DDS Dental Pharmacology and Anesthesia

Question 1

The maximum recommended dose of lidocaine with epinephrine (1:100,000) for a healthy 70 kg adult dental patient is approximately:

Accepted Answer

500 mg (≈13.9 carpules)

Answer

200 mg (≈5.5 carpules)

Answer

100 mg (≈2.7 carpules)

Answer

700 mg (≈19.4 carpules)

Question 2

Which local anesthetic has the longest duration of action for dental pulp anesthesia?

Accepted Answer

Bupivacaine

Answer

Lidocaine

Answer

Prilocaine

Answer

Mepivacaine

Question 3

Methemoglobinemia is a specific adverse effect associated with which local anesthetic?

Accepted Answer

Prilocaine

Answer

Lidocaine

Answer

Bupivacaine

Answer

Articaine

Question 4

Epinephrine in local anesthetic cartridges acts by:

Accepted Answer

Causing local vasoconstriction to slow systemic absorption and prolong anesthesia

Answer

Directly blocking sodium channels to enhance anesthesia depth

Answer

Raising the pH of the solution to increase un-ionized free base form

Answer

Inhibiting prostaglandin synthesis at the injection site

Question 5

The pKa of lidocaine is approximately 7.9. In an infected (acidic) tissue environment, anesthesia is difficult because:

Accepted Answer

More of the drug is in the ionized (charged) form, which cannot penetrate the nerve membrane

Answer

Infection destroys the drug before it can act

Answer

The pH rise increases vasoconstriction and limits drug delivery

Answer

Acidic tissue accelerates myelination of nerve fibers

Question 6

Which drug is used to reverse soft tissue anesthesia after dental procedures by antagonizing epinephrine's vasoconstriction?

Accepted Answer

Phentolamine mesylate (OraVerse)

Answer

Naloxone

Answer

Flumazenil

Answer

Atropine