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Pharmacology and Therapeutics Flashcards

7 cards from real NBDE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Pharmacology and Therapeutics flashcards as text

  1. Which alpha-2 adrenergic agonist is used as an adjunct for sedation in dentistry and can cause rebound hypertension upon abrupt withdrawal?

    Answer: Clonidine

    Clonidine acts centrally on alpha-2 receptors to reduce sympathetic outflow; abrupt withdrawal causes rebound hypertension due to sympathetic surge.

  2. A patient taking SSRIs (e.g., fluoxetine) is prescribed tramadol for postoperative pain. The PRIMARY concern with this combination is:

    Answer: Serotonin syndrome due to excess serotonergic activity

    Both SSRIs and tramadol increase serotonergic transmission; combining them raises the risk of serotonin syndrome (agitation, hyperthermia, clonus).

  3. Which property of a local anesthetic MOST determines its duration of action?

    Answer: Degree of protein binding

    Local anesthetics with higher protein binding (e.g., bupivacaine at ~95%) remain bound to sodium channel proteins longer, extending their duration of action.

  4. Vasopressin (felypressin) is used as a vasoconstrictor with prilocaine. Compared to epinephrine, it is PREFERRED in patients with:

    Answer: Severe cardiovascular disease or thyrotoxicosis

    Felypressin acts on V1 receptors without beta-adrenergic stimulation, making it safer in patients with ischemic heart disease or hyperthyroidism.

  5. Which drug is used to treat acute narrow-angle glaucoma that can be precipitated by anticholinergic premedications given in dentistry?

    Answer: Pilocarpine eye drops

    Pilocarpine, a cholinergic miotic, reverses pupillary dilation and reduces intraocular pressure in acute angle-closure glaucoma.

  6. Epinephrine is included in local anesthetic solutions primarily to:

    Answer: Reduce systemic absorption and prolong anesthetic duration

    Epinephrine causes local vasoconstriction, slowing systemic absorption of the anesthetic, which prolongs duration and reduces peak plasma toxicity.

  7. A patient undergoing IV sedation receives too much midazolam and becomes apneic. After airway management, which reversal agent should be administered?

    Answer: Flumazenil 0.2 mg IV titrated

    Flumazenil competitively reverses benzodiazepine-induced sedation and respiratory depression; it is titrated in 0.2 mg increments to avoid resedation.