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opioid use and abuse prevention 13 : Before prescribing opioids, health care providers should ensure that opioids are appropriately indicated, discuss the risks and benefits of opioid use and review treatment goals, and take a thorough history of substance use and review the prescription drug-monitoring program data to determine whether patients have received prior opioid prescriptions. Breast-feeding should be encouraged in women who are stable on their opioid agonists, who are not using illicit

Cardiology. Only an estimated 54% of those people have their condition under control. 2 Hundreds of thousands of deaths each year are primarily due to high blood pressure, 1 and this disease ends up costing patients in the United States $48.6 billion each year. 3 Because of the growing public health concern that is associated with hypertension, it is important that dental providers are knowledgeable about the implications, management, and treatment options available for the hypertensive patient. This article will provide a contemporary review of the definition

Part I of this series provided an overview of hypertension and the physiology of blood pressure regulation. In addition, drugs affecting predominantly renal control of hypertension were discussed. In part II, the remaining major antihypertensive medications will be reviewed as well as anesthetic implications of managing patients with hypertension. CALCIUM CHANNEL BLOCKERS The currently available calcium channel blockers (CCBs) inhibit the opening of L-type voltage-gated calcium channels, and when inward flux of

paresthesia than lidocaine. More recently, Garisto et al 15 reviewed claims of paresthesia in the United States during the period of November 1997 through August 2008 and found 248 cases of paresthesia following dental procedures. Most cases (∼95%) involved mandibular nerve blocks, and in 89% of these the lingual nerve was affected. Compared to other local anesthetics, paresthesia was found to be 7.3 times more likely with 4% articaine and 3.6 times more likely with 4% prilocaine. Similar findings from reports of paresthesia in Denmark were published by Hillerup

, and their benefit is limited to prophylactic regimens. Acupuncture has been fairly well established in the prevention of PONV. 16 It consists of stimulating the so-called P6 wrist point (located on the ventral surface of the forearm approximately 3 fingerwidths proximal to the wrist joint) by using acupuncture, acupressure, and other techniques. The reader is referred to an excellent review of principles and devices by Chernyak and Sessler. 17 Occasionally one hears anecdotal evidence regarding the use of ephedrine to prevent nausea and vomiting

Delivery of local anesthesia for dental procedures is a very common and quite safe practice. 1 , 2 Limited complications occur when providing either infiltration or block injections into the perioral tissues, and a number of these have been identified and presented in published case reports and reviews. 2 – 6 Although most of these reported complications have been relatively minor , there have been several descriptions of temporary, and occasional permanent, ocular disturbances following injection of local anesthetics. 7 – 16 This

. Benzodiazepines are sedative hypnotic agents that have been in clinical use since the 1960s for sedation, anterograde amnesia, anxiolysis, as well as treatment of seizures, substance withdrawal states, insomnia, and drug-associated agitation. Allergic reactions are rare, with few cases reported in literature. 3 , 4 Amid these sparse reports, a lack of consistent methods for diagnosis stimulates investigation into identification of the causative agent and classification of the observed reactions. BENZODIAZEPINE ALLERGY: REVIEW OF LITERATURE A

intent of decreasing excitability and physical activity while also creating a calming effect prior to dental treatment ( Tables 1 and 2 ). In addition, drugs with sedative and/or hypnotic effects can also be used with the intent of producing drowsiness or somnolence. 1 Understanding the key differences between various drug classes and available oral sedatives is imperative when developing an anesthetic plan that fits the needs of the patient and dental procedure. This review will discuss some of the common historical medications along with more contemporary agents

, Ghignone M , Quintin L. Dexmedtomidine and clonidine: from second- to first-line sedative agents in the critical care setting . J Intensive Care Med . 2012 ; 27 : 219 – 237 . 11 Carollo DS , Nossaman BD , Ramadhyani U. Dexmedetomidine: a review of