Pharmacology and Pain Management Flashcards

Which drug interaction is most concerning when prescribing metronidazole?

Answer: Warfarin — increased anticoagulant effect

Metronidazole inhibits CYP2C9, reducing warfarin metabolism and significantly increasing INR, raising the risk of bleeding.

Nitrous oxide/oxygen sedation is contraindicated in which patient?

Answer: A patient with chronic obstructive pulmonary disease (COPD)

Patients with COPD rely on hypoxic drive; supplemental oxygen via nitrous oxide sedation can suppress their respiratory drive and cause respiratory depression.

Naloxone is the reversal agent for which class of drugs?

Answer: Opioids

Naloxone is a competitive opioid receptor antagonist that rapidly reverses respiratory depression, sedation, and analgesia caused by opioid overdose.

Which medication used for oral sedation has the highest risk of paradoxical excitation in children?

Answer: Midazolam

Midazolam can cause paradoxical reactions (agitation, combativeness, increased anxiety) in approximately 1–15% of pediatric patients.

Penicillin V potassium is classified as which type of antibiotic?

Answer: Beta-lactam

Penicillin V is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins.

A patient on bisphosphonate therapy presents for a dental extraction. The primary concern is:

Answer: Medication-related osteonecrosis of the jaw (MRONJ)

Bisphosphonates inhibit osteoclast activity, impairing bone remodeling and healing, which can lead to MRONJ following invasive dental procedures.