Hi,
I have a patient with severe dental phobia. I'd like to use something
to relax her before her appointments. She has responded quite poorly
to N2O and gotten very sick afterwards. I am thinking about Valium at
this time. What do you recommend and at what dosage.
Any help would be appreciated. I do not have much experience
pre-medicating with sedatives.

am

i use halcion 25 mg one tab two hrs prior to appt.  then one tab one hr
prior to appt.  the patients are sedate and the drug often induces
retrograde amnesia.  no memory of the visit is a good visit for some
terrified patients.  the effects are gone within 6-8 hrs but no driving or
caring for children.
no nausea.

sincerely
jason etherton

Hi There,
If a patient is in fear with shaking, than I given Aconite C15 1 h before
treatment,
but some more symptoms can be useful.
Proka

{*filter*}Versed (midazolam) from Roche,  is now available for in-office use.
Quick onset of action and short half-life, but expensive. And you have
to dispense it yourself to the patient, but according to the pedo guys
and gals it is the best available so far. Better than atarax, or valium,
or chl{*filter*}hydrate and predictable by mg/kg of body weight, not  a wild
ass guess as to what dosage will work.

Caveat is that you should have all the monitoring stuff available if you
use it e.g. pulse oximeter.

1 to 1.5mg of Xanax might help prior to treatment.  Safe, effective.  Have
someone to drive her home.

It's a great anxiolytic.

Jason, I'm not a doctor but rather a patient.  If you'll indulge me, I
think you misplaced the decimal on your recommended dosage.

And I'd like to add that the benefits you highlight definitely do not
work for everyone, and Halcion can certainly cause severe nausea,
vomiting, and vertigo in some people.  I might be unusual, but I wanted
to make the statement that one should try this ahead of time to ensure
it is adequate and tolerable.  It is definitely not fool proof enough to
trust for the first time for an anxious patient just prior to a
procedure.  Ditto for Xanax.

- Keith

a quick right hook to the jaw ought to do the trick!
=)

 > Halcion can certainly cause severe nausea

Any drug can probably be associated with almost any effect, but nausea is
very (I mean *very*) rare with benzodiazepines (in fact, they have an *anti*
nauseant effect).  Your case appears to be unusual, if not unique, in many
respects, so you can't generalize from yourself to other people's responses
to medication.

You're right about the decimal point of course.  I think even *you* would
become anxiety-free after twenty-five milligrams of Halcion -- e.g., a
bottle of 100 of the strongest tablets :)

 > It is definitely not fool proof enough to trust for
 > the first time for an anxious patient just prior to a
 > procedure.

That's like saying that the combination of Diprivan, fentanyl, and halothane
is "definitely not fool proof enough to trust for the first time" for
general anesthesia.  Believe me, in any non-tolerant individual (i.e.,
someone who does not regularly take benzos) -- with the exception of you --
the Halcion schedule that "am" described, or the dose of Xanax that
"Zugumba" described, will be more than enough to overcome any level of
anxiety.

By the way, I wish you luck in finding a dentist willing to administer a
fentanyl orlet in the office.  If that doesn't work, you may have to
consider a tire iron blow to the back of the head ...

 > If a patient is in fear with shaking, than I given
 > Aconite C15 1 h before treatment

Huh?  Why not try Graphite #2, or maybe just plain water?  Exactly as
effective, and cheaper.