4- oral sedation
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Questions and Answers

What is the defining characteristic of a monitor as opposed to an instrument?

  • It measures the central nervous system
  • It measures physiologic functions
  • It delivers an audible or visual warning when the measured function falls outside predetermined parameters (correct)
  • It is noninvasive

    • Which of the following is NOT a requirement of the ideal monitoring device according to the text?

  • Highly technical (correct)
  • Reliable
  • Stable
  • Easily integrated with other monitoring equipment

    • Which physiologic functions are typically measured by monitoring devices according to the text?

  • Immune system, Digestive system, Skeletal system, Endocrine system
  • Central nervous system, Respiratory system, Cardiovascular system, Temperature (correct)
  • Muscular system, Endocrine system, Skeletal system, Digestive system
  • Urinary system, Lymphatic system, Integumentary system, Reproductive system

    • What is the recommended heart rate range for adults before starting treatment?

    <p>Between 60 and 110 beats per minute</p> Signup and view all the answers

    In which type of sedation is continuous pulse monitoring mandatory?

    <p>General anesthesia</p> Signup and view all the answers

    Which vital signs are recommended to be monitored at regular intervals during parenteral sedation?

    <p>Pulse, blood pressure, and oxygen status</p> Signup and view all the answers

    What blood pressure level represents an ASA 4 risk according to the text?

    <p>a and b</p> Signup and view all the answers

    Which method is mentioned as the second method to determine the status of a patient’s cardiovascular system?

    <p>Blood pressure monitoring</p> Signup and view all the answers

    At what blood pressure level should medical consultation and management be sought before the start of elective dental or surgical care?

    <p>200 mm Hg systolic</p> Signup and view all the answers

    Why is intra-arterial blood pressure monitoring not really needed during outpatient sedation?

    <p>Outpatient sedation typically involves lower risk procedures</p> Signup and view all the answers

    Why are standard lead I (right arm → left arm) or lead II (right arm → left leg) most commonly used during anesthesia for electrocardiography?

    <p>They permit excellent detection of dysrhythmias</p> Signup and view all the answers

    What increases one’s ability to detect possibly significant changes in the functioning of the myocardium at a time when corrective treatment may usually restore a normal rhythm?

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

    When are dysrhythmias more likely to appear, according to the text?

    <p>During general anesthesia</p> Signup and view all the answers

    What are two common causes of dysrhythmias according to the text?

    <p>Hypoxia and endogenous catecholamine release</p> Signup and view all the answers

    Why is casual monitoring by observation of the rise and fall of the patient’s chest considered unreliable?

    <p>It may not detect respiratory depression or arrest in time</p> Signup and view all the answers

    What is the value of the precordial-pretracheal stethoscope as a monitoring device?

    <p>It is valuable for monitoring breathing during general anesthesia and sedation</p> Signup and view all the answers

    When is tachypnea most likely to occur according to the text?

    <p>In the presence of anxiety or pathologic conditions</p> Signup and view all the answers

    What does bradypnea indicate according to the text?

    <p>It is noted after administration of larger doses of opioid agonist analgesics</p> Signup and view all the answers

    What is the main function of a pulse oximeter as mentioned in the text?

    <p>Detecting and quantifying hypoxemia</p> Signup and view all the answers

    Which wavelengths of light does the pulse oximeter measure as they pass through living tissue?

    <p>660 nm and 910 nm</p> Signup and view all the answers

    What percentage of patients who received anesthesia demonstrated hypoxia during routine surgical procedures in one study mentioned in the text?

    <p>53%</p> Signup and view all the answers

    Which type of hemoglobin absorbs the selected wavelengths of light measured by the pulse oximeter?

    <p>Both HbO2 and Hb</p> Signup and view all the answers

    What principle do noninvasive CO2 monitors use to measure the levels of inspired and end-tidal CO2?

    <p>Infrared absorption</p> Signup and view all the answers

    When do audible and visual alarms alert the operator when using CO2 monitors?

    <p>When apnea occurs</p> Signup and view all the answers

    What is the frequency with which the CO2 monitor assesses the patient's breath?

    <p>Every breath taken by the patient</p> Signup and view all the answers

    What does the bispectral (BIS) index range from, as mentioned in the text?

    <p>0 to 100</p> Signup and view all the answers

    What does the Aspect EEG monitor quantitate?

    <p>Hypnotic component of anesthesia</p> Signup and view all the answers

    What is the main purpose of Bispectral Electroencephalographic Monitoring (BIS Monitoring) as mentioned in the text?

    <p>Quantitating anesthetic effects on the brain</p> Signup and view all the answers

    Why is it important to determine whether a patient has an elevated temperature before the start of planned treatment?

    <p>To assess the impact on the cardiovascular and respiratory systems</p> Signup and view all the answers

    Which route is mentioned as the most practical method for routinely monitoring temperature in a dental office?

    <p>Oral route</p> Signup and view all the answers

    What is the advantage of using digital thermometers for monitoring body temperature?

    <p>They provide a rapid assessment of body temperature</p> Signup and view all the answers

    What is one of the purposes of preparing a written record for each patient during the administration of sedative or anesthetic drugs?

    <p>To serve as a trend plot of vital values</p> Signup and view all the answers

    What is a disadvantage of oral sedation mentioned in the text?

    <p>Reliance on patient compliance</p> Signup and view all the answers

    What is an advantage of oral sedation according to the text?

    <p>Decreased severity of adverse reactions</p> Signup and view all the answers

    Which factor influences the absorption of drugs from the GI tract by affecting the gastric emptying time?

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

    In what form are drugs more rapidly absorbed, according to the text?

    <p>Aqueous solution</p> Signup and view all the answers

    What is estimated to be delayed by as much as two times in a fearful patient, thereby delaying the onset of action of anti-anxiety drugs?

    <p>Gastric emptying time</p> Signup and view all the answers

    What is the primary use of the oral route mentioned in the text?

    <p>Anxiety management</p> Signup and view all the answers

    What is a common problem with recommended doses mentioned in the text?

    <p>They often lead to inadequate anxiety reduction in the dental setting</p> Signup and view all the answers

    What is the primary purpose of titration by appointment?

    <p>To assess the efficacy of sedation achieved at the first appointment and adjust drug dosage if necessary</p> Signup and view all the answers

    Why is titration by appointment important dentistry?

    <p>To ensure that the appropriate drug dosage is achieved through gradual adjustments</p> Signup and view all the answers

    Which type of sedative-hypnotics is not a benzodiazepine?

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

    At what dosage do benzodiazepine sedative-hypnotics produce hypnosis?

    <p>Higher dosages</p> Signup and view all the answers

    Which sedative-hypnotic is a chloral derivative?

    <p>Chloral hydrate</p> Signup and view all the answers

    Where are the specific receptors for benzodiazepines isolated?

    <p>Within the spinal cord and the brain</p> Signup and view all the answers

    At what doses do benzodiazepines depress the limbic system and thalamus, according to the text?

    <p>Doses smaller than those depressing the reticular activating system (RAS) and the cerebral cortex</p> Signup and view all the answers

    What distinguishes the depressant effects of benzodiazepines from barbiturates?

    <p>Benzodiazepines depress the limbic system at smaller doses than those depressing the reticular activating system (RAS) and the cerebral cortex, unlike barbiturates</p> Signup and view all the answers

    Which benzodiazepine is most suited for patients requiring minimal to moderate sedation to sleep restfully the evening before their treatment?

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

    What is the primary use of oral triazolam in dentistry in North America?

    <p>Promotion of restful sleep before treatment</p> Signup and view all the answers

    Why is it important to consider the onset and duration of action when choosing a specific benzodiazepine for a patient?

    <p>To meet the needs of both the patient and the dentist</p> Signup and view all the answers

    What is a contraindication for the use of Valium (Diazepam)?

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

    When is the peak time for Valium (Diazepam)?

    <p>1 hour</p> Signup and view all the answers

    What is the recommended dose of Valium (Diazepam) 1 hour before treatment?

    <p>5-10 mg</p> Signup and view all the answers

    What is the oral dose of Versed (Midazolam) mentioned in the text?

    <p>5 mg/kg</p> Signup and view all the answers

    What is the primary advantage of using Versed (Midazolam) over valium?

    <p>More potent</p> Signup and view all the answers

    What is the typical peak time for triazolam (Halcion) mentioned in the text?

    <p>1 hour</p> Signup and view all the answers

    What is the recommended dose range for triazolam (Halcion) as mentioned in the text?

    <p>0.125-5 mg</p> Signup and view all the answers

    What is the recommended dosage range for Alprazolam (Xanax) according to the text?

    <p>0.25-1.0 mg</p> Signup and view all the answers

    What is a contraindication for the use of Alprazolam (Xanax) as mentioned in the text?

    <p>Acute narrow angle glaucoma</p> Signup and view all the answers

    What is the dosage range for Zolpidem (Ambien) as mentioned in the text?

    <p>5-10 mg</p> Signup and view all the answers

    What is the primary purpose of Flumazenil as mentioned in the text?

    <p>To compete with benzodiazepine for receptor site</p> Signup and view all the answers

    What is the usual dose of Flumazenil for reversing CNS and respiratory depressant effects?

    <p>0.2 mg IV over 15 seconds</p> Signup and view all the answers

    What is the total dose of Flumazenil that can be administered to reverse CNS and respiratory depressant effects?

    <p>1 mg</p> Signup and view all the answers

    What is the peak time for Noctec (chloral hydrate) according to the text?

    <p>1/2 hour to 1 hour</p> Signup and view all the answers

    What is the duration of action for Noctec (chloral hydrate) as mentioned in the text?

    <p>4-8 hours</p> Signup and view all the answers

    What is the average dose of Noctec (chloral hydrate) according to the text?

    <p>500-2000 mg</p> Signup and view all the answers

    What is the duration of action for Benadryl (diphenhydramine) as mentioned in the text?

    <p>4-6 hours</p> Signup and view all the answers

    What is the concentration of diphenhydramine in the elixir form of Benadryl (diphenhydramine) according to the text?

    <p>12.5 mg/5ml/teaspoon</p> Signup and view all the answers

    What is the typical peak time for Benadryl (diphenhydramine) according to the text?

    <p>1 hour</p> Signup and view all the answers

    What effect do opioids produce when administered alone in the absence of pain?

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

    What is the recommended dose of triazolam (Halcion) for dental procedures of moderate length?

    <p>0.125–0.5 mg</p> Signup and view all the answers

    Why is it prudent to start with a shorter appointment and less invasive treatment when using a sedative agent for dental procedures?

    <p>To gauge the appropriateness of the chosen sedative agent</p> Signup and view all the answers

    For longer dental appointments (2–4 hours), which benzodiazepine is recommended based on its longer acting nature?

    <p>Lorazepam (Ativan)</p> Signup and view all the answers

    What has been shown to be effective for short dental procedures (1 hour) based on the text?

    <p>Zaleplon 10–20 mg given 1 hour prior</p> Signup and view all the answers

    What is the recommended time for evaluating the efficacy of the sedation after administering the sedative drug?

    <p>45 minutes</p> Signup and view all the answers

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