NBDE II - Mental Dental Pharmacology UPDATED ACTUAL
Questions and CORRECT Answers
Which local anesthetics are classified as - Lidocaine
amides? - Bupivicaine
- Mepivicaine
- Articaine
- Prilocaine
Differentiate between the metabolism of - Amides are metabolized in the liver
amides vs. ester local anestetics? - Esters are metabolized in the plasma via plasma esterases
Which local anesthetics are classified as - Procaine
esters? - Cocaine
- Tetracaine
- Benzocaine
Why are ester local anesthetics used less Due to greater toxicity and more allergenicity
commonly?
Which local anesthetic is safest in children? Lidocaine
Which amide local anesthetic is NOT safe Bupivacaine
to use in children?
Which local anesthetic causes the LEAST Mepivicaine
amount of vasodilation?
Which local anesthetic has both amide and Articaine ➞ classified as an amide local anesthetic, but it has
ester characteristics? one ester chain
Which local anesthetic can cause Prilocaine ➞ results it too little oxygen delivery to the tissues
methemoglobinemia?
, Which amide local anesthetic has the - Longest = Bupivacaine (0.5%)
longest duration of action? Shortest - Shortest = Articaine (4%)
duration?
Bupivacaine comes in ____ % concentration. 0.5%
What is the ONLY local anesthetic that acts Cocaine = ester local anesthetic
as a vasoconstrictor?
What are the pharmacodynamics of local Sodium channel blockers = prevents nerve impulses from
anesthetics? being transduced via inhibiting depolarization from occurring
Only the ______________ form of local Non-ionized (free base) form
anesthetics can diffuse through/penetrate
the neuron membrane.
What is the effect of inflamed tissue on the Inflamed tissue has a lower pH ➞ this decreases the amount
effectiveness of local anesthetic? of non-ionized LA available to penetrate the neuron
membrane ➞ reduces the effectiveness of LA in inflamed
tissue
How does blood flow affect the ↑ blood flow at the injection site decreases the potency and
pharmacokinetics of local anesthetics? duration of action of the LA at the injection site
This is why epinephrine is commonly added = vasoconstrictor
The lower the pKa ➞ the ___________________ Lower pKa = stronger acid ➞ faster onset of action
(weaker or stronger) the acid. How does this
affect the onset of action of an LA?
A carpule of local anesthetic contains 1.8 mL
_ ____ mL.
How much lidocaine is in a single carpule? 1 carpule of local anesthetic contains 1.8 mL of liquid ➞ for a
2% solution of lidocaine this means a single carpule contains
36 mg of lidocaine
How much Articaine is in a single carpule? 1 carpule of local anesthetic contains 1.8 mL of liquid ➞ for a
4% solution of articaine this means a single carpule contains
72 mg of lidocaine
A carpule of 2% lidocaine solution with 1 carpule of local anesthetic contains 1.8 mL of solution
1:100K epi would contain how much 1:100,000K epi = .001% epinephrine
epinephrine in mg? 1.8 mL x 0.001 = 0.018 mg epinephrine in 1 cartridge of LA
Questions and CORRECT Answers
Which local anesthetics are classified as - Lidocaine
amides? - Bupivicaine
- Mepivicaine
- Articaine
- Prilocaine
Differentiate between the metabolism of - Amides are metabolized in the liver
amides vs. ester local anestetics? - Esters are metabolized in the plasma via plasma esterases
Which local anesthetics are classified as - Procaine
esters? - Cocaine
- Tetracaine
- Benzocaine
Why are ester local anesthetics used less Due to greater toxicity and more allergenicity
commonly?
Which local anesthetic is safest in children? Lidocaine
Which amide local anesthetic is NOT safe Bupivacaine
to use in children?
Which local anesthetic causes the LEAST Mepivicaine
amount of vasodilation?
Which local anesthetic has both amide and Articaine ➞ classified as an amide local anesthetic, but it has
ester characteristics? one ester chain
Which local anesthetic can cause Prilocaine ➞ results it too little oxygen delivery to the tissues
methemoglobinemia?
, Which amide local anesthetic has the - Longest = Bupivacaine (0.5%)
longest duration of action? Shortest - Shortest = Articaine (4%)
duration?
Bupivacaine comes in ____ % concentration. 0.5%
What is the ONLY local anesthetic that acts Cocaine = ester local anesthetic
as a vasoconstrictor?
What are the pharmacodynamics of local Sodium channel blockers = prevents nerve impulses from
anesthetics? being transduced via inhibiting depolarization from occurring
Only the ______________ form of local Non-ionized (free base) form
anesthetics can diffuse through/penetrate
the neuron membrane.
What is the effect of inflamed tissue on the Inflamed tissue has a lower pH ➞ this decreases the amount
effectiveness of local anesthetic? of non-ionized LA available to penetrate the neuron
membrane ➞ reduces the effectiveness of LA in inflamed
tissue
How does blood flow affect the ↑ blood flow at the injection site decreases the potency and
pharmacokinetics of local anesthetics? duration of action of the LA at the injection site
This is why epinephrine is commonly added = vasoconstrictor
The lower the pKa ➞ the ___________________ Lower pKa = stronger acid ➞ faster onset of action
(weaker or stronger) the acid. How does this
affect the onset of action of an LA?
A carpule of local anesthetic contains 1.8 mL
_ ____ mL.
How much lidocaine is in a single carpule? 1 carpule of local anesthetic contains 1.8 mL of liquid ➞ for a
2% solution of lidocaine this means a single carpule contains
36 mg of lidocaine
How much Articaine is in a single carpule? 1 carpule of local anesthetic contains 1.8 mL of liquid ➞ for a
4% solution of articaine this means a single carpule contains
72 mg of lidocaine
A carpule of 2% lidocaine solution with 1 carpule of local anesthetic contains 1.8 mL of solution
1:100K epi would contain how much 1:100,000K epi = .001% epinephrine
epinephrine in mg? 1.8 mL x 0.001 = 0.018 mg epinephrine in 1 cartridge of LA
