerve cell membranes, preventing the propagation of nerve impulses and inducing localized numbness. The document discusses the mechanisms of action, factors affecting activity, termination of effects, use of vasoconstrictors, classification, adverse effects, and techniques of local anesthesia. It also covers the introduction, objectives, mechanisms, activity, termination, classification, effects, and choice of local anesthetic agents.
This document provides an overview of pharmacology topics related to local anesthetics. It begins with a brief history of local anesthetics and discusses the chemistry, including the differences between ester and amide local anesthetics. It covers stereoisomerism, structure-activity relationships, and peripheral nerve anatomy. Mechanisms of action are explained, including the roles of lipophilicity, pKa, and ionized vs. non-ionized forms. Pharmacokinetics, systemic absorption, and toxicity risks are also summarized. The document aims to inform on the essential science underlying local anesthetic use and effects.
Similar to A Review of The Use of Local Anesthetics (20)
1. A Review of The Use ofA Review of The Use of
Local Anesthetics andLocal Anesthetics and
Anxiolytics in The DentalAnxiolytics in The Dental
Practice SettingPractice Setting
Charles Sharkey M.S. M.B.A.Charles Sharkey M.S. M.B.A.
Pharm D.Pharm D.
Pharmacy Site ManagerPharmacy Site Manager
Brooklyn/SAECC campusBrooklyn/SAECC campus
January 2008January 2008
2. Learning ObjectivesLearning Objectives
At the conclusion of this presentationAt the conclusion of this presentation
the practicing dentist will have anthe practicing dentist will have an
increased understanding of theincreased understanding of the
following for local anesthetics, andfollowing for local anesthetics, and
anxiolytic drugs.anxiolytic drugs.
PharmacologyPharmacology
Monitoring parametersMonitoring parameters
Adverse effect profileAdverse effect profile
3. Historical Perspective on LocalHistorical Perspective on Local
AnestheticsAnesthetics
Local Anesthetics have been used inLocal Anesthetics have been used in
Dentistry for over 100 years.Dentistry for over 100 years.
Prior to this in the 1800’s a “swig ofPrior to this in the 1800’s a “swig of
whiskey” was used before a dentalwhiskey” was used before a dental
procedure.procedure.
1840 Dr. Horace Wells used Nitrous1840 Dr. Horace Wells used Nitrous
OxideOxide
1840 Dr. William Morton used Ether1840 Dr. William Morton used Ether
4. Historical Perspective on LocalHistorical Perspective on Local
AnestheticsAnesthetics
On September 30, 1846 Dr. MortonOn September 30, 1846 Dr. Morton
extracted a tooth while using Ether.extracted a tooth while using Ether.
The patients name was Mr. EbenThe patients name was Mr. Eben
Frost.Frost.
1859 Albert Niemann extracted an1859 Albert Niemann extracted an
alkaloid called Cocaine.alkaloid called Cocaine.
1901 Heinrich Braun demonstrated1901 Heinrich Braun demonstrated
use of Epinephrine to retarduse of Epinephrine to retard
absorption of local anesthetics.absorption of local anesthetics.
5. Historical Perspective of LocalHistorical Perspective of Local
AnestheticsAnesthetics
1904 Alfred Einhorn introduced1904 Alfred Einhorn introduced
Procaine (Novocaine)Procaine (Novocaine)
The race began for more effectiveThe race began for more effective
local anesthetics in dentistry.local anesthetics in dentistry.
1943 Nils Lofgren introduced1943 Nils Lofgren introduced
Lidocaine (Xylocaine)Lidocaine (Xylocaine)
Movement here is from generalMovement here is from general
anesthetics to local agents.anesthetics to local agents.
6. Classification of Local AnestheticsClassification of Local Anesthetics
Three components: aromatic group,Three components: aromatic group,
intermediate chain, and aminointermediate chain, and amino
terminus.terminus.
Ester or AmideEster or Amide
Lipophilic and hydrophilic groupsLipophilic and hydrophilic groups
Weak basesWeak bases
Balance between hydrophilicity (i.e.Balance between hydrophilicity (i.e.
ability to be solubilized in dentalability to be solubilized in dental
syringe) and lipophilicity (onset andsyringe) and lipophilicity (onset and
duration of clinical action)duration of clinical action)
7. Classification of Local AnestheticsClassification of Local Anesthetics
Ester or Amide classificationEster or Amide classification
Amides are preferred.Amides are preferred.
Preference is due to the way thePreference is due to the way the
drugs are broken down in the body.drugs are broken down in the body.
Amides are reduced in the liver andAmides are reduced in the liver and
excreted in the kidney.excreted in the kidney.
Amides less likely to cause allergicAmides less likely to cause allergic
reactions.reactions.
8. Pharmacology of the LocalPharmacology of the Local
AnestheticsAnesthetics
Local anesthesia is produced whenLocal anesthesia is produced when
propagation of action potential ispropagation of action potential is
prevented.prevented.
Block the entry of sodium ions.Block the entry of sodium ions.
Sensations cannot be transmittedSensations cannot be transmitted
from the tooth to the brain.from the tooth to the brain.
Reversible reaction. No loss ofReversible reaction. No loss of
consciousnessconsciousness
9. Pharmacology of Local AnestheticsPharmacology of Local Anesthetics
Local anesthetics effect axonalLocal anesthetics effect axonal
membranes of peripheral nerves.membranes of peripheral nerves.
General Anesthetics work on theGeneral Anesthetics work on the
synapses of the Central Nervoussynapses of the Central Nervous
SystemSystem
Local Anesthetics work best on TypeLocal Anesthetics work best on Type
C small nerve fibers in comparison toC small nerve fibers in comparison to
Type A or Type B.Type A or Type B.
This translates into no feeling of painThis translates into no feeling of pain
but may experience feeling ofbut may experience feeling of
pressurepressure
10. Requirements for a LocalRequirements for a Local
AnestheticAnesthetic
High intrinsic activityHigh intrinsic activity
Rapid onsetRapid onset
Duration of action of 30 to 60Duration of action of 30 to 60
minutesminutes
Low systemic toxicityLow systemic toxicity
Low incidence of serious adverseLow incidence of serious adverse
reactions.reactions.
11. Factors to considerFactors to consider
pH of the surrounding tissuepH of the surrounding tissue
pKa of the drugpKa of the drug
Balance of lipophilicity andBalance of lipophilicity and
hydrophilicityhydrophilicity
Proximity of injection to the nerve.Proximity of injection to the nerve.
Chemical classChemical class
VasoconstrictorVasoconstrictor
12. Local Anesthetics In PerspectiveLocal Anesthetics In Perspective
Dentists in the U.S. useDentists in the U.S. use
approximately 1,500 to 2000approximately 1,500 to 2000
cartridges per year.cartridges per year.
300 million cartridges are300 million cartridges are
administered per year.administered per year.
Local anesthetics are Relatively safeLocal anesthetics are Relatively safe
medications based on statistics,medications based on statistics,
doses used, and application.doses used, and application.
13. Response to Local AnestheticsResponse to Local Anesthetics
Patients Psychological StatePatients Psychological State
Health of tissueHealth of tissue
Injection techniqueInjection technique
Agent selectedAgent selected
Vasoconstrictor or NotVasoconstrictor or Not
14. Development of Local AnestheticsDevelopment of Local Anesthetics
1884 Cocaine1884 Cocaine
1904 Procaine1904 Procaine
1932 Tetracaine1932 Tetracaine
1948 Lidocaine1948 Lidocaine
1963 Bupivacaine1963 Bupivacaine
1969 Articaine1969 Articaine
15. Duration of actionDuration of action
Bupivacine with EpiBupivacine with Epi >90>90
minutesminutes
Etidocaine with EpiEtidocaine with Epi >90>90
minutesminutes
Lidocaine (No epi)Lidocaine (No epi) 3030
minutesminutes
Lidocaine with EpiLidocaine with Epi 6060
minutesminutes
MepivacaineMepivacaine (No epi)(No epi) 30 to30 to
60 min
16. Local Anesthetics-Clinical PearlsLocal Anesthetics-Clinical Pearls
Lidocaine with Epi 1:100,000Lidocaine with Epi 1:100,000
common.common.
Mepivacaine with NO EPI used forMepivacaine with NO EPI used for
patients who cannot tolerate apatients who cannot tolerate a
vasoconstrictor.vasoconstrictor.
Bupivacaine is used for longerBupivacaine is used for longer
procedures.procedures.
Bupivacaine is not recommended forBupivacaine is not recommended for
children or handicapped due tochildren or handicapped due to
increased risk of postop injury.increased risk of postop injury.
17. Local Anesthetics-Adverse EffectsLocal Anesthetics-Adverse Effects
Psychogenic including syncope,Psychogenic including syncope,
hyperventilation, nausea, vomiting.hyperventilation, nausea, vomiting.
Allergic reactions to esters,Allergic reactions to esters,
preservatives.preservatives.
Sedation, slurred speech.Sedation, slurred speech.
MethemoglobinemiaMethemoglobinemia
ParenthesisParenthesis
18. A Word About VasoconstrictorsA Word About Vasoconstrictors
Local anesthetics have vasodilatorLocal anesthetics have vasodilator
properties.properties.
Prolong the duration of action of theProlong the duration of action of the
local anestheticlocal anesthetic
Decrease absorption of anestheticDecrease absorption of anesthetic
Range of 1:50,000 t0 1:200,000 ofRange of 1:50,000 t0 1:200,000 of
Epinephrine.Epinephrine.
19. Local Anesthetic Drug InteractionsLocal Anesthetic Drug Interactions
Beta blockers + EpiBeta blockers + Epi
Tricyclic antidepressants + EpiTricyclic antidepressants + Epi
Cocaine + EpiCocaine + Epi
20. Special Patient PopulationsSpecial Patient Populations
Fairly safe in pregnant and lactatingFairly safe in pregnant and lactating
patients. Lidocaine has a Categorypatients. Lidocaine has a Category
rating of FDA B.rating of FDA B.
Pediatrics should avoid BupivacainePediatrics should avoid Bupivacaine
Geriatric patients should have noGeriatric patients should have no
significant difference in responsesignificant difference in response
22. Articaine vs. LidocaineArticaine vs. Lidocaine
Articaine was approved in the US forArticaine was approved in the US for
dental use in 2000dental use in 2000
Some dentists claim it has betterSome dentists claim it has better
bone perfusion, and actually worksbone perfusion, and actually works
betterbetter
Thiophene ring, and ester linkageThiophene ring, and ester linkage
23. Articaine vs. LidocaineArticaine vs. Lidocaine
Anecdotal reports claiming superiorAnecdotal reports claiming superior
efficacy of Articaineefficacy of Articaine
Literate points to comparableLiterate points to comparable
efficacy with Lidocaine 2% plusefficacy with Lidocaine 2% plus
epinephrineepinephrine
24. Antianxiety MedicationsAntianxiety Medications
Fear and anxiety are common inFear and anxiety are common in
dental patientsdental patients
Mild fears can impact oral healthMild fears can impact oral health
Antianxiety medications are used inAntianxiety medications are used in
clinical dentistry for premedication ofclinical dentistry for premedication of
the nervous and apprehensivethe nervous and apprehensive
patientpatient
25. Antianxiety medicationsAntianxiety medications
Benzodiazepines are the most widelyBenzodiazepines are the most widely
prescribed classprescribed class
Selective, effective, and safeSelective, effective, and safe
Pharmacologically act in the CNSPharmacologically act in the CNS
Several dozen agents marketedSeveral dozen agents marketed
worldwideworldwide
26. Pharmacology of BenzodiazepinesPharmacology of Benzodiazepines
Stimulate gamma amino-butyric acidStimulate gamma amino-butyric acid
(GABA)(GABA)
GABA is a major inhibitoryGABA is a major inhibitory
neurotransmitter in the CNSneurotransmitter in the CNS
Effect the flow of chloride ions inEffect the flow of chloride ions in
neuronal tissue which effects nerveneuronal tissue which effects nerve
transmissiontransmission
28. BenzodiazepinesBenzodiazepines
The dentist is faced with the questionThe dentist is faced with the question
of which agent to use?of which agent to use?
But the real issue is not so muchBut the real issue is not so much
which agent to use but when towhich agent to use but when to
administeradminister
Avoid excessive CNS adverse effectsAvoid excessive CNS adverse effects
29. Properties of benzodiazpinesProperties of benzodiazpines
Triazolam 0.125mg-0.5mg orally hasTriazolam 0.125mg-0.5mg orally has
a 2-4 hour durationa 2-4 hour duration
Midazolam 0.5mgs/kg IV has aMidazolam 0.5mgs/kg IV has a
duration of 1-2 hoursduration of 1-2 hours
Lorazepam 1-3mgs orally has a 6-8Lorazepam 1-3mgs orally has a 6-8
hour durationhour duration
30. Properties of benzodiazepinesProperties of benzodiazepines
Alprazolam 1mg orally has a durationAlprazolam 1mg orally has a duration
of 6-8 hoursof 6-8 hours
Diazepam 5mgs-10mgs orally has aDiazepam 5mgs-10mgs orally has a
duration of 6-8 hoursduration of 6-8 hours
31. Benzodiazepines—Adverse EffectsBenzodiazepines—Adverse Effects
CNS related including drowsiness,CNS related including drowsiness,
excessive sedation, lethargy.excessive sedation, lethargy.
Normal doses do not effectNormal doses do not effect
respiration. However, it does haverespiration. However, it does have
some respiratory depressantsome respiratory depressant
potentialpotential
32. BenzodiazepinesBenzodiazepines
Recommend you select a short actingRecommend you select a short acting
agent i.e. Alprazolam and administeragent i.e. Alprazolam and administer
it before the procedureit before the procedure
Avoid a longer acting agent such asAvoid a longer acting agent such as
diazepamdiazepam