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(2) Emergency Drugs in Dental Practice

(2) Emergency Drugs in Dental Practice

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Published by Rishwan Omer Salih

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Published by: Rishwan Omer Salih on Jun 09, 2009
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01/14/2013

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EMERGENCY DRUGS IN DENTAL PRACTICEINTRODUCTIONCollapse of a patient in the dental surgery is an infrequent occurrence whose incidence islargely unknown. Dentists must be aware of the potential medical complications that mayarise through the delivery of dental care to medically compromised patients.This article reviews the more common emergency drugs that the dental team may have toadminister in general dental practice. Practitioners administrating general anesthetics andusing intravenous sedation techniques should undergo recognized training in advancecardiac life support.The drugs commonly used are1.oxygen2.adrenaline3.glyceryl trinitrate4.nitrous oxide5.glucagon6.glucose7.salbutamol8.hydrocortisone9.diazepam10.flumazenil ; and11.chlorpheniramineIn all cases, the best method of managing medical emergencies is by preventing themfrom occurring in the first place. With this in mind, it is essential to take a comprehensivemedial history from any patient about to receive dental care. This will:
help to warn the clinician about any potential complications that may arise duringdental treatment;
indicate necessary preventive measures that can be taken to help prevent a crisis;and
aid in the rapid diagnosis of the cause of collapse.
 
Drug Indications Administration DoseAdults childrenOxygen All emergenciesexcepthyperventilationFace mask Bag valve mask 4-6l/min10 l/minAdrenaline Anaphylaxis intramuscular0.5-1mg10µg/kgGlyceryl trinitrate Acute chest pain Sublingual 0.3-1mgNot appropriate Nitrous oxide MyocardialinfarctionInhalation 50% oxygen+50% nitrousoxideGlucagon Hypoglycaemia Intramuscular 1mg 0.5mg(under 12years)Glucose HypoglycaemiaIntravenous 50ml of 50%1-2ml/kg of 50%SalbutamolAcute asthma Inhalation 2 puffsupto20times1 puff upto 20timesHydrocortisone Prophylaxis andtreatment of acute adrenalcrisis;anaphylaxis;asthmaIntramuscular200mg25mg(<1yr);50mg(1-5yrs);100mg(6-12yrs)Diazepam StatusepilepticusIntravenousRectal solution10 mg10mg200-300µg/kg5mg(1-3yrs);100mg(6-12yrs)Flumazenil Benzodiazepine-inducedrespiratorydepressionIntravenous 200µgover 15s,then100µgevery60s.max1mgInadequate dataChlorpheniramine AnaphylaxisUrticariaIntramuscular Oral10-20mg4mg tds200µg/kg(<12yrs);1mg/12h(1-2yrs);1mg/8h(2-5yrs)2mg/8h(6-12yrs)

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