Question 1

A patient can produce endogenous epinephrine far in excess of that administered in dentistry in the presence of inadequate anesthesia.

Accepted Answer

A) True 
 B)False  True

Question 2

Which agent has the greater proportion of a-adrenergic activity to b-adrenergic activity?

Accepted Answer

A)  Levonordefrin 
B)  Epinephrine 
C)  Neither-they have equivalent proportions. 
A)  Levonordefrin 
B)  Epinephrine 
C)  Neither-they have equivalent proportions. A

Question 3

Several cases of methemoglobinemia have been reported after the use of:

Accepted Answer

A)  lidocaine. 
B)  mepivacaine. 
C)  prilocaine. 
D)  articaine. 
A)  lidocaine. 
B)  mepivacaine. 
C)  prilocaine. 
D)  articaine. C

Question 4

Which nerve function is the most sensitive to inhibition by local anesthetic agents?

Accepted Answer

A)  Touch 
B)  Warmth 
C)  Pressure 
D)  Autonomic 
E)  Pain 
A)  Touch 
B)  Warmth 
C)  Pressure 
D)  Autonomic 
E)  Pain

Question 5

The rate of local anesthetic absorption is increased by the presence of local inflammation.

Accepted Answer

A) True 
 B)False

Question 6

Plain anesthetics without vasoconstrictor will exhibit a _____ duration of action and result in a _____ rapid buildup of a systemic blood level.

Accepted Answer

A)  shorter; less 
B)  shorter; more 
C)  longer; less 
D)  longer; more 
A)  shorter; less 
B)  shorter; more 
C)  longer; less 
D)  longer; more

Question 7

Lidocaine with epinephrine 1:100,000 provides a _____ duration of pulpal anesthesia.

Accepted Answer

A)  30-minute 
B)  30- to 60-minute 
C)  60- to 90-minute 
D)  90-minute or more 
A)  30-minute 
B)  30- to 60-minute 
C)  60- to 90-minute 
D)  90-minute or more

Question 8

Reducing the rate of systemic absorption of a local anesthetic is important when it is used in dentistry because:

Accepted Answer

A)  otherwise, too large an area would be anesthetized. 
B)  if not, the anesthesia would not last long enough to complete a dental procedure. 
C)  the chance of systemic toxicity is reduced. 
D)  local anesthesia is associated with respiratory depression. 
A)  otherwise, too large an area would be anesthetized. 
B)  if not, the anesthesia would not last long enough to complete a dental procedure. 
C)  the chance of systemic toxicity is reduced. 
D)  local anesthesia is associated with respiratory depression.

Question 9

The mechanism of local anesthetics involves action on:

Accepted Answer

A)  myelinated nerve. 
B)  axons. 
C)  sodium channels. 
D)  both a and c. 
E)  both b and c. 
A)  myelinated nerve. 
B)  axons. 
C)  sodium channels. 
D)  both a and c. 
E)  both b and c.

Question 10

Prilocaine plain has a duration of action slightly _____ than mepivacaine plain, and prilocaine with epinephrine has a duration of action slightly _____ than lidocaine with epinephrine.

Accepted Answer

A)  shorter; shorter 
B)  shorter; longer 
C)  longer; shorter 
D)  longer; longer 
A)  shorter; shorter 
B)  shorter; longer 
C)  longer; shorter 
D)  longer; longer

Question 11

Which of the following components of an injected amide local anesthetic agent may produce a hypersensitivity reaction that exhibits itself as an acute asthmatic attack?

Accepted Answer

A)  The vasoconstrictor 
B)  The antioxidant for the vasoconstrictor 
C)  The sodium hydroxide 
D)  The sodium chloride 
A)  The vasoconstrictor 
B)  The antioxidant for the vasoconstrictor 
C)  The sodium hydroxide 
D)  The sodium chloride

Question 12

A cardiac patient can be given _____ cartridges of a dental anesthetic with epinephrine 1:100,000 without exceeding the cardiac dose for the vasoconstrictor.

Accepted Answer

A)  0.5 
B)  2 
C)  4 
D)  6 
A)  0.5 
B)  2 
C)  4 
D)  6

Question 13

The maximal safe dose of lidocaine 2% with 1:100,000 epinephrine is approximately _____ cartridges.

Accepted Answer

A)  3 
B)  6.5 
C)  8.5 
D)  11.5 
A)  3 
B)  6.5 
C)  8.5 
D)  11.5

Question 14

Which of the following local anesthetic agents is both an ester and an amide?

Accepted Answer

A)  Benzonatate 
B)  Articaine 
C)  Bupivacaine 
D)  Dyclonine 
A)  Benzonatate 
B)  Articaine 
C)  Bupivacaine 
D)  Dyclonine

Question 15

Which of the following local anesthetic agents have the potential to cause methemoglobinemia as an adverse effect?

Accepted Answer

A)  Prilocaine and lidocaine 
B)  Lidocaine and mepivacaine 
C)  Prilocaine and mepivacaine 
D)  Prilocaine and articaine 
E)  Mepivacaine and articaine 
A)  Prilocaine and lidocaine 
B)  Lidocaine and mepivacaine 
C)  Prilocaine and mepivacaine 
D)  Prilocaine and articaine 
E)  Mepivacaine and articaine

Question 16

No justification exists for the use of epinephrine in a concentration greater than 1:200,000, except in cases in which hemostasis is needed.

Accepted Answer

A) True 
 B)False

Question 17

The following states are characteristics of the salt form of a local anesthetic except which one?

Accepted Answer

A)  Charged, cation (ionized) 
B)  Alkaline 
C)  Crystalline solid 
D)  Stable 
A)  Charged, cation (ionized) 
B)  Alkaline 
C)  Crystalline solid 
D)  Stable

Question 18

Addition of vasoconstrictor to local anesthetic (1)reduces blood supply to the area, (2)increases blood supply to the area, (3)limits systemic absorption, (4)increases systemic absorption, (5)reduces systemic toxicity, and (6)increases systemic toxicity.
Which of these are correct?

Accepted Answer

A)  1, 3, 5 
B)  1, 4, 5 
C)  2, 3, 5 
D)  2, 3, 6 
E)  2, 4, 6 
A)  1, 3, 5 
B)  1, 4, 5 
C)  2, 3, 5 
D)  2, 3, 6 
E)  2, 4, 6

Question 19

Levonordefrin is commonly combined with which local anesthetic?

Accepted Answer

A)  Lidocaine 
B)  Procaine 
C)  Mepivacaine 
D)  Bupivacaine 
A)  Lidocaine 
B)  Procaine 
C)  Mepivacaine 
D)  Bupivacaine

Question 20

Approximately _____% of articaine is metabolized by the liver.

Accepted Answer

A)  5 to 10 
B)  20 to 25 
C)  50 to 75 
D)  90 
A)  5 to 10 
B)  20 to 25 
C)  50 to 75 
D)  90

Exam 9: Local Anesthetics

A patient can produce endogenous epinephrine far in excess of that administered in dentistry in the presence of inadequate anesthesia.

Which agent has the greater proportion of a-adrenergic activity to b-adrenergic activity?

Several cases of methemoglobinemia have been reported after the use of:

Which nerve function is the most sensitive to inhibition by local anesthetic agents?

The rate of local anesthetic absorption is increased by the presence of local inflammation.

Plain anesthetics without vasoconstrictor will exhibit a _____ duration of action and result in a _____ rapid buildup of a systemic blood level.

Lidocaine with epinephrine 1:100,000 provides a _____ duration of pulpal anesthesia.

Reducing the rate of systemic absorption of a local anesthetic is important when it is used in dentistry because:

The mechanism of local anesthetics involves action on:

Prilocaine plain has a duration of action slightly _____ than mepivacaine plain, and prilocaine with epinephrine has a duration of action slightly _____ than lidocaine with epinephrine.

Which of the following components of an injected amide local anesthetic agent may produce a hypersensitivity reaction that exhibits itself as an acute asthmatic attack?

A cardiac patient can be given _____ cartridges of a dental anesthetic with epinephrine 1:100,000 without exceeding the cardiac dose for the vasoconstrictor.

The maximal safe dose of lidocaine 2% with 1:100,000 epinephrine is approximately _____ cartridges.

Which of the following local anesthetic agents is both an ester and an amide?

Which of the following local anesthetic agents have the potential to cause methemoglobinemia as an adverse effect?

No justification exists for the use of epinephrine in a concentration greater than 1:200,000, except in cases in which hemostasis is needed.

The following states are characteristics of the salt form of a local anesthetic except which one?

Addition of vasoconstrictor to local anesthetic (1)reduces blood supply to the area, (2)increases blood supply to the area, (3)limits systemic absorption, (4)increases systemic absorption, (5)reduces systemic toxicity, and (6)increases systemic toxicity. Which of these are correct?

Levonordefrin is commonly combined with which local anesthetic?

Approximately _____% of articaine is metabolized by the liver.

Information Sources, Regulatory Agencies, Drug Legislation, and Prescription Writing

Drug Action and Handling

Adverse Reactions

Autonomic Drugs

Nonopioid (Nonnarcotic)Analgesics

Opioid (Narcotic)Analgesics and Antagonists

Antiinfective Agents

Antifungal and Antiviral Agents

General Anesthetics

Antianxiety Agents

Oral Conditions and Their Treatment

Hygiene-Related Oral Disorders

Drugs for the Treatment of Cardiovascular Disease

Drugs for the Treatment of Gastrointestinal Disorders

Drugs for the Treatment of Seizure Disorders

Drugs for the Treatment of Central Nervous System Disorders

Adrenocorticosteroids

Drugs for the Treatment of Respiratory Disorders

Drugs for the Treatment of Allergic Rhinitis

Drugs for the Treatment of Diabetes Mellitus

Drugs for the Treatment of Other Endocrine Disorders

Antineoplastic Drugs

Emergency Drugs

Pregnancy and Breast Feeding

Drug Abuse

Natural/Herbal Products and Dietary Supplements

Filters

Plain anesthetics without vasoconstrictor will exhibit a _ duration of action and result in a _ rapid buildup of a systemic blood level.

Prilocaine plain has a duration of action slightly _ than mepivacaine plain, and prilocaine with epinephrine has a duration of action slightly _ than lidocaine with epinephrine.