ADAT Dental Pharmacology 1 — Questions and Answers
Question 1: Which local anesthetic has the longest duration of action and is most commonly used for prolonged dental procedures?
- Lidocaine
- Mepivacaine
- Bupivacaine (Correct answer)
- Prilocaine
Correct answer: Bupivacaine
Bupivacaine has the longest duration of action among local anesthetics used in dentistry, making it ideal for lengthy procedures.
Question 2: What is the maximum safe dose of lidocaine with epinephrine for a healthy adult patient?
- 3.0 mg/kg up to 300 mg
- 4.4 mg/kg up to 500 mg
- 7.0 mg/kg up to 500 mg (Correct answer)
- 2.0 mg/kg up to 200 mg
Correct answer: 7.0 mg/kg up to 500 mg
The maximum safe dose of lidocaine with epinephrine is 7.0 mg/kg with an absolute maximum of 500 mg in healthy adults.
Question 3: Which analgesic is contraindicated in patients with aspirin-exacerbated respiratory disease (AERD)?
- Acetaminophen
- Opioid analgesics
- NSAIDs (Correct answer)
- Gabapentin
Correct answer: NSAIDs
NSAIDs, including aspirin and ibuprofen, are contraindicated in AERD because they can trigger severe bronchospasm.
Question 4: What is the mechanism of action of penicillin antibiotics?
- Inhibit bacterial DNA gyrase
- Inhibit bacterial cell wall synthesis by binding PBPs (Correct answer)
- Disrupt bacterial cell membrane integrity
- Inhibit bacterial protein synthesis at the 50S ribosome
Correct answer: Inhibit bacterial cell wall synthesis by binding PBPs
Penicillins bind penicillin-binding proteins (PBPs) and inhibit transpeptidation, disrupting bacterial cell wall synthesis.
Question 5: Which drug interaction is most clinically significant when prescribing metronidazole to a dental patient?
- Antacids reducing absorption
- Disulfiram-like reaction with alcohol (Correct answer)
- Reduced efficacy of acetaminophen
- Increased sedation with caffeine
Correct answer: Disulfiram-like reaction with alcohol
Metronidazole inhibits aldehyde dehydrogenase, causing a disulfiram-like reaction (flushing, nausea, vomiting) when combined with alcohol.
Question 6: Which vasoconstrictors are most commonly combined with local anesthetics in dental cartridges in the US?
- Phenylephrine and norepinephrine
- Epinephrine and levonordefrin (Correct answer)
- Dopamine and epinephrine
- Vasopressin and levonordefrin
Correct answer: Epinephrine and levonordefrin
Epinephrine (1:50,000–1:200,000) and levonordefrin (1:20,000 with mepivacaine) are the two vasoconstrictors approved for use in US dental cartridges.
ADAT Dental Pharmacology 1
Which local anesthetic has the longest duration of action and is most commonly used for prolonged dental procedures?