Podcast
Questions and Answers
What is the most common systemic complication that occurs in a dental office?
What is the most common systemic complication that occurs in a dental office?
Which of the following is a predisposing factor for syncope related to psychogenic factors?
Which of the following is a predisposing factor for syncope related to psychogenic factors?
Which clinical manifestation occurs during the presyncope phase?
Which clinical manifestation occurs during the presyncope phase?
What is the primary goal when managing a patient experiencing syncope?
What is the primary goal when managing a patient experiencing syncope?
Signup and view all the answers
Which position should a patient be placed in if they exhibit syncope?
Which position should a patient be placed in if they exhibit syncope?
Signup and view all the answers
Which of the following is a management step for vasodepressor syncope?
Which of the following is a management step for vasodepressor syncope?
Signup and view all the answers
What can be a physical, non-psychogenic factor contributing to syncope?
What can be a physical, non-psychogenic factor contributing to syncope?
Signup and view all the answers
During the syncope phase, which of the following is NOT a typical clinical manifestation?
During the syncope phase, which of the following is NOT a typical clinical manifestation?
Signup and view all the answers
What is the primary action to take when a patient regains consciousness after a syncopal episode?
What is the primary action to take when a patient regains consciousness after a syncopal episode?
Signup and view all the answers
What is one effective method to prevent the toxicity associated with local anesthetics?
What is one effective method to prevent the toxicity associated with local anesthetics?
Signup and view all the answers
Which factor is NOT a cause of toxicity in local anesthetics?
Which factor is NOT a cause of toxicity in local anesthetics?
Signup and view all the answers
What is a common manifestation of a severe local anesthetic overdose?
What is a common manifestation of a severe local anesthetic overdose?
Signup and view all the answers
Which local anesthetic is considered the most toxic which may lead to overdose reactions?
Which local anesthetic is considered the most toxic which may lead to overdose reactions?
Signup and view all the answers
What can lead to an elevated blood level of lidocaine and ensure an overdose reaction?
What can lead to an elevated blood level of lidocaine and ensure an overdose reaction?
Signup and view all the answers
What is a potential risk of injecting local anesthetics too quickly?
What is a potential risk of injecting local anesthetics too quickly?
Signup and view all the answers
Which of the following practices is recommended in prevention of local anesthetic toxicity?
Which of the following practices is recommended in prevention of local anesthetic toxicity?
Signup and view all the answers
Which symptom is associated with generalized tonic-clonic seizures?
Which symptom is associated with generalized tonic-clonic seizures?
Signup and view all the answers
What is the appropriate action to take in the management of local anesthetics overdose?
What is the appropriate action to take in the management of local anesthetics overdose?
Signup and view all the answers
Which of the following is a sign of vasoconstrictor overdose?
Which of the following is a sign of vasoconstrictor overdose?
Signup and view all the answers
What is the recommended patient position during vasoconstrictor overdose management?
What is the recommended patient position during vasoconstrictor overdose management?
Signup and view all the answers
Which statement best describes idiosyncrasy in relation to drug responses?
Which statement best describes idiosyncrasy in relation to drug responses?
Signup and view all the answers
Which of the following actions should be taken if a patient exhibits anxiety during vasoconstrictor overdose?
Which of the following actions should be taken if a patient exhibits anxiety during vasoconstrictor overdose?
Signup and view all the answers
What is the first step in managing symptoms of local anesthetic overdose?
What is the first step in managing symptoms of local anesthetic overdose?
Signup and view all the answers
Which of these symptoms is a common manifestation of vasoconstrictor overdose?
Which of these symptoms is a common manifestation of vasoconstrictor overdose?
Signup and view all the answers
What characterizes urticaria in patients experiencing allergic reactions?
What characterizes urticaria in patients experiencing allergic reactions?
Signup and view all the answers
Which of the following is NOT a common allergen related to allergic reactions?
Which of the following is NOT a common allergen related to allergic reactions?
Signup and view all the answers
Which immediate management step is recommended when a patient shows signs of urticaria?
Which immediate management step is recommended when a patient shows signs of urticaria?
Signup and view all the answers
In the management of suspected anaphylaxis, what is one of the initial steps to take?
In the management of suspected anaphylaxis, what is one of the initial steps to take?
Signup and view all the answers
What symptom is associated with bronchospasm during an allergic reaction?
What symptom is associated with bronchospasm during an allergic reaction?
Signup and view all the answers
Which of the following medications would be inappropriate for immediate management of skin reactions in allergies?
Which of the following medications would be inappropriate for immediate management of skin reactions in allergies?
Signup and view all the answers
Which of the following is a respiratory symptom of an allergic reaction?
Which of the following is a respiratory symptom of an allergic reaction?
Signup and view all the answers
In managing severe allergic reactions, what is the purpose of corticosteroid administration?
In managing severe allergic reactions, what is the purpose of corticosteroid administration?
Signup and view all the answers
Study Notes
Systemic Complications of Local Anesthesia
-
Syncope (fainting)
-
Definition: Sudden, temporary loss of consciousness due to cerebral ischemia.
-
Incidence: Most common dental office complication.
-
Synonyms: Psychogenic syncope, vasodepressor attack, vasovagal syncope, fainting.
-
Predisposing factors (psychogenic): Anxiety, severe pain, emotional stress, sight of blood/instruments.
-
Predisposing factors (physical): Prolonged standing, exhaustion, hunger/starvation, hot/crowded environment.
-
Clinical manifestations: Pallor, perspiration, visual disturbances, coldness of hands/feet, nausea, dizziness, tachycardia, low blood pressure, weak pulse, dilated pupils, irregular breathing.
-
Treatment:
- Terminate procedure.
- Call medical assistance/activate emergency code.
- Place patient in Trendelenburg position (supine with head below legs).
- Monitor vital signs.
- For vasodepressor syncope: Inhale aromatic ammonia, administer 6L/min oxygen.
-
-
Toxicity (Overdose)
-
Definition: Clinical manifestations resulting from excessively high drug levels in target organs.
-
Causes: Intravascular injection, rapid drug absorption, presence of vasoconstrictor, rapid IV administration, too large dose, slow biotransformation, slow drug elimination (renal dysfunction)
-
Local anesthetics can cause CNS and cardiovascular depression
-
Presentation of toxicity: increased excitation, headache, dizziness, muscle twitching (face and extremities), blurred vision, auditory disturbances, numbness, talkativeness, increased heart rate and breathing, increased blood pressure, gagging, vomiting, tremors, consciousness loss, generalised tonic-clonic seizures.
-
Management:
- Stop drug administration
- Summon medical assistance
- Monitor vital signs
- Administer Intravenous Anticonvulsant, such as Diazepam, Midazolam.
-
-
Idiosyncrasy
- Definition: Any unexpected reaction to a drug (different from expected response), not attributable to overdose or allergy.
- Cause: Genetic mechanism.
-
Allergy
-
Definition: Exaggerated immune response to a normally harmless substance.
-
Allergens: Esters (Para-amino-benzoic-acid products), Sodium Bisulfite/Metabisulfite, Methylparaben.
-
Prevention: Preanesthetic evaluation, avoid drugs reported in patient history, refer for local anesthetic allergy testing.
-
Signs and symptoms: Urticaria (hives), angioedema (swelling), respiratory distress (bronchospasm, laryngeal edema), cardiovascular symptoms (tachycardia, palpitations, hypotension), gastrointestinal symptoms (nausea, vomiting), genitourinary symptoms (incontinence), loss of consciousness.
-
Management (immediate onset skin signs):
- Stop all drugs
- Call medical help
- Administer antihistamine (IM or IV)
- Administer corticosteroid
- Monitor vital signs
- Consult physician.
- Observe in office for an hour
-
Management (anaphylaxis):
- Immediately stop procedure
- Clear airway, call for help
- Place patient supine (semi-reclined if respiratory distress)
- Administer epinephrine (IM) immediately
- Monitor vital signs continuously
- Repeat epinephrine every 5 minutes if needed.
- Administer oxygen, antihistamine, and corticosteroids as directed.
- Prepare for transport.
-
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the systemic complications associated with local anesthesia, focusing on syncope or fainting. It includes definitions, predisposing factors, clinical manifestations, and treatment protocols. Enhance your understanding of this common dental complication.
