Please enable JavaScript.

Coggle requires JavaScript to display documents.

Local Anesthetic (Reason for failure (Inflammation and infection ("…

- - - - Block injection
      - PDL or intraosseous injection
      - Buccal / Lingual infiltration with articaine
- - - - <1% incidence of allergic reaction
      - Types
        
        Lidocaine HCl
        
        2% plain
        
        2% with 1:100,000 or 1:50,000 epinephrine
        
        Mepivicaine HCl
        
        3% plain
        
        2% with 1:20,000 levonordefrin
        
        Prilocaine HCl
        
        4% plain (Citanest)
        
        4% with 1:200,000 epinephrine (Citanest forte)
        
        Articaine HCl
        
        4% with 1:100,000 or 1:200,000 epinephrine
        
        Bupivicaine HCl
        
        0.5% with 1:200,000 epinephrine
      - Metabolism
        
        Primarily biotransformed in liver by P-450 cytochrome
        
        Articaine begins biotransformation in the bloodstream
        
        Decreased liver function
        
        Articaine a better agent
        
        Reduce maximum safe dosages
    - - High incidence of allergic reaction
      - Not available in US
  - - - Mepivicaine
      - Prilocaine
    - - Lidocaine
      - Mepivicaine
      - Articaine
      - Prilocaine
    - - Bupivicaine
    - - Prilocaine
      - Articaine
  - - - Lidocaine
        
        13.3 cartridge
      - Mepivicaine
        
        3% plain
        
        7.4 cartridges
        
        2% with levonordefrin
        
        11.1 cartridges
      - Prilocaine
        
        8.33 catridges
      - Articaine
        
        6.66 cartidges
    - - Half life
      - Vasoconstrictors
        
        Slow rate of uptake into bloodstream
        
        Increase the duration of anesthesia
        
        Induce localized hemostasis
        
        Concerns
        
        Existing systemic disease
        
        Medications that may have an adverse interaction with the agent
        
        Absolute contraindications
        
        Unstable angina
        
        Myocardial infarction within 6 months
        
        Coronary artery bypass surgery within 3 months
        
        Refractory arrhythmias
        
        Untreated or uncontrolled hypertension
        
        Untreated / uncontrolled congestive heart disease
        
        Uncontrolled diabetes or other endocrine diseases
        
        Relative contraindications
        
        Patients taking tricyclic antidepressants
        
        Phenothiazine antipsychotics
        
        Nonselective beta blockers
        
        Recreational drugs
- - - - Question patient
      - Probe area
    - - EPT
      - Cold test
  - - - Anesthetic agent
        
        Diffusion to the site
        
        Lipid solubility
        
        Protein binding to receptor sites
        
        Concentration
      - Technique
        
        Block
        
        Infiltration
        
        Works better in maxilla
        
        Better for anteriors and bicuspids
        
        Greater success using articaine
      - Vasoconstrictor presence
      - Anatomy
        
        Diameter of nerve bundle
        
        Amount of myelin sheath present
        
        Critical length
        
        3 nodes minimum (5 mm)
    - - Transport / perfusion rate
      - Disassociation rate
      - Re-association rate
      - Binding rate