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What is the most common complication of local anesthetic administration in a dental office?
What is the most common complication of local anesthetic administration in a dental office?
Which of the following is NOT a physical factor that increases the risk of syncope?
Which of the following is NOT a physical factor that increases the risk of syncope?
What is one of the management steps for a patient experiencing syncope?
What is one of the management steps for a patient experiencing syncope?
Which of the following symptoms is associated with the presyncope phase of syncope?
Which of the following symptoms is associated with the presyncope phase of syncope?
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Which term is synonymous with the common name for syncope?
Which term is synonymous with the common name for syncope?
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What position should a patient be placed in during an episode of vasodepressor syncope?
What position should a patient be placed in during an episode of vasodepressor syncope?
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What is the primary characteristic of urticaria in allergy responses?
What is the primary characteristic of urticaria in allergy responses?
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Inhalation of which substance is used to stimulate the respiratory system during a syncope episode?
Inhalation of which substance is used to stimulate the respiratory system during a syncope episode?
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Which of the following is a common cardiovascular symptom associated with allergic reactions?
Which of the following is a common cardiovascular symptom associated with allergic reactions?
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What is the first step in managing immediate-onset skin signs of allergy?
What is the first step in managing immediate-onset skin signs of allergy?
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What is one clinical manifestation of syncope?
What is one clinical manifestation of syncope?
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Which substance is identified as an allergen related to anesthetics?
Which substance is identified as an allergen related to anesthetics?
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In the management of anaphylaxis, what is the correct positioning of the patient?
In the management of anaphylaxis, what is the correct positioning of the patient?
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What neurological symptom can occur during an allergic reaction?
What neurological symptom can occur during an allergic reaction?
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Which of the following reactions does NOT typically occur in a respiratory allergic response?
Which of the following reactions does NOT typically occur in a respiratory allergic response?
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What is a common gastrointestinal symptom associated with allergic reactions?
What is a common gastrointestinal symptom associated with allergic reactions?
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What should be done first when a patient regains consciousness after experiencing post-syncope?
What should be done first when a patient regains consciousness after experiencing post-syncope?
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Which method is used to prevent inadvertent intravascular injection during local anesthetic administration?
Which method is used to prevent inadvertent intravascular injection during local anesthetic administration?
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What is the primary factor that leads to rapid absorption of local anesthetics into the circulation?
What is the primary factor that leads to rapid absorption of local anesthetics into the circulation?
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Which local anesthetic is known to be the most toxic when used?
Which local anesthetic is known to be the most toxic when used?
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What consequence results from rapid intravenous administration of lidocaine?
What consequence results from rapid intravenous administration of lidocaine?
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Which of the following strategies does not contribute to the prevention of toxicity from local anesthetics?
Which of the following strategies does not contribute to the prevention of toxicity from local anesthetics?
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What should be done regarding the maximum recommended dose of local anesthetics?
What should be done regarding the maximum recommended dose of local anesthetics?
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Which symptom is typically associated with mild to moderate overdose of local anesthetics?
Which symptom is typically associated with mild to moderate overdose of local anesthetics?
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What is one of the management steps for local anesthetic overdose toxicity?
What is one of the management steps for local anesthetic overdose toxicity?
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Which symptom is NOT associated with vasoconstrictor overdose toxicity?
Which symptom is NOT associated with vasoconstrictor overdose toxicity?
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What position is recommended for a patient experiencing vasoconstrictor overdose?
What position is recommended for a patient experiencing vasoconstrictor overdose?
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Which of the following treatments should be avoided in the case of local anesthetic overdose?
Which of the following treatments should be avoided in the case of local anesthetic overdose?
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What is the definition of idiosyncrasy in relation to local anesthetics?
What is the definition of idiosyncrasy in relation to local anesthetics?
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Which of the following is a symptom of generalized tonic-clonic seizures?
Which of the following is a symptom of generalized tonic-clonic seizures?
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During an overdose of local anesthetics, which of the following signs may NOT be observed?
During an overdose of local anesthetics, which of the following signs may NOT be observed?
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Which of the following is an appropriate intervention for managing a vasoconstrictor overdose?
Which of the following is an appropriate intervention for managing a vasoconstrictor overdose?
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Study Notes
Systemic Complications of Local Anesthesia
- Local anesthesia complications can include syncope, toxicity (overdose), idiosyncrasy, and allergy.
Syncope
- Definition: Sudden, temporary loss of consciousness due to cerebral ischemia.
- Incidence: Most common complication in dental offices.
- Synonyms: Vasodepressor attack, vasovagal syncope, fainting.
- Predisposing Psychogenic Factors: Anxiety, severe pain, emotional stress, sight of blood/instruments.
- Predisposing Physical Factors: Prolonged standing, exhaustion/hunger/starvation, hot/crowded environments.
- Clinical Manifestations: Paleness, perspiration, visual disturbances, restlessness, coldness of extremities, nausea, tachycardia, dizziness, low blood pressure, weak pulse, irregular breathing, pupillary dilation, loss of consciousness; presyncope (precursor signs).
- Postsyncope Management: Monitor vital signs, return patient to seated position, stop treatment for the day, record incident, arrange transport home.
- Management of Syncope: Terminate procedure, call medical assistance/emergency, place patient in Trendelenburg position (head lower than legs), acquire vital signs (BP, RR, HR, Temp.).
- Management of Vasodepressor Syncope: Inhale aromatic ammonia to stimulate respiratory system & raise blood pressure. Administer 6L/min of oxygen via mask or nasal hood.
Toxicity (Overdose)
- Definition: Clinical manifestations from an overly high blood level of a drug in various target tissues/organs.
- Causes: Intravascular injection (unintentional injection into a blood vessel leading to high drug levels rapidly), rapid absorption (drug diffusing into bloodstream quickly due to vasodilation from the anesthetic), presence of vasoconstrictor (reduces drug absorption). Rate of injection matters.
- Other Causes: Large dose, slow biotransformation (liver problem), slow elimination (kidney problem).
- Manifestations: Increased excitation, headache & dizziness, twitching, blurred vision, auditory disturbance, numbness, talkativeness, increased respiratory & heart rate, increased blood pressure, gagging & vomiting, tremors, drowsiness, hallucinations, disorientation, loss of consciousness (mild-moderate), generalized tonic-clonic seizures, depression of respiratory, heart, and blood pressure.
- Management: Stop procedure, reassure patient, administer oxygen, call medical assistance, monitor vital signs, administer Intravenous anticonvulsants (diazepam, midazolam).
Idiosyncrasy
- Definition: Unexpected response to medication that isn't an overdose or allergic reaction.
- Cause: Often due to genetic mechanisms.
Allergy
- Definition: Exaggerated immune response to harmless substance.
- Allergens: Esters, sodium bisulfite/metabisulfite (antioxidants), methylparaben (preservative).
- Prevention: Adequate pre-anesthetic evaluation, avoid known allergens, refer for testing for allergy.
- Clinical Manifestations: Dermatological (urticaria, angioedema, itching), respiratory (bronchospasm, laryngeal edema), cardiovascular (tachycardia, hypotension, cardiac arrest), gastrointestinal (nausea, vomiting, abdominal cramps), genitourinary (urinary incontinence), neurologic (lightheadedness, anxiety, impending doom).
- Management: Stop procedure, administer oxygen, call medical help, administer epinephrine, antihistamines (IM or IV), corticosteroids (IM or IV), closely monitor vital signs, prepare for transport.
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Description
Explore the various systemic complications associated with local anesthesia, including syncope, toxicity, and allergic reactions. This quiz covers the definitions, incidence, causes, and management of these complications, providing an in-depth look at each aspect.
