DH 410 Emergencies in Dental Practice
32 Questions
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DH 410 Emergencies in Dental Practice

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Questions and Answers

What should be avoided when managing an overdose in a victim of drug toxicity?

  • Giving an emetic agent (correct)
  • Cooling the skin with lukewarm water
  • Providing benzodiazepines
  • Administration of activated charcoal
  • Which of the following is a common symptom of opioid toxicity?

  • Hypotension (correct)
  • Pupil dilation
  • High blood pressure
  • Increased heart rate
  • What mechanism do opioids use to produce their effects?

  • Block the release of dopamine
  • Inhibit the absorption of enzymes in the GI tract
  • Bind with specific opioid receptors (correct)
  • Enhance the activity of serotonin
  • Which of the following is NOT a typical route of administration for opioids?

    <p>Transdermal</p> Signup and view all the answers

    What is a potential severe consequence of benzodiazepine overdose?

    <p>Respiratory arrest</p> Signup and view all the answers

    What symptom is associated with benzodiazepine toxicity?

    <p>Lethargy</p> Signup and view all the answers

    Which property is NOT associated with benzodiazepines?

    <p>Analgesic effects</p> Signup and view all the answers

    For what purpose is activated charcoal administered in cases of drug overdose?

    <p>To prevent systemic absorption of drugs</p> Signup and view all the answers

    Which drug is considered a CNS stimulant that can lead to toxicity symptoms such as euphoria and tachycardia?

    <p>Amphetamine</p> Signup and view all the answers

    What is a common sign of cocaine toxicity?

    <p>Euphoria</p> Signup and view all the answers

    Which of the following is NOT a typical symptom of amphetamine toxicity?

    <p>Hypotension</p> Signup and view all the answers

    What should be part of the emergency management for someone experiencing amphetamine or cocaine toxicity?

    <p>Monitor vital signs</p> Signup and view all the answers

    Which of the following drugs is a dopamine reuptake inhibitor commonly associated with feelings of euphoria?

    <p>Cocain</p> Signup and view all the answers

    What is considered an extreme symptom of cocaine toxicity?

    <p>Cerebral hemorrhage</p> Signup and view all the answers

    Which condition is most likely related to methamphetamine use?

    <p>Meth mouth</p> Signup and view all the answers

    When managing a patient with drug toxicity, what is a priority action?

    <p>Contact emergency medical services</p> Signup and view all the answers

    Which factor does NOT influence the healing of wounds?

    <p>Type of suture used</p> Signup and view all the answers

    What is the primary reason for being more aggressive with layered closure in facial wounds?

    <p>To preserve normal facial contours</p> Signup and view all the answers

    Which of the following is a risk factor for wound infection according to established studies?

    <p>Presence of foreign body</p> Signup and view all the answers

    When repairing a laceration through the vermilion border of the lip, what is the first step?

    <p>Use traction to align the lips</p> Signup and view all the answers

    What should be done when encountering intraoral injuries?

    <p>Irrigate as per normal procedure</p> Signup and view all the answers

    What is a distinguishing feature of wounds located on the face compared to other areas?

    <p>Lower incidence of infection</p> Signup and view all the answers

    What is essential to inspect for in lip lacerations?

    <p>Intraoral foreign bodies</p> Signup and view all the answers

    In a three-layer closure for through-and-through lip lacerations, which layer is sutured first?

    <p>Mucosal layer</p> Signup and view all the answers

    Which component of the skin is responsible for the majority of collagen production?

    <p>Dermis</p> Signup and view all the answers

    What stage of wound healing involves the development of an epithelial covering over an insutured wound?

    <p>Epithelialization</p> Signup and view all the answers

    Which stage of wound healing is primarily characterized by the movement of skin edges towards the center of the defect?

    <p>Contraction</p> Signup and view all the answers

    What can lead to persistent inflammation and result in poor wound healing?

    <p>Infection or foreign materials</p> Signup and view all the answers

    At what point in the wound healing process do fibroblasts begin synthesizing collagen?

    <p>By the fourth day</p> Signup and view all the answers

    What does scar maturation refer to in the context of wound healing?

    <p>Increase in scar strength and remodeling</p> Signup and view all the answers

    What is the main biological process served by the inflammation stage of wound healing?

    <p>Removal of debris and bacteria</p> Signup and view all the answers

    Which of the following statements about scar tissue is correct?

    <p>It continues to remodel for up to two years after a wound</p> Signup and view all the answers

    Study Notes

    Drug Overdose and Toxicity Overview

    • Major focus on actions of CNS stimulants and depressants, their toxicities, and treatment.
    • Recognition of signs and symptoms of common drug abuse and overdose.

    CNS Stimulants

    • Amphetamines

      • Act as central nervous system stimulants.
      • Examples include Ritalin, Adderall, Phentermine, and Methamphetamine.
      • Trigger sympathetic nervous system, leading to increased heart rate, pupil dilation, and reduced digestion.
      • Prevent reuptake of excitatory neurotransmitters, causing a constant state of excitation.
    • Signs and Symptoms of Amphetamine Toxicity

      • Euphoria, restlessness, talkativeness, anxiety, and agitation.
      • Physical symptoms include tachycardia, hypertension, chest pains, heart palpitations, and possible coma or myocardial infarction (MI).
      • Associated clinical signs include "meth mouth" and rampant caries.
    • Cocaine

      • A potent CNS stimulant and vasoconstrictor, also used as a local anesthetic.
      • Functions as a dopamine reuptake inhibitor, producing euphoria.
    • Signs and Symptoms of Cocaine Toxicity

      • Symptoms include anxiety, agitation, hyperthermia, seizures, and hallucinations.
      • Additional physical symptoms involve tachycardia, chest pain, hypertension, ventricular fibrillation, and potential cerebrovascular accidents (CVA).

    Emergency Management of Amphetamine & Cocaine Toxicity

    • Urgent actions include contacting EMS, positioning patient for comfort, and monitoring vital signs.
    • Follow C-A-B guidelines (Circulation, Airway, Breathing) as necessary.
    • Benzodiazepines may be administered by trained professionals.
    • Cooling the patient's skin with lukewarm water and air fans is recommended.
    • Avoid the use of emetics, as this may induce seizures.

    CNS Depressants

    • Opioids

      • Derived from the opium poppy, with natural sources like morphine and codeine, and synthetic drugs such as heroin and fentanyl.
      • Can be taken orally, smoked, or injected.
    • Mechanism of Action of Opioids

      • Bind to specific opioid receptors in the CNS and spinal cord, resulting in sedation, euphoria, and pain reduction.
      • Inhibit gastrointestinal motility, leading to constipation.
    • Signs and Symptoms of Opioid Toxicity

      • Present with lethargy, pupil constriction, shallow breathing, hypotension, bradycardia, and flaccid muscles.
      • Severe overdose can lead to coma, respiratory depression, and death.
    • Benzodiazepines

      • Primarily used to treat anxiety, seizures, and muscle spasms.
      • Administered orally or via IM/IV routes (e.g., Valium, Xanax, Ativan).
      • Enhance the action of the inhibitory neurotransmitter GABA in the CNS.
    • Signs and Symptoms of Benzodiazepine Toxicity

      • Lethargy, slurred speech, ataxia, mental confusion, and potential for coma or respiratory arrest.

    Skin Anatomy

    • Epidermis: Composed of keratinized squamous epithelium, avascular in nature.
    • Dermis: Dense, fibro-elastic tissue that is highly vascularized; primarily made of fibroblasts which produce collagen and elastin.
    • Subcutaneous Layer: Connects the dermis to underlying tissues, containing varying amounts of adipose tissue.

    Wound Healing Stages

    • Hemostasis: Initial stage to stop bleeding.
    • Inflammation: Removes debris and bacteria; prolonged inflammation can lead to poor healing.
    • Epithelialization: Occurs within 24-48 hours in sutured wounds; impeded by eschar and debris.
    • Fibroplasia: Begins on the fourth day with fibroblasts synthesizing collagen, forming initial scar tissue.
    • Contraction: Skin edges move towards the center of the wound, influenced by surrounding muscle.
    • Scar Maturation: Scar strength increases rapidly from days 5-17, and continues to remodel for up to 2 years, never fully reaching original skin strength.

    Wound Evaluation - History

    • Identify factors affecting healing and risk of infection, including:
      • Mechanism and time of injury, environment, potential contaminants, animal species in bites, and patient's medical history.
    • Assess tetanus immunization status and consider handedness or vocation.

    Wound Infection Risk Factors

    • Risk factors include older age, diabetes, width of laceration, and presence of foreign bodies.

    Specific Wounds – Face

    • Facial wounds are less prone to infection due to high vascularity.
    • Debridement should be minimal to maintain facial contours.
    • Aggressive layered closure is recommended for facial wounds.

    Specific Wounds - Lips

    • Anatomy: Includes skin, vermilion border, vermilion, oral mucosa, and obicularis oris.
    • Always inspect lip wounds intraorally for foreign bodies like teeth fragments.
    • For lacerations through the vermilion border:
      • Use traction for alignment before stitching, starting at the vermilion border.
      • Repair the orbicularis oris and then the skin.
    • Through and through lacerations require a three-layer closure:
      • Mucosal layer (rapidly absorbable suture).
      • Orbicularis oris.
      • Skin layer.

    Specific Wounds – Intraoral

    • Normal irrigation practices apply.
    • Lacerations of the buccal mucosa and gingiva may heal without repair if edges are not widely separated.

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    Description

    This quiz covers the recognition and treatment of drug overdose and toxicity in dental practice, focusing on CNS stimulants and depressants. It emphasizes the signs and symptoms of toxicity from commonly abused drugs, and appropriate treatment modalities for affected patients.

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