Anesthesia and pain management

Can patients with chronic hep C with cirrhosis use Tylenol (acetaminophen)

Yes, up to 2g/day. You cannot use NSAID’s (Ibuprofen or advil)

T/F: NSAID’s are contraindicated for patients taking ACE inhibitors like lisinopril

T

What are the 2 synthetic opioids

Fentanyl and methadone

What are the 2 semi-synthetic opioids

Oxycodone and hydrocodone

What are the 2 natural opioids

Morphine and codeine

What are examples of schedule 2 drugs

Vicodin/Hydrocodone, cocaine, and meth

What are examples of schedule 1 drugs

Heroin and LSD

What are examples of schedule 3 drugs

Tylenol with codeine, ketamine, and testosterone

What are examples of schedule 4 drugs

Xanax, valium, tramadol

What are examples of schedule 5 drugs

Robitussin AC and Lyrica

What does epinephrine bind to to cause vasoconstriction

Alpha-1

What block should be used to anesthetize all ipsilateral mandibular teeth

Gow gates

What is Naproxen/Aleve

NSAID with side effects of rash, vision change, tinnitus, fatigue, headache, confusion, and dizziness

Articaine is a pregnancy category _ drug meaning what

Category C, meaning it should be used with caution

What are the 2 local anesthetics that are 100% safe to be used on a pregnant woman

Lidocaine and prilocaine

T/F: Codeine is contraindicated in liver failure

T

What is methadone used for

Helps prevent withdrawal symptoms

What are the 3 ester local anesthetics

Procaine, benzocaine, and tetracaine

What is the minimum % of oxygen needed during nitrous

30%

If a patient OD’s on opioids, what should be given

Naloxone

What are symptoms of local anesthetic toxicity

Dizzy, excessive talking, hypertension, anxiety, and confusion

What is a common side effect of opioid use

Constipation

What is the maximum epinephrine does you should give to a patient with cardiovascular disease

0.04mg

What compound acts as a buffer in local anesthetics

Sodium bicarbonate

What local anesthetic has a black label

Prilocaine 4% without epi

What local anesthetic has a yellow label

Prilocaine 4% with 1:100,000 epi

What is Capsaicin

A neurotoxin that depletes substance P from sensory nerves

What is the least common local anesthetic complication

Infection

What are enteral routes

Drug absorption through the GI, oral, rectal, and sublingual. NOT through submucosal

What does aspirin toxicity do

Decreases absorption of uric acid, causes tinnitus, GI bleed, and metabolic acidosis

How do you calculate Kg’s from lbs to figure out how much dose you can give a pt

Multiply the lbs by 0.45 to convert their weight into kg. Then multiply the kg by the max dose

T/F: You cannot give NSAID’s to patients with asthma

T

What LA is red

Lidocaine 1:100,000

What LA is green

Lidocaine 1:50,000

What LA is blue

Bupivicaine 0.5% 1:200,000

What LA is gold

Articaine 4% 1:100,000

What LA is gray

Articaine 4% 1:200,000

What is used to reverse LA in kids

Phentolamine/OraVerse

T/F: NSAID’s should be avoided in patients with kidney disease

T

Steroid drugs always end with what suffix

-one

T/F: Nitrous can interfere with vitamin B12 but not MI history

T

Epinephrine in local anesthetic does what to blood flow

Decreases it

When should diazepam/valium be taken

5mg an hour before the appointment or the night before

Intravascular injection can result in what

Tachycardia (increase in heart rate)

Benzodiazepam OD with Valium/diazepam is treated with what

Flumazenil

T/F: NSAID’s should be avoided in patients with GERD

T

T/F: Esters are more likely to cause an allergic reaction compared to amides

T

What is Triazolam

An anti-anxiety medication that should be taken for shorter appointments an hour before said appointment

What is the maximum dose of ibuprofen

800mg/day

Which local anesthetic is the most cardiotoxic

Bupivicaine

Where is the first pass metabolism of opioids

Liver

What is Naloxone

u-opioid receptor antagonist

What is commonly used for conscious IV sedation

Midazolam

What is morphine

A full mu-opioid receptor agonist that can increase pneumonia risk. It is analgesic (pain reliever) and anxiolytic

T/F: Dexmedetomide is an analgesic and anxiolytic

T

NSAID’s prevent the production of what

Prostaglandin production

Posterior superior alveolar nerve block requires a high tuberosity approach which increases the risk of what

hematoma

Is mandibular infiltration enough to anesthetize for extractions or pulpotomies

No